The authors thank all the participants, investigators, board members, and medical staff involved in the RPOTECT study. The authors are also grateful to the members of the Data and Safety Monitoring Board: Munehide Matsuhisa, MD, PhD (Tokushima University Graduate School, Tokushima, Japan), Junya Ako, MD, PhD, (Kitasato University, Sagamihara, Japan), Yoshimasa Aso, MD, PhD (Dokkyo Medical University, Mibu, Japan), Masaharu Ishihara, MD, PhD (Hyogo College of Medicine, Nishinomiya, Japan), Kazuo Kitagawa, MD, PhD (Tokyo Women’s Medical University, Tokyo, Japan), and Akira Yamashina, MD, PhD (Kiryu University, Midori, Japan). Protect study investigators and organization:Principal Investigators: Koichi Node, MD, PhD (Saga University, Saga, Japan) and Toyoaki Murohara, MD, PhD (Nagoya University, Naogya, Japan). Masafumi Kitakaze, MD, PhD (Hanwa Daini Senboku Hospital, Sakai, Japan). Steering Committee: Yoshihiko Nishio, MD, PhD (Kagoshima University, Kagoshima, Japan), Teruo Inoue, MD, PhD (Dokkyo Medical University, Mibu, Japan), Mitsuru Ohishi, MD, PhD (Kagoshima University, Kagoshima, Japan), Kazuomi Kario, MD, PhD (Jichi Medical University School of Medicine, Shimotsuke, Japan), Masataka Sata, MD, PhD (Tokushima University Graduate School, Tokushima, Japan), Michio Shimabukuro, MD, PhD (Fukushima Medical University, Fukushima, Japan), Wataru Shimizu, MD, PhD (Nippon Medical School, Tokyo, Japan), Hideaki Jinnouchi, MD, PhD, (Jinnouchi Hospital, Kumamoto, Japan), Isao Taguchi, MD, PhD, (Dokkyo Medical University, Saitama Medical Center, Saitama, Japan), Hirofumi Tomiyama, MD, PhD (Tokyo Medical University, Tokyo, Japan), and Koji Maemura, MD, PhD (Nagasaki University, Nagasaki, Japan). Executive Committee: Makoto Suzuki, MD, PhD (Yokohama Minami Kyosai Hospital, Yokohama, Japan), Shinichi Ando, MD, PhD (Saiseikai Futsukaichi Hospital, Chikushino, Japan), Kazuo Eguchi, MD, PhD (Saitama Red Cross Hospital, Saitama, Japan), Haruo Kamiya, MD, PhD (Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan), Tomohiro Sakamoto, MD, PhD (Saiseikai Kumamoto Hospital, Kumamoto, Japana), Hiroki Teragawa, MD, PhD (JR Hiroshima Hospital, Hiroshima, Japan), and Mamoru Nanasato, MD, PhD (Sakakibara Heart Institute, Fuchu, Japan). Data and Safety Monitoring Board: Munehide Matsuhisa, MD, PhD (Tokushima University Graduate School, Tokushima, Japan), Junya Ako, MD, PhD, (Kitasato University, Sagamihara, Japan), Yoshimasa Aso, MD, PhD (Dokkyo Medical University, Mibu, Japan), Masaharu Ishihara, MD, PhD (Hyogo College of Medicine, Nishinomiya, Japan), Kazuo Kitagawa, MD, PhD (Tokyo Women’s Medical University, Tokyo, Japan), and Akira Yamashina, MD, PhD (Kiryu University, Midori, Japan). Imaging Core Laboratory: Tsukuba Echo Core Laboratory. LLC, Tomoko Ishizu, MD, PhD (Tsukuba University, Tsukuba, Japan). Monitoring: Yumi Ikehara, MSc and Shinichiro Ueda, MD, PhD (Clinical Trial and Management Center, University of Ryukyus Hospital, Nishihara, Japan). Audit Team: Clinical Research Support Center, University of the Ryukyus, Nishihara, Japan. Data Center and Data Management: Ayako Takamori, Ph.D. (Clinical Research Center, Saga University Hospital, Saga, Japan). Statistical Analysis: Hisako Yoshida, PhD (Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan) and Takumi Imai, PhD (Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan). Study Secretariat: Atsushi Tanaka, MD, PhD (Saga University, Saga, Japan), Miki Mori (Saga University, Saga, Japan), Kaori Yamaguchi (Saga University, Saga, Japan), Soiken Inc., Tokyo, Japan, and the Organization for Clinical Medicine Promotion, Tokyo, Japan. Site Investigators (duplicates excluded): Drs. Machiko Asaka and Tetsuya Kaneko (Saga University, Saga, Japan), Drs. Masashi Sakuma, Shigeru Toyoda, Takahisa Nasuno, Michiya Kageyama, Jojima Teruo, Iijima Toshie, and Haruka Kishi (Dokkyo Medical University, Mibu, Japan), Dr. Hirotsugu Yamada, Kenya Kusunose, Daiju Fukuda, Shusuke Yagi, Koji Yamaguchi, Takayuki Ise, Yutaka Kawabata, and Akio Kuroda (Tokushima University Graduate School, Tokushima, Japan), Drs. Yuichi Akasaki and Mihoko Kurano (Kagoshima University, Kagoshima, Japan), Drs. Satoshi Hoshide, Takahiro Komori, Tomoyuki Kabutoya, and Yukiyo Ogata (Jichi Medical University School of Medicine, Shimotsuke, Japan), Drs. Yuji Koide, Hiroaki Kawano, Satoshi Ikeda, Satoki Fukae and Seiji Koga (Nagasaki University, Nagasaki, Japan), Dr. Yukihito Higashi, Shinji Kishimoto, Masato Kajikawa, and Tatsuya Maruhashi (Hiroshima Universsity, Hiroshima, Japan), Dr. Yoshiaki Kubota (Nippon Medical School, Tokyo, Japan), Drs. Yoshisato Shibata and Nehiro Kuriyama (Miyazaki Medical Association Hospital, Miyazaki, Japan), Dr. Ikuko Nakamura (Saga-Ken Medical Centre Koseikan, Saga, Japan), Dr. Kanemitsu Hironori (International University of Health and Welfare, Nasushiobara, Japan), Dr. Bonpei Takase (National Defense Medical College, Tokorozawa, Japan), Drs. Yuichi Orita, Chikage Oshita, and Yuko Uchimura (JR Hiroshima Hospital, Hiroshima, Japan), Drs. Ruka Yoshida, Yukihiko Yoshida, Hirohiko Suzuki, Yasuhiro Ogura, Mayuho Maeda, Masaki Takenaka, Takumi Hayashi, and Mirai Hirose (Nagoya Daini Red Cross Hospital, Nagoya, Japan), Dr. Itaru Hisauchi (Dokkyo Medical University, Saitama Medical Center, Saitama, Japan), Drs. Toshiaki Kadokami and Ryo Nakamura (Saiseikai Futsukaichi Hospital, Chikushino, Japan), Dr. Junji Kanda (Asahi General Hospital, Asahi, Japan), Dr. Kazuo Matsunaga (Imari Arita Kyoritsu Hospital, Matsuura, Japan), Drs. Masaaki Hoshiga, Koichi Sohmiya, and Yumiko Kanzaki (Osaka Medical and Pharmaceutical University), Dr. Arihiro Koyosue (Tokyo-Eki Center-Building Clinic, Tokyo, Japan), Drs. Hiroki Uehara, Naoto Miyagi, Toshiya Chinen, Kentaro Nakamura, Chikashi Nago, Suguru Chiba, Sho Hatano, Yoshikatsu Gima, and Masami Abe (Urasoe General Hospital, Urasoe, Japan), Drs. Masayoshi Ajioka, Hiroshi Asano, Yoshihiro Nakashima, Hiroyuki Osanai, Takahiro Kanbara, and Yusuke Sakamoto (Tosei General Hospital, Seto, Japan), Drs. Mitsutoshi Oguri, Shiou Ohguchi, Kunihiko Takahara, Kazuhiro Izumi, and Kenichiro Yasuda (Kasugai Municipal Hospital, Kasugai, Japan), Drs. Akihiro Kudo and Noritaka Machii (Fukushima Medical University, Fukushima, Japan), Drs. Ryota Morimoto, Yasuko Bando, Takahiro Okumura, and Toru Kondo (Nagoya University, Naogya, Japan), Drs. Shin-ichiro Miura, Yuhei Shiga, Joji Mirii, Makoto Sugihara, and Tadaaki Arimura (Fukuoka University School of Medicine, Fukuoka, Japan), Dr. Junko Nakano (Saiseikai Fukushima General Hospital, Fukushima, Japan), Drs. Tomohiro Sakamoto and Kazuhisa Kodama (Saiseikai Kumamoto Hospital, Kumamoto, Japan), Drs. Nobuyuki Ohte, Tomonori Sugiura, and Kazuaki Wakami (Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan), Drs. Yasuhiko Takemoto, Minoru Yoshiyama, Taichi Shuto, and Kazuo Fukumoto (Osaka City University, Osaka, Japan), Drs. Yosuke Okada, Kenichi Tanaka, Satomi Sonoda, Akemi Tokutsu, Takashi Otsuka, Fumi Uemura, Kenji Koikawa, Megumi Miyazaki, Maiko Umikawa, and Manabu Narisawa (University of Occupational and Environmental Health, Japan, Kitakyusyu, Japan), Dr. Machi Furuta (Wakayama Medical University, Wakayama, Japan), Dr. Hiroshi Minami (Aidu Chuo Hospital, Aiduwakamatsu, Japan), Dr. Masaru Doi (Doi Naika Clinicm Kumamoto, Japan), Drs. Kazuhiro Sugimoto and Susumu Suzuki (Ohta Nishinouchi Hospital, Koriyama, Japan), and Drs. Akira Kurozumi and Kosuke Nishio (Wakamatsu Hospital of the University of Occupational and Environmental Health, Japan, Kitakyusyu, Japan).