著者
Hiroki Kitakata Yoshinori Katsumata Shun Kohsaka Otoya Sekine Takashi Kohno Motoaki Sano Keiichi Fukuda
出版者
The Japanese Circulation Society
雑誌
Circulation Reports (ISSN:24340790)
巻号頁・発行日
vol.3, no.5, pp.300-303, 2021-05-10 (Released:2021-05-10)
参考文献数
14
被引用文献数
2

Background:Patient perspectives in cardiovascular diseases (CVD) are significantly associated with clinical outcomes.Methods and Results:Among 100 patients who responded to a telephone survey in a university hospital setting in Tokyo during the coronavirus disease (COVID-19) pandemic, 20% reported depressive symptoms and 33% were hesitant to contact medical staff in the event of CVD exacerbation. Interestingly, the frequency of depressive symptoms was maintained even after a decline in the number of newly COVID-19-infected patients.Conclusions:Our telemedicine practices revealed the magnitude of our patients’ mental health conditions and their hesitation to contact medical facilities in the event of CVD exacerbation.
著者
Jin Komuro Yuji Nagatomo Keitaro Mahara Mitsuaki Isobe Ayumi Goda Yasumori Sujino Atsushi Mizuno Yasuyuki Shiraishi Takashi Kohno Shun Kohsaka Tsutomu Yoshikawa West Tokyo Heart Failure (WET-HF) Registry Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Reports (ISSN:24340790)
巻号頁・発行日
vol.1, no.4, pp.162-170, 2019-04-10 (Released:2019-04-10)
参考文献数
31
被引用文献数
8

Background: The concept of Clinical Scenario (CS) classification has been widely utilized to aid in choosing appropriate management strategies for acute decompensated heart failure (ADHF). Methods and Results: The West Tokyo-Heart Failure (WET-HF) Registry is a multicenter, prospective cohort registry enrolling consecutive hospitalized ADHF patients. Based on systolic blood pressure (SBP) at admission, 4,000 patients enrolled between 2006 and 2017 were classified into 3 groups: CS1, SBP ≥140 mmHg; CS2, 100≤SBP<140 mmHg; and CS3, SBP <100 mmHg. The CS1 group had a high rate of fluid retention such as leg edema, and the largest reduction in body weight at discharge. In-hospital diuretics use was the most frequent in CS1. Although the primary endpoint of long-term all-cause death and/or ADHF re-hospitalization was more common in more advanced CS, there was no significant difference between the 3 CS groups in patients with HF with preserved ejection fraction (HFpEF; P=0.10). Although more advanced CS was associated with larger left ventricular (LV) chamber size in HF with reduced EF (HFrEF), it was associated with smaller LV size in HFpEF. Conclusions: The long-term prognostic value of CS classification was limited in HFpEF. Whereas CS was closely associated with degree of LV remodeling in HFrEF, a smaller LV chamber might be associated with a lower cardiovascular functional reserve in HFpEF.
著者
Keitaro Shinada Takashi Kohno Keiichi Fukuda Michiaki Higashitani Naoto Kawamatsu Takeshi Kitai Tatsuhiro Shibata Makoto Takei Kotaro Nochioka Gaku Nakazawa Hiroki Shiomi Mitsunori Miyashita Atsushi Mizuno
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-23-0507, (Released:2023-11-22)
参考文献数
29
被引用文献数
1

Background: Enhanced discussions regarding end-of-life (EOL) are crucial to provide appropriate care for seriously ill patients. However, the current status of EOL discussions, especially their timing and influencing factors, among patients with cardiovascular diseases (CVD) remains unknown.Methods and Results: We conducted a cross-sectional questionnaire survey of bereaved family members of CVD patients who died at 10 tertiary care institutes in Japan. In all, 286 bereaved family members (38.2% male; median age 66.0 [interquartile range 58.0–73.0] years) of CVD patients were enrolled; of these, 200 (69.9%) reported that their families had had EOL discussions with physicians. The major topic discussed was resuscitation (79.0%), and 21.5% discussed the place of EOL care. Most discussions were held during hospitalization of the patient (88.2%). More than half (57.1%) the discussions were initiated less than 1 month before the patient died, and 22.6% of family members felt that this timing of EOL discussions was late. Bereaved family members’ perception of late EOL discussions was associated with the family members aggressive attitude towards life-prolonging treatment, less preparedness for bereavement, and less satisfaction with EOL care.Conclusions: Approximately 70% of bereaved family members of CVD patients had EOL discussions, which were often held shortly before the patient died. Further research is required to establish an ideal approach to EOL discussions at an appropriate time, which may improve the quality of EOL care.
著者
Takanori Ohata Nozomi Niimi Yasuyuki Shiraishi Fumiko Nakatsu Ichiro Umemura Takashi Kohno Yuji Nagatomo Makoto Takei Tomohiko Ono Munehisa Sakamoto Shintaro Nakano Keiichi Fukuda Shun Kohsaka Tsutomu Yoshikawa
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-23-0356, (Released:2023-10-31)
参考文献数
43
被引用文献数
1

Background: Despite recommendations from clinical practice guidelines to initiate and titrate guideline-directed medical therapy (GDMT) during their hospitalization, patients with acute heart failure (AHF) are frequently undertreated. In this study we aimed to clarify GDMT implementation and titration rates, as well as the long-term outcomes, in hospitalized AHF patients.Methods and Results: Among 3,164 consecutive hospitalized AHF patients included in a Japanese multicenter registry, 1,400 (44.2%) with ejection fraction ≤40% were analyzed. We assessed GDMT dosage (β-blockers, renin-angiotensin inhibitors, and mineralocorticoid-receptor antagonists) at admission and discharge, examined the contributing factors for up-titration, and evaluated associations between drug initiation/up-titration and 1-year post-discharge all-cause death and rehospitalization for HF via propensity score matching. The mean age of the patients was 71.5 years and 30.7% were female. Overall, 1,051 patients (75.0%) were deemed eligible for GDMT, based on their baseline vital signs, renal function, and electrolyte values. At discharge, only 180 patients (17.1%) received GDMT agents up-titrated to >50% of the maximum titrated dose. Up-titration was associated with a lower risk of 1-year clinical outcomes (adjusted hazard ratio: 0.58, 95% confidence interval: 0.35–0.96). Younger age and higher body mass index were significant predictors of drug up-titration.Conclusions: Significant evidence-practice gaps in the use and dose of GDMT remain. Considering the associated favorable outcomes, further efforts to improve its implementation seem crucial.
著者
Takashi Kohno Jing Li Kazuyuki Aihara
出版者
一般社団法人 電子情報通信学会
雑誌
Nonlinear Theory and Its Applications, IEICE (ISSN:21854106)
巻号頁・発行日
vol.5, no.3, pp.379-390, 2014 (Released:2014-07-01)
参考文献数
39
被引用文献数
2 8

Neuromorphic systems are designed by mimicking or being inspired by the nervous system, which realizes robust, autonomous, and power-efficient information processing by highly parallel architecture. It is a candidate of the next-generation computing system that is expected to have advanced information processing ability by power-efficient and parallel architecture. A silicon neuronal network is a neuromorphic system with a most detailed level of analogy to the nervous system. It is a network of silicon neurons connected via silicon synapses;they are electronic circuits to reproduce the electrophysiological activity of neuronal cells and synapses, respectively. There is a trade-off between the proximity to the neuronal and synaptic activities and simplicity and power-consumption of the circuit. Power-efficient and simple silicon neurons assume uniform spikes, but biophysical experimental data suggest the possibility that variety of spikes given to a synapse is playing a certain role in the information processing in the brain. In this article, we review our design approach of silicon neuronal networks where uniform spikes are not assumed. Simplicity of the circuits is brought by mathematical techniques of qualitative neuronal modeling. Though it is neither simpler nor low-power consuming than above silicon neurons, it is expected to be more appropriate for silicon neuronal networks applied to brain-morphic computing.
著者
Tsuyoshi Shiga Tsuyoshi Suzuki Keisuke Kida Atsushi Suzuki Takashi Kohno Akiko Ushijima Shunsuke Kiuchi Shunsuke Ishii Makoto Murata Takeshi Ijichi Makoto Suzuki Masako Nishikawa on behalf of the EXCILE-HF Trial Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Reports (ISSN:24340790)
巻号頁・発行日
pp.CR-22-0134, (Released:2023-03-24)
参考文献数
15

Background: A high resting heart rate is an independent risk factor for mortality and morbidity in patients with cardiovascular diseases. Ivabradine selectively inhibits the funny current (If) and decreases heart rate without affecting cardiac conduction, contractility, or blood pressure. The effect of ivabradine on exercise tolerance in patients with heart failure with reduced ejection fraction (HFrEF) on standard drug therapies remains unclear.Methods and Results: This multicenter interventional trial of patients with HFrEF and a resting heart rate ≥75 beats/min in sinus rhythm treated with standard drug therapies will consist of 2 periods: a 12-week open-label, randomized, parallel-group intervention period (standard drug treatment+ivabradine group and standard drug treatment group) to compare changes in exercise tolerance between the 2 groups; and a 12-week open-label ivabradine treatment period for all patients to evaluate the effect of adding ivabradine on exercise tolerance. The primary endpoint will be the change in peak oxygen uptake (V̇O2) during the cardiopulmonary exercise test from Week 0 (baseline) to Week 12. Secondary endpoints will be time-dependent changes in peak V̇O2from Week 0 to Weeks 12 and 24. Adverse events will also be evaluated.Conclusions: The EXCILE-HF trial will provide meaningful information regarding the effects of ivabradine on exercise tolerance in patients with HFrEF receiving standard drug therapies and suggestions for the initiation of ivabradine treatment.
著者
Timothée Leleu Timothée Levi Takashi Kohno Kazuyuki Aihara
出版者
The Institute of Electronics, Information and Communication Engineers
雑誌
Nonlinear Theory and Its Applications, IEICE (ISSN:21854106)
巻号頁・発行日
vol.9, no.2, pp.281-294, 2018 (Released:2018-04-01)
参考文献数
26

Reconstructing accurately the structure of neural networks from biological data is essential for the analysis of simultaneous recordings from many neurons, and, in turn, for the understanding of neural codes and the design of neural prostheses. Classical techniques are generally based on cross-correlations and cannot reconstruct unambiguously the network structure. Recently, we have proposed a method for which there is one-to-one correspondence between statistical properties of packets of spikes (or avalanches) and the network structure, but this mapping was only proven for simpler neuronal model. In the following, we show using numerical simulation of the Izhikevich model that the proposed method is general, and is particularly well-fitted for the analysis of neural activity recorded from cultured neuronal networks coupled to microelectrode arrays.
著者
Yoshiyasu Aizawa Mai Kimura Takashi Kohno Jun Fujita Keiichi Fukuda
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-15-1272, (Released:2015-12-11)
参考文献数
14
被引用文献数
1 2

The American Heart Association Scientific Sessions were held in Orlando on November 7–15, 2015. The meeting attracted more than 18,000 participants, including physicians, research scientists, students, and paramedical personnel, from more than 100 countries. Sessions over the 5 days included a comprehensive and unparalleled education delivered via more than 5,000 presentations, with 1,000 invited faculty members and 4,000 abstract presentations from the world leaders in cardiovascular disease. It also displayed the newest cardiovascular technology and resources by more than 200 exhibitors. There were 19 trials scheduled in 6 late-breaking clinical trial sessions. The Systolic Blood Pressure Intervention Trial (SPRINT) aimed to determine the most appropriate targets for the systolic blood pressure among persons without diabetes. A total of 9,361 persons with systolic blood pressure of ≥130 mmHg and an increased cardiovascular risk, but without diabetes, were randomly assigned to a target systolic blood pressure of <120 mmHg (intensive treatment) or a target of <140 mmHg (standard treatment). A significantly lower rate of the primary composite outcome and all-cause mortality in the intensive-treatment group than in the standard-treatment group was observed. Summaries and overviews of the late-breaking trials, clinical science special report sessions, and sessions to which members of the Japanese Circulation Society contributed are presented.
著者
Takashi Kohno
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-14-1329, (Released:2014-12-15)
参考文献数
17
被引用文献数
12 16

The American Heart Association (AHA) Scientific Sessions were held in Chicago on November 15–19, 2014. The meeting attracted more than 17,000 participants, including physicians, research scientists, students, and paramedical personnel, from more than 100 countries. Sessions over the 5 days included comprehensive and unparalleled education delivered via more than 5,000 presentations, with 1,000 invited faculty members and 4,000 abstract presentations from world leaders in cardiovascular (CV) disease. There were 16 trials scheduled in 4 late-breaking clinical trial sessions. The Dual Antiplatelet Therapy study revealed that aspirin plus a thienopyridine beyond 1 year subsequent to placement of a drug-eluting stent, as compared with aspirin therapy alone, significantly reduced stent thrombosis and major CV and cerebrovascular events but was associated with increased risk of bleeding. The IMPROVE-IT research showed that, relative to simvastatin with placebo, simvastatin with 10 mg of ezetimibe daily led to a significantly lower primary combined endpoint in moderate- to high-risk patients, who stabilized following acute coronary syndrome. This was the first trial to demonstrate incremental clinical benefit by adding a nonstatin agent to statin therapy and reaffirmed the low-density lipoprotein (LDL) hypothesis stating that reducing LDL-cholesterol prevents CV events. Summaries and overviews of both the late-breaking trials and the sessions to which members of the Japanese Circulation Society contributed are presented.