- 著者
- Hitonobu Tomoike Hiroyuki Yokoyama Yoko Sumita Sotaro Hanai Akiko Kada Tomonori Okamura Junichi Yoshikawa Yoshinori Doi Masatsugu Hori Chuwa Tei on behalf of the Scientific Committee of the JCS
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.79, no.5, pp.1058-1067, 2015-04-24 (Released:2015-04-24)
- 参考文献数
- 33
- 被引用文献数
- 18 19
Background:The geographic distribution of cardiovascular (CV) health-care services has not been assessed systematically.Methods and Results:Data of the Japanese Circulation Society (JCS) annual survey were provided to the JCS working group with the permission of the JCS Scientific Committee. The status of CV practice in 2010 was then assessed in 47 prefectures retrospectively, along with national census and gross domestic product (GDP) data. The surveyed indices included resources (hospitals, beds and cardiologists), burden (number of inpatients), and outcome (CV mortality and autopsy) in each prefecture, which correlated well with respective populations or GDP. Inequality of geographic distribution was evident for pediatrics among the 47 prefectures, according to Lorenz curve, Gini coefficient or the maximum/minimum ratio for each index. According to the Gini coefficients, only the number of inpatients (medical or acute myocardial infarction) and beds for the total number of general hospitals or the hospitals surveyed in the present JCS study were lower than expected with regard to GDP.Conclusions:Geographic disparity of CV resources or burden was larger in pediatrics than in CV medicine or surgery. Improvement of equality in CV practice with regard to appropriateness and quality are the coming challenges for the JCS. (Circ J 2015; 79: 1058–1067)
- 著者
- Soichiro Kitamura Takeshi Nakatani Tomoko Kato Masanobu Yanase Junjiro Kobayashi Hiroyuki Nakajima Toshihiro Funatsu Koichi Toda Akiko Kada Hitoshi Ogino Toshikatsu Yagihara
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.73, no.7, pp.1235-1239, 2009 (Released:2009-06-25)
- 参考文献数
- 22
- 被引用文献数
- 14 19
Background: The purpose of this study was to evaluate the hemodynamic and echocardiographic function of hearts transplanted with the modified bicaval anastomosis technique (mBCAT). Methods and Results: Twenty consecutive patients (14 males, 6 females, age range 14-61 [41.3 ±11.5 years]) were evaluated 3.4 ±2.2 years after heart transplantation using the mBCAT. All patients were in status I on the waiting list, and 18 (90%) had had a left ventricular assist device. The donor age was 39 ±12 years. Triple immunosuppressive regimen and cardiac biopsy were routinely performed. There was no hospital mortality. One death occurred 4.2 years after the operation because of bone marrow dysplasia and infection. The 8-year survival was 89% (95%confidence interval: 0.43-0.98). All the hemodynamic variables returned to the normal range. Low right atrial pressure (3.2 ±1.5 mmHg) and low pulmonary wedge pressure (6.7 ±2.1 mmHg) were associated with an excellent cardiac index (3.9 ±0.7 L · min-1 · m-2). Echocardiography revealed an excellent late peak velocity (52 ±19 cm/s) and an E/A ratio (1.4 ±0.6) of tricuspid flow. The grade (0-4) of tricuspid regurgitation averaged 1.5 ±0.8. Conclusions: Hemodynamic and echocardiographic results for mBCAT were excellent. The 8-year survival was 89% with all surviving patients in New York Heart Association class I. The mBCAT is easy to perform and further facilitates cardiac transplantation. (Circ J 2009; 73: 1235-1239)