著者

Ryuji Fukazawa Junjiro Kobayashi Mamoru Ayusawa Hiromichi Hamada Masaru Miura Yoshihide Mitani Etsuko Tsuda Hiroyuki Nakajima Hiroyuki Matsuura Kazuyuki Ikeda Kazuhiko Nishigaki Hiroyuki Suzuki Kei Takahashi Kenji Suda Hiroshi Kamiyama Yoshihiro Onouchi Tohru Kobayashi Hiroyoshi Yokoi Kisaburo Sakamoto Masami Ochi Soichiro Kitamura Kenji Hamaoka Hideaki Senzaki 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-19-1094, (Released:2020-07-08)

参考文献数

459

被引用文献数

31 157

著者

Kosuke Kiyohara Junya Sado Tetsuhisa Kitamura Mamoru Ayusawa Masahiko Nitta Taku Iwami Ken Nakata Yasuto Sato Noriko Kojimahara Naohito Yamaguchi Tomotaka Sobue Yuri Kitamura for the SPIRITS Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-1237, (Released:2018-02-15)

参考文献数

34

被引用文献数

1 19

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Background:A better understanding of the epidemiology of pediatric out-of-hospital cardiac arrest (OHCA) occurring in school settings is important to establish an evidence-based strategy for prevention and better prognosis.Methods and Results:The Stop and Prevent cardIac aRrest, Injury, and Trauma in Schools (SPIRITS) is a nationwide prospective observational study linking databases from 2 nationally representative registries, the Injury and the Accident Mutual Aid Benefit System of The Japan Sport Council and the All-Japan Utstein Registry of the Fire and Disaster Management Agency. Using these databases, we described the detailed characteristics and outcomes of pediatric OHCAs that occurred in school settings in Japan between 2009 and 2014. During the 6-year study period, 295 OHCA cases were confirmed. Overall incidence rate was 0.4 per 100,000 students per year. The majority of OHCA cases had a cardiac origin (71%), occurred during exercise (65%), were witnessed by bystanders (70%), and received bystander-initiated cardiopulmonary resuscitation (73%). In approximately one-third of cases the student was defibrillated by public-access automated external defibrillator (38%). The proportion of patients with 1-month survival and a favorable neurological outcome was 34% among all OHCAs and 43% among OHCAs of cardiac origin.Conclusions:In Japan, approximately 50 pediatric cases of OHCA consistently occur yearly in school settings. The majority of students received basic life support from bystanders, and patients with OHCA of cardiac origin had a relatively good prognosis.

著者

Kenji Suda Yoshiyuki Kudo Takashi Higaki Yuichi Nomura Masaru Miura Masahiko Matsumura Mamoru Ayusawa Shunichi Ogawa Toyojiro Matsuishi

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.73, no.7, pp.1319-1323, 2009 (Released:2009-06-25)

参考文献数

17

被引用文献数

48 57

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Background: To determine the prognosis of patients with giant coronary aneurysms (GA) caused by Kawasaki disease (KD) treated with combined oral warfarin and aspirin. Methods and Results: A multicenter follow-up study of 83 patients (65 males, 18 females) with GA who had been treated for ≥3 months with warfarin. Most patients were placed on the combination therapy as soon as the GA was detected and remained on it for 6.0 ±5.3 years, giving a total of 482 patient-years. Target international normalized ratio of prothrombin time ranged from 1.5 to ≥2.5. During this observational period, 5 patients suffered from 8 episodes of acute myocardial infarction and 1 died. Coronary thrombus formation enforced 6 courses of intracoronary thrombolysis in 3 patients (1-4 times). Consequently, freedom of cardiac events was 92.5% at 1 year and 91% at 10 years and the linearized cardiac event rate was 2.9% patient-year. Hemorrhagic complications occurred on 8 occasions (1 subdural hematoma) in 5 patients, giving 1.7% patient-year. Conclusions: The combination of warfarin and aspirin has an acceptably high cardiac-event-free survival in patients with GA caused by KD, though it has a certain risk of hemorrhagic complications. (Circ J 2009; 73: 1319-1323)

著者

Keiichi Hirono Yukiko Hata Makoto Nakazawa Nobuo Momoi Tohru Tsuji Taro Matsuoka Mamoru Ayusawa Yuriko Abe Tamaki Hayashi Nobuyuki Tsujii Tadaaki Abe Heima Sakaguchi Ce Wang Asami Takasaki Shinya Takarada Mako Okabe Nariaki Miyao Hideyuki Nakaoka Keijiro Ibuki Kazuyoshi Saito Sayaka Ozawa Naoki Nishida Neil E. Bowles Fukiko Ichida

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-18-0470, (Released:2018-08-18)

参考文献数

37

被引用文献数

7

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Background: Left ventricular non-compaction (LVNC) is a cardiomyopathy morphologically characterized by 2-layered myocardium and numerous prominent trabeculations, and is often associated with dilated cardiomyopathy (DCM). Variants in the gene encoding tafazzin (TAZ) may change mitochondrial function and cause dysfunction of many organs, but they also contribute to the DCM phenotype in LVNC, and the clinical and echocardiographic features of children with this phenotype are poorly understood. Methods and Results: We enrolled 92 DCM phenotype LVNC patients and performed next-generation sequencing to identify the genetic etiology. Ten TAZ variants were identified in 15 male patients (16.3%) of the 92 patients, including 3 novel missense substitutions. The patients with TAZ variants had a higher frequency of early onset of disease (92.3% vs. 62.3%, P=0.0182), positive family history (73.3% vs. 20.8%, P=0.0001), and higher LV posterior wall thickness Z-score (8.55±2.60 vs. 5.81±2.56, P=0.0103) than those without TAZ variants, although the mortality of both groups was similar. Conclusions: This study provides new insight into the impact of DCM phenotype LVNC and emphasizes the clinical advantages available for LVNC patients with TAZ variants.

著者

Ryuji Fukazawa Tohru Kobayashi Masashi Mikami Tsutomu Saji Kenji Hamaoka Hitoshi Kato Hiroyuki Suzuki Etsuko Tsuda Mamoru Ayusawa Masaru Miura Ryota Ebata Tomio Kobayashi Mayumi Yashiro Shunichi Ogawa

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.82, no.1, pp.239-246, 2017-12-25 (Released:2017-12-25)

参考文献数

22

被引用文献数

38

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Background:Giant coronary aneurysm is the most severe sequela in Kawasaki disease, occurring in approximately 0.2% of patients in Japan. Regression is rare, while myocardial infarction (MI) and sudden death are relatively common. Herein, we reviewed patients with giant coronary aneurysm in a 10-year period.Methods and Results:A nationwide questionnaire survey was conducted based on a national epidemiological database from 1999 to 2010. We identified 355 giant coronary aneurysm patients, of whom 209 were analyzed. The 5- and 10-year total cardiac event-free rates were 0.72 and 0.68, respectively. Twelve patients died, and MI was observed in 32 patients (18.1%). Five and 6 deaths were due to coronary rupture and MI, respectively. All ruptures occurred within 1 month of onset, while most MI occurred within 18 months. There was no death beyond 2 years. Aneurysm size was significantly related to the occurrence of MI in both the right and left coronary arteries. At the time of writing, 55% of patients had no exercise limitations. And including patients who cannot perform strenuous exercises, 81% of patients were leading ordinary lives.Conclusions:Severe cardiac events are likely to occur within 2 years from onset of Kawasaki disease, while no deaths occurred beyond this time. Hence, careful monitoring is needed especially for the first 2 years. Most patients with giant coronary aneurysms can lead ordinary lives with appropriate management.