文献一覧: Keiichi Fukuda (著者)

11 0 0 0 OA A Novel Risk Stratification System for Ischemic Stroke in Japanese Patients With Non-Valvular Atrial Fibrillation

著者: Ken Okumura Hirofumi Tomita Michikazu Nakai Eitaro Kodani Masaharu Akao Shinya Suzuki Kenshi Hayashi Mitsuaki Sawano Masahiko Goya Takeshi Yamashita Keiichi Fukuda Hisashi Ogawa Toyonobu Tsuda Mitsuaki Isobe Kazunori Toyoda Yoshihiro Miyamoto Hiroaki Miyata Tomonori Okamura Yusuke Sasahara for the J-RISK AF Research Group
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-20-1075, (Released:2021-03-25)
参考文献数: 22
被引用文献数: 1 15

Background:Recently, identification of independent risk factors for ischemic stroke in Japanese non-valvular atrial fibrillation (NVAF) patients was made by analyzing the 5 major Japanese registries: J-RHYTHM Registry, Fushimi AF Registry, Shinken Database, Keio interhospital Cardiovascular Studies, and the Hokuriku-Plus AF Registry.Methods and Results:The predictive value of the risk scheme in Japanese NVAF patients was assessed. Of 16,918 patients, 12,289 NVAF patients were analyzed (mean follow up, 649±181 days). Hazard ratios (HRs) of each significant, independent risk factor were determined by using adjusted Cox-hazard proportional analysis. Scoring system for ischemic stroke was created by transforming HR logarithmically and was estimated by c-statistic. During the 21,820 person-years follow up, 241 ischemic stroke events occurred. Significant risk factors were: being elderly (aged 75–84 years [E], HR=1.74), extreme elderly (≥85 years [EE], HR=2.41), having hypertension (H, HR=1.60), previous stroke (S, HR=2.75), type of AF (persistent/permanent) (T, HR=1.59), and low body mass index <18.5 kg/m2(L, HR=1.55) after adjusting for oral anticoagulant treatment. The score was assigned as follows: 1 point to H, E, L, and T, and 2 points to EE and S (HELT-E2S2score). The C-statistic, using this score, was 0.681 (95% confidence interval [CI]=0.647–0.714), which was significantly higher than those using CHADS2(0.647; 95% CI=0.614–0.681, P=0.027 for comparison) and CHA2DS2-VASc scores (0.641; 95% CI=0.608–0.673, P=0.008).Conclusions:The HELT-E2S2score may be useful for identifying Japanese NVAF patients at risk of ischemic stroke.

2022-04-12 18:28:21
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9 0 0 0 OA JCS/JHFS 2018 Guideline on the Diagnosis and Treatment of Cardiomyopathies

著者: Hirokai Kitaoka Hiroyuki Tsutsui Toru Kubo Tomomi Ide Taishiro Chikamori Keiichi Fukuda Noboru Fujino Taiki Higo Mitsuaki Isobe Chizuko Kamiya Seiya Kato Yasuki Kihara Koichiro Kinugawa Shintaro Kinugawa Shigetoyo Kogaki Issei Komuro Nobuhisa Hagiwara Minoru Ono Yuichiro Maekawa Shigeru Makita Yoshiro Matsui Shouji Matsushima Yasushi Sakata Yoshiki Sawa Wataru Shimizu Kunihiko Teraoka Miyuki Tsuchihashi-Makaya Hatsue Ishibashi-Ueda Masafumi Watanabe Michihiro Yoshimura Arata Fukusima Satoshi Hida Shungo Hikoso Teruhiko Imamura Hiroko Ishida Makoto Kawai Toshiro Kitagawa Takashi Kohno Satoshi Kurisu Yoji Nagata Makiko Nakamura Hiroyuki Morita Hitoshi Takano Tsuyoshi Shiga Yasuyoshi Takei Shinsuke Yuasa Teppei Yamamoto Tetsu Watanabe Takashi Akasaka Yoshinori Doi Takeshi Kimura Masafumi Kitakaze Masami Kosuge Morimasa Takayama Hitonobu Tomoike 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-20-0910, (Released:2021-07-22)
参考文献数: 687
被引用文献数: 45

2021-08-27 20:34:56
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9 0 0 0 OA Cardiology Department Practices in the First Wave of the Coronavirus Disease Pandemic ― A Nationwide Survey in Japan by the Japanese Circulation Society―

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: pp.CR-21-0002, (Released:2021-02-05)
参考文献数: 21
被引用文献数: 6

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.

2021-02-09 14:15:05
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9 0 0 0 OA Feasibility and Safety of Hydrogen Gas Inhalation for Post-Cardiac Arrest Syndrome – First-in-Human Pilot Study –

著者: Tomoyoshi Tamura Kei Hayashida Motoaki Sano Masaru Suzuki Takayuki Shibusawa Joe Yoshizawa Yosuke Kobayashi Takeshi Suzuki Shigeo Ohta Hiroshi Morisaki Keiichi Fukuda Shingo Hori
出版者: 日本循環器学会
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: vol.80, no.8, pp.1870-1873, 2016-07-25 (Released:2016-07-25)
参考文献数: 5
被引用文献数: 54

Background:Hydrogen gas inhalation (HI) ameliorates cerebral and cardiac dysfunction in animal models of post-cardiac arrest syndrome (PCAS). HI for human patients with PCAS has never been studied.Methods and Results:Between January 2014 and January 2015, 21 of 107 patients with out-of-hospital cardiac arrest achieved spontaneous return of circulation. After excluding 16 patients with specific criteria, 5 patients underwent HI together with target temperature management (TTM). No undesirable effects attributable to HI were observed and 4 patients survived 90 days with a favorable neurological outcome.Conclusions:HI in combination with TTM is a feasible therapy for patients with PCAS. (Circ J 2016; 80: 1870–1873)

2020-11-28 04:32:45
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8 0 0 0 OA JCS/JHFS 2021 Statement on Palliative Care in Cardiovascular Diseases

著者: Toshihisa Anzai Takuma Sato Yoshihiro Fukumoto Chisato Izumi Yoshiyuki Kizawa Masatoshi Koga Katsuji Nishimura Mitsuru Ohishi Akihiro Sakashita Yasushi Sakata Tsuyoshi Shiga Yasuchika Takeishi Satoshi Yasuda Kazuhiro Yamamoto Takahiro Abe Rie Akaho Yasuhiro Hamatani Hayato Hosoda Naoki Ishimori Mika Kato Yoshiharu Kinugasa Takuro Kubozono Toshiyuki Nagai Shogo Oishi Katsuki Okada Tatsuhiro Shibata Atsushi Suzuki Tsuyoshi Suzuki Masahito Takagi Yasuko Takada Kenkichi Tsuruga Akiomi Yoshihisa Dai Yumino Keiichi Fukuda Yasuki Kihara Yoshihiko Saito Yoshiki Sawa Hiroyuki Tsutsui Takeshi Kimura 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-20-1127, (Released:2021-03-26)
参考文献数: 316
被引用文献数: 16

2021-03-27 20:59:46
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4 0 0 0 OA Preoperative Instrumental Activities of Daily Living Predicts Survival After Transcatheter Aortic Valve Implantation

著者: Shogo Fukui Michiyuki Kawakami Yohei Otaka Aiko Ishikawa Fumiaki Yashima Kentaro Hayashida Yuko Oguma Keiichi Fukuda Meigen Liu
出版者: The Japanese Circulation Society
雑誌: Circulation Reports (ISSN:24340790)
巻号頁・発行日: vol.2, no.2, pp.83-88, 2020-02-10 (Released:2020-02-10)
参考文献数: 32
被引用文献数: 1 4

Background:This aim of this study was to clarify prognosis after transcatheter aortic valve implantation (TAVI) in patients with aortic stenosis (AS) and to identify baseline factors associated with mortality.Methods and Results:We prospectively enrolled 257 consecutive elderly persons with AS who were referred to Keio University Hospital and who underwent assessment of cardiac, physical (walking speed), cognitive, and renal functions, nutritional status, activities of daily living (ADL), instrumental ADL (IADL) assessed with the Frenchay activities index (FAI), and comorbidities. The primary outcome was postoperative death. Differences in basic characteristics were compared between a group that survived for a median of 661 days (IQR, 0–1,289 days) after TAVI and a group that did not. Multivariate hazard ratios (HR) were calculated for independent factors selected in Cox proportional hazard models. Thirty-one individuals died during follow-up. Walking speed was significantly faster (0.87±0.25 vs. 0.70±0.24 m/s, P<0.001) and FAI was significantly higher (21.2±8.0 vs. 15.7±8.0, P=0.026) in the survival group compared with those who died. Multivariate HR for mortality according to walking speed was 0.05 (95% CI: 0.028–0.091) in model 1 and 0.04 (95% CI: 0.020–0.081) in model 2, and those for FAI were 0.94 (95% CI: 0.92–0.95) and 0.92 (95% CI: 0.90–0.92), respectively.Conclusions:Preoperative walking speed and IADL are crucial factors associated with prognosis after TAVI even after adjustment.

2022-09-05 05:05:37
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4 0 0 0 OA Patient Perspectives in the Era of Remote Medical Visits During the Coronavirus Disease (COVID-19) Pandemic ― Insights From Outpatient Care of Cardiovascular Disease ―

著者: Hiroki Kitakata Yoshinori Katsumata Shun Kohsaka Otoya Sekine Takashi Kohno Motoaki Sano Keiichi Fukuda
出版者: The Japanese Circulation Society
雑誌: Circulation Reports (ISSN:24340790)
巻号頁・発行日: vol.3, no.5, pp.300-303, 2021-05-10 (Released:2021-05-10)
参考文献数: 14
被引用文献数: 2

Background:Patient perspectives in cardiovascular diseases (CVD) are significantly associated with clinical outcomes.Methods and Results:Among 100 patients who responded to a telephone survey in a university hospital setting in Tokyo during the coronavirus disease (COVID-19) pandemic, 20% reported depressive symptoms and 33% were hesitant to contact medical staff in the event of CVD exacerbation. Interestingly, the frequency of depressive symptoms was maintained even after a decline in the number of newly COVID-19-infected patients.Conclusions:Our telemedicine practices revealed the magnitude of our patients’ mental health conditions and their hesitation to contact medical facilities in the event of CVD exacerbation.

2021-05-10 19:42:45
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3 0 0 0 OA End-of-Life Discussions and Their Timing for Patients With Cardiovascular Diseases ― From the Perspective of Bereaved Family Members ―

著者: Keitaro Shinada Takashi Kohno Keiichi Fukuda Michiaki Higashitani Naoto Kawamatsu Takeshi Kitai Tatsuhiro Shibata Makoto Takei Kotaro Nochioka Gaku Nakazawa Hiroki Shiomi Mitsunori Miyashita Atsushi Mizuno
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-23-0507, (Released:2023-11-22)
参考文献数: 29
被引用文献数: 1

Background: Enhanced discussions regarding end-of-life (EOL) are crucial to provide appropriate care for seriously ill patients. However, the current status of EOL discussions, especially their timing and influencing factors, among patients with cardiovascular diseases (CVD) remains unknown.Methods and Results: We conducted a cross-sectional questionnaire survey of bereaved family members of CVD patients who died at 10 tertiary care institutes in Japan. In all, 286 bereaved family members (38.2% male; median age 66.0 [interquartile range 58.0–73.0] years) of CVD patients were enrolled; of these, 200 (69.9%) reported that their families had had EOL discussions with physicians. The major topic discussed was resuscitation (79.0%), and 21.5% discussed the place of EOL care. Most discussions were held during hospitalization of the patient (88.2%). More than half (57.1%) the discussions were initiated less than 1 month before the patient died, and 22.6% of family members felt that this timing of EOL discussions was late. Bereaved family members’ perception of late EOL discussions was associated with the family members aggressive attitude towards life-prolonging treatment, less preparedness for bereavement, and less satisfaction with EOL care.Conclusions: Approximately 70% of bereaved family members of CVD patients had EOL discussions, which were often held shortly before the patient died. Further research is required to establish an ideal approach to EOL discussions at an appropriate time, which may improve the quality of EOL care.

2023-12-25 23:30:24
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3 0 0 0 OA Safety and Efficacy of Ambrisentan–Phosphodiesterase Type 5 (PDE5) Inhibitor Combination Therapy for Japanese Pulmonary Arterial Hypertension Patients in Real-World Clinical Practice

著者: Masaharu Kataoka Toru Satoh Hiromi Matsubara Koji Yamamoto Tsukasa Inada Kazunari Umezawa Tomohiko Takahashi Atsushi Nakano Keiichi Fukuda
出版者: The Japanese Circulation Society
雑誌: Circulation Reports (ISSN:24340790)
巻号頁・発行日: vol.1, no.6, pp.268-275, 2019-06-10 (Released:2019-06-10)
参考文献数: 15
被引用文献数: 2

Background:This retrospective study was conducted to evaluate the safety and efficacy of ambrisentan combination therapy with phosphodiesterase type 5 (PDE5) inhibitors in Japanese patients with pulmonary arterial hypertension (PAH).Methods and Results:PAH patients who received ambrisentan for the first time in combination with a PDE5 inhibitor between January 2013 and the end of August 2015 were included in this study. Adverse drug reaction (ADR) safety analysis, as well as the efficacy analysis focusing on changes in clinical parameters, were investigated for overall cases and cases stratified by patient background. Forty-eight consecutive patients (n=21, 43.8% with idiopathic PAH; male/female, 18/30; average age, 43.3±17.4 years; World Health Organization functional class III/IV, n=22, 45.8%) who were treated with ambrisentan and a PDE5 inhibitor in Japan underwent the safety analysis. A total of 14 ADR occurred in 10 patients (20.8%). ADR included headache (8.3%), face edema (4.2%), angina pectoris (2.1%), hyperemia (2.1%), dyspnea (2.1%), pulmonary hypertension (i.e., worsening of PAH, 2.1%), nausea (2.1%), hepatic function abnormal (2.1%), edema (2.1%), and sudden death (2.1%). On analysis of hemodynamics parameters, there was a significant improvement in the mean pulmonary arterial pressure (−13.5 mmHg, P=0.0001) and pulmonary vascular resistance (−563.53 dyn·s·cm−5, P=0.0033).Conclusions:Ambrisentan combination therapy is safe and effective in hemodynamics improvement.

2019-06-12 07:17:56
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2 0 0 0 OA Initiation and Up-Titration of Guideline-Based Medications in Hospitalized Acute Heart Failure Patients ― A Report From the West Tokyo Heart Failure Registry ―

著者: Takanori Ohata Nozomi Niimi Yasuyuki Shiraishi Fumiko Nakatsu Ichiro Umemura Takashi Kohno Yuji Nagatomo Makoto Takei Tomohiko Ono Munehisa Sakamoto Shintaro Nakano Keiichi Fukuda Shun Kohsaka Tsutomu Yoshikawa
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-23-0356, (Released:2023-10-31)
参考文献数: 43
被引用文献数: 1

Background: Despite recommendations from clinical practice guidelines to initiate and titrate guideline-directed medical therapy (GDMT) during their hospitalization, patients with acute heart failure (AHF) are frequently undertreated. In this study we aimed to clarify GDMT implementation and titration rates, as well as the long-term outcomes, in hospitalized AHF patients.Methods and Results: Among 3,164 consecutive hospitalized AHF patients included in a Japanese multicenter registry, 1,400 (44.2%) with ejection fraction ≤40% were analyzed. We assessed GDMT dosage (β-blockers, renin-angiotensin inhibitors, and mineralocorticoid-receptor antagonists) at admission and discharge, examined the contributing factors for up-titration, and evaluated associations between drug initiation/up-titration and 1-year post-discharge all-cause death and rehospitalization for HF via propensity score matching. The mean age of the patients was 71.5 years and 30.7% were female. Overall, 1,051 patients (75.0%) were deemed eligible for GDMT, based on their baseline vital signs, renal function, and electrolyte values. At discharge, only 180 patients (17.1%) received GDMT agents up-titrated to >50% of the maximum titrated dose. Up-titration was associated with a lower risk of 1-year clinical outcomes (adjusted hazard ratio: 0.58, 95% confidence interval: 0.35–0.96). Younger age and higher body mass index were significant predictors of drug up-titration.Conclusions: Significant evidence-practice gaps in the use and dose of GDMT remain. Considering the associated favorable outcomes, further efforts to improve its implementation seem crucial.

2023-12-25 18:02:07
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2 0 0 0 OA Cardiology Department Practices in the First Wave of the Coronavirus Disease Pandemic ― A Nationwide Survey in Japan by the Japanese Circulation Society―

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

2021-03-11 12:45:20
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2 0 0 0 OA Barriers Associated With Door-to-Balloon Delay in Contemporary Japanese Practice

著者: Nobuhiro Ikemura Mitsuaki Sawano Yasuyuki Shiraishi Ikuko Ueda Hiroaki Miyata Yohei Numasawa Shigetaka Noma Masahiro Suzuki Yukihiko Momiyama Taku Inohara Kentaro Hayashida Shinsuke Yuasa Yuichiro Maekawa Keiichi Fukuda Shun Kohsaka
出版者: 日本循環器学会
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: vol.81, no.6, pp.815-822, 2017-05-25 (Released:2017-05-25)
参考文献数: 37
被引用文献数: 12

Background:Door-to-balloon (DTB) time ≤90 min is an important quality indicator in the management of ST-elevation myocardial infarction (STEMI), but a considerable number of patients still do not meet this goal, particularly in countries outside the USA and Europe.Methods and Results:We analyzed 2,428 STEMI patients who underwent primary PCI ≤12 h of symptom onset who were registered in an ongoing prospective multicenter database (JCD-KiCS registry), between 2008 and 2013. We analyzed both the time trend in DTB time within this cohort in the registry, and independent predictors of delayed DTB time >90 min. Median DTB time was 90 min (IQR, 68–115 min) during the study period and there were no significant changes with year. Predictors for delay in DTB time included peripheral artery disease, prior revascularization, off-hour arrival, age >75 years, heart failure at arrival, and use of IABP or VA-ECMO. Notably, high-volume PCI-capable institutions (PCI ≥200/year) were more adept at achieving shorter DTB time compared with low-volume institutions (PCI <200/year).Conclusions:Half of the present STEMI patients did not achieve DTB time ≤90 min. Targeting the elderly and patients with multiple comorbidities, and PCI performed in off-hours may aid in its improvement.

1 0 0 0 OA A Novel Risk Stratification System for Ischemic Stroke in Japanese Patients With Non-Valvular Atrial Fibrillation

著者: Ken Okumura Hirofumi Tomita Michikazu Nakai Eitaro Kodani Masaharu Akao Shinya Suzuki Kenshi Hayashi Mitsuaki Sawano Masahiko Goya Takeshi Yamashita Keiichi Fukuda Hisashi Ogawa Toyonobu Tsuda Mitsuaki Isobe Kazunori Toyoda Yoshihiro Miyamoto Hiroaki Miyata Tomonori Okamura Yusuke Sasahara for the J-RISK AF Research Group
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: vol.85, no.8, pp.1254-1262, 2021-07-21 (Released:2021-07-21)
参考文献数: 22
被引用文献数: 1 15

2022-04-10 09:51:51
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1 0 0 0 OA The Effects of Hydrogen Gas Inhalation on Adverse Left Ventricular Remodeling After Percutaneous Coronary Intervention for ST-Elevated Myocardial Infarction ― First Pilot Study in Humans ―

著者: Yoshinori Katsumata Fumiya Sano Takayuki Abe Tomoyoshi Tamura Taishi Fujisawa Yasuyuki Shiraishi Shun Kohsaka Ikuko Ueda Koichiro Homma Masaru Suzuki Shigeo Okuda Yuichiro Maekawa Eiji Kobayashi Shingo Hori Junichi Sasaki Keiichi Fukuda Motoaki Sano
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: vol.81, no.7, pp.940-947, 2017-06-23 (Released:2017-06-23)
参考文献数: 28
被引用文献数: 18 47

Background:Hydrogen gas inhalation (HI) reduced infarct size and mitigated adverse left ventricular (LV) remodeling in a rat model of acute myocardial infarction (AMI). We designed a prospective, open-label, rater-blinded clinical pilot study in patients experiencing ST-elevated MI (STEMI).Methods and Results:The 20 patients with an initial diagnosis of STEMI were assigned to either an HI group (1.3% H2with 26% oxygen) or a control group (26% oxygen). There were no HI-related severe adverse events. In the full analysis set, the cardiac salvage index as evaluated using cardiac magnetic resonance imaging at 7 days after primary percutaneous coronary intervention (PCI), showed no significant between-group difference (HI: 50.0±24.3%; control: 60.1±20.1%; P=0.43). However, the improvement from day 7 in the HI group was numerically greater than that in the control group in some of the surrogate outcomes at 6-month follow-up, including the LV stroke volume index (HI: 9.2±7.1 mL/m2; control: −1.4±7.2 mL/m2; P=0.03) and the LV ejection fraction (HI: 11.0%±9.3%; control: 1.7%±8.3%; P=0.11).Conclusions:The first clinical study has shown that HI during PCI is feasible and safe and may also promote LV reverse remodeling at 6 months after STEMI. The study was not powered to test efficacy and a further large-scale trial is warranted. (Clinical trials registration: UMIN00006825)

2021-02-22 22:19:46
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1 0 0 0 OA A Statement on the Appropriate Administration of Tafamidis in Patients With Transthyretin Cardiac Amyloidosis

著者: Jin Endo Motoaki Sano Yasuhiro Izumiya Kenichi Tsujita Kazufumi Nakamura Nobuhiro Tahara Koichiro Kuwahara Takayuki Inomata Mitsuharu Ueda Yoshiki Sekijima Yukio Ando Hiroyuki Tsutsui Mitsuaki Isobe Keiichi Fukuda
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-19-0811, (Released:2019-11-16)
参考文献数: 4
被引用文献数: 18

Transthyretin cardiac amyloidosis is a progressive and life-threating disease that is significantly underdiagnosed, and the actual number of patients with the disease is presently unknown. Accumulation of wild-type transthyretin-derived amyloid in the heart is a common finding in very elderly patients. Recent clinical trials demonstrated that tafamidis reduced all-cause death and the number of cardiovascular hospitalizations when compared with placebo. The Japanese Ministry of Health, Labour and Welfare approved tafamidis (Vyndaqel®, Pfizer Inc.) for the treatment of cardiomyopathy caused by both wild-type and mutated transthyretin-derived amyloidoses. This scientific statement on transthyretin-derived cardiac amyloidosis summarizes the conditions for reimbursement of the cost of tafamidis therapy, and the institutional and physician requirements for the introduction of tafamidis.

2019-11-26 15:58:02
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1 0 0 0 OA Quantitative imaging mass spectroscopy reveals roles of heme oxygenase-2 for protecting against transhemispheric diaschisis in the brain ischemia

著者: Shinichi Goto Takayuki Morikawa Akiko Kubo Keiyo Takubo Keiichi Fukuda Mayumi Kajimura Makoto Suematsu
出版者: SOCIETY FOR FREE RADICAL RESEARCH JAPAN
雑誌: Journal of Clinical Biochemistry and Nutrition (ISSN:09120009)
巻号頁・発行日: vol.63, no.1, pp.70-79, 2018 (Released:2018-07-01)
参考文献数: 30
被引用文献数: 6

Carbon monoxide-generating heme oxygenase-2 is expressed in neurons and plays a crucial role for regulating hypoxic vasodilation through mechanisms unlocking carbon monoxide-dependent inhibition of H2S-generating cystathionine β-synthase expressed in astrocytes. This study aims to examine whether heme oxygenase-2 plays a protective role in mice against stroke. Focal ischemia was induced by middle cerebral artery occlusion. Regional differences in metabolites among ipsilateral and contralateral hemispheres were analysed by quantitative imaging mass spectrometry equipped with an image-processing platform to optimize comparison of local metabolite contents among different animals. Under normoxia, blood flow velocity in precapillary arterioles were significantly elevated in heme oxygenase-2-null mice vs controls, while metabolic intermediates of central carbon metabolism and glutamate synthesis were elevated in the brain of heme oxygenase-2-null mice, suggesting greater metabolic demands to induce hyperemia in these mice. In response to focal ischemia, heme oxygenase-2-null mice exhibited greater regions of ischemic core that coincide with notable decreases in energy metabolism in the contralateral hemisphere as well as in penumbra. In conclusion, these findings suggest that heme oxygenase-2 is involved in mechanisms by which not only protects against compromised energy metabolism of the ipsilateral hemisphere but also ameliorates transhemispheric diaschisis of the contralateral hemisphere in ischemic brain.

2018-08-09 17:29:12
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1 0 0 0 OA Effect of Smoking Status on Clinical Outcome and Efficacy of Clopidogrel in Acute Coronary Syndrome

著者: Masaki Kodaira Hiroaki Miyata Yohei Numasawa Ikuko Ueda Yuichiro Maekawa Koichiro Sueyoshi Shiro Ishikawa Takahiro Ohki Kouji Negishi Keiichi Fukuda Shun Kohsaka
出版者: 日本循環器学会
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-16-0032, (Released:2016-05-27)
参考文献数: 40
被引用文献数: 2 13

Background:The “smoker’s paradox” is an otherwise unexplained phenomenon in which the mortality of smokers after acute myocardial infarction is reduced, contrary to expectations. It has been suggested that an association with antiplatelet agents exists, but the true mechanism remains largely unidentified.Methods and Results:The analysis included 6,195 consecutive patients who underwent percutaneous coronary intervention (PCI) for acute coronary syndrome, registered in the Japanese multicenter PCI registry. Smokers were significantly younger and had less comorbidity than non-smokers. Unadjusted in-hospital mortality rate, general complication rate, and bleeding complication rate were lower in smokers than in non-smokers. After adjustment, the trend persisted and smoking was not associated with overall mortality (odds ratio [OR], 0.90; 95% confidence interval [CI]: 0.61–1.34; P=0.62), and was associated with lower overall (P=0.032) and bleeding complication events (P=0.040). Clopidogrel effectively reduced the occurrence of in-hospital complications and major adverse cardiac events in smokers compared with non-smokers (OR, 0.55; 95% CI: 0.53–0.98 vs. OR, 1.20; 95% CI: 0.87–1.67; and OR, 0.37; 95% CI: 0.20–0.70 vs. OR, 1.48; 95% CI: 0.90–2.43, respectively).Conclusions:The smoker’s paradox was largely explained by confounding factors related to the lower risk profile of smokers, and they benefited from a positive modification of the efficacy of clopidogrel.

2016-06-03 00:35:26
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1 0 0 0 OA Report of the American Heart Association (AHA) Scientific Sessions 2015, Orlando

著者: Yoshiyasu Aizawa Mai Kimura Takashi Kohno Jun Fujita Keiichi Fukuda
出版者: 日本循環器学会
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-15-1272, (Released:2015-12-11)
参考文献数: 14
被引用文献数: 1 2

The American Heart Association Scientific Sessions were held in Orlando on November 7–15, 2015. The meeting attracted more than 18,000 participants, including physicians, research scientists, students, and paramedical personnel, from more than 100 countries. Sessions over the 5 days included a comprehensive and unparalleled education delivered via more than 5,000 presentations, with 1,000 invited faculty members and 4,000 abstract presentations from the world leaders in cardiovascular disease. It also displayed the newest cardiovascular technology and resources by more than 200 exhibitors. There were 19 trials scheduled in 6 late-breaking clinical trial sessions. The Systolic Blood Pressure Intervention Trial (SPRINT) aimed to determine the most appropriate targets for the systolic blood pressure among persons without diabetes. A total of 9,361 persons with systolic blood pressure of ≥130 mmHg and an increased cardiovascular risk, but without diabetes, were randomly assigned to a target systolic blood pressure of <120 mmHg (intensive treatment) or a target of <140 mmHg (standard treatment). A significantly lower rate of the primary composite outcome and all-cause mortality in the intensive-treatment group than in the standard-treatment group was observed. Summaries and overviews of the late-breaking trials, clinical science special report sessions, and sessions to which members of the Japanese Circulation Society contributed are presented.

2015-12-11 06:03:51
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1 0 0 0 OA Outcomes of Percutaneous Coronary Intervention Performed With or Without Preprocedural Dual Antiplatelet Therapy

著者: Yukinori Ikegami Shun Kohsaka Hiroaki Miyata Ikuko Ueda Jun Fuse Munehisa Sakamoto Yasuyuki Shiraishi Yohei Numasawa Koji Negishi Iwao Nakamura Yuichiro Maekawa Yukihiko Momiyama Keiichi Fukuda
出版者: 日本循環器学会
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-15-0484, (Released:2015-10-07)
参考文献数: 30
被引用文献数: 3 7

Background:Preprocedural dual antiplatelet therapy (DAPT) in percutaneous coronary interventions (PCI) has been shown to improve outcomes; however, the efficacy of the procedure and its complications in Japanese patients remain largely unexplored, so we examined the risks and benefits of DAPT before PCI and its association with in-hospital outcomes.Methods and Results:We analyzed data from patients who had undergone PCI at 12 centers within the metropolitan Tokyo area between September 2008 and September 2013.Our study group comprised 6,528 patients, of whom 2,079 (31.8%) were not administered preprocedural DAPT. Non-use of preprocedural DAPT was associated with death, postprocedural shock, or heart failure (odds ratio [OR]: 1.47, 95% confidence interval [CI]: 1.10–1.96, P=0.009), and postprocedural myocardial infarction (OR: 1.41, 95% CI: 1.18–1.69, P<0.001) after adjusting propensity scores for known predictors of in-hospital complications. Non-use of DAPT was not associated with procedure-related bleeding complications (OR: 0.98, 95% CI: 0.71–1.59, P=0.764).Conclusions:Approximately one-third of the patients who underwent PCI did not receive preprocedural DAPT despite guideline recommendations. Our results indicate that patients undergoing PCI with DAPT have a lower risk of postprocedural cardiac events without any increased bleeding risk. Further studies are needed to implement the use of DAPT in real-world PCI.

2015-10-13 20:10:42
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1 0 0 0 OA Prevalence of Patent Foramen Ovale in the Japanese Population – Autopsy Study –

著者: Junko Kuramoto Akio Kawamura Tomohisa Dembo Tokuhiro Kimura Keiichi Fukuda Yasunori Okada
出版者: 日本循環器学会
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-15-0197, (Released:2015-06-18)
参考文献数: 21
被引用文献数: 4 25

Background:Patent foramen ovale (PFO) can cause ischemic stroke because of paradoxical embolism. Autopsy studies have shown that the prevalence of PFO is 25% in whites or blacks. However, there is a paucity of data on the prevalence of PFO in Asians. The aim of this study was to clarify the prevalence of PFO in the Japanese population.Methods and Results:We reviewed 52,717 autopsy reports, which were collected and edited by the Japanese Society of Pathology from 2009 to 2012. Next, we inspected consecutive 103 formalin-fixed specimens that had already been examined by certified pathologists from 2009 to 2013 to find PFO and atrial septal aneurysm (ASA). ASA was defined as ≥10 mm protrusion of the septum into the left or the right atrium. In the database of the Japanese Society of Pathology, the incidence of PFO was 0.08% (43/52,717). Inspection of heart specimens disclosed that the prevalence of PFO was 13.6% (14/103). None of the PFO cases was reported at the original autopsy. PFO was more frequently found in the subjects with ASA (50%) than in those without ASA (9.7%) (P=0.004).Conclusions:PFO is under-reported in autopsy reports. Re-evaluation of heart specimens disclosed that theprevalence of PFO was 13.6%. The prevalence was lower than reported in the past.

2015-06-18 17:28:03
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