- 著者
- Ayumu Fujioka Kenji Yanishi Arito Yukawa Kojiro Imai Isao Yokota Kei Fujikawa Ayumu Yamada Akari Naito Keisuke Shoji Hirofumi Kawamata Yukihito Higashi Tomoaki Ishigami Ken-ichiro Sasaki Syuhei Tara Koichiro Kuwahara Satoshi Teramukai Satoaki Matoba
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-23-0046, (Released:2023-03-10)
- 参考文献数
- 24
- 被引用文献数
- 4
Background: Thromboangiitis obliterans (TAO) can lead to the development of critical limb-threatening ischemia (CLTI). Despite conventional treatments, such as smoking cessation or revascularization, young patients (<50 years) still require limb amputation. Therapeutic angiogenesis using bone marrow-derived mononuclear cell (BM-MNC) implantation has been tested and shown to have reasonable efficacy in CLTI. In this multicenter prospective clinical trial, we evaluated the safety and efficacy of BM-MNC implantation in CLTI patients with TAO.Methods and Results: We enrolled 22 CLTI patients with skin perfusion pressure (SPP) <30 mmHg. The primary endpoint of this trial is the recovery of SPP in the treated limb after a 180-day follow-up period. Secondary endpoints include the pain scale score and transcutaneous oxygen pressure (TcPO2). One patient dropped out during follow-up, leaving 21 patients (mean age 48 years, 90.5% male, Fontaine Class IV) for analysis. BM-MNC implantation caused no serious adverse events and increased SPP by 1.5-fold compared with baseline. Surprisingly, this effect was sustained over the longer term at 180 days. Secondary endpoints also supported the efficacy of this novel therapy in relieving pain and increasing TcPO2. Major amputation-free and overall survival probabilities at 3 years among all enrolled patients were high (95.5% and 89.5%, respectively).Conclusions: BM-MNC implantation showed safety and significant efficacy in CLTI patients with TAO.
- 著者
- Keitaro Senoo Tomonori Miki Takashi Okura Hirokazu Shiraishi Takeshi Shirayama Keiji Inoue Tomohiko Sakatani Ken Kakita Tetsuhisa Hattori Kentaro Nakai Takanori Ikeda Satoaki Matoba
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Reports (ISSN:24340790)
- 巻号頁・発行日
- vol.2, no.7, pp.345-350, 2020-07-10 (Released:2020-07-10)
- 参考文献数
- 21
- 被引用文献数
- 4
Background:Hypertension in patients with atrial fibrillation (AF) is a known independent risk factor for stroke. The Complete blood pressure (BP) monitor (Omron Healthcare, Kyoto, Japan) was developed as the first BP monitor with electrocardiogram (ECG) capability in a single device to simultaneously monitor ECG and BP readings. This study investigated whether the Complete can accurately differentiate sinus rhythm (SR) from AF during BP measurement.Methods and Results:Fifty-six consecutive patients with persistent AF admitted for catheter ablation were enrolled in the study (mean age 65.8 years; 83.9% male). In all patients, 12-lead ECGs and simultaneous Complete recordings were acquired before and after ablation. The Complete interpretations were compared with physician-reviewed ECGs, whereas Complete recordings were reviewed by cardiologists in a blinded manner and compared with ECG interpretations. Sensitivity, specificity, and κ coefficient were also determined. In all, 164 Complete and ECG recordings were simultaneously acquired from the 56 patients. After excluding unclassified recordings, the Complete automated algorithm performed well, with 100% sensitivity, 86% specificity, and a κ coefficient of 0.87 compared with physician-interpreted ECGs. Physician-interpreted Complete recordings performed well, with 99% sensitivity, 85% specificity, and a κ coefficient of 0.85 compared with physician-interpreted ECGs.Conclusions:The Complete, which combines BP and ECG monitoring, can accurately differentiate SR from AF during BP measurement.
- 著者
- Tatsuya Kawasaki Hirokazu Shiraishi Satoaki Matoba
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-23-0131, (Released:2023-06-07)
- 参考文献数
- 29
- 被引用文献数
- 1
Background: Patients with hypertrophic cardiomyopathy (HCM) show various physical findings, but their clinical significance has not been systematically evaluated.Methods and Results: This study evaluated 105 consecutive patients with HCM who had undergone phonocardiography and external pulse recording. Physical examinations included a visible jugular a-wave (Jug-a), audible 4th sound (S4), and double or sustained apex beat. The primary outcome was a composite of all-cause death and hospitalization for cardiovascular disease. A total of 104 non-HCM subjects served as controls. The prevalence of visible Jug-a in the seated or supine position, audible S4, and a sustained or double apex beat in patients with HCM were 10%, 71%, 70%, 42%, and 27%, respectively, all of which were significantly higher than in the controls (0%, 20%, 11%, 17%, and 2%; P<0.001 for all comparisons). The combination of visible Jug-a in the supine position and audible S4 yielded a specificity of 94% and sensitivity of 57%. During a follow-up period of 6.6 years, 6 patients died and 10 were hospitalized. The absence of audible S4 was a predictor of cardiovascular events (hazard ratio, 3.91; 95% confidence interval, 1.41 to 10.8; P=0.005).Conclusions: Detection of these findings has clinical importance in the diagnosis and risk stratification of HCM prior to the use of advanced imaging techniques.
- 著者
- Akira Shikuma Masahiro Nishi Satoaki Matoba
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-23-0543, (Released:2023-10-05)
- 参考文献数
- 26
- 被引用文献数
- 2
Background: Limited studies have demonstrated sex differences in the clinical outcomes and quality of care among elderly patients hospitalized with acute myocardial infarction (AMI).Methods and Results: Using nationwide cardiovascular registry data collected in Japan between 2012 and 2019, we enrolled patients aged ≥45 years. The 30-day and all in-hospital mortality rates, as well as process-of-care measures, were assessed, and mixed-effects logistic regression analysis was performed. A total 254,608 patients were included and stratified into 3 age groups: middle-aged, old and oldest old. The 30-day mortality rates for females and males were as follows: 3.0% vs. 2.7%, with an adjusted odds ratio (OR) of 1.17 (95% confidence interval (CI): 1.01–1.36, P=0.030) in middle-aged patients; 7.2% vs. 5.8%, with an OR of 1.14 (95% CI: 1.09–1.21, P<0.001) in old patients; and 19.6% vs. 15.5% with an OR of 1.17 (95% CI: 1.09–1.26, P<0.001) in the oldest old patients. Moreover, significantly higher numbers of female AMI patients across all age groups died in hospital, as well as having fewer invasive procedures and cardiovascular prescriptions, compared with their male counterparts.Conclusions: This nationwide cohort study revealed that female middle-aged and elderly patients experienced suboptimal quality of care and poorer in-hospital outcomes following AMI, compared with their male counterparts, highlighting the need for more effective management in consideration of sex-specific factors.
- 著者
- Tomotsugu Seki Makoto Murata Kensuke Takabayashi Takashi Yanagisawa Masayuki Ogihara Ritsuko Kurimoto Keisuke Kida Koichi Tamita Xiaoyang Song Neiko Ozasa Ryoji Taniguchi Miho Nishitani-Yokoyama Shinji Koba Ryosuke Murai Yutaka Furukawa Maki Hamasaki Hirokazu Kondo Hironori Hayashi Asako Ootakara-Katsume Kento Tateishi Satoaki Matoba Hitoshi Adachi Hirokazu Shiraishi for the START Investigators
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Reports (ISSN:24340790)
- 巻号頁・発行日
- vol.5, no.3, pp.90-94, 2023-03-10 (Released:2023-03-10)
- 参考文献数
- 18
Background: Clinical practice guidelines strongly recommend optimal medical therapy (OMT), including lifestyle modification, pharmacotherapy, and exercise-based cardiac rehabilitation (CR), in patients with stable ischemic heart disease (SIHD). However, the efficacy and safety of CR in patients with SIHD without revascularization remain unclear.Methods and Results: The Prospective Registry of STable Angina RehabiliTation (Pre-START) study is a multicenter, prospective, single-arm, open-label pilot study to evaluate the efficacy and safety of CR on health-related quality of life (HRQL), exercise capacity, and clinical outcomes in Japanese patients with SIHD without revascularization. In this study, all patients will undergo guideline-based OMT and are encouraged to have 36 outpatient CR sessions within 5 months after enrollment. The primary endpoint is the change in the Seattle Angina Questionnaire-7 summary score between baseline and the 6-month visit; an improvement of ≥5 points will be defined as a clinically important change. Secondary endpoints include changes in other HRQL scores and exercise capacity between baseline and the 6-month visit, as well as clinical outcomes between enrollment and the 6-month visit.Conclusions: The Pre-START study will provide valuable evidence to elucidate the efficacy and safety of CR in patients with SIHD and indispensable information for a subsequent randomized controlled trial. The study was registered with the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (ID: UMIN000045415) on April 1, 2022.
- 著者
- Michiyo Yamano Tetsuhiro Yamano Takeshi Nakamura Kan Zen Hirokazu Shiraishi Takeshi Shirayama Satoaki Matoba
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Reports (ISSN:24340790)
- 巻号頁・発行日
- vol.2, no.2, pp.113-120, 2020-02-10 (Released:2020-02-10)
- 参考文献数
- 23
- 被引用文献数
- 2
Background:The aim of this study was to identify factors of left ventricular filling pressure (LVFP) elevation following transcatheter atrial septal defect (ASD) closure.Methods and Results:The study involved 97 adult patients with sinus rhythm who underwent both transcatheter ASD closure and transthoracic echocardiography. Elevated LVFP was diagnosed during the first month of follow-up according to the American Society of Echocardiography guidelines: that is, ratio of transmitral early filling to the lateral annular diastolic velocity (lateral E/e’) >13 was used to exclude the effect of the device on the atrial septum. Fifteen patients (15.5%) were diagnosed with increased LVFP during the 1-month follow-up period (median lateral E/e’: from 9.2, IQR, 6.6–10.8; to 15.5, IQR, 13.8–17.8; P<0.001). Independent predictors of LVFP elevation were left ventricular (LV) relative wall thickness, lateral E/e›, and peak tricuspid regurgitation pressure gradient (TRPG) at baseline (OR, 1.67; 95% CI: 1.04–2.69; OR, 1.52; 95% CI: 1.07–2.15; and OR, 1.14; 95% CI: 1.04–1.25; cut-offs: 0.42, 7.5, and 27.0 mmHg, respectively). Median lateral E/e› returned to baseline in most patients with LVFP elevation during 6 months of subsequent follow-up (1-month–6-month follow-up: 15.5, IQR, 13.8–17.8; 11.1, IQR, 8.8–14.8, respectively; P=0.001).Conclusions:The increase in Doppler-estimated LVFP following transcatheter ASD closure may be related to LV hypertrophy, diastolic dysfunction, and peak TRPG in elderly patients.
- 著者
- Tomotsugu Seki Makoto Murata Kensuke Takabayashi Takashi Yanagisawa Masayuki Ogihara Ritsuko Kurimoto Keisuke Kida Koichi Tamita Xiaoyang Song Neiko Ozasa Ryoji Taniguchi Miho Nishitani-Yokoyama Shinji Koba Ryosuke Murai Yutaka Furukawa Maki Hamasaki Hirokazu Kondo Hironori Hayashi Asako Ootakara-Katsume Kento Tateishi Satoaki Matoba Hitoshi Adachi Hirokazu Shiraishi for the START Investigators
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Reports (ISSN:24340790)
- 巻号頁・発行日
- pp.CR-22-0131, (Released:2023-02-25)
- 参考文献数
- 18
Background: Clinical practice guidelines strongly recommend optimal medical therapy (OMT), including lifestyle modification, pharmacotherapy, and exercise-based cardiac rehabilitation (CR), in patients with stable ischemic heart disease (SIHD). However, the efficacy and safety of CR in patients with SIHD without revascularization remain unclear.Methods and Results: The Prospective Registry of STable Angina RehabiliTation (Pre-START) study is a multicenter, prospective, single-arm, open-label pilot study to evaluate the efficacy and safety of CR on health-related quality of life (HRQL), exercise capacity, and clinical outcomes in Japanese patients with SIHD without revascularization. In this study, all patients will undergo guideline-based OMT and are encouraged to have 36 outpatient CR sessions within 5 months after enrollment. The primary endpoint is the change in the Seattle Angina Questionnaire-7 summary score between baseline and the 6-month visit; an improvement of ≥5 points will be defined as a clinically important change. Secondary endpoints include changes in other HRQL scores and exercise capacity between baseline and the 6-month visit, as well as clinical outcomes between enrollment and the 6-month visit.Conclusions: The Pre-START study will provide valuable evidence to elucidate the efficacy and safety of CR in patients with SIHD and indispensable information for a subsequent randomized controlled trial. The study was registered with the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (ID: UMIN000045415) on April 1, 2022.
- 著者
- Tetsuhiro Yamano Keizo Furukawa Satoaki Matoba
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-16-0887, (Released:2016-09-09)
- 参考文献数
- 14
- 被引用文献数
- 5 7
- 著者
- Tetsuya Tatsumi Eishi Ashihara Toshihide Yasui Shinsaku Matsunaga Atsumichi Kido Yuji Sasada Satoshi Nishikawa Mitsuyoshi Hadase Masahiro Koide Reo Nakamura Hidekazu Irie Kazuki Ito Akihiro Matsui Hiroyuki Matsui Maki Katamura Shigehiro Kusuoka Satoaki Matoba Satoshi Okayama Manabu Horii Shiro Uemura Chihiro Shimazaki Hajime Tsuji Yoshihiko Saito Hiroaki Matsubara
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.71, no.8, pp.1199-1207, 2007 (Released:2007-07-25)
- 参考文献数
- 40
- 被引用文献数
- 59 73
Background Transplantation of non-expanded peripheral blood mononuclear cells (PBMNCs) enhances neovessel formation in ischemic myocardium and limbs by releasing angiogenic factors. This study was designed to examine whether intracoronary transplantation of PBMNCs improves cardiac function after acute myocardial infarction (AMI). Methods and Results After successful percutaneous coronary intervention (PCI) for a ST-elevation AMI with occlusion of proximal left anterior descending coronary artery within 24 h, patients were assigned to either a control group or the PBMNC group that received intracoronary infusion of PBMNCs within 5 days after PCI. PBMNCs were obtained from patients by COBE spectra-apheresis and concentrated to 10 ml, 3.3 ml of which was infused via over-the-wire catheter. The primary endpoint was the global left ventricular ejection fraction (LVEF) change from baseline to 6 months' follow-up. The data showed that the absolute increase in LVEF was 7.4% in the control group and 13.4% (p=0.037 vs control) in the PBMNC group. Cell therapy resulted in a greater tendency of ΔRegional ejection fraction (EF) or significant improvement in the wall motion score index and Tc-99m-tetrofosmin perfusion defect score associated with the infarct area, compared with controls. Moreover, intracoronary administration of PBMNCs did not exacerbate either left ventricular (LV) end-diastolic and end-systolic volume expansion or high-risk arrhythmia, without any adverse clinical events. Conclusion Intracoronary infusion of non-expanded PBMNCs promotes improvement of LV systolic function. This less invasive and more feasible approach to collecting endothelial progenitor cells may provide a novel therapeutic option for improving cardiac function after AMI. (Circ J 2007; 71: 1199 - 1207)
- 著者
- Jun Shiraishi Yoshio Kohno Takeshi Nakamura Takashi Yanagiuchi Sho Hashimoto Daisuke Ito Masayoshi Kimura Akihiro Matsui Hirokazu Yokoi Masayasu Arihara Masayuki Hyogo Takatomo Shima Takahisa Sawada Satoaki Matoba Hiroyuki Yamada Akiyoshi Matsumuro Takeshi Shirayama Makoto Kitamura Keizo Furukawa on Behalf of the AMI-Kyoto Multi-Center Risk Study Group
- 出版者
- 一般社団法人 日本内科学会
- 雑誌
- Internal Medicine (ISSN:09182918)
- 巻号頁・発行日
- vol.53, no.9, pp.933-939, 2014 (Released:2014-05-01)
- 参考文献数
- 27
- 被引用文献数
- 2 17
Objective The predictors of in-hospital outcomes after primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) complicated with heart failure or cardiogenic shock at presentation remain unclear. Methods Using the AMI-Kyoto Multi-Center Risk Study database, the clinical background characteristics, angiographic findings, primary PCI results, and in-hospital prognoses were retrospectively compared between primary PCI-treated AMI patients with a Killip class status of ≥2 (Killip 2-4 patients, n=390) and those with a Killip class 1 status (Killip 1 patients, n=1,057). Results The Killip 2-4 patients were more likely to have a higher age and proportion of women and exhibited a higher prevalence of previous myocardial infarction, diabetes mellitus and chronic kidney disease or anemia on admission, lower systolic blood pressure (SBP) values on admission, a higher rate of multivessels or left main trunk as the culprit artery, a larger number of diseased vessels, a lower Thrombolysis In Myocardial Infarction (TIMI) grade in the infarct-related artery (IRA) before/after primary PCI and a significantly higher in-hospital mortality rate than the Killip 1 patients. According to a multivariate analysis, age was found to be an independent positive predictor of in-hospital mortality, while admission SBP was an independent positive predictor of in-hospital survival in both groups. In contrast, anemia on admission was found to be an independent predictor of in-hospital death, while the TIMI 3 flow in the IRA after PCI was found to be an independent factor for survival in the Killip 2-4 patients, but not the Killip 1 patients. Conclusion Anemia on admission and the final TIMI 3 flow in the IRA are critical determinants of in-hospital death in AMI patients with a Killip class status of ≥2 undergoing primary PCI.