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Article History

Received: 11 April 2026

Accepted: 8 June 2026

First Online: 26 June 2026

Declarations

:

: The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the Kanagawa Cardiovascular and Respiratory Center (approval number: KCRC-25-0029). Written informed consent was obtained from all participants.

: Not applicable.

: Dr. Ryota Otoshi reports receiving personal honoraria for lectures or educational activities from Boehringer Ingelheim and Mochida Pharmaceutical Co., Ltd. Dr. Hideya Kitamura reports personal honoraria for lectures from Boehringer Ingelheim and AstraZeneca. Dr. Takashi Niwa reports personal honoraria for lectures from Boehringer Ingelheim. Dr. Tomohisa Baba reports consulting fees from Daiichi Sankyo Co., Ltd., AstraZeneca K.K., and Nippon Boehringer Ingelheim; and honoraria for lectures from Daiichi Sankyo Co., Ltd., Nippon Boehringer Ingelheim, Ono Pharmaceutical Co., Ltd., Bristol Myers Squibb K.K., Taiho Pharmaceutical Co., Ltd., Merck Biopharma Co., Ltd., Mochida Pharmaceutical Co., Ltd., MSD K.K., Chugai Pharmaceutical Co., Ltd., and KYORIN Pharmaceutical Co., Ltd. Dr. Tae Iwasawa reports personal honoraria for lectures from Boehringer Ingelheim and institutional collaborative support from Canon Medical Systems. Dr. Yayoi Natsume-Kitatani reports joint research funding relationships with KYORIN Pharmaceutical Co., Ltd., Medical & Biological Laboratories Co., Ltd., and NTT Inc.; consulting fees from Kaken Pharmaceutical Co. Ltd.; lecture fees from multiple corporate entities; writing honoraria from NTS Inc.; a patent (JP Patent No. 7704373); and an unpaid leadership role in the Japanese Society for Bioinformatics. Dr. Takashi Ogura reports receiving personal honoraria from Boehringer Ingelheim, Shionogi & Co., Ltd., Astellas Pharma, Toray Industries, Eisai Pharma, and Taiho Pharmaceutical. He also serves as an advisory board member for Bristol-Myers Squibb Company, Taiho Pharmaceutical Co., Ltd., and Boehringer Ingelheim. All other authors declare no conflicts of interest related to this manuscript.