著者

Masaharu Akao Hiroshi Inoue Takeshi Yamashita Hirotsugu Atarashi Takanori Ikeda Yukihiro Koretsune Ken Okumura Shinya Suzuki Hiroyuki Tsutsui Kazunori Toyoda Atsushi Hirayama Masahiro Yasaka Takenori Yamaguchi Satoshi Teramukai Tetsuya Kimura Yoshiyuki Morishima Atsushi Takita Wataru Shimizu

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0143, (Released:2023-07-21)

参考文献数

21

被引用文献数

1

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Background: This sub-analysis of the ANAFIE Registry, a prospective, observational study of >30,000 Japanese non-valvular atrial fibrillation (NVAF) patients aged ≥75 years, assessed the prevalence of direct oral anticoagulant (DOAC) under-dose prevalence, identified the factors of under-dose prescriptions, and examined the relationship between DOAC dose and clinical outcomes.Methods and Results: Patients, divided into 5 groups by DOAC dose (standard, over-, reduced, under-, and off-label), were analyzed for background factors, cumulative incidences, and clinical outcome risk. Endpoints were stroke/systemic embolic events (SEE), major bleeding, and all-cause death during the 2-year follow-up. Of 18,497 patients taking DOACs, 20.7%, 3.8%, 51.6%, 19.6%, and 4.3%, were prescribed standard, over-, reduced, under-, and off-label doses. Factors associated with under-dose use were female sex, age ≥85 years, reduced creatinine clearance, history of major bleeding, polypharmacy, antiplatelet agents, heart failure, dementia, and no history of catheter ablation or cerebrovascular disease. After confounder adjustment, under-dose vs. standard dose was not associated with the incidence of stroke/SEE or major bleeding but was associated with a higher mortality rate. Patients receiving an off-label dose showed similar tendencies to those receiving an under-dose; that is, they showed the highest mortality rates for stroke/SEE, major bleeding, and all-cause death.Conclusions: Inappropriate low DOAC doses (under- or off-label dose) were not associated with stroke/SEE or major bleeding but were associated with all-cause death.

著者

Katsushige Ono Yu-ki Iwasaki Masaharu Akao Takanori Ikeda Kuniaki Ishii Yasuya Inden Kengo Kusano Yoshinori Kobayashi Yukihiro Koretsune Tetsuo Sasano Naokata Sumitomo Naohiko Takahashi Shinichi Niwano Nobuhisa Hagiwara Ichiro Hisatome Tetsushi Furukawa Haruo Honjo Toru Maruyama Yuji Murakawa Masahiro Yasaka Eiichi Watanabe Takeshi Aiba Mari Amino Hideki Itoh Hisashi Ogawa Yasuo Okumura Chizuko Aoki-Kamiya Jun Kishihara Eitaro Kodani Takashi Komatsu Yusuke Sakamoto Kazuhiro Satomi Tsuyoshi Shiga Tetsuji Shinohara Atsushi Suzuki Shinya Suzuki Yukio Sekiguchi Satoshi Nagase Noriyuki Hayami Masahide Harada Tadashi Fujino Takeru Makiyama Mitsunori Maruyama Junichiro Miake Shota Muraji Hiroshige Murata Norishige Morita Hisashi Yokoshiki Koichiro Yoshioka Kenji Yodogawa Hiroshi Inoue Ken Okumura Takeshi Kimura Hiroyuki Tsutsui Wataru Shimizu on behalf of the Japanese Circulation Society and Japanese Heart Rhythm Society Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-1212, (Released:2022-03-11)

参考文献数

998

被引用文献数

44

著者

Hiroko Deguchi Masataka Ikeda Tomomi Ide Tomonori Tadokoro Soichiro Ikeda Kosuke Okabe Akihito Ishikita Keita Saku Shouji Matsushima Hiroyuki Tsutsui

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-1039, (Released:2020-03-24)

参考文献数

20

被引用文献数

2 36

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Background:Ischemic preconditioning (IPC) is an effective procedure to protect against ischemia/reperfusion (I/R) injury. Hypoxia-inducible factor-1α (Hif-1α) is a key molecule in IPC, and roxadustat (RXD), a first-in-class prolyl hydroxylase domain-containing protein inhibitor, has been recently developed to treat anemia in patients with chronic kidney disease. Thus, we investigated whether RXD pretreatment protects against I/R injury.Methods and Results:RXD pretreatment markedly reduced the infarct size and suppressed plasma creatinine kinase activity in a murine I/R model. Analysis of oxygen metabolism showed that RXD could produce ischemic tolerance by shifting metabolism from aerobic to anaerobic respiration.Conclusions:RXD pretreatment may be a novel strategy against I/R injury.

著者

Yuya Matsue Yoshiharu Kinugasa Takeshi Kitai Shogo Ohishi Kazuhiro Yamamoto Hiroyuki Tsutsui

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

pp.CR-20-0081, (Released:2020-08-13)

参考文献数

18

被引用文献数

3

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Background:The effect of the COVID-19 pandemic on the respiratory management strategy with regard to the use of non-invasive positive pressure ventilation (NPPV) and high-flow nasal cannula (HFNC) in patients with acute heart failure (AHF) in Japan is unclear.Methods and Results:This cross-sectional study used a self-reported online questionnaire, with responses from 174 institutions across Japan. More than 60% of institutions responded that the treatment of AHF patients requiring respiratory management became fairly or very difficult during the COVID-19 pandemic than earlier, with institutions in alert areas considering such treatment significantly more difficult than those in non-alert areas (P=0.004). Overall, 61.7% and 58.8% of institutions changed their indications for NPPV and HFNC, respectively. Significantly more institutions in the alert area changed their practices for the use of NPPV and HFNC during the COVID-19 pandemic (P=0.004 and P=0.002, respectively). When there was insufficient time or information to determine whether AHF patients may have concomitant COVID-19, institutions in alert areas were significantly more likely to refrain from using NPPV and HFNC than institutions in non-alert areas.Conclusions:The COVID-19 pandemic has compelled healthcare providers to change the respiratory management of AHF, especially in alert areas.

著者

Hiroyuki Tsutsui Tomomi Ide Yasushi Kawasaki

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-0590, (Released:2020-07-31)

参考文献数

7

被引用文献数

2

著者

Toru Kubota Genya Sunagawa Daisuke Nagatomo Yoshitomo Tsutsui Hiroyuki Tsutsui

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0992, (Released:2020-02-27)

参考文献数

2

被引用文献数

3

著者

Yasuhiro Nakano Tetsuya Matoba Mitsutaka Yamamoto Shunsuke Katsuki Yasuaki Koga Yasushi Mukai Shujiro Inoue Nobuhiro Suematsu Taiki Higo Masao Takemoto Kenji Miyata Makoto Usui Toshiaki Kadokami Hideki Tashiro Kunio Morishige Kiyoshi Hironaga Hiroyuki Tsutsui for the QcVIC Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

pp.CR-23-0047, (Released:2023-06-06)

参考文献数

36

被引用文献数

1

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Background: Recent revisions of clinical guidelines by the Japanese Circulation Society, American Heart Association/American College of Cardiology, and European Society of Cardiology updated the management of antithrombotic strategies for patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI). However, the extent to which these guidelines have been implemented in real-world daily clinical practice is unclear.Methods and Results: We conducted surveys on the status of antithrombotic therapy for patients with AF undergoing PCI every 2 years from 2014 to 2022 in 14 cardiovascular centers in Japan. The primary use of drug-eluting stents increased from 10% in 2014 to 95–100% in 2018, and the use of direct oral anticoagulants increased from 15% in 2014 to 100% in 2018, in accordance with the revised practice guidelines. In patients with acute coronary syndrome, the duration of triple therapy within 1 month was approximately 10% until 2018, and increased to >70% from 2020. In patients with chronic coronary syndrome, the duration of triple therapy within 1 month was approximately 10% until 2016, and >75% from 2018. Since 2020, the most common timing of discontinuation of dual antiplatelet therapy to transition to anticoagulation monotherapy during the chronic phase of PCI has been 1 year after PCI.Conclusions: Japanese interventional cardiologists have updated their treatment strategies for patients with AF undergoing PCI according to revisions of clinical practice guidelines.

著者

Hiroyuki Tsutsui Shin-ichi Momomura Tohru Masuyama Yoshihiko Saito Issei Komuro Toyoaki Murohara Shintaro Kinugawa on behalf of CIBIS-J Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.6, pp.1269-1277, 2019-05-24 (Released:2019-05-24)

参考文献数

24

被引用文献数

6 10

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Background: The comparative tolerability, efficacy, and safety of bisoprolol and carvedilol have not been established in Japanese patients with heart failure and reduced ejection fraction (HFrEF). Methods and Results: The CIBIS-J trial is a multicenter, open-label, non-inferiority randomized controlled trial of bisoprolol vs. carvedilol in 217 patients with HFrEF (EF ≤40%). The primary endpoint was tolerability, defined as reaching and maintaining the maximum maintenance dose (bisoprolol 5 mg/day or carvedilol 20 mg/day) during 48 weeks of treatment. The primary endpoint was achieved in 41.4% of patients in bisoprolol (n=111) and 42.5% in carvedilol (n=106) groups. The non-inferiority of tolerability of bisoprolol compared with carvedilol was not supported, however, neither β-blocker was superior with regard to tolerability. Heart rate (HR) decreased in both groups and its decrease from baseline was significantly greater in the bisoprolol group (20.3 vs. 15.4 beats/min at 24 week, P<0.05). Plasma B-type natriuretic peptide (BNP) levels decreased in both groups and the decrease was significantly greater in the carvedilol group (12.4 vs. 39.0 % at 24 weeks, P<0.05). Conclusions: There were no significant differences between bisoprolol and carvedilol in the tolerability of target doses in Japanese HFrEF patients. The clinical efficacy and safety were also similar despite the greater reduction in HR by bisoprolol and plasma BNP by carvedilol.

著者

Teruhiko Imamura Shintaro Kinugawa Toshihiro Muramatsu Tsuyoshi Shiga Akiyoshi Ogimoto Toshihisa Anzai Nobuhisa Hagiwara Hiroyuki Tsutsui Issei Komuro Koichiro Kinugawa

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.10, pp.431-437, 2019-10-10 (Released:2019-10-10)

参考文献数

22

被引用文献数

8

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Background:The vasopressin type-2 receptor antagonist tolvaptan is an essential tool in the management of decompensated heart failure (HF) in the inpatient setting for short-term use with careful monitoring. There is conflicting evidence, however, for its long-term use.Methods and Results:In this prospective, multi-center, open-labeled, randomized control trial, Assessment of QUAlity of life during long-term treatment of ToLVaptan in refractory HF (AQUA-TLV study), patients with congestive HF refractory to furosemide ≥60 mg/day were randomly assigned to a control group or tolvaptan add-on group and followed for 6 months, after confirmation of baseline urine osmolality ≥350 mOsm/L. Twenty-nine patients (median age, 60 years; 22 male) were enrolled and assigned to a control group (n=16) or a tolvaptan group (n=13). Minnesota Living with Heart Failure Questionnaire score improved significantly in the tolvaptan group (from 58 to 10, P=0.030). In the tolvaptan group, diuretics dose reduced (P=0.001), serum creatinine decreased (P=0.040), and hyponatremia tended to improve (P=0.12). The tolvaptan group had a lower HF readmission rate compared with the control group (0.213 vs. 1.242 events/year, P=0.13).Conclusions:Six-month tolvaptan therapy improved quality of life and renal function and reduced HF readmissions, when given to the estimated responders (UMIN Clinical Trial Registry Number: UMIN 000009604).

著者

Fumio Terasaki Arata Azuma Toshihisa Anzai Nobukazu Ishizaka Yoshio Ishida Mitsuaki Isobe Takayuki Inomata Hatsue Ishibashi-Ueda Yoshinobu Eishi Masafumi Kitakaze Kengo Kusano Yasushi Sakata Noriharu Shijubo Akihito Tsuchida Hiroyuki Tsutsui Takatomo Nakajima Satoshi Nakatani Taiko Horii Yoshikazu Yazaki Etsuro Yamaguchi Tetsuo Yamaguchi Tomomi Ide Hideo Okamura Yasuchika Kato Masahiko Goya Mamoru Sakakibara Kyoko Soejima Toshiyuki Nagai Hiroshi Nakamura Takashi Noda Takuya Hasegawa Hideaki Morita Tohru Ohe Yasuki Kihara Yoshihiko Saito Yukihiko Sugiyama Shin-ichiro Morimoto Akira Yamashina on behalf of the Japanese Circulation Society Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.11, pp.2329-2388, 2019-10-25 (Released:2019-10-25)

参考文献数

355

被引用文献数

95 243

著者

Miyuki Tsuchihashi Hiroyuki Tsutsui Kazunori Kodama Fumiyoshi Kasagi Akira Takeshita

出版者

The Japanese Circulation Society

雑誌

JAPANESE CIRCULATION JOURNAL (ISSN:00471828)

巻号頁・発行日

vol.64, no.12, pp.953-959, 2000 (Released:2001-05-31)

参考文献数

36

被引用文献数

80 80

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The clinical characteristics and prognosis of patients with congestive heart failure (CHF) have been described by a number of previous studies, but very little information is available on this issue in Japan. This study aimed to delineate the clinical characteristics and prognosis of Japanese patients hospitalized with CHF. Medical records were reviewed for 230 consecutive patients at 5 teaching hospitals in Fukuoka, Japan from January to December 1997 and the survival and hospital readmission were followed through December 1999 (mean follow-up, 2.4 years). The study population had a high mean age, contained a larger population of women especially in the older ages, and had a higher incidence of overt HF (48%) despite a relatively normal ejection fraction on echocardiography. Major causes of CHF were ischemic, valvular, and hypertensive heart diseases. The 1-year mortality rate was as low as 8.3% whereas rates of hospital readmission because of an exacerbation of CHF were as high as 40% during the follow-up period. Patients hospitalized with CHF in routine clinical practice in Japan have characteristics that differ from those in the population included in community-based studies or large clinical trials.

著者

Yasuhiro Nakano Mitsutaka Yamamoto Tetsuya Matoba Shunsuke Katsuki Soichi Nakashiro Susumu Takase Yusuke Akiyama Takuya Nagata Yasushi Mukai Shujiro Inoue Keiji Oi Taiki Higo Masao Takemoto Nobuhiro Suematsu Kenichi Eshima Kenji Miyata Makoto Usui Kenji Sadamatsu Toshiaki Kadokami Kiyoshi Hironaga Ikuyo Ichi Koji Todaka Junji Kishimoto Hiroyuki Tsutsui for the QcVIC Investigators

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.63507, (Released:2022-12-01)

参考文献数

18

被引用文献数

4

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Aim: Several clinical trials using intravascular ultrasound (IVUS) evaluation have demonstrated that intensive lipid-lowering therapy by statin or a combination therapy with statin and ezetimibe results in significant regression of coronary plaque volume. However, it remains unclear whether adding ezetimibe to statin therapy affects coronary plaque composition and the molecular mechanisms of plaque regression. We conducted this prospective IVUS analysis in a subgroup from the CuVIC trial. Methods: The CuVIC trial was a prospective randomized, open, blinded-endpoint trial conducted among 11 cardiovascular centers, where 260 patients with coronary artery disease who received coronary stenting were randomly allocated into either the statin group (S) or the combined statin and ezetimibe group (S+E). We enrolled 79 patients (S group, 39 patients; S+E group, 40 patients) in this substudy, for whom serial IVUS images of nonculprit lesion were available at both baseline and after 6-8 months of follow-up. Results: After the treatment period, the S+E group had significantly lower level of low-density lipoprotein cholesterol (LDL-C; 80.9±3.7 vs. 67.7±3.8 mg/dL, p=0.0143). Campesterol, a marker of cholesterol absorption, and oxysterols (β-epoxycholesterol, 4β-hydroxycholesterol, and 27-hydroxycholesterol) were also lower in the S +E group. IVUS analyses revealed greater plaque regression in the S+E group than in the S group (−6.14% vs. −1.18% for each group, p=0.042). It was noteworthy that the lowering of campesterol and 27-hydroxycholesterol, but not LDL-C, had a significant positive correlation with plaque regression. Conclusions: Compared with statin monotherapy, ezetimibe in combination with statin achieved significantly lower LDL-C, campesterol, and 27-hydroxycholesterol, which resulted in greater coronary plaque regression.

著者

Tetsuya Matoba Hiroyuki Tsutsui

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0645, (Released:2021-08-18)

参考文献数

12

著者

Atsushi Mizuno Chisa Matsumoto Daisuke Yoneoka Takuya Kishi Mari Ishida Shoji Sanada Memori Fukuda Yoshihiko Saito Keiko Yamauchi-Takihara Hiroyuki Tsutsui Keiichi Fukuda Issei Komuro Koichi Node

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.3, no.3, pp.137-141, 2021-03-10 (Released:2021-03-10)

参考文献数

21

被引用文献数

6

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Background:From the early phase of the Coronavirus disease-2019 (COVID-19) pandemic, cardiologists have paid attention not only to COVID-19-associated cardiovascular sequelae, but also to treatment strategies for rescheduling non-urgent procedures. The chief objective of this study was to explore confirmed COVID-19 cardiology case experiences and departmental policies, and their regional heterogeneity in Japan.Methods and Results:We performed a retrospective analysis of a nationwide survey performed by the Japanese Circulation Society on April 13, 2020. The questionnaire included cardiology department experience with confirmed COVID-19 cases and restriction policies, and was sent to 1,360 certified cardiology training hospitals. Descriptive analysis and spatial autocorrelation analysis of each response were performed to reveal the heterogeneity of departmental policies. The response rate was 56.8% (773 replies). Only 16% of all responding hospitals experienced a COVID-19 cardiology case. High-risk procedures were restricted in more than one-fifth of hospitals, including transesophageal echocardiography (34.9%) and scheduled catheterization (39.5%). The presence of a cardiologist in the COVID-19 team, the number of board-certified cardiologists, any medical resource shortage and a state of emergency were positively correlated with any type of restriction.Conclusions:We found both low clinical case experiences with COVID-19 and restrictions of cardiovascular procedures during the first COVID-19 wave in Japan. Restrictions arising as a result of COVID-19 were affected by hospital- and country-level variables, such as a state of emergency.

著者

Kazuo Kimura Takeshi Kimura Masaharu Ishihara Yoshihisa Nakagawa Koichi Nakao Katsumi Miyauchi Tomohiro Sakamoto Kenichi Tsujita Nobuhisa Hagiwara Shunichi Miyazaki Junya Ako Hirokuni Arai Hideki Ishii Hideki Origuchi Wataru Shimizu Hirofumi Takemura Yoshio Tahara Yoshihiro Morino Kenji Iino Tomonori Itoh Yoshitaka Iwanaga Keiji Uchida Hirohisa Endo Ken Kongoji Kenji Sakamoto Hiroki Shiomi Takao Shimohama Atsushi Suzuki Jun Takahashi Ichiro Takeuchi Akihito Tanaka Toshihiro Tamura Takahiro Nakashima Teruo Noguchi Daisuke Fukamachi Tomohiro Mizuno Junichi Yamaguchi Kenji Yodogawa Masami Kosuge Shun Kohsaka Hideaki Yoshino Satoshi Yasuda Hiroaki Shimokawa Atsushi Hirayama Takashi Akasaka Kazuo Haze Hisao Ogawa Hiroyuki Tsutsui Tsutomu Yamazaki on behalf of the Japanese Circulation Society Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0133, (Released:2019-03-29)

参考文献数

1064

被引用文献数

31 316

著者

Sanae Hamaguchi Shintaro Kinugawa Daisuke Goto Miyuki Tsuchihashi-Makaya Takashi Yokota Satoshi Yamada Hisashi Yokoshiki Akira Takeshita Hiroyuki Tsutsui JCARE-CARD Investigators

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.75, no.10, pp.2403-2410, 2011 (Released:2011-09-22)

参考文献数

26

被引用文献数

30 69

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Background: Aging is associated with adverse outcomes in patients with cardiac diseases. Whether elderly patients hospitalized with heart failure (HF) had increased risks for mortality and rehospitalization compared with younger patients during the long-term follow-up was examined. The predictors of these adverse outcomes were also identified. Methods and Results: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) studied prospectively the characteristics and treatments in a broad sample of 2,675 patients hospitalized with worsening HF and the outcomes were followed up. The majority of elderly patients were female, had lower body mass index (BMI), a higher rate of ischemic, valvular, and hypertensive heart disease as etiologies of HF, a lower estimated glomerular filtration rate (eGFR), lower hemoglobin, and higher left ventricular ejection fraction values. Even after adjustment for covariates, the elderly patients were associated with higher risks of adverse outcomes. The predictors for all-cause death were: lower eGFR, lower BMI, male sex, sustained ventricular tachycardia or fibrillation (VT/VF), and the use of diuretics at discharge. Conclusions: Among patients hospitalized with HF, elderly patients had a worse prognosis than younger patients. Lower eGFR, lower BMI, male sex, sustained VT/VF, and diuretic use were independent predictors for all-cause death in these patients with higher risk. (Circ J 2011; 75: 2403-2410)

著者

Yoshitomo Tsutsui Shouji Matsushima Nobuyuki Enzan Eri Noda Keisuke Shinohara Toru Hashimoto Tomomi Ide Shintaro Kinugawa Hiroyuki Tsutsui

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0554, (Released:2023-02-16)

参考文献数

36

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Background: Little is known about nationwide temporal trends in the clinical characteristics and treatment of dilated cardiomyopathy (DCM) in Japan.Methods and Results: We collected data regarding demographics, echocardiography, and treatment of DCM between 2003 to 2013 from Clinical Personal Records, a national registry organized by the Japanese Ministry of Health, Labour, and Welfare. Among the 40,794 DCM patients screened, 27,702 with left ventricular ejection fraction (LVEF) <50% and age ≥18 years were enrolled in this study and divided into 3 groups according to registration year: Group 1, 2003–2005 (10,006 patients); Group 2, 2006–2010 (11,252 patients); and Group 3, 2011–2013 (6,444 patients). Over time, there were decreases in age at registration (mean [±SD] 58.6±13.0 vs. 56.8±13.8 vs. 56.2±13.8 years; P<0.001) and LVEF (33.5±10.0% vs. 31.1±9.9% vs. 29.2± 9.7%; P<0.001), and an increase in patients with New York Heart Association Class III–IV (28.2% vs. 35.2% vs. 41.0%; P<0.001). The use of β-blockers (59.1% vs. 79.3% vs. 87.8%; P<0.001) and mineralocorticoid receptor antagonists (30.6% vs. 35.8% vs. 39.7%; P<0.001) increased over time. In multivariate analysis, male sex, systolic blood pressure, chronic kidney disease, hemoglobin, and registration year were positively associated, whereas age and LVEF were negatively associated, with β-blocker prescription.Conclusions: Although the clinical characteristics of DCM changed, the implementation of optimal medical therapy for DCM increased from 2003 to 2013 in Japan.

著者

Ken-ichi Hiasa Hidetaka Kaku Goro Kawahara Hiroshi Inoue Takeshi Yamashita Masaharu Akao Hirotsugu Atarashi Takanori Ikeda Yukihiro Koretsune Ken Okumura Wataru Shimizu Kazunori Toyoda Atsushi Hirayama Masahiro Yasaka Takenori Yamaguchi Satoshi Teramukai Tetsuya Kimura Jumpei Kaburagi Atsushi Takita Hiroyuki Tsutsui

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.86, no.2, pp.222-232, 2022-01-25 (Released:2022-01-25)

参考文献数

31

被引用文献数

4

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Background:Echocardiographic data on the cardiac structure and function in elderly patients with atrial fibrillation (AF) and heart failure (HF) are limited. This subcohort study of the ANAFIE Registry analyzed echocardiographic parameters to identify cardiac structural and functional characteristics.Methods and Results:Of 32,726 subjects in the ANAFIE population, 1,494 (4.6%) were entered as the echocardiography subcohort. Half of the patients, including those with persistent and permanent AF, older age (≥80 years), and CHADS2score ≥2, had left atrial (LA) volume index ≥48 mL/m2, indicating severe LA enlargement. LA enlargement significantly correlated with impaired LA reservoir function, regardless of age and CHADS2score. Types of AF and rhythm were strongly related to LA volume and reservoir function (P<0.0001). Moderate-to-severe mitral and tricuspid regurgitation were significantly more common, and the early diastolic mitral inflow velocity to mitral annulus velocity ratio was significantly higher among patients with than without HF history (all, P<0.0001).Conclusions:In this subcohort, LA enlargement correlated with impaired LA reservoir function. Elderly patients with non-valvular AF and a history of HF had LA enlargement and dysfunction, increased LV mass index, low LV ejection fraction, and high heart rate.

著者

Yasuki Nakada Rika Kawakami Shouji Matsushima Tomomi Ide Koshiro Kanaoka Tomoya Ueda Satomi Ishihara Taku Nishida Kenji Onoue Tsunenari Soeda Satoshi Okayama Makoto Watanabe Hiroyuki Okura Miyuki Tsuchihashi-Makaya Hiroyuki Tsutsui Yoshihiko Saito

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.5, pp.1019-1024, 2019-04-25 (Released:2019-04-25)

参考文献数

22

被引用文献数

8 13

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Background: Prognosis after acute decompensated heart failure (ADHF) is poor. An appropriate risk score that would allow for improved care and treatment of ADHF patients after discharge, however, is lacking. Methods and Results: We used 2 HF cohorts, the NARA-HF study and JCARE-CARD, as derivation and validation cohorts, respectively. The primary endpoint was all-cause death during the 2-year follow-up, excluding in-hospital death. Age, hemoglobin (Hb), and brain natriuretic peptide (BNP) at discharge were identified as independent risk factors. We determined 3 categorizations on the basis of these parameters, termed A2B score: age (<65 years, 0; 65–74 years, 1; ≥75 years, 2), anemia (Hb <10 g/dL, 2; 10–11.9 g/dL, 1; ≥12 g/dL, 0) and BNP (<200 pg/mL, 0; 200–499 pg/mL, 1; ≥500 pg/mL, 2). We divided patients into 4 groups according to A2B score (extremely low, 0; low, 1–2; medium, 3–4; high, 5–6). For the extremely low-risk group, the 2-year survival rate was 97.8%, compared with 84.5%, 66.1%, and 45.2% for the low-, medium-, and high-risk groups, respectively. Using the JCARE-CARD as a validation model, for the extremely low-risk group, the 2-year survival was 95.4%, compared with 90.2%, 75.0%, and 55.6% for the low-, medium-, and high-risk groups, respectively. Conclusions: The user-friendly A2B score is useful for estimating survival rate in ADHF patients at discharge.

著者

Takeshi Yamashita Masaharu Akao Hirotsugu Atarashi Takanori Ikeda Yukihiro Koretsune Ken Okumura Wataru Shimizu Shinya Suzuki Hiroyuki Tsutsui Kazunori Toyoda Atsushi Hirayama Masahiro Yasaka Takenori Yamaguchi Satoshi Teramukai Tetsuya Kimura Yoshiyuki Morishima Atsushi Takita Hiroshi Inoue

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0614, (Released:2023-01-17)

参考文献数

26

被引用文献数

3

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Background: Previous studies on mortality in atrial fibrillation (AF) included a limited number of elderly patients receiving direct oral anticoagulants (DOACs). This subanalysis of the ANAFIE Registry evaluated 2-year mortality according to causes of death of elderly non-valvular AF (NVAF) patients in the DOAC era.Methods and Results: The ANAFIE Registry was a multicenter prospective observational study. Mean patient age was 81.5 years and 57.3% of patients were male. Of the 32,275 patients completing the study, 2,242 died. The most frequent causes of death were cardiovascular (CV) death (32.4%), followed by infection (17.1%) and malignancy (16.1%). Incidence rates of CV-, malignancy-, and infection-related death were 1.20, 0.60, and 0.63 per 100 person-years, respectively. Patients aged ≥85 years showed increased proportions of non-CV and non-malignancy deaths and a decreased proportion of malignancy deaths compared with patients aged <85 years. The incidence of death due to congestive heart failure/cardiogenic shock, infection, and renal disease was higher in patients aged ≥85 than those aged <85 years. Compared with warfarin, DOACs were associated with a significantly lower risk of death by intracranial hemorrhage, ischemic stroke, and renal disease.Conclusions: This subanalysis described the mortality according to causes of death of Japanese elderly NVAF patients in the DOAC era. Our results imply that a more holistic approach to comorbid conditions and stroke prevention are required in these patients.