著者

Bonpei Takase Takanori Ikeda Wataru Shimizu Haruhiko Abe Takeshi Aiba Masaomi Chinushi Shinji Koba Kengo Kusano Shinichi Niwano Naohiko Takahashi Seiji Takatsuki Kaoru Tanno Eiichi Watanabe Koichiro Yoshioka Mari Amino Tadashi Fujino Yu-ki Iwasaki Ritsuko Kohno Toshio Kinoshita Yasuo Kurita Nobuyuki Masaki Hiroshige Murata Tetsuji Shinohara Hirotaka Yada Kenji Yodogawa Takeshi Kimura Takashi Kurita Akihiko Nogami Naokata Sumitomo 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-22-0827, (Released:2023-09-11)

参考文献数

738

被引用文献数

7

著者

Nobutaka Nagano Toshiyuki Nagai Yasuo Sugano Yoshiaki Morita Yasuhide Asaumi Takeshi Aiba Hideaki Kanzaki Kengo Kusano Teruo Noguchi Satoshi Yasuda Hisao Ogawa Toshihisa Anzai

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.79, no.7, pp.1601-1608, 2015-06-25 (Released:2015-06-25)

参考文献数

38

被引用文献数

20 29

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Background:Basal thinning of the interventricular septum (IVS) is an important diagnostic feature of cardiac sarcoidosis (CS), but its long-term prognostic significance remains unclear.Methods and Results:We examined 74 consecutive patients who were diagnosed with CS. Basal IVS thickness at a point located 10 mm from the aortic annulus was measured. IVS thickness at the left ventricular minor axis level (IVS) was also measured according to the recommended procedure of the American Society of Echocardiography. Patients were divided into 2 groups based on the presence or absence of basal IVS thinning, which was defined as basal IVS ≤4 mm and/or basal IVS/IVS ratio ≤0.6. Basal IVS thinning was observed in 21 patients and was associated with greater long-term adverse events during follow-up (5.1±2.5 years), although the baseline characteristics were comparable between groups (overall, P<0.01; all-cause death, P=0.53; symptomatic arrhythmias, P<0.01; heart failure admission, P=0.027). Multivariate analysis showed basal IVS thinning was an independent determinant of long-term adverse events (hazard ratio 2.86, 95% confidence interval 1.31–6.14) even after adjustment for existing prognostic variables.Conclusions:The presence of basal IVS thinning at the time of CS diagnosis was associated with poor long-term clinical outcomes, suggesting its prognostic significance in patients with CS. (Circ J 2015; 79: 1601–1608)

著者

Ahmed Arafa Yoshihiro Kokubo Keiko Shimamoto Rena Kashima Emi Watanabe Yukie Sakai Jiaqi Li Masayuki Teramoto Haytham A. Sheerah Kengo Kusano

出版者

The Japanese Society for Hygiene

雑誌

Environmental Health and Preventive Medicine (ISSN:1342078X)

巻号頁・発行日

vol.27, pp.10, 2022 (Released:2022-03-04)

参考文献数

10

被引用文献数

12

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Background: A protective role for physical activity against the development of atrial fibrillation (AF) has been suggested. Stair climbing is a readily available form of physical activity that many people practice. Herein, we investigated the association between stair climbing and the risk of AF in a Japanese population.Methods: In this prospective cohort study, we used data of 6,575 people registered in the Suita Study, aged 30–84 years, and had no history of AF. The frequency of stair climbing was assessed by a baseline questionnaire, while AF was diagnosed during the follow-up using a 12-lead ECG, health records, check-ups, and death certificates. We used the Cox regression to calculate the hazard ratios and 95% confidence intervals of AF incidence for climbing stairs in 20–39%, 40–59%, and ≥60% compared with <20% of the time.Results: Within 91,389 person-years of follow-up, 295 participants developed AF. The incidence of AF was distributed across the stair climbing groups <20%, 20–39%, 40–59%, and ≥60% as follows: 3.57, 3.27, 3.46, and 2.63/1,000 person-years, respectively. Stair climbing ≥60% of the time was associated with a reduced risk of AF after adjustment for age and sex 0.69 (0.49, 0.96). Further adjustment for lifestyle and medical history did not affect the results 0.69 (0.49, 0.98).Conclusion: Frequent stair climbing could protect from AF. From a preventive point of view, stair climbing could be a simple way to reduce AF risk at the population level.

著者

Yoshihiro Kokubo Makoto Watanabe Aya Higashiyama Yoko M Nakao Kengo Kusano Yoshihiro Miyamoto

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-0277, (Released:2017-05-25)

参考文献数

50

被引用文献数

79

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Background:An atrial fibrillation (AF) risk score for a non-Western general population has not been established.Methods and Results:A total of 6,898 participants (30–79 years old) initially free of AF have been prospectively followed for incident AF since 1989. AF was diagnosed when AF or atrial flutter was present on ECG at a biannual health examination; was indicated as a current illness; or was in the medical records during follow-up. Cox proportional hazard ratios were analyzed after adjusting for cardiovascular risk factors at baseline. During the 95,180 person-years of follow-up, 311 incident AF events occurred. We developed a scoring system for each risk factor as follows: 0/−5, 3/0, 7/5, and 9/9 points for men/women in their 30 s–40 s, 50 s, 60 s, and 70 s, respectively; 2 points for systolic hypertension, overweight, excessive drinking, or coronary artery disease; 1 point for current smoking; −1 point for moderate non-high-density lipoprotein-cholesterol; 4 points for arrhythmia; and 8, 6, and 2 points for subjects with cardiac murmur in their 30 s–40 s, 50 s, and 60 s, respectively (C-statistic 0.749; 95% confidence interval, 0.724−0.774). Individuals with score ≤2, 10–11, or ≥16 points had, respectively, ≤1%, 9%, and 27% observed probability of developing AF in 10 years.Conclusions:We developed a 10-year risk score for incident AF using traditional risk factors that are easily obtained in routine outpatient clinics/health examinations without ECG.

著者

Akihiko Nogami Takashi Kurita Haruhiko Abe Kenji Ando Toshiyuki Ishikawa Katsuhiko Imai Akihiko Usui Kaoru Okishige Kengo Kusano Koichiro Kumagai Masahiko Goya Yoshinori Kobayashi Akihiko Shimizu Wataru Shimizu Morio Shoda Naokata Sumitomo Yoshihiro Seo Atsushi Takahashi Hiroshi Tada Shigeto Naito Yuji Nakazato Takashi Nishimura Takashi Nitta Shinichi Niwano Nobuhisa Hagiwara Yuji Murakawa Teiichi Yamane Takeshi Aiba Koichi Inoue Yuki Iwasaki Yasuya Inden Kikuya Uno Michio Ogano Masaomi Kimura Shun-ichiro Sakamoto Shingo Sasaki Kazuhiro Satomi Tsuyoshi Shiga Tsugutoshi Suzuki Yukio Sekiguchi Kyoko Soejima Masahiko Takagi Masaomi Chinushi Nobuhiro Nishi Takashi Noda Hitoshi Hachiya Masataka Mitsuno Takeshi Mitsuhashi Yasushi Miyauchi Aya Miyazaki Tomoshige Morimoto Hiro Yamasaki Yoshifusa Aizawa Tohru Ohe Takeshi Kimura Kazuo Tanemoto Hiroyuki Tsutsui Hideo Mitamura on behalf of the JCS/JHRS Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-0637, (Released:2021-06-01)

参考文献数

1350

被引用文献数

75

著者

Akihiko Nogami Takashi Kurita Kengo Kusano Masahiko Goya Morio Shoda Hiroshi Tada Shigeto Naito Teiichi Yamane Masaomi Kimura Tsuyoshi Shiga Kyoko Soejima Takashi Noda Hiro Yamasaki Yoshifusa Aizawa Tohru Ohe Takeshi Kimura Shun Kohsaka Hideo Mitamura on behalf of the Japanese Circulation Society / the 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-21-0162, (Released:2022-01-06)

参考文献数

183

被引用文献数

20

著者

Satoshi Oka Yusuke Watanabe Masashi Amano Tsukasa Kamakura Chisato Izumi Kengo Kusano

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

pp.CR-23-0052, (Released:2023-08-09)

参考文献数

1

著者

Takeshi Aiba Kohei Ishibashi Kazuko Hattori Mitsuru Wada Nobuhiko Ueda Yuichiro Miyazaki Akinori Wakamiya Kenichiro Yamagata Yuko Inoue Koji Miyamoto Satoshi Nagase Kengo Kusano

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0515, (Released:2021-07-17)

被引用文献数

6

著者

Naoaki Onishi Kazuaki Kaitani Yoshihisa Nakagawa Atsushi Kobori Koichi Inoue Toshiya Kurotobi Itsuro Morishima Yumie Matsui Hirosuke Yamaji Yuko Nakazawa Kengo Kusano Yukiko Shimizu Koji Hanazawa Toshihiro Tamura Chisato Izumi Takeshi Morimoto Koh Ono Takeshi Kimura Satoshi Shizuta on behalf of the KPAF Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0671, (Released:2024-01-11)

参考文献数

31

被引用文献数

1

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Background: Catheter ablation (CA) for atrial fibrillation (AF) in patients on hemodialysis (HD) is reported to have a high risk of late recurrence (LR). However, the relationship between early recurrence (ER) within a 90-day blanking period after CA in AF patients and LR in HD patients remains unclear.Methods and Results: Of the 5,010 patients in the Kansai Plus Atrial Fibrillation Registry, 5,009 were included in the present study. Of these patients, 4,942 were not on HD (non-HD group) and 67 were on HD (HD group). HD was an independent risk factor for LR after the initial CA (adjusted hazard ratio 1.6; 95% confidence interval 1.1–2.2; P=0.01). In patients with ER, the rate of sinus rhythm maintenance at 3 years after the initial CA was significantly lower in the HD than non-HD group (11.4% vs. 35.4%, respectively; log-rank P=0.004). However, in patients without ER, there was no significant difference in the rate of sinus rhythm maintenance at 3 years between the HD and non-HD groups (67.7% vs. 74.5%, respectively; log-rank P=0.62).Conclusions: ER in HD patients was a strong risk factor for LR. However, even HD patients could expect a good outcome without ER after the initial CA.

著者

Ahmed Arafa Yoshihiro Kokubo Rena Kashima Chisa Matsumoto Masayuki Teramoto Kengo Kusano

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0464, (Released:2023-09-22)

参考文献数

35

被引用文献数

1

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Background: Atrial fibrillation (AF) is the most diagnosed arrhythmia in clinical settings. The fatty liver index (FLI) is a marker of liver steatosis with potential cardiovascular implications. This study investigated whether FLI could predict the risk of AF.Methods and Results: We used data from the Suita Study, a Japanese population-based prospective cohort study. A total of 2,346 men and 3,543 women, aged 30–84 years, without prevalent AF were included and followed up. The diagnosis of AF was established during follow-up using electrocardiograms, hospital records, and death certificates. FLI was assessed during a baseline health checkup. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for incident AF per FLI quintile and log-transformed FLI. Within a median 14.5 years of follow-up, 142 men and 105 women developed AF. Compared with women in the third (middle) FLI quintile, women in the first (lowest), fourth, and fifth (highest) quintiles showed a higher risk of AF, with multivariable-adjusted HRs of 2.37 (95% CI 1.06–5.31), 2.60 (95% CI 1.30–5.17), and 2.04 (95% CI 1.00–4.18), respectively. No corresponding associations were observed in men. The change in log-transformed FLI was not associated with the risk of AF in either sex.Conclusions: A U-shaped association between FLI and AF risk was detected in Japanese women. FLI could be a screening tool to detect women at high risk of developing AF.

著者

Ahmed Arafa Yoshihiro Kokubo Rena Kashima Masayuki Teramoto Yukie Sakai Saya Nosaka Keiko Shimamoto Haruna Kawachi Chisa Matsumoto Kengo Kusano

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0378, (Released:2022-10-25)

参考文献数

38

被引用文献数

1

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Background: The incidence and prevalence of atrial fibrillation (AF) are increasing. The white blood cell (WBC) count is an indicator of systemic inflammation and is related to increased cardiovascular disease risk. Using data from the Suita Study, we investigated the association between WBC count and AF risk in the general Japanese population.Methods and Results: This prospective cohort study included 6,884 people, aged 30–84 years, with no baseline AF. Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for AF incidence by WBC count quintile. Within a median follow-up period of 14.6 years, 312 AF cases were diagnosed. Compared with the lowest WBC count quintile, the highest quintile was associated with an increased AF risk (HR 1.57; 95% CI 1.07–2.29). The association was more pronounced among women than men (HR 2.16 [95% CI 1.10–4.26] and 1.55 [95% CI 0.99–2.44], respectively; P interaction=0.07), and among current than non-smokers (HR 4.66 [95% CI 1.89–11.50] and 1.61 [95% CI 1.01–2.57], respectively; P interaction=0.20). For each 1.0×109-cells/L increment in WBC count, AF risk increased by 9% in men (9% in non-smokers, 10% in current smokers) and 20% in women (13% in non-smokers, 32% in current smokers).Conclusions: A higher WBC count was positively associated with an elevated AF risk in the general Japanese population, especially in women who smoked.

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

41

著者

Kayo Misumi Michio Nakanishi Hiroyuki Miura Ayumi Date Tatsuo Tokeshi Leon Kumasaka Tetsuo Arakawa Kazuhiro Nakao Takuya Hasegawa Shigefumi Fukui Masanobu Yanase Teruo Noguchi Kengo Kusano Satoshi Yasuda Yoichi Goto

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-1300, (Released:2021-06-30)

参考文献数

33

被引用文献数

5

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Background:In patients with chronic heart failure with reduced ejection fraction (HFrEF), cardiac resynchronization therapy (CRT) improves left ventricular ejection fraction (LVEF) and exercise-based cardiac rehabilitation (ECR) enhances exercise capacity. This study examined the relationship between the 2 responses.Methods and Results:Sixty-four consecutive HFrEF patients who participated in a 3-month ECR program after CRT were investigated. Patients were categorized according to a median improvement in peak oxygen uptake (PV̇O2) after ECR of 7% as either good (n=32; mean percentage change in PV̇O2[%∆PV̇O2]=23.2%) or poor (n=32; mean %∆PV̇O2=2.5%) responders. There was no significant difference in baseline characteristics between the good and poor responders, except for PV̇O2(51% vs. 59%, respectively; P=0.01). The proportion of good CRT responders was similar between the good and poor responders (%∆LVEF ≥10%; 53% vs. 47%, respectively; P=NS). Overall, there was no significant correlation between %∆LVEF after CRT and %∆PV̇O2after ECR. Notably, among poor CRT responders (n=32), the prevalence of atrial fibrillation (0% vs. 29%; P<0.03) and baseline PV̇O2(48% vs. 57%; P<0.05) were significantly lower among those with a good (n=15) than poor (n=17) response to ECR.Conclusions:In patients with HFrEF, good ECR and CRT responses are unrelated. A good PV̇O2response to ECR can be achieved even in poor CRT responders, particularly in those with a sinus rhythm or low baseline PV̇O2.

著者

Hiroki Nakano Kazunori Omote Toshiyuki Nagai Michikazu Nakai Kunihiro Nishimura Yasuyuki Honda Satoshi Honda Naotsugu Iwakami Yasuo Sugano Yasuhide Asaumi Takeshi Aiba Teruo Noguchi Kengo Kusano Hiroyuki Yokoyama Satoshi Yasuda Hisao Ogawa Taishiro Chikamori Toshihisa Anzai on behalf of the NaDEF Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.3, pp.614-621, 2019-02-25 (Released:2019-02-25)

参考文献数

36

被引用文献数

2 6

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Background: The ideal mortality prediction model (MPM) for acute heart failure (AHF) patients would have sufficient and stable predictive ability for long-term as well as short-term mortality. However, published MPMs for AHF predominantly predict short-term mortality up to 90 days, and their prognostic performance for long-term mortality remains unclear. Methods and Results: We analyzed 609 AHF patients in a prospective registry from January 2013 to May 2016. We compared the prognostic performance for long-term mortality among 8 systematically identified MPMs for AHF that predict short-term mortality up to 90 days from admission. The PROTECT 7-day model showed the highest c-index for long-term as well as short-term mortality among the studied MPMs. Sensitivity analyses revealed serum albumin and total cholesterol to be the most important variables, as dropping these variables resulted in a significant decline in c-index, when compared with other variables specific to the PROTECT 7-day model. Furthermore, significant improvements in c-index and net reclassification were observed when serum albumin or serum albumin plus total cholesterol was added to the studied MPMs, other than the PROTECT 7-day model. Conclusions: The PROTECT 7-day model demonstrated the highest predictive performance for long-term as well as short-term mortality in AHF patients among the published MPMs. Our findings indicate the importance of accounting for nutritional status such as serum albumin and total cholesterol in AHF patients when developing a MPM.

著者

Nobuhiko Ueda Takashi Noda Koshiro Kanaoka Yuichiro Miyazaki Akinori Wakamiya Kenzaburo Nakajima Tsukasa Kamakura Mitsuru Wada Kenichiro Yamagata Kohei Ishibashi Yuko Inoue Koji Miyamoto Satoshi Nagase Takeshi Aiba Hideaki Kanzaki Chisato Izumi Teruo Noguchi Satoshi Yasuda Kengo Kusano

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0547, (Released:2023-12-05)

参考文献数

27

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Background: Atrial tachyarrhythmias (ATAs) are reportedly associated with ventricular arrhythmias (VAs). However, little is known about the association between ATA duration and the risk of VA. We investigated the relationship between ATA duration and subsequent VA in patients with a cardiac resynchronization therapy defibrillator (CRT-D).Methods and Results: We investigated associations between the longest ATA duration during the first year after cardiac resynchronization therapy (CRT) implantation and VA and VA relevant to ATA (VAATA) in 160 CRT-D patients. ATAs occurred in 63 patients in the first year. During a median follow-up of 925 days from 1 year after CRT implantation, 40 patients experienced 483 VAs. Kaplan-Meier analysis showed a significantly higher risk of VA in patients with than without ATA in the first year (log rank P=0.0057). Hazard ratios (HR) of VA (HR 2.36, 2.10, and 3.04 for ATA >30s, >6 min and >24 h, respectively) and only VAATA (HR 4.50, 5.59, and 11.79 for ATA >30s, >6 min and >24 h, respectively) increased according to the duration of ATA. In multivariate analysis, ATA >24 h was an independent predictor of subsequent VA (HR 2.42; P=0.02).Conclusions: Patients with ATA >24 h in the first year after CRT had a higher risk of subsequent VA and VAATA. The risk of VA, including VAATA, increased with the longest ATA duration.

著者

Kenji Ando Kanki Inoue Tomoo Harada Satoshi Shizuta Yukihiko Yoshida Kengo Kusano Tatsuya Onuki Yuji Watari Akio Fukui Shingo Sasaki Morio Shoda Nobuhiro Nishii Akira Shiose Junya Hosoda Chie Okai Kurt Stromberg Jeffrey Murphy Thomas R Holmes Kyoko Soejima

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0269, (Released:2023-08-02)

参考文献数

15

被引用文献数

2

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Background: The Micra leadless pacemaker has demonstrated favorable outcomes in global trials, but its real-world performance and safety in a Japan-specific population is unknown.Methods and Results: Micra Acute Performance (MAP) Japan enrolled 300 patients undergoing Micra VR leadless pacemaker implantation in 15 centers. The primary endpoint was the acute (30-day) major complication rate. The 30-day and 6-month major complication rates were compared to global Micra studies. All patients underwent successful implantation with an average follow-up of 7.23±2.83 months. Compared with previous Micra studies, Japanese patients were older, smaller, more frequently female, and had a higher pericardial effusion risk score. 11 acute major complications were reported in 10 patients for an acute complication rate of 3.33% (95% confidence interval: 1.61–6.04%), which was in line with global Micra trials. Pericardial effusion occurred in 4 patients (1.33%; 3 major, 1 minor). No procedure or device-related deaths occurred. Frailty significantly improved from baseline to follow-up as assessed by Japan Cardiovascular Health Study criteria.Conclusions: In a Japanese cohort, implantation of the Micra leadless pacemaker had a high success rate and low major complication rate. Despite the Japan cohort being older, smaller, and at higher risk, the safety and performance was in line with global Micra trials.

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

95 237

著者

Kengo Kusano Nobuyoshi Sugishita Masaharu Akao Hikari Tsuji Kunihiko Matsui Shinya Hiramitsu Yutaka Hatori Hironori Odakura Hiroyuki Kamada Koji Miyamoto Hisao Ogawa

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-1244, (Released:2021-04-02)

参考文献数

23

被引用文献数

4

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Background:Direct oral anticoagulants have become a standard therapy for non-valvular atrial fibrillation (NVAF). However, little is known about their effectiveness/safety when prescribed by general practitioners to treat high-risk populations such as the elderly, those who are frail or have cognitive dysfunction.Methods and Results:In this multicenter, prospective study, a total of 5,717 NVAF patients (mean age 73.9 years) receiving rivaroxaban were registered by general practitioners, with a maximum 3-year follow up (mean 2.0±0.5 years). The primary endpoint was a composite of stroke and systemic embolism (SE). The annual incidence (per 100 person-years) of stroke/SE was 1.23% and for major bleeding, it was 0.63%. Multivariate analyses identified age ≥75 years (hazard ratio [HR]; 2.67, P<0.001) and history of ischemic stroke (HR; 1.89, P=0.005) as significant risk factors of stroke/SE, with history of major bleeding (HR; 14.9, P<0.001) and warfarin use (HR; 2.15, P=0.002) as risk factors for major bleeding events. Neither cognitive dysfunction, defined by the receipt of anti-dementia medications, nor frailty, evaluated by the classification of the Japanese Long-term Care Insurance system, correlated with stroke/SE or major bleeding events.Conclusions:The low incidence of adverse events, including stroke/SE and bleeding, in patients prescribed rivaroxaban by general practitioners supports its use as a safe and efficacious treatment in the standard clinical care of high-risk patient populations.

著者

Kazutaka Aonuma Hiro Yamasaki Masato Nakamura Takashi Matsumoto Morimasa Takayama Kenji Ando Kenzo Hirao Masahiko Goya Yoshihiro Morino Kentaro Hayashida Kengo Kusano Yutaka Gomi Michael L. Main Takahiro Uchida Shigeru Saito

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-0196, (Released:2020-06-26)

参考文献数

16

被引用文献数

15

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Background:The SALUTE trial was a prospective, multicenter, single-arm trial to confirm the safety and efficacy of the WATCHMAN left atrial appendage closure (LAAC) device for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF) in Japan.Methods and Results:A total of 54 subjects (including 12 roll-in subjects) with a WATCHMAN implant procedure were followed in 10 investigational centers. Follow-up visits were performed up to 2 years post-implant. The baseline CHA2DS2-VASc score was 3.6±1.6 and the baseline HAS-BLED score was 3.0±1.1. All 42 subjects in the intention to treat (ITT) cohort underwent successful implantation of the LAAC device without any serious complications, achieving the prespecified performance goal. The effective LAAC rate was maintained at 100% from 45 days to 12 months post-implant, achieving the prespecified performance goal. During follow-up, 1 subject died of heart failure, and 3 had ischemic strokes, but there were no cases of hemorrhagic stroke or systemic embolism. All events were adjudicated as unrelated to the WATCHMAN device/procedure by the independent Clinical Events Committee. All 3 ischemic strokes were classified as nondisabling based on no change in the modified Rankin scale score.Conclusions:Final results of the SALUTE trial demonstrated that the WATCHMAN LAAC device is an effective and safe alternative nonpharmacological therapy for stroke risk reduction in Japanese NVAF patients who are not optimal candidates for lifelong anticoagulation. (Trial Registration: clinicaltrials.gov Identifier NCT 03033134)

著者

Tomomi Nagayama Satoshi Nagase Tsukasa Kamakura Mitsuru Wada Kohei Ishibashi Yuko Y. Inoue Koji Miyamoto Takashi Noda Takeshi Aiba Hiroshi Takaki Masaru Sugimachi Wataru Shimizu Teruo Noguchi Satoshi Yasuda Shiro Kamakura Kengo Kusano

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-18-0643, (Released:2019-01-12)

参考文献数

38

被引用文献数

7

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Background: Spontaneous type 1 electrocardiogram (ECG) in the right precordial lead is a dominant predictor of ventricular fibrillation (VF) in Brugada syndrome (BrS). In some BrS patients with VF, however, spontaneous type 1 ECG is undetectable, even in repeated ECG and immediately after VF. This study investigated differences between BrS patients with spontaneous or drug-induced type 1 ECG. Methods and Results: We evaluated 15 BrS patients with drug-induced (D-BrS) and 29 with spontaneous type 1 ECG (SP-BrS). All patients had had a previous VF episode. In each D-BrS patient, ECG was recorded more than 15 times (mean, 46±34) during 7.2±5.1 years of follow-up. Age and family history were comparable between groups. Inferolateral early repolarization (ER) was observed in 13 D-BrS (87%) at least once but in only 3 SP-BrS (10%, P<0.01). Immediately after VF, inferolateral ER was accentuated in 9 of 10 D-BrS, while type 1 ECG was accentuated in 12 of 16 SP-BrS. Fragmented QRS in the right precordial lead and aVR sign were absent in D-BrS but present in 20 (69%, P<0.01) and 11 (38%, P<0.01) SP-BrS, respectively. There was no prognostic difference between groups. Conclusions: Although having similar clinical profiles, there are obvious ECG differences between VF-positive BrS patients with spontaneous or drug-induced type 1 ECG. The inferolateral lead rather than the right precordial lead on ECG may be particularly crucial in some BrS patients.