著者
Shingo Matsumoto Rine Nakanishi Ryo Ichibayashi Mitsuru Honda Kei Hayashida Atsushi Sakurai Nobuya Kitamura Takashi Tagami Taka-aki Nakada Munekazu Takeda Takanori Ikeda SOS-KANTO Study Group
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-22-0047, (Released:2022-05-14)
参考文献数
35
被引用文献数
1

Background: Heart rate (HR) predicts outcomes in patients with acute coronary syndrome (ACS), whereas the impact of HR on outcomes after out-of-hospital cardiac arrest (OHCA) remains unclear. This study aimed to investigate the impact of HR after resuscitation on outcomes after OHCA and whether the impact differs with OHCA etiology.Methods and Results: Of 16,452 patients suffering from OHCA, this study analyzed 741 adults for whom HR after resuscitation was recorded by 12-lead electrocardiogram upon hospital arrival. Etiology of OHCA was categorized into 3 groups: ACS, non-ACS, and non-cardiac. Patients in each etiology group were further divided into tachycardia (>100 beats/min) and non-tachycardia (≤100 beats/min). The impact of HR on outcomes was evaluated in each group. Among the 741 patients, the mean age was 67.6 years and 497 (67.1%) patients were male. The primary outcome – 3-month all-cause mortality – was observed in 55.8% of patients. Tachycardia after resuscitation in patients with ACS was significantly associated with higher all-cause mortality at 3 months (P=0.002), but there was no significant association between tachycardia and mortality in non-ACS and non-cardiac etiology patients. In a multivariate analysis model, the incidence of tachycardia after resuscitation independently predicted higher 3-month all-cause mortality in OHCA patients with ACS (hazard ratio: 2.17 [95% confidence interval: 1.05–4.48], P=0.04).Conclusions: Increased HR after resuscitation was associated with higher mortality only in patients with ACS.
著者
Takashi Oka Rine Nakanishi Takayuki Kabuki Hidenobu Hashimoto Takahiro Fujii Shintarou Dobashi Takanori Ikeda
出版者
International Heart Journal Association
雑誌
International Heart Journal (ISSN:13492365)
巻号頁・発行日
vol.63, no.1, pp.91-98, 2022-01-29 (Released:2022-01-29)
参考文献数
32
被引用文献数
1

Balloon pulmonary angioplasty (BPA) is a robust treatment and has been performed among patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). A lung perfusion scan (LPS) is required for inspection in deciding the curative effect judgment and treatment lesion of BPA. Nevertheless, the impact of BPA in the improvement of right heart system function is not well known. We investigated whether BPA improves right heart function alongside other parameters.We studied 20 patients with CTEPH (mean age 63.6 ± 15.9 years, male 30.0%) who underwent BPA. All study sets including right heart catheter, pulmonary angiography, 6-minute walk test (6MWT), blood gas analysis, and LPS were performed before BPA treatment. All parameters using right heart catheter and oxygenation level were measured at room air temperature. Regarding LPS, right ventricular ejection fraction (RVEF) was calculated using the first-pass method. These parameters before BPA were compared with those after BPA.In total, 120 BPAs were performed (mean number of procedures/patient; 6.0 ± 2.4 sessions). Per BPA session, 6.0 ± 2.4 areas and 10.0 ± 4.3 lesions were treated with a volume of 181.3 ± 53.5 mL of contrast media. No complication required an invasive procedure. World Health Organization functional class, 6MWT, pulmonary artery pressure, pulmonary vascular resistance, and oxygenation level were significantly improved after BPA. RVEF via LPS was also significantly improved after BPA (45.0 ± 6.2% to 50.6 ± 2.9%, P < 0.001).In the present study, we found that RVEF via LPS was improved through appropriate BPA alongside the other parameters. It would be useful to be able to evaluate right heart function.