- 著者
- Sasaki Takeshi Niwano Shinichi Sasaki Sae Imaki Ryuta Yuge Masaru Hirasawa Shoji Satoh Daisuke Moriguchi Masahiko Fujiki Akira Izumi Tohru
- 出版者
- 社団法人日本循環器学会
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.70, no.2, pp.169-173, 2006-01-20
- 被引用文献数
- 2 13 19
Background Little is known about the shortening of atrial refractoriness as a result of electrical remodeling in atrial fibrillation (AF) in clinical cases, especially in terms of long-term follow-up, because of a lack of noninvasive testing methods. Methods and Results The present study population comprised 38 consecutive patients with persistent AF (PAF, >1 month). Before and after the follow-up period of 1-14 months, surface ECGs were recorded for analysis. In each case, the fibrillation wave was purified by subtracting the QRS-T complex template and then power spectral analysis was performed. The mean fibrillation cycle length (FCL) and FCL coefficient of variation (FCL-CV) were determined from peak power frequency in 20 epochs in each recording. The change in FCL (ΔFCL) was calculated by subtracting the baseline FCL from the FCL after the follow-up period. To correct for the difference in the follow-up period, ΔFCL was divided by the follow-up period in each case. In 38 cases, mean FCL decreased from 160±20ms to 151±19ms (p<0.05), and the FCL-CV also decreased from 15±9% to 12±5% (p<0.05). The corrected ΔFCL was -2.4±7.6 (ms/month) and there was a significant negative correlation between corrected ΔFCL and baseline FCL (p<0.01). Conclusion Shortening of the FCL during a relatively long-term follow-up period was observed in patients with PAF.
- 著者
- Nakajima Kenichi Yamasaki Yoshimitsu Kusuoka Hideo Izumi Tohru Kashiwagi Atsunori Kawamori Ryuzo Shimamoto Kazuaki Yamada Nobuhiro Nishimura Tsunehiko
- 出版者
- Springer Berlin / Heidelberg
- 雑誌
- European Journal of Nuclear Medicine and Molecular Imaging (ISSN:16197070)
- 巻号頁・発行日
- vol.36, no.12, pp.2049-2057, 2009-12
- 被引用文献数
- 29
Purpose Diabetic patients have a high risk for cardiovascular events. The role of myocardial perfusion imaging was investigated in asymptomatic diabetic patients to evaluate short-term prognosis in a Japanese population. Methods A total of 506 asymptomatic patients ≥50 years of age who had carotid artery maximum intima-media thickness ≥1.1 mm, urinary albumin excretion of ≥30 mg/g creatinine, with additional criteria of abdominal obesity, low HDL cholesterol, high triglyceride level, and hypertension were enrolled and followed up over a 3-year period. Gated SPECT with stress-rest protocol was performed and analyzed by summed defect scores and QGS software. One-year cardiovascular events were analyzed. Results Myocardial ischemia was observed in 17% of patients, and abnormal perfusion findings of ischemia and/or scar were observed in 32% of patients. By the end of the 1-year follow-up, 33 (6.5%) cardiovascular events occurred including 6 all-cause deaths. Patients with summed stress score (SSS) >8 had a higher incidence of either death or cardiovascular events. Event-free survival rates for SSS 0–3, 4–8, 9–13, and ≥14 were 0.96, 0.95, 0.82, and 0.76, respectively. Multivariate Cox regression analysis showed that significant variables were SSS, history of cerebrovascular accident, and electrocardiographic abnormality at rest. Conclusion The 1-year interim summary showed that cardiovascular events were significantly higher in patients with SPECT abnormality, although hard cardiac event rate was relatively low. Targeted treatment strategy is required for asymptomatic but potentially high-risk diabetic patients.