著者

Masato Nakamura Hitoshi Yaku Junya Ako Hirokuni Arai Tohru Asai Taishiro Chikamori Hiroyuki Daida Kiyoshi Doi Toshihiro Fukui Toshiaki Ito Kazushige Kadota Junjiro Kobayashi Tatsuhiko Komiya Ken Kozuma Yoshihisa Nakagawa Koichi Nakao Hiroshi Niinami Takayuki Ohno Yukio Ozaki Masataka Sata Shuichiro Takanashi Hirofumi Takemura Takafumi Ueno Satoshi Yasuda Hitoshi Yokoyama Tomoyuki Fujita Tokuo Kasai Shun Kohsaka Takashi Kubo Susumu Manabe Naoya Matsumoto Shigeru Miyagawa Tomohiro Mizuno Noboru Motomura Satoshi Numata Hiroyuki Nakajima Hirotaka Oda Hiromasa Otake Fumiyuki Otsuka Ken-ichiro Sasaki Kazunori Shimada Tomoki Shimokawa Toshiro Shinke Tomoaki Suzuki Masao Takahashi Nobuhiro Tanaka Hiroshi Tsuneyoshi Taiki Tojo Dai Une Satoru Wakasa Koji Yamaguchi Takashi Akasaka Atsushi Hirayama Kazuo Kimura Takeshi Kimura Yoshiro Matsui Shunichi Miyazaki Yoshitaka Okamura Minoru Ono Hiroki Shiomi Kazuo Tanemoto on behalf of the Japanese Circulation Society Joint Working Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-1282, (Released:2022-01-31)

参考文献数

1179

被引用文献数

38

著者

Shuji Moriyama Masahiko Hara Takafumi Hirota Kosuke Nakata Hideki Doi Toshiyuki Matsumura Yushi Araki Yukihiro Inomata Toshihiro Fukui

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0076, (Released:2023-09-07)

参考文献数

29

被引用文献数

1

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Background: Acute aortic dissection (AAD) has high morbidity and a high fatality rate for a cardiovascular disease. Recent studies suggested that the incidence of AAD is increasing. However, the actual incidence and mortality rates of AAD are not well known. This study investigated the current epidemiology of AAD within the Yatsushiro medical jurisdictional area.Methods and Results: A population-based review of patients with AAD was performed in a geographically well-defined area. Data were collected retrospectively from January 2011 to December 2020 for a total of 196 patients with AAD (Stanford Type A, n=126 [64.3%]; Stanford Type B, n=70 [35.7%]). The mean patient age was 74.3 years, and 55.6% (109/196) were women. The crude and age-standardized incidence rates of AAD in our medical jurisdictional area were 13.6 and 11.4 per 100,000 inhabitants per year, respectively. The crude and age-standardized 30-day mortality rates of AAD were 4.9 and 4.0 per 100,000 inhabitants per year, respectively. There were upward tendencies for both the incidence and 30-day mortality rate of AAD with age, with both being significantly higher in patients aged ≥85 years (P<0.001).Conclusions: This population-based study detected a higher incidence of AAD than previous studies, but reported a lower incidence of AAD in men than in women. Increasing age was associated with an increased incidence and mortality rate of AAD.

著者

Naoya Araki Takafumi Hirota Hideaki Hidaka Tatsuya Horibe Ryosuke Numaguchi Jun Takaki Kosaku Nishigawa Takashi Yoshinaga Toshihiro Fukui

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

pp.CR-23-0060, (Released:2023-07-11)

参考文献数

23

被引用文献数

1

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Background: This single-center retrospective analysis investigated the number of days required for postoperative 6-minute walk distance (6MWD) to recover to preoperative values after coronary artery bypass grafting (CABG) and the factors influencing this recovery.Methods and Results: The 6MWD was measured in 101 patients (median age 69 years; 18 women) before and every day after CABG. Univariate and multivariate analyses were performed to identify factors affecting 6MWD recovery to preoperative values after CABG. The median number of days required for recovery of 6MWD after CABG was 9 (interquartile range 7–11 days). Patients were divided into 2 groups based on the median number of days required for recovery of 6MWD; there were 60 patients in the early recovery group (<9 days) and 41 in the “non-early” recovery group (38 who recovered after the median 9 days, and 3 who did not recover during hospitalization). Using univariate logistic regression analysis, diabetes (P=0.01), stroke (P=0.26), left ventricular ejection fraction (P=0.27), and grip strength (P=0.13) were selected for multivariate analysis. Multivariate logistic regression analysis revealed that diabetes (odds ratio 2.955; 95% confidence interval 1.208–7.229; P=0.02) was the only independent predictor of 6MWD recovery.Conclusions: Diabetes was the single factor influencing the recovery of postoperative 6MWD in patients undergoing CABG.

著者

Jun Takaki Jun Morinaga Tatsuaki Sadanaga Takahumi Hirota Hideaki Hidaka Tatsuya Horibe Kosaku Nishigawa Takashi Yoshinaga Toshihiro Fukui

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0570, (Released:2023-11-25)

参考文献数

17

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Background: Cardiac surgery-associated (CSA) acute kidney injury (AKI) is a severe postoperative complication in patients undergoing off-pump coronary artery bypass grafting (OPCAB). Early detection of postoperative CSA-AKI may be key to improving patient outcomes. This study explored the use of renal biomarkers measured immediately after surgery for the early detection of CSA-AKI in patients undergoing OPCAB.Methods and Results: In all, 111 patients who underwent OPCAB at Kumamoto University Hospital between June 2020 and October 2022 were included in this study. Urinary neutrophil gelatinase-associated lipocalin, liver-type fatty acid-binding protein, and N-acetyl-β-D-glucosaminidase (NAG) were measured upon arrival in the intensive care unit (ICU) after surgery. AKI was diagnosed using KDIGO criteria. Of the 111 patients, 32 (28.8%) developed postoperative AKI. Regarding AKI staging, 19 (59.4%), 11 (34.4%), and 2 (6.3%) patients had Stage 1, 2, and 3 AKI, respectively. There were significant differences in chronic kidney disease, preoperative estimated glomerular filtration rate (eGFR), and NAG between the AKI and non-AKI groups. Multivariate analysis showed that preoperative eGFR (odds ratio [OR] for 5-mL/min/1.73 m2increase in eGFR 0.75; 95% confidence interval [CI] 0.63–0.89) and increasing urinary NAG concentrations at ICU admission (OR 2.44; 95% CI 1.30–4.60) were significant risk factors for CSA-AKI in OPCAB patients.Conclusions: NAG and eGFR may be valuable biomarkers for the early detection of CSA-AKI in patients undergoing OPCAB.

著者

Atsushi Nakahira Yasuyuki Sasaki Hidekazu Hirai Toshihiro Fukui Manabu Motoki Yosuke Takahashi Hiroki Oe Toru Kataoka Shigefumi Suehiro

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.71, no.12, pp.1996-1998, 2007 (Released:2007-11-25)

参考文献数

7

被引用文献数

18 22

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Aneurysmal circumflex coronary artery (Cx) with fistulous connection to the coronary sinus is a rare clinical entity that usually remains asymptomatic until later in life, so the ideal therapeutic strategy is poorly defined. The timing of surgical treatment for asymptomatic patients is a big issue, and whether to leave or exclude the diffuse aneurysm in addition to ligation of the fistula is controversial, considering the native myocardial circulation. Complete surgical repair, including exclusion of a diffusely aneurysmal Cx and coronary revascularization to a graftable branch in the circumflex area combined with ligation of its fistula, is quite challenging and sometimes fatal because of a broad posterolateral myocardial infarction without revascularization caused by a lack of graftable branches. A case of diffuse aneurysmal Cx, which ruptured into the left atrium after surgical ligation of its fistulous connection to the coronary sinus, is presented. Simple ligation of the fistula, leaving a gigantic aneurysmal circumflex artery, is hazardous for later rupture and should be avoided. Therapeutic strategies for this complex disorder are discussed, including the optimal timing of surgical treatment. (Circ J 2007; 71: 1996 - 1998)

著者

Makoto Miyake Misa Takegami Yuki Obayashi Masashi Amano Takeshi Kitai Tomoyuki Fujita Tadaaki Koyama Hidekazu Tanaka Kenji Ando Tatsuhiko Komiya Masaki Izumo Hiroya Kawai Kiyoyuki Eishi Kiyoshi Yoshida Takeshi Kimura Ryuzo Nawada Tomohiro Sakamoto Yoshisato Shibata Toshihiro Fukui Kenji Minatoya Kenichi Tsujita Yasushi Sakata Tetsuya Kimura Kumiko Sugio Atsushi Takita Atsushi Iwakura Toshihiro Tamura Kunihiro Nishimura Yutaka Furukawa Chisato Izumi for the BPV-AF Registry Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0226, (Released:2022-07-08)

参考文献数

28

被引用文献数

2

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Background: Current guidelines equally recommend direct oral anticoagulants (DOACs) and warfarin for atrial fibrillation (AF) patients with a bioprosthetic valve (BPV); however, there are limited data comparing DOACs and warfarin in AF patients with an aortic BPV.Methods and Results: This post-hoc subgroup analysis of a multicenter, prospective, observational registry (BPV-AF Registry) aimed to compare DOACs and warfarin in AF patients with an aortic BPV. The primary outcome was a composite of stroke, systemic embolism, major bleeding, heart failure requiring hospitalization, all-cause death, or BPV reoperation. The analysis included 479 patients (warfarin group, n=258; DOAC group, n=221). Surgical aortic valve replacement was performed in 74.4% and 36.7% of patients in the warfarin and DOAC groups, respectively. During a mean follow up of 15.5 months, the primary outcome occurred in 45 (17.4%) and 32 (14.5%) patients in the warfarin and DOAC groups, respectively. No significant difference was found in the primary outcome between the 2 groups (adjusted hazard ratio: 0.88, 95% confidence interval: 0.51–1.50). No significant multiplicative interaction was observed between the anticoagulant effects and type of aortic valve procedure (P=0.577).Conclusions: Among AF patients with an aortic BPV, no significant difference was observed in the composite outcome of adverse clinical events between patients treated with warfarin and those treated with DOACs, suggesting that DOACs can be used as alternatives to warfarin in these patients.