著者

Kenji Hanada Takahiko Kinjo Hiroaki Yokoyama Michiko Tsushima Maiko Senoo Hiroaki Ichikawa Fumie Nishizaki Shuji Shibutani Takashi Yokota Ken Okumura Hirofumi Tomita

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0023, (Released:2023-09-28)

参考文献数

38

被引用文献数

2

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Background: The characteristics and clinical outcomes associated with sustained ventricular tachycardia and fibrillation (VT/VF) in Japanese acute myocardial infarction (AMI) patients remain unknown.Methods and Results: Consecutive AMI patients (n=1,941) transferred to the Hirosaki University Hospital and treated with primary percutaneous coronary intervention (PCI) within 12 h of onset were retrospectively studied. The incidence of VT/VF during hospitalization was 8.3%, and 75% of cases occurred by the end of PCI. Independent predictors associated with VT/VF occurrence by the end of PCI and after PCI, respectively, were identified. Additionally, the differences between patients with VT and VF were examined, which revealed that the characteristics of patients and predictors for VT and VF were clearly different. Additionally, the QRS duration during VT was measured, which demonstrated the possible involvement of Purkinje fibers for VT in the acute phase of AMI. Of the patients with VT/VF, 12% required ECMO support due to refractory VT/VF despite intravenous antiarrhythmic agents such as β-blockers, amiodarone, and nifekalant. Among the patients discharged alive, 1,690 were followed up for a mean of 3.7 years. VT/VF occurrence during hospitalization did not affect the mid-term clinical outcomes even in patients with VT.Conclusions: The results clearly indicated that VT/VF is still a serious complications of AMI. We need to identify patients at high risk of developing VT/VF for careful observation and appropriate intervention.

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

Sanae Hamaguchi Shintaro Kinugawa Daisuke Goto Miyuki Tsuchihashi-Makaya Takashi Yokota Satoshi Yamada Hisashi Yokoshiki Akira Takeshita Hiroyuki Tsutsui JCARE-CARD Investigators

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.75, no.10, pp.2403-2410, 2011 (Released:2011-09-22)

参考文献数

26

被引用文献数

30 69

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Background: Aging is associated with adverse outcomes in patients with cardiac diseases. Whether elderly patients hospitalized with heart failure (HF) had increased risks for mortality and rehospitalization compared with younger patients during the long-term follow-up was examined. The predictors of these adverse outcomes were also identified. Methods and Results: The Japanese Cardiac Registry of Heart Failure in Cardiology (JCARE-CARD) studied prospectively the characteristics and treatments in a broad sample of 2,675 patients hospitalized with worsening HF and the outcomes were followed up. The majority of elderly patients were female, had lower body mass index (BMI), a higher rate of ischemic, valvular, and hypertensive heart disease as etiologies of HF, a lower estimated glomerular filtration rate (eGFR), lower hemoglobin, and higher left ventricular ejection fraction values. Even after adjustment for covariates, the elderly patients were associated with higher risks of adverse outcomes. The predictors for all-cause death were: lower eGFR, lower BMI, male sex, sustained ventricular tachycardia or fibrillation (VT/VF), and the use of diuretics at discharge. Conclusions: Among patients hospitalized with HF, elderly patients had a worse prognosis than younger patients. Lower eGFR, lower BMI, male sex, sustained VT/VF, and diuretic use were independent predictors for all-cause death in these patients with higher risk. (Circ J 2011; 75: 2403-2410)

著者

Liselotte B. CHRISTIANSEN Flemming DELA Jørgen KOCH Takashi YOKOTA

出版者

公益社団法人 日本獣医学会

雑誌

Journal of Veterinary Medical Science (ISSN:09167250)

巻号頁・発行日

pp.14-0573, (Released:2015-02-11)

被引用文献数

1 3

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No studies have investigated the mitochondrial function in permeabilized muscle fiber from cats. The aim of this study was to investigate tissue-specific and substrate-specific characteristics of mitochondrial oxidative phosphorylation (OXPHOS) capacity in feline permeabilized oxidative muscle fibers. Biopsies of left ventricular cardiac muscle and soleus muscle, a type I-rich oxidative skeletal muscle, were obtained from 15 healthy domestic cats. Enzymatic activity of citrate synthase (CS), a biomarker of mitochondrial content, was measured. Mitochondrial OXPHOS capacity with various kinds of non-fatty-acid substrates and fatty-acid substrate in permeabilized muscle fiber was measured by using high-resolution respirometry. CS activity in the heart was 3 times higher than in the soleus muscle. Mitochondrial state 3 respiration, ADP-stimulated respiration, with complex I-linked and complex I+II-linked substrates, respectively, was significantly higher in the heart than in the soleus muscle when normalized for muscle mass, but not for CS activity, indicating that greater capacity for mitochondrial OXPHOS with these non-fatty-acid substrates in the heart may depend on higher mitochondrial content. In contrast, the soleus muscle had higher mitochondrial state 3 respiration with fatty acids than the heart when normalized for CS activity, indicating greater capacity for fatty-acid oxidation per mitochondrion in the soleus. Our findings suggest that there are tissue- specific and substrate-specific quantitative and qualitative differences in mitochondrial OXPHOS capacity between the different types of oxidative muscles from cats.

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.

著者

Takashi Yokota Yasuo Kunii Shin Teshima Yasuo Yamada Toshihiro Saito Shu Kikuchi Hidemi Yamauchi

出版者

東北ジャーナル刊行会

雑誌

The Tohoku Journal of Experimental Medicine (ISSN:00408727)

巻号頁・発行日

vol.186, no.2, pp.121-130, 1998 (Released:2005-10-14)

参考文献数

16

被引用文献数

30 62

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A retrospective analysis was carried out on 93 patients with signet ring cell carcinoma of the stomach operated on between 1985 and 1995, to review the clinicopathologic characteristics from the database of gastric cancer at Sendai National Hospital. The results were compared with those for 590 patients with other types of gastric carcinoma. Women were afflicted as commonly as men in the signet ring cell carcinoma group. These patients tended to be younger and to have larger tumors. The histological type was commonly scirrhous and infiltrative. The survival of patients with signet ring cell carcinoma was worse than that of patients with other types of gastric cancer but the difference was not statistically significant. Patients with early signet ring cell carcinoma had a good prognosis, similar to that of the other groups. However, prognosis of patients with advanced signet ring cell carcinoma was poor compared with patients with other types of this disease. In multivariate analysis, the statistical significant prognostic factors were vascular microinvasion and tumor location. These findings suggest that signet ring cell carcinoma of the stomach should be regarded as a distinct type of gastric cancer.