著者
Atsushi Suzuki Ryudo Fujiwara Hiroyuki Asada Kohei Iwasa Tomohiro Miyata Woo Hyung Song Kotaro Higuchi Hidenobu Seo Yuki Sakamoto Masahiro Shimizu Fumitaka Soga Hiroyuki Shibata Amane Kozuki Ryoji Nagoshi H. Immo Lehmann Yoichi Kijima Junya Shite
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-21-0423, (Released:2021-07-30)
参考文献数
17
被引用文献数
4

Background:The use of iodine contrast agents is one possible limitation in cryoballoon ablation (CBA) for atrial fibrillation (AF). This study investigated intracardiac echography (ICE)-guided contrast-free CBA.Methods and Results:The study was divided into 2 phases. First, 25 paroxysmal AF patients (Group 1) underwent CBA, and peri-balloon leak flow velocity (PLFV) was assessed using ICE and electrical pulmonary vein (PV) lesion gaps were assessed by high-density electroanatomical mapping. Then, 24 patients (Group 2) underwent ICE-guided CBA and were compared with 25 patients who underwent conventional CBA (historical controls). In Group 1, there was a significant correlation between PLFV and electrical PV gap diameter (r=–0.715, P<0.001). PLFV was higher without than with an electrical gap (mean [±SD] 127.0±28.6 vs. 66.6±21.0 cm/s; P<0.001) and the cut-off value of PLFV to predict electrical isolation was 105.7 cm/s (sensitivity 0.700, specificity 0.929). In Group 2, ICE-guided CBA was successfully performed with acute electrical isolation of all PVs and without the need for “rescue” contrast injection. Atrial tachyarrhythmia recurrence at 6 months did not differ between ICE-guided and conventional CBA (3/24 [12.5%] vs. 5/25 [20.0%], respectively; P=0.973, log-rank test).Conclusions:PLFV predicted the presence of an electrical PV gap after CBA. ICE-guided CBA was feasible and safe, and could potentially be performed completely contrast-free without a decrease in ablation efficacy.
著者
Yasuhiro Hamatani Yasuko Takada Yoshihiro Miyamoto Yukie Kawano Yuta Anchi Tatsuhiro Shibata Atsushi Suzuki Mitsunori Nishikawa Hiroto Ito Masashi Kato Tsuyoshi Shiga Yoshihiro Fukumoto Chisato Izumi Satoshi Yasuda Hisao Ogawa Yasuo Sugano Toshihisa Anzai
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-19-0225, (Released:2020-01-25)
参考文献数
25
被引用文献数
17

Background:Palliative care is highly relevant for patients with heart failure (HF), and there is a need for quantitative information on quality of care. Accordingly, this study aimed to develop a set of quality indicators (QIs) for palliative care of HF patients, and to conduct a practical pilot measurement of the proposed QIs in clinical practice.Methods and Results:We used a modified Delphi technique, a consensus method that involves a comprehensive literature review, face-to-face multidisciplinary panel meeting, and anonymous rating in 2 rounds. A 15-member multidisciplinary expert panel individually rated each potential indicator on a scale of 1 (lowest) to 9 (highest) for appropriateness. All indicators receiving a median score ≥7 without significant disagreement were included in the final set of QIs. Through the consensus-building process, 35 QIs were proposed for palliative care in HF patients. Practical measurement in HF patients (n=131) from 3 teaching hospitals revealed that all of the proposed QIs could be obtained retrospectively from medical records, and the following QIs had low performance (<10%): “Intervention by multidisciplinary team”, “Opioid therapy for patients with refractory dyspnea”, and “Screening for psychological symptoms”.Conclusions:The first set of QIs for palliative care of HF patients was developed and could clarify quantitative information and might improve the quality of care.
著者
Asami Yoshimura Noriko Kikuchi Satoshi Saito Atsushi Suzuki Hidetoshi Hattori Morio Shoda Yuki Ichihara Hiroshi Niinami Nobuhisa Hagiwara Junichi Yamaguchi Shinichi Nunoda
出版者
The Japanese Circulation Society
雑誌
Circulation Reports (ISSN:24340790)
巻号頁・発行日
vol.4, no.9, pp.405-411, 2022-09-09 (Released:2022-09-09)
参考文献数
23
被引用文献数
1

Background: For elderly patients with refractory heart failure (HF), destination therapy (DT) with a continuous-flow left ventricular assist device (LVAD) is a possible treatment. The aim of DT is for long-term, satisfying quality of life on LVAD support. Previously, elderly non-responders to cardiac resynchronization therapy (CRT) were primarily destined for palliative care, but DT has been available in Japan since April 30, 2021. This study investigated the prognosis of elderly CRT non-responders and assessed the feasibility of DT in these patients based on the J-HeartMate Risk Score (J-HMRS).Methods and Results: Of the 559 patients who underwent CRT at Tokyo Women’s Medical University between 2000 and 2018, 198 were aged 65–75 years. Among these, 76 were identified as non-responders based on echocardiographic data, and were included in this study. We calculated patients’ J-HMRS and investigated associations between the J-HMRS and cardiac events after CRT. Patients were divided into 3 groups according to the J-HMRS: low (n=23), medium (n=29), and high (n=24) risk. Patients in the low-risk group experienced as many HF rehospitalizations and ventricular arrhythmia events as those in the other groups. However, survival analysis revealed that, after CRT, survival was higher for patients in the low- compared with high-risk group (P=0.04).Conclusions: The J-HMRS classified 30% of elderly CRT non-responders as low risk and as suitable candidates for DT in Japan.
著者
Yasuhiro Hamatani Yasuko Takada Yoshihiro Miyamoto Yukie Kawano Yuta Anchi Tatsuhiro Shibata Atsushi Suzuki Mitsunori Nishikawa Hiroto Ito Masashi Kato Tsuyoshi Shiga Yoshihiro Fukumoto Chisato Izumi Satoshi Yasuda Hisao Ogawa Yasuo Sugano Toshihisa Anzai
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.84, no.4, pp.584-591, 2020-03-25 (Released:2020-03-25)
参考文献数
25
被引用文献数
13 17

Background:Palliative care is highly relevant for patients with heart failure (HF), and there is a need for quantitative information on quality of care. Accordingly, this study aimed to develop a set of quality indicators (QIs) for palliative care of HF patients, and to conduct a practical pilot measurement of the proposed QIs in clinical practice.Methods and Results:We used a modified Delphi technique, a consensus method that involves a comprehensive literature review, face-to-face multidisciplinary panel meeting, and anonymous rating in 2 rounds. A 15-member multidisciplinary expert panel individually rated each potential indicator on a scale of 1 (lowest) to 9 (highest) for appropriateness. All indicators receiving a median score ≥7 without significant disagreement were included in the final set of QIs. Through the consensus-building process, 35 QIs were proposed for palliative care in HF patients. Practical measurement in HF patients (n=131) from 3 teaching hospitals revealed that all of the proposed QIs could be obtained retrospectively from medical records, and the following QIs had low performance (<10%): “Intervention by multidisciplinary team”, “Opioid therapy for patients with refractory dyspnea”, and “Screening for psychological symptoms”.Conclusions:The first set of QIs for palliative care of HF patients was developed and could clarify quantitative information and might improve the quality of care.
著者
Hidetoshi Hattori Atsushi Suzuki Tsuyoshi Shiga Tomohiro Nishinaka Satoshi Saito Kenji Yamazaki Shinichi Nunoda Nobuhisa Hagiwara
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.82, no.9, pp.2305-2310, 2018-08-24 (Released:2018-08-24)
参考文献数
22
被引用文献数
1

Background: Recurrent ventricular tachyarrhythmias (VTA) are “A factor” modifiers in the Interagency Registry for Mechanically Assisted Circulatory Support profile. The effect of recurrent VTA on clinical outcome, however, is controversial. We evaluated the impact of recurrent VTA on outcome in Japanese heart transplant candidates with a left ventricular assist device (LVAD). Methods and Results: Sixty-six adult patients with advanced heart failure who were listed for heart transplantation between January 2005 and October 2017 were enrolled in the study. Recurrent VTA (modifier A status) was defined as a sustained ventricular tachycardia or fibrillation that required implantable cardioverter defibrillator shocks or an external defibrillator more than twice weekly. The primary outcome was death from any cause. The secondary outcomes were the first occurrence of VTA and recurrent VTA after LVAD implantation. Sixteen patients (24%) met the criteria for modifier A status, and 15 patients had an LVAD implanted. During a median follow-up of 1,124 days, 21 of 60 patients with an LVAD died. There was a significantly higher mortality rate in LVAD patients with modifier A status than in those who did not meet the modifier A criteria. On multivariate analysis, patients with modifier A status had an increased risk of mortality (HR, 3.43; 95% CI: 1.30–8.61, P=0.001). Conclusions: Recurrent VTA might be a marker for worse outcome in Japanese heart transplant candidates with an LVAD.
著者
Tsuyoshi Shiga Tsuyoshi Suzuki Keisuke Kida Atsushi Suzuki Takashi Kohno Akiko Ushijima Shunsuke Kiuchi Shunsuke Ishii Makoto Murata Takeshi Ijichi Makoto Suzuki Masako Nishikawa on behalf of the EXCILE-HF Trial Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Reports (ISSN:24340790)
巻号頁・発行日
pp.CR-22-0134, (Released:2023-03-24)
参考文献数
15

Background: A high resting heart rate is an independent risk factor for mortality and morbidity in patients with cardiovascular diseases. Ivabradine selectively inhibits the funny current (If) and decreases heart rate without affecting cardiac conduction, contractility, or blood pressure. The effect of ivabradine on exercise tolerance in patients with heart failure with reduced ejection fraction (HFrEF) on standard drug therapies remains unclear.Methods and Results: This multicenter interventional trial of patients with HFrEF and a resting heart rate ≥75 beats/min in sinus rhythm treated with standard drug therapies will consist of 2 periods: a 12-week open-label, randomized, parallel-group intervention period (standard drug treatment+ivabradine group and standard drug treatment group) to compare changes in exercise tolerance between the 2 groups; and a 12-week open-label ivabradine treatment period for all patients to evaluate the effect of adding ivabradine on exercise tolerance. The primary endpoint will be the change in peak oxygen uptake (V̇O2) during the cardiopulmonary exercise test from Week 0 (baseline) to Week 12. Secondary endpoints will be time-dependent changes in peak V̇O2from Week 0 to Weeks 12 and 24. Adverse events will also be evaluated.Conclusions: The EXCILE-HF trial will provide meaningful information regarding the effects of ivabradine on exercise tolerance in patients with HFrEF receiving standard drug therapies and suggestions for the initiation of ivabradine treatment.
著者
Chika Fujisawa-Tanaka Izumi Hiratsuka Megumi Shibata Kei Kurihara Naohiro Aida Takeshi Takayanagi Yusuke Seino Taihei Ito Takashi Kenmochi Atsushi Suzuki
出版者
Fujita Medical Society
雑誌
Fujita Medical Journal (ISSN:21897247)
巻号頁・発行日
pp.2022-019, (Released:2022-12-27)
参考文献数
28

Objectives: Type 1 diabetes mellitus (T1DM) patients with diabetic kidney disease-induced kidney failure have a significantly impaired quality of life (QOL), resulting in a high level of physical, mental, and social anxiety. In this study, we evaluated the QOL of T1DM patients on the list for pancreas transplantation (PTx) at their registration, and determined whether PTx improved their QOL.Methods: There were 58 patients (men/women, 22/36; mean age, 42.8±8.0 years) with T1DM and who were registered on the waiting list for PTx. Quantitative QOL assessment was performed using the Medical Health Survey Short Form (SF-36) version 2. Changes in the QOL before and after PTx were also examined in 24 of these patients.Results: The mean value of each endpoint and the summary score of the SF-36 physical (PCS), mental (MCS), and role (RCS) components were all below the national normal level at PTx registration. No significant difference in QOL scores was observed in the intergroup comparison of 35 patients on dialysis, 13 patients without dialysis, and ten patients after kidney transplantation. The 24 patients who underwent PTx showed improvement in PCS, MCS, and most SF-36 scores.Conclusion: T1DM patients waiting for PTx had a decreased QOL, regardless of dialysis, and PTx improved their QOL.
著者
Yasutaka Tsujimoto Tomoaki Nakamura Jun Onishi Naoto Ishimaru Naoko Iwata Haruki Fujisawa Atsushi Suzuki Yoshihisa Sugimura Kazuo Chihara
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
pp.7663-21, (Released:2021-08-06)
参考文献数
26
被引用文献数
2

A 21-year-old Japanese man without known diabetes mellitus had abdominal pain. The diagnosis was ketoacidosis and hypertriglyceridemia-induced acute pancreatitis. He had polydipsia and polyuria and had habitually drunk several soft drinks every day for two years. After hospitalization, despite adequate liquid intake, dehydration remained with hypotonic polyuria. Further examinations revealed the coexistence of central diabetes insipidus (CDI), possibly caused by lymphocytic infundibulo-neurohypophysitis, based on anti-rabphilin-3A antibody positivity. Although CDI had been undiagnosed for two years, over-consumption of sugar-rich soft drinks to ease thirst caused ketoacidosis, hypertriglyceridemia, and acute pancreatitis. There are no previous reports of this three-part combination of symptoms caused by CDI.
著者
諏訪 僚太 中村 崇 井口 亮 中村 雅子 守田 昌哉 加藤 亜記 藤田 和彦 井上 麻夕里 酒井 一彦 鈴木 淳 小池 勲夫 白山 義久 野尻 幸宏 Ryota Suwa Takashi Nakamura Akira Iguchi Masako Nakamura Masaya Morita Aki Kato Kazuhiko Fujita Mayuri Inoue Kazuhiko Sakai Atsushi Suzuki Isao Koike Yoshihisa Sirayama Yukihiro Nojiri 京都大学フィールド科学教育研究センター瀬戸臨海実験所 九州大学付属天草臨海実験所 琉球大学熱帯生物圏研究センター瀬底研究施設 琉球大学熱帯生物圏研究センター瀬底研究施設 琉球大学熱帯生物圏研究センター瀬底研究施設 琉球大学大学院理工学研究科 琉球大学大学院理工学研究科 東京大学海洋研究所 琉球大学熱帯生物圏研究センター瀬底研究施設 産業技術総合研究所 琉球大学 京都大学フィールド科学教育研究センター瀬戸臨海実験所 国立環境研究所地球環境研究センター Seto Marine Biological Laboratory Field Science Education and Research Center Kyoto University Amakusa Marine Laboratory Kyusyu University Sesoko Station Tropical Biosphere Research Center University of the Ryukyus Sesoko Station Tropical Biosphere Research Center University of the Ryukyus Sesoko Station Tropical Biosphere Research Center University of the Ryukyus Graduate School of Engineering and Science University of the Ryukyus Graduate School of Engineering and Science University of the Ryukyus Ocean Research Institute The University of Tokyo Sesoko Station Tropical Biosphere Research Center University of the Ryukyus Geological Survey of Japan National Institute of Advanced Industrial Science and Technology(AIST) University of the Ryukyus Seto Marine Biological Laboratory Field Science Education and Research Center Kyoto University Center for Global Environmental Research National Institute for Environmental Studies
出版者
日本海洋学会
雑誌
海の研究 (ISSN:09168362)
巻号頁・発行日
vol.19, no.1, pp.21-40, 2010-01-05
参考文献数
102
被引用文献数
3

産業革命以降の二酸化炭素(CO_2)排出量の増加は,地球規模での様々な気候変動を引き起こし,夏季の異常高海水温は,サンゴ白化現象を引き起こすことでサンゴ礁生態系に悪影響を及ぼしたことが知られている。加えて,増加した大気中CO_2が海水に溶け込み,酸として働くことで生じる海洋酸性化もまた,サンゴ礁生態系にとって大きな脅威であることが認識されつつある。本総説では,海洋酸性化が起こる仕組みと共に,海洋酸性化がサンゴ礁域の石灰化生物に与える影響についてのこれまでの知見を概説する。特に,サンゴ礁の主要な石灰化生物である造礁サンゴや紅藻サンゴモ,有孔虫に関しては,その石灰化機構を解説すると共に,海洋酸性化が及ぼす影響について調べた様々な研究例を取り上げる。また,これまでの研究から見えてきた海洋酸性化の生物への影響評価実験を行う上で注意すべき事項,そして今後必要となる研究の方向性についても述べたい。The increase of the atmospheric carbon dioxide (CO_2) concentration after the industrial revolution caused global climate change. During the last several decades, coral reef ecosystems have been devastated by the mass-scale coral bleaching events caused by abnormally high seawater temperature in summer. In addition, increased atmospheric CO_2dissolves in the ocean, acts as an acid and finally decreases the pH level of seawater. This phenomenon, known as ocean acidification, is now being considered as a future threat to the calcifying organisms in coral reef ecosystems. In this review, we summarize basic backgrounds of ocean acidification as well as its potential impacts on coral reef calcifiers. Together with the distinctive mechanisms of calcification among specific groups, we review the impacts of ocean acidification on major reef-builders such as scleractinian corals, calcareous red algae and reef-dwelling foraminifera. Finally, we point out some recently-recognized problems in acidified seawater experiments as well as the future direction of this research field.