著者
Tadashi Nakajima Reika Kawabata-Iwakawa Yoshiaki Kaneko Shin-ichiro Hamano Rie Sano Shuntaro Tamura Hiroshi Hasegawa Takashi Kobari Yoshihiko Kominato Masahiko Nishiyama Masahiko Kurabayashi
出版者
International Heart Journal Association
雑誌
International Heart Journal (ISSN:13492365)
巻号頁・発行日
pp.20-203, (Released:2020-09-12)
参考文献数
19
被引用文献数
7

While a KCND3 V392I mutation uniquely displays a mixed electrophysiological phenotype of Kv4.3, only limited clinical information on the mutation carriers is available. We report two teenage siblings exhibiting both cardiac (early repolarization syndrome and paroxysmal atrial fibrillation) and cerebral phenotypes (epilepsy and intellectual disability), in whom we identified the KCND3 V392I mutation. We propose a link between the KCND3 mutation with a mixed electrophysiological phenotype and cardiocerebral phenotypes, which may be defined as a novel cardiocerebral channelopathy.
著者
Yoshiaki Ohyama Norimichi Koitabashi Tetsuya Nakamura Yoko Sumita Michikazu Nakai Kunihiro Nishimura Yoshihiro Miyamoto Masahiko Kurabayashi
出版者
The Japanese Circulation Society
雑誌
Circulation Reports (ISSN:24340790)
巻号頁・発行日
vol.1, no.7, pp.296-302, 2019-07-10 (Released:2019-07-10)
参考文献数
23
被引用文献数
1

Background:Previous randomized clinical studies have raised concerns about whether inferior vena cava filter (IVCF) can benefit patients with venous thromboembolism (VTE). The present study therefore investigated whether IVCF are associated with in-hospital mortality in Japan.Methods and Results:This study was based on the Diagnosis Procedure Combination database in the Japanese Registry of All Cardiac and Vascular Datasets (JROAD-DPC). Of 2,368,165 patients included in JROAD-DPC, we identified 28,238 who were hospitalized with VTE between 2012 and 2014. We compared in-hospital mortality rates between patients with or without IVCF using propensity score (PS) matching. PS were estimated using logistic regression models in which IVCF was the dependent variable. The other variables consisted of age, sex, Charlson comorbidity index, anti-thrombotic agents and clinical disease status. Patients were aged 68±16 years, and 59.7% were female. Of 28,238 patients, 6,937 (24.5%) were treated with an IVCF. The overall in-hospital mortality was 4.3%. On PS-matched analysis in-hospital mortality was significantly lower with, than without, IVCF (3.1% vs. 4.4%, P<0.001; OR, 0.65; 95% CI: 0.54–0.79).Conclusions:Having an IVCF was independently associated with lower in-hospital mortality in Japanese patients with VTE. This is in sharp contrast to the benefits of IVCF in other countries. The reasons for this difference require further investigation.
著者
Yoshiaki Kaneko Tadashi Nakajima Takashi Iizuka Shuntaro Tamura Hiroshi Hasegawa Masahiko Kurabayashi
出版者
International Heart Journal Association
雑誌
International Heart Journal (ISSN:13492365)
巻号頁・発行日
vol.61, no.2, pp.380-383, 2020-03-28 (Released:2020-03-28)
参考文献数
13
被引用文献数
1 3

We report a case of atypical slow-slow atrioventricular nodal reentrant tachycardia (AVNRT) utilizing a superior slow pathway as a retrograde limb. The standard electrophysiological criteria confirm the diagnosis of this AVNRT by successfully excluding a diagnosis of atrial tachycardia and atrioventricular reentrant tachycardia. The earliest atrial activation during tachycardia was found at the interatrial septum 17.5 mm superior to the site identified during retrograde conduction with the fast pathway. The tachycardia was not inducible after ablation at the right posterior septum, consistent with successful ablation of the typical slow pathway.
著者
Yoshiaki Kaneko Tadashi Nakajima Akihiko Nogami Yasuya Inden Tetsuya Asakawa Itsuro Morishima Akira Mizukami Takashi Iizuka Shuntaro Tamura Chihiro Ota Yasunori Kanzaki Kazuya Nakagawa Makoto Suzuki Masahiko Kurabayashi
出版者
The Japanese Circulation Society
雑誌
Circulation Reports (ISSN:24340790)
巻号頁・発行日
vol.1, no.2, pp.46-54, 2019-02-08 (Released:2019-02-08)
参考文献数
40
被引用文献数
4 4

Background: The existence of atypical fast-slow (F/S) atrioventricular (AV) nodal reentrant tachycardias (NRT) using slow pathway (SP) variants connected to the right atrial (RA) inferolateral (inf) free wall (FW) along the tricuspid annulus (TA), has been neither confirmed nor precisely characterized. Methods and Results: We studied 7 patients (mean age, 48±16 years; 5 men) with F/S-AVNRT with long RP intervals and an earliest atrial activation at the RA inf-FW along the TA (inf-F/S-AVNRT). AV reentrant tachycardia was excluded on observation of the transition zone criteria in all 7 patients. Atrial tachycardia was excluded on the observation of a V-A-V activation sequence after the induction or entrainment of the tachycardia from the right ventricle in all. During the tachycardia, low-frequency, fractionated potentials (LP) preceding the local atrial electrogram were recorded near the site of the earliest atrial activation in 6 patients. Observations of conduction delay and block of the LP during ventricular entrainment or ablation of the tachycardia indicated that LP reflect retrograde activation via the inf-SP. Retrograde SP conduction was interrupted at the site of earliest atrial activation in 3 patients, and in the right posterior septum in 4 patients. Conclusions: inf-F/S-AVNRT are distinct supraventricular tachycardia incorporating an SP variant connected to the RA inf-FW along the TA in the retrograde direction, which were eliminated by ablation.
著者
Yoshiaki Kaneko Tadashi Nakajima Tadanobu Irie Fumio Suzuki Masaki Ota Takafumi Iijima Mio Tamura Takashi Iizuka Shuntaro Tamura Akihiro Saito Masahiko Kurabayashi
出版者
International Heart Journal Association
雑誌
International Heart Journal (ISSN:13492365)
巻号頁・発行日
vol.55, no.1, pp.84-86, 2014 (Released:2014-02-07)
参考文献数
23
被引用文献数
7 9

An 81-year-old man with long RP narrow QRS tachycardia underwent catheter ablation. Ventricular pacing reset the atrial cycle over a retrograde slow pathway, followed by termination of the tachycardia without atrial capture, confirming the diagnosis of fast-slow atrioventricular nodal reentrant tachycardia (AVNRT). The earliest atrial activation during tachycardia was found in the noncoronary sinus of Valsalva, where the first delivery of radiofrequency energy terminated and eliminated the inducibility of the tachycardia, by retrograde conduction block over the slow pathway. This is the first report of a fast-slow AVNRT, with successful ablation of the slow pathway from a noncoronary sinus of Valsalva.
著者
Makoto Shibata Megumi Uchida Setsuki Tsukagoshi Koichi Yamaguchi Aya Yamaguchi Natsumi Furuta Kouki Makioka Toshitaka Maeno Yukio Fujita Masahiko Kurabayashi Yoshio Ikeda
出版者
The Japanese Society of Internal Medicine
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
vol.54, no.23, pp.3057-3060, 2015 (Released:2015-12-01)
参考文献数
13
被引用文献数
5 9

A 64-year-old Japanese woman presented with a three-month history of progressive numbness and weakness of the lower extremities. A neurological examination and nerve conduction study indicated sensorimotor polyneuropathy. Since the serum anti-Hu antibody titer was remarkably elevated, paraneoplastic neurological syndrome was highly suspected. A thoracoscopic biopsy of the hilar lymph nodes, in which 18F-fluorodeoxyglucose uptake was obviously increased, revealed pathological findings for small-cell lung cancer (SCLC). Subsequently, the patient presented with generalized tonic-clonic seizures, and cerebral MRI showed reversible multifocal brain lesions, considered to reflect paraneoplastic encephalopathy. After two courses of chemotherapy for SCLC, the brain lesions totally disappeared.
著者
Makoto Murata Hitoshi Adachi Shigeru Oshima Masahiko Kurabayashi
出版者
International Heart Journal Association
雑誌
International Heart Journal (ISSN:13492365)
巻号頁・発行日
pp.17-245, (Released:2018-06-06)
参考文献数
33
被引用文献数
6

Hyperglycemia is an established risk factor of coronary artery disease (CAD). However, hyperglycemia with preserved pancreatic β cell function induces hyperinsulinemia to correct the glucose profile and may even result in reactive hypoglycemia (RH), which induces an inflammatory response. In this study, the incidence of RH and its effect on arteriosclerosis were examined in CAD patients with a lengthy oral glucose tolerance test (OGTT).We performed a prospective cross-sectional study on 116 nondiabetic CAD patients [70 ± 9 years, 70% male, HbA1c < 6.5%] using coronary angiography and a 4-hour OGTT. Blood samples were collected prior to and 4 hours after the glucose load to evaluate arteriosclerosis markers. Hypoglycemia following the glucose tolerance test was defined as blood glucose levels < 70 mg/dL. We comparatively examined markers of inflammation and arteriosclerosis between the RH group and the non-RH group.A glucose metabolism disorder was observed in 69% of the patients. Hypoglycemia was observed in 24% (28 individuals) of the patients. All showed a RH pattern with no symptoms. The RH group exhibited significantly elevated insulin levels at 1 hour. Furthermore, a significant increase in the white blood cell (WBC) count during OGTT was observed in the RH group compared with the non-RH group [delta WBC; RH: 4.84 (-4.17-20.75) versus non-RH: -2.17 (-9.23-9.09) %; P = 0.04].Asymptomatic RH and an augmentation of inflammation were observed at an incidence of 24% in CAD patients.
著者
Kazuaki Negishi Mitsuru Kobayashi Izuru Ochiai Yuji Yamazaki Hisashi Hasegawa Takeyoshi Yamashita Takehisa Shimizu Shu Kasama Masahiko Kurabayashi
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.74, no.12, pp.2734-2740, 2010 (Released:2010-11-25)
参考文献数
32
被引用文献数
17 43

Background: Fibroblast growth factor 23 (FGF-23) is a novel bone-derived phosphate-regulating hormone, and serum FGF-23 levels are associated with mortality among hemodialysis (HD) patients. However, the pathophysiological role of FGF-23 in those patients remains unclear, so the association between serum FGF-23 levels and known cardiac biomarkers or echocardiographic measurements were investigated in long-term HD patients without cardiac symptoms. Methods and Results: The 87 consecutive patients treated in a single HD center (51 males, 36 females; mean age 64 years, mean HD duration 5.8 years) were included in this study. Comprehensive echocardiography was performed after HD. Blood samples were obtained before HD. Serum FGF-23 levels in dialysis patients were 1,171±553pg/ml. In univariate analysis, serum phosphate (r=0.443, P<0.001) and calcium levels (r=0.256, P=0.04), left ventricular mass index (LVMI) (r=0.268, P=0.039) were significantly associated with FGF-23 levels. Neither the B-type natriuretic peptide (BNP) nor the cardiac troponin T level was correlated with FGF-23. In multivariate regression analysis, only LVMI (β=0.287, P=0.031, confidence interval (CI) 0.390-8.040) and phosphate levels (β=0.419, P=0.001, CI 57.12-207.7) and calcium levels (β=0.277, P=0.025, CI 24.95-360.1) remained significantly correlated with FGF-23. Conclusions: Beside BNP, FGF-23 was identified as a factor that is significantly associated with LVMI. FGF-23 could be a novel biomarker of left ventricular overload, which is closely associated with the increased risk of death in HD patients. (Circ J 2010; 74: 2734-2740)
著者
Yae Matsuo Marcus Sandri Norman Mangner Nicolas Majunke Ingo Dähnert Gerhard Schuler Masahiko Kurabayashi Sven Möbius-Winkler
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-13-0828, (Released:2014-01-11)
参考文献数
29
被引用文献数
7 17

Background: Transcatheter left atrial appendage (LAA) closure is an alternative therapy for stroke prevention in atrial fibrillation (AF) patients. However; real-world efficacy, safety and complications have yet to be investigated. We sought to determine the procedural outcomes and potential complications of LAA closure in routine clinical practice at a high-volume center. Methods and Results: The study group comprised 179 patients (105 males; 72.7±9.0 years) with AF undergoing LAA closure at a single center in Germany. The rate of successful implantation was 98.9% (2 patients did not undergo implantation) and the overall procedure-related complication rate was 11.2% (major: 3.3%: tamponade 2; possibility of transient ischemic attack (TIA) 1; device dislocation 3; minor: 7.8%: pericardial effusion 2; air embolization with transient ST segment elevation 3; thrombus on device/sheath 3; puncture complications 5). At 45 days; 99.4% showed successful sealing of the LAA and 94.5% discontinued oral anticoagulation (OAC). TIA occurred in 2 patients during 6-month follow-up; but no cases of stroke were reported. There were no hemorrhagic stroke or device-related deaths. Only 1 patient was hospitalized with traumatic subdural hematoma. Minor bleeding was reported in 5 patients. Conclusions: Transcatheter LAA closure in a high-volume center is safe and feasible. Life-threatening complications are rare. Discontinuation of OAC 45 days after implantation was also safe.