著者
Jumpei Yamamoto Masao Moroi Hiromasa Hayama Masaya Yamamoto Hisao Hara Yukio Hiroi
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-23-0238, (Released:2023-07-11)
参考文献数
40

Background: Patients with atrial fibrillation (AF) and heart failure (HF) have elevated left ventricular end-diastolic pressure in addition to decreased left atrial (LA) function, but there are few reports of useful prognostic indices that can be seen on echocardiography. In this study, we investigated the association between LA reservoir strain (LARS) and prognosis in this group of patients.Methods and Results: We retrospectively enrolled patients with acute HF complicated by AF who were consecutively admitted to hospital between January 2014 and December 2018. A total of 320 patients (mean age 79±12 years, 163 women) were included in the analysis. During a median follow-up of 473 days, 92 cardiovascular deaths and 113 all-cause deaths occurred. In the multivariate analysis, LARS was an independent predictor of all-cause death (hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.90–0.99, P=0.016). Multivariate analysis also showed that the patients in the lowest LARS tertile (<7.16%) had a significantly increased risk of cardiovascular death (HR 1.76, 95% CI 1.05–2.96; P=0.033) and all-cause death (HR 1.90, 95% CI 1.17–3.08; P=0.009) in comparison with patients in the highest LARS tertile (>10.52%).Conclusions: We found a significant association between LARS and death in patients with AF and HF. Patients with reduced LARS had poor prognosis, suggesting the need for aggressive therapy to improve their LA dysfunction.
著者
Rubuna Sato Masahiro Ishikane Noriko Kinoshita Tetsuya Suzuki Takato Nakamoto Kayoko Hayakawa Norifumi Bekki Hisao Hara Norio Ohmagari
出版者
National Center for Global Health and Medicine
雑誌
Global Health & Medicine (ISSN:24349186)
巻号頁・発行日
pp.2020.01044, (Released:2020-05-15)
参考文献数
13
被引用文献数
14

Hypercoagulation and anticoagulation treatment have become new challenges in coronavirus disease 2019 (COVID-19) patients during the COVID-19 pandemic. We herein suggest an algorithm for an anticoagulation treatment with unfractionated heparin in moderate to severe COVID-19 cases in Japan, and report a case of COVID-19 pneumonia with anticoagulation treatment. Although several promising drugs for COVID-19 are being tested in clinical trials, definitive treatments have not yet been established. In this report, we demaonstrate that anticoagulation treatment with unfractionated heparin has the possibility of becoming at least a supportive treatment for COVID-19 patients.
著者
Hiromasa Hayama Satoshi Ide Masao Moroi Yui Kitami Norifumi Bekki Shuji Kubota Yukari Uemura Hisao Hara Satoshi Kutsuna Norio Ohmagari Yukio Hiroi
出版者
National Center for Global Health and Medicine
雑誌
Global Health & Medicine (ISSN:24349186)
巻号頁・発行日
pp.2021.01025, (Released:2021-04-02)
参考文献数
30
被引用文献数
14

The aim of this study is to investigate myocardial damage in recovering coronavirus disease 2019 (COVID-19) patients with high-sensitivity troponin levels (hsTnT) and echocardiography. In this single-center cohort study, 215 COVID-19 recovered patients were recruited from all over Japan between April and September 2020. Demographic characteristics, hsTnT levels, and echocardiography data were collected for 209 patients, after excluding those without serum samples or good-quality echocardiographic images. The mean (± standard deviation) age was 44 (± 12) years (range: 36-55 years), and 50.7% of the patients were males. The median time interval (interquartile range) from COVID-19 onset to post-recovery examination was 56 days (34-96 days). Seventy-four recovered patients (35.4%) had hsTnT less than detection sensitivity (< 3 pg/mL) and 135 recovered patients (64.6%) had hsTnT ≥ 3 pg/mL. Ejection fraction was more than 50% in all cases. Left ventricular global longitudinal strain (LVGLS) and right ventricular free-wall longitudinal strain (RVFWLS) were reduced in 62 (29.7%) and 8 patients (3.8%), respectively. They were significantly associated with elevated hsTnT levels. In cases with hsTnT above 5 pg/mL, the LVGLS was greatly reduced to 19.0 ± 2.2% (p < 0.001). Multivariate linear regression analysis showed that elevated hsTnT level was an independent predictor of reduced LVGLS (standardized β = -0.34; p < 0.001). In recovered COVID-19 patients, even a slight increase in hsTnT above detection sensitivity was associated with decreased LVGLS. hsTnT and echocardiography may be useful tools to detect myocardial injury in recovered COVID-19 patients.
著者
Yumi Matsushita Tetsuji Yokoyama Kayoko Hayakawa Nobuaki Matsunaga Hiroshi Ohtsu Sho Saito Mari Terada Setsuko Suzuki Shinichiro Morioka Satoshi Kutsuna Shinya Tsuzuki Hisao Hara Akio Kimura Norio Ohmagari
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
vol.33, no.1, pp.38-44, 2023-01-05 (Released:2023-01-05)
参考文献数
27

Background: Prioritization for novel coronavirus disease 2019 (COVID-19)-related health policies usually considers age and certain other characteristics, but sex is rarely included, despite the higher risk of severe disease in men. The aim of this study was to compare the impact of sex and age on the severity of COVID-19 by estimating the age difference in years for which the risk for men versus women is the same.Methods: We analyzed 23,414 Japanese COVID-19 inpatients aged 20–89 years (13,360 men and 10,054 women). We graded the severity of COVID-19 (0 to 5) according to the most intensive treatment required during hospitalization. The risk of grade 2/3/4/5 (non-invasive positive pressure ventilation/invasive mechanical ventilation/extracorporeal membrane oxygenation/death), grade 3/4/5, and separately grade 5 was analyzed using a multiple logistic regression model.Results: The odds ratio (OR) of grades 2/3/4/5, 3/4/5 (primary outcome), and 5 for men relative to women was 2.76 (95% CI, 2.44–3.12), 2.78 (95% CI, 2.42–3.19), and 2.60 (95% CI, 2.23–3.03), respectively, after adjustment for age and date of admission. These risks for men were equivalent to those for women 14.1 (95% CI, 12.3–15.8), 11.2 (95% CI, 9.7–12.8), and 7.5 (95% CI, 6.3–8.7) years older, respectively.Conclusion: The risks of worse COVID-19 prognosis (grades 3/4/5) in men were equivalent to those of women 11.2 years older. Reanalyzing data extracted from four previous studies also revealed a large impact of sex difference on the severity of COVID-19. We should pay more attention to sex differences to predict the risk of COVID-19 severity and to formulate public health policy accordingly.
著者
Yumi Matsushita Tetsuji Yokoyama Kayoko Hayakawa Nobuaki Matsunaga Hiroshi Ohtsu Sho Saito Mari Terada Setsuko Suzuki Shinichiro Morioka Satoshi Kutsuna Shinya Tsuzuki Hisao Hara Akio Kimura Norio Ohmagari
出版者
Japan Epidemiological Association
雑誌
Journal of Epidemiology (ISSN:09175040)
巻号頁・発行日
pp.JE20220056, (Released:2022-07-16)
参考文献数
27

Background: Prioritization for novel coronavirus disease 2019 (COVID-19)-related health policies usually considers age and certain other characteristics, but sex is rarely included, despite the higher risk of severe disease in men. The aim of this study was to compare the impact of sex and age on the severity of COVID-19 by estimating the age difference in years for which the risk for men versus women is the same.Methods: We analyzed 23,414 Japanese COVID-19 inpatients aged 20–89 years (13,360 men and 10,054 women). We graded the severity of COVID-19 (0 to 5) according to the most intensive treatment required during hospitalization. The risk of grade 2/3/4/5 (non-invasive positive pressure ventilation/invasive mechanical ventilation/extracorporeal membrane oxygenation/death), grade 3/4/5, and separately grade 5 was analyzed using a multiple logistic regression model.Results: The odds ratio (OR) of grades 2/3/4/5, 3/4/5 (primary outcome), and 5 for men relative to women was 2.76 (95% CI, 2.44–3.12), 2.78 (95% CI, 2.42–3.19), and 2.60 (95% CI, 2.23–3.03), respectively, after adjustment for age and date of admission. These risks for men were equivalent to those for women 14.1 (95% CI, 12.3–15.8), 11.2 (95% CI, 9.7–12.8), and 7.5 (95% CI, 6.3–8.7) years older, respectively.Conclusion: The risks of worse COVID-19 prognosis (grades 3/4/5) in men were equivalent to those of women 11.2 years older. Reanalyzing data extracted from four previous studies also revealed a large impact of sex difference on the severity of COVID-19. We should pay more attention to sex differences to predict the risk of COVID-19 severity and to formulate public health policy accordingly.
著者
Shuji Kubota Hisao Hara Yukio Hiroi
出版者
National Center for Global Health and Medicine
雑誌
Global Health & Medicine (ISSN:24349186)
巻号頁・発行日
pp.2021.01024, (Released:2021-07-03)
参考文献数
98
被引用文献数
9

The prognosis has improved remarkably in recent years with the development of cancer treatment. With the increase in the number of cancer survivors, complications of cardiovascular disease have become a problem. Therefore, the field of onco-cardiology has been attracting attention. The field of onco-cardiology covers a wide range of areas. In the past, cardiac dysfunction caused by cardiotoxic drug therapies such as doxorubicin (Adriamycin) was the most common cause of cardiac dysfunction, but nowadays, cardiovascular complications caused by aging cancer survivors, atherosclerotic disease in cardiovascular risk carriers, thromboembolism, and new drugs (e.g., myocarditis caused by immune checkpoint inhibitors and hypertension caused by angiogenesis) are becoming more common. In this review, we summarize the latest findings of cardiotoxicity of cancer therapy, appropriate treatment and prevention, and cardiovascular complications of novel chemotherapy, which will increase in demand in the near future.
著者
Rubuna Sato Masahiro Ishikane Noriko Kinoshita Tetsuya Suzuki Takato Nakamoto Kayoko Hayakawa Norifumi Bekki Hisao Hara Norio Ohmagari
出版者
National Center for Global Health and Medicine
雑誌
Global Health & Medicine (ISSN:24349186)
巻号頁・発行日
vol.2, no.3, pp.190-192, 2020-06-30 (Released:2020-07-04)
参考文献数
13
被引用文献数
1 14

Hypercoagulation and anticoagulation treatment have become new challenges in coronavirus disease 2019 (COVID-19) patients during the COVID-19 pandemic. We herein suggest an algorithm for an anticoagulation treatment with unfractionated heparin in moderate to severe COVID-19 cases in Japan, and report a case of COVID-19 pneumonia with anticoagulation treatment. Although several promising drugs for COVID-19 are being tested in clinical trials, definitive treatments have not yet been established. In this report, we demaonstrate that anticoagulation treatment with unfractionated heparin has the possibility of becoming at least a supportive treatment for COVID-19 patients.