著者

Shigeru Makita Takanori Yasu Yoshihiro J Akashi Hitoshi Adachi Hideo Izawa Shunichi Ishihara Yoshitaka Iso Hideo Ohuchi Kazuto Omiya Yusuke Ohya Koichi Okita Yutaka Kimura Akira Koike Masahiro Kohzuki Shinji Koba Masataka Sata Kazunori Shimada Tomoki Shimokawa Hirokazu Shiraishi Naokata Sumitomo Tetsuya Takahashi Tomoyuki Takura Hiroyuki Tsutsui Masatoshi Nagayama Emiko Hasegawa Yoshihiro Fukumoto Yutaka Furukawa Shin-ichiro Miura Satoshi Yasuda Sumio Yamada Yuichiro Yamada Dai Yumino Toshiko Yoshida Takuji Adachi Toshimi Ikegame Kazuhiro P Izawa Takeshi Ishida Neiko Ozasa Naohiko Osada Hiroaki Obata Naoya Kakutani Yusuke Kasahara Masaaki Kato Kentaro Kamiya Shintaro Kinugawa Yuji Kono Yasuyuki Kobayashi Teruyuki Koyama Kazuhiro Sase Shinji Sato Tatsuhiro Shibata Norio Suzuki Daisuke Tamaki Minako Yamaoka-Tojo Michio Nakanishi Eisaku Nakane Mari Nishizaki Taiki Higo Kanta Fujimi Tasuku Honda Yasuharu Matsumoto Noriko Matsumoto Ikuko Miyawaki Makoto Murata Shusuke Yagi Masanobu Yanase Midori Yamada Miho Yokoyama Noboru Watanabe Haruki Ito Takeshi Kimura Syunei Kyo Yoichi Goto Ryuji Nohara Ken-Ichi Hirata on behalf of the Japanese Circulation Society/the Japanese Association of Cardiac Rehabilitation Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0234, (Released:2022-12-09)

参考文献数

559

被引用文献数

67

著者

Koji Ishikawa Arata Fukushima Takashi Yokota Shingo Takada Takaaki Furihata Naoya Kakutani Katsuma Yamanashi Yoshikuni Obata Ippei Nakano Takahiro Abe Shintaro Kinugawa Toshihisa Anzai

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.4, pp.179-186, 2019-04-10 (Released:2019-04-10)

参考文献数

41

被引用文献数

4

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Background: In heart failure (HF) management, early ambulation is recommended to prevent physical deconditioning. The effects of delayed ambulation on later clinical outcomes and the factors linked to delayed ambulation in hospitalized HF patients, however, remain unestablished. Methods and Results: We retrospectively investigated 101 patients (mean age, 66±17 years) who were hospitalized for acute decompensated HF. During the mean follow-up of 244±15 days after hospital discharge, 34 patients had cardiovascular events leading to death or unplanned readmission. Patients with cardiovascular events had longer median days to acquire ambulation than those without cardiovascular events (11 days, IQR, 8–20 days vs. 7 days, IQR, 5–15 days, P<0.001). The optimal cut-off period until initiation of ambulation to discriminate cardiovascular events was 8 days, indicating that longer days (≥8 days) to acquire ambulation was associated with higher rates of cardiovascular events, even after adjustment of multiple confounders. On multivariate analysis, age >65 years (odds ratio [OR], 2.49; 95% confidence interval [CI]: 1.04–6.09) and increase in blood urea nitrogen (BUN; OR, 1.04; 95% CI: 1.01–1.08) were independent predictors of delayed ambulation. Conclusions: Delayed ambulation is associated with older age and increased BUN in patients with acute HF. Time to ambulation in the recovery phase of acute HF is important, and delayed ambulation may increase the rate of cardiovascular events after hospital discharge.

著者

Naoya Kakutani Arata Fukushima Shintaro Kinugawa Takashi Yokota Tatsuya Oikawa Mikito Nishikawa Risako Nakamura Takanori Tsukada Shigeki Mori Ichiro Yoshida Toshihisa Anzai

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

pp.CR-19-0004, (Released:2019-02-19)

参考文献数

30

被引用文献数

14

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Background: Early ambulation has been shown to be associated with shorter hospital stay and better clinical outcomes in patients with acute heart failure (HF). Early mobilization program in combination with structured exercise training is recommended, but has yet to be developed and implemented in HF. Methods and Results: We developed a progressive mobilization program for HF patients that classifies the mobilization process into 7 stages based on disease condition and physical function. We retrospectively analyzed 136 patients with acute HF (80±11 years), who were assigned either to the mobilization program (intervention group, n=75) or to usual care (control group, n=61). The program was safely implemented without any adverse events. Hospital stay was significantly reduced in the intervention group compared with the control group (33±25 vs. 51±36 days, P<0.01). The intervention group had higher activities of daily living (ADL) score at discharge evaluated using the Barthel index (64±38 vs. 49±36, P<0.05). The intervention group also had a higher percentage of discharge to home (71% vs. 52%, P<0.05) and a lower rate of HF-related readmission (16% vs. 36%, P<0.05) compared with the control group. Conclusions: The progressive mobilization program for acute HF was feasible and was associated with better ADL and reduced hospital stay, leading to improvement of clinical outcome.

著者

Ippei Nakano Shintaro Kinugawa Hiroaki Hori Arata Fukushima Takashi Yokota Shingo Takada Naoya Kakutani Yoshikuni Obata Katsuma Yamanashi Toshihisa Anzai

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

pp.19-400, (Released:2020-01-17)

参考文献数

41

被引用文献数

11

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Heart failure (HF) is associated with aberrant skeletal muscle impairments, which are closely linked to the severity of HF. A low level of brain-derived neurotrophic factor (BDNF), a myokine produced in the skeletal muscle, is known to be involved in reduced exercise capacity and poor prognosis in HF. However, little is known about the factors or conditions of skeletal muscle associated with BDNF levels. We investigated the association between serum BDNF levels and the skeletal muscle mass and function in HF patients (n = 60, 63 ± 13 years) and age-matched controls (n = 29, 61 ± 16 years). The serum BDNF level was significantly lower in the HF patients compared to the controls (24.9 ± 0.9 versus 28.6 ± 1.3, P = 0.021). In a univariate analysis, BDNF was significantly correlated with the peak oxygen uptake, estimated glomerular filtration rate, 10-m gait speed, and muscle strength, but not with the body mass index or lean mass in the HF group. A multiple linear regression analysis revealed that BDNF was independently associated with muscle strength (β-coefficient = 2.80, 95%CI: 1.89-11.8, P = 0.008). Serum BDNF levels were associated with exercise capacity and skeletal muscle function, but not with muscle mass. These novel findings may suggest that BDNF production is controlled by muscle function and activity and consequently regulates exercise capacity, highlighting the importance of adequate training regarding skeletal muscle in HF patients.