著者
Shun Kohsaka Kenji Fukushima Ippei Watanabe Susumu Manabe Nozomi Niimi Yodo Gatate Mitsuaki Sawano Shintaro Nakano
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-21-0345, (Released:2021-06-18)
参考文献数
68
被引用文献数
3

Coronary artery disease (CAD) remains a leading cause of mortality and morbidity in developed countries. Although urgent revascularization is the cornerstone of management of acute coronary syndrome (ACS), for patients with stable CAD recent large-scale clinical trials indicate that a mechanical ‘fix’ of a narrowed artery is not obviously beneficial; ACS and stable CAD are increasingly recognized as different clinical entities. We review the perspectives on (1) modifying the diagnostic pathway of stable CAD with the incorporation of modern estimates of pretest probability, (2) non-imaging evaluations based on their availability, (3) the optimal timing of invasive coronary angiography and revascularization, and (4) the implementation of medical therapy during the work-up.
著者
Risako Nakao Michinobu Nagao Kenji Fukushima Akiko Sakai Eri Watanabe Masateru Kawakubo Shuji Sakai Nobuhisa Hagiwara
出版者
The Japanese Circulation Society
雑誌
Circulation Reports (ISSN:24340790)
巻号頁・発行日
pp.CR-18-0024, (Released:2019-07-26)
参考文献数
33
被引用文献数
4

Background:We investigated the association between left ventricle ejection fraction (LVEF) and vortex flow (VF), and whether cardiac resynchronization therapy (CRT) response can be predicted using VF mapping (VFM) in patients with dilated cardiomyopathy (DCM).Methods and Results:Cardiac magnetic resonance imaging data for 20 patients with heart failure (HF) with LVEF ≥40% and 25 patients with DCM with LVEF <40%, scheduled for CRT, were retrospectively analyzed. The maximum VF (MVF) on short-axis, long-axis and 4-chamber LV cine imaging were calculated using VFM. Summed MVF was used as a representative value for each case and was significantly greater for patients with DCM than for patients with HF with LVEF ≥40% (25.2±19.2% vs. 12.1±15.4%, P<0.005). Summed MVF was significantly greater for CRT responders (n=12, 35.8±22.7%) than for non-responders (n=13, 15.8±8.7%, P=0.04) during the mean follow-up period of 38.4 months after CRT. Patients with summed MVF ≥31.3% had a significantly higher major adverse cardiac event-free rate than those with MVF <31.3% (log-rank=4.51, P<0.05).Conclusions:On VFM analysis, LV VF interrupted efficient ejection in HF. Summed MVF can predict CRT response in DCM.