著者
Takahisa Kondo Shigeki Osugi Keiko Shimokata Haruo Honjo Yasuhiro Morita Kengo Maeda Kentaro Yamashita Takashi Muramatsu Satoshi Shintani Kunihiro Matsushita Toyoaki Murohara
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.75, no.12, pp.2885-2892, 2011 (Released:2011-11-25)
参考文献数
35
被引用文献数
48 51

Background: Smoking is still a major health problem among males in Japan. The effects of smoking and quitting on mortality and cardiovascular disease (CVD) need updating. Methods and Results: This was a prospective cohort study with a median follow-up of 7.5 years of a total of 25,464 healthy male Japanese workers aged 20-61 years who were not on any medication. The adjusted hazard ratios (HR; 95% confidence interval) for all-cause death were 1.51 (0.73, 2.94), 1.68 (1.07, 2.70), 1.30 (0.70, 2.34), and those for total CVD events 1.91 (0.72, 4.67), 2.94 (1.65, 5.63), and 3.25 (1.69, 6.54) for light smokers (1-10cigarettes/day), moderate smokers (11-20/day), and heavy smokers (≥21/day) compared to never-smokers, respectively. Total CVD events increased dose-dependently as the number of cigarettes/day increased. Acute myocardial infarction was increased at any level of smoking. Stroke was increased at a moderate level of smoking. Quitting for ≥4 years, compared with continuing smokers, reduced the HR for all-cause death to 0.64 (0.38, 1.01), and total CVD events to 0.34 (0.17, 0.62). Conclusions: In healthy young- and middle-aged Japanese males, a significant increase in HR for total CVD events was confirmed for a smoking level of 11-20 cigarettes/day. Quitting reduced the HR for total CVD events, with quitting for ≥4 years being statistically significant. A similar trend was observed for all-cause mortality. (Circ J 2011; 75: 2885-2892)
著者
Yusuke Uemura Rei Shibata Kenji Takemoto Masayoshi Koyasu Shinji Ishikawa Toyoaki Murohara Masato Watarai
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.82, no.11, pp.2793-2799, 2018-10-25 (Released:2018-10-25)
参考文献数
36
被引用文献数
19 35

Background: Hospitalization for heart failure (HF) carries a risk of impairment in physical activity. We assessed the association between changes in Barthel index (BI) during hospitalization and prognosis in patients with acute HF. Methods and Results: We evaluated the BI in 256 patients with acute HF at the time of hospital admission (pre-BI) and at discharge (post-BI). All patients were followed for 1 year after discharge. BI significantly decreased during hospitalization in enrolled patients. Patients with a post-BI <60 had longer hospital stays and higher rates of non-home discharge, and had a lower 1-year survival rate than those with a post-BI ≥60. Multivariate Cox regression analysis revealed that post-BI, not pre-BI or changes in BI, significantly correlated with all-cause death and the composite of all-cause death or rehospitalization for HF for 1 year after discharge. Patients with decreasing BI during hospitalization had significantly lower all-cause death- or HF readmission-free survival following acute HF than those having a pre-BI ≥60 and changes in BI ≥0. Conclusions: Results demonstrate that low BI at discharge and decreased BI during hospitalization predicted poor outcomes in Japanese patients with acute HF. A comprehensive approach, beginning in the acute phase, aiming to maintain patients’ ability to perform activities of daily living could provide better management of HF.
著者
Akihiro Hirashiki Atsuya Shimizu Noriyuki Suzuki Kenichiro Nomoto Manabu Kokubo Kakeru Hashimoto Kenji Sato Izumi Kondo Toyoaki Murohara Hidenori Arai
出版者
The Japanese Circulation Society
雑誌
Circulation Reports (ISSN:24340790)
巻号頁・発行日
pp.CR-21-0143, (Released:2022-02-05)
参考文献数
38

Background:The relationship between frailty status and laboratory measurements in cardiovascular disease (CVD) remains unclear. We investigated which laboratory measurements indicated frailty in stable older CVD patients.Methods and Results:One-hundred thirty-eight stable older CVD patients were evaluated by laboratory measurements, with frailty assessed using the Kihon Checklist (KCL). Laboratory measurements were compared between frail and non-frail groups. Across the entire cohort, mean age was 81.7 years, mean left ventricular ejection fraction was 57.8%, and mean plasma B-type natriuretic peptide was 182 pg/mL. KCL scores were used to divide patients into non-frail (n=43; KCL <8) and frail (n=95; KCL ≥8) groups. Serum iron was significantly lower in the frail than non-frail group (mean [±SD] 61.2±30.3 vs. 89.5±26.1 μg/dL, respectively; P<0.001). Blood urea nitrogen (BUN; 27.3±16.5 vs. 19.7±8.2 mg/dL; P=0.013) and C-reactive protein (CRP; 1.05±1.99 vs. 0.15±0.21 mg/dL; P=0.004) were significantly higher in the frail than non-frail group. Multivariate analysis revealed that serum iron, CRP, and BUN were significant independent predictors of frailty (β=−0.069, 0.917, and 0.086, respectively).Conclusions:Frailty status was significantly associated with iron, CRP, and BUN in stable older CVD patients. Composite biomarkers (inflammation, iron deficiency, and renal perfusion) may be useful for assessing frailty in these patients.
著者
Naoki Shibata Norio Umemoto Akihito Tanaka Kensuke Takagi Makoto Iwama Yusuke Uemura Yosuke Inoue Yosuke Negishi Taiki Ohashi Miho Tanaka Ruka Yoshida Kiyokazu Shimizu Hiroshi Tashiro Naoki Yoshioka Itsuro Morishima Toshiyuki Noda Masato Watarai Hiroshi Asano Toshikazu Tanaka Yosuke Tatami Yasunobu Takada Hideki Ishii Toyoaki Murohara on behalf of N-Registry Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-20-0545, (Released:2021-03-20)
参考文献数
39
被引用文献数
3

Background:Data regarding the clinical features, outcomes and prognostic factors in patients presenting with acute total/subtotal occlusion of the unprotected left main coronary artery (LMCA) remain limited.Methods and Results:From a multi-center registry, 134 patients due to acute total/subtotal occlusion of the unprotected LMCA were reviewed. Emergency room (ER) status classification was defined according to the presence of cardiogenic shock and cardiopulmonary arrest (CPA) in the ER (class 1=no cardiogenic shock; class 2= cardiogenic shock but not CPA; and class 3=CPA). In-hospital mortality and cerebral performance category (CPC) as the endpoints were evaluated. One-half (67/134) of the enrolled patients presented with total occlusion of the unprotected LMCA. Regarding ER status classification, class 1, 2, and 3 were observed in 30.6%, 45.5%, and 23.9% of the patients, respectively. In-hospital mortality occurred in 73 (54.5%) patients; of the remaining patients, 52 (85.3%) could be discharged with a CPC 1 or 2. ER status classification (odds ratio 4.4 [95% confidence interval: 2.33–10.67]; P<0.001) and total occlusion of the unprotected LMCA (odds ratio 8.29 [95% confidence interval 2.93–23.46]; P<0.001) were strong predictors of in-hospital mortality.Conclusions:Acute total/subtotal occlusion involving the unprotected LMCA appeared to be associated with high in-hospital mortality. ER status classification and initial flow in the unprotected LMCA were significant predictive factors of in-hospital mortality.
著者
Mikito Takefuji Toyoaki Murohara
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.83, no.2, pp.261-266, 2019-01-25 (Released:2019-01-25)
参考文献数
76
被引用文献数
15

The identification of corticotropin-releasing hormone (CRH) has led to the discovery of a growing family of ligands and receptors. CRH receptor 1 (CRHR1) and CRHR2 are mammalian G-protein coupled receptors (GPCRs) with high affinity for CRH and the CRH family of peptides. CRHR1 is predominantly expressed in the brain and plays a vital role in the hypothalamic-pituitary-adrenal (HPA) axis stress responses by secreting adrenal corticotropic hormone (ACTH). CRHR2 is predominantly expressed in the heart, and a CRHR2-specific ligand, urocortin 2 (UCN2), shows positive cardiac chronotropic and inotropic effects through 3´,5´-cyclic adenosine monophosphate (cAMP) signaling in response to CRHR2-mediated Gαs activation in mice and humans. Central administration of the CRH family of peptides increases mean arterial pressure through CRHR1 activation, whereas peripheral administration of the peptides decreases mean arterial pressure through CRHR2 activation. These observations have led to further investigations of CRHR2 as an important and unique GPCR in the physiological and pathological functioning of the cardiovascular (CV) system. Moreover, recent clinical trials demonstrate CRHR2 as a potentially therapeutic target in the treatment of heart failure. We present recent reviews of the role of CRHRs in basic CV physiology and in the pathophysiology of CV diseases.
著者
Akinori Sawamura Takahiro Okumura Akihiro Hirakawa Masaaki Ito Yukio Ozaki Nobuyuki Ohte Tetsuya Amano Toyoaki Murohara on behalf of the CHANGE PUMP Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.82, no.3, pp.699-707, 2018-02-23 (Released:2018-02-23)
参考文献数
24
被引用文献数
2 22

Background:Cardiac recovery and prevention of end-organ damage are the cornerstones of establishing successful bridge to recovery (BTR) in patients with fulminant myocarditis (FM) supported with percutaneous venoarterial extracorporeal membrane oxygenation (VA-ECMO). However, the timing and method of successful BTR prediction still remain unclear. We aimed to develop a prediction model for successful BTR in patients with FM supported with percutaneous VA-ECMO.Methods and Results:This was a retrospective multicenter chart review enrolling 99 patients (52±16 years; female, 42%) with FM treated with percutaneous VA-ECMO. The S-group comprised patients who experienced percutaneous VA-ECMO decannulation and subsequent discharge (n=46), and the F-group comprised patients who either died in hospital or required conversion to other forms of mechanical circulatory support (n=53). At VA-ECMO initiation (0-h), the S-group had significantly higher left ventricular ejection fraction (LVEF) and lower aspartate aminotransferase (AST) concentration than the F-group. At 48 h, the LVEF, increase in the LVEF, and reduction of AST from 0-h were identified as independent predictors in the S-group. Finally, we developed an S-group prediction model comprising these 3 variables (area under the curve, 0.844; 95% confidence interval, 0.745–0.944).Conclusions:We developed a model for use 48 h after VA-ECMO initiation to predict successful BTR in patients with FM.
著者
Rei Shibata Noriyuki Ouchi Toyoaki Murohara
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.73, no.4, pp.608-614, 2009 (Released:2009-03-25)
参考文献数
97
被引用文献数
90 163

Obesity is strongly associated with metabolic and cardiovascular disorders. Adiponectin is an adipose-derived plasma protein that is downregulated in subjects with obesity-related disorders. Low levels of adiponectin are associated with the increased prevalence of obesity-linked cardiovascular diseases, including ischemic heart disease and peripheral artery disease. Experimental findings have shown that adiponectin has beneficial effects in the cardiovascular system by directly acting on the component cells of the heart and blood vessels. Adiponectin protects cardiovascular tissues under conditions of stress through a number of mechanisms: inhibition of pro-inflammatory and hypertrophic responses, and stimulation of endothelial cell responses. These effects of adiponectin are mainly attributed to the modulation of signaling molecules, including AMP-activated protein kinase. Thus, adiponectin could be a promising therapeutic target for cardiovascular diseases. (Circ J 2009; 73: 608 - 614)
著者
Kiyoshi Hibi Shinjo Sonoda Masanori Kawasaki Yutaka Otsuji Toyoaki Murohara Hideki Ishii Katsuhiko Sato Ryoji Koshida Yukio Ozaki Masataka Sata Yoshihiro Morino Tadashi Miyamoto Tetsuya Amano Satoshi Morita Ken Kozuma Kazuo Kimura Hisayoshi Fujiwara for the Ezetimibe-ACS Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-17-0598, (Released:2017-12-07)
参考文献数
34
被引用文献数
31

Background:The results of previous clinical trials on the effects of ezetimibe-statin combination therapy on atherosclerosis are inconsistent, and the anti-atherosclerotic effect of ezetimibe remains controversial.
著者
Toyoaki Murohara
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-15-0396, (Released:2015-05-11)
参考文献数
19
被引用文献数
3 4

The 64thAnnual Scientific Sessions and Exposition of the American College of Cardiology (ACC) were held at the San Diego Convention Center from March 14–16, 2015. The ACC Scientific Sessions are 1 of 2 major scientific cardiology meetings in the United States, with nearly 20,000 attendees, including 15,000 cardiovascular professionals. There were over 2,100 oral and poster abstracts, and more than 15 late-breaking clinical trials (LBCTs) abstructs. This report presents the highlights and several key presentations, especially the LBCTs, from the ACC Scientific Sessions 2015. I hope this review will help cardiologists update to the latest information.
著者
Rie Okamoto Akihiro Hirashiki Xian Wu Cheng Takashi Yamada Shuzo Shimazu Norihiro Shinoda Takahiro Okumura Kyosuke Takeshita Yasuko Bando Takahisa Kondo Toyoaki Murohara
出版者
一般社団法人 インターナショナル・ハート・ジャーナル刊行会
雑誌
International Heart Journal (ISSN:13492365)
巻号頁・発行日
vol.54, no.4, pp.202-206, 2013 (Released:2013-08-06)
参考文献数
25
被引用文献数
8 17

Cardiac troponins provide diagnostic and prognostic information on ischemic heart disease, but their roles in hypertrophic cardiomyopathy (HCM) are unclear. We sought to investigate the associations between elevated serum cardiac troponins T (cTnT) and I (cTnI) levels and cardiac injury in patients with HCM. We measured serum cTnT and cTnI in a peripheral vein of 73 consecutive HCM patients in stable condition. In addition, to examine the transcardiac release of cTnT and that of cTnI, we measured them in the aortic root and coronary sinus. Mitochondrial- and Ca2+-handling-related gene expression assays were analyzed by endomyocardial biopsy specimens. Based on the median value of serum cTnT, we divided the patients into two groups [group A: cTnT < 0.008 ng/mL, (n = 35), group B: cTnT group ≥ 0.008 ng/mL, (n = 38)]. Left ventricular (LV) mass index was significantly higher, while LV ejection fraction was significantly lower, in group B than in group A. Meanwhile, there was a significantly positive correlation between the transcardiac gradient of serum cTnT or cTnI, and the mRNA level of troponin I3 (r = 0.473, r = 0.516, respectively). The mRNA level of troponin T2 significantly correlated with mRNA levels of sarco-endoplasmic reticulum Ca2+-ATPase 2, cytochrome c oxidase subunit 5B, and troponin I3 (r = 0.486, r = 0.957, r = 0.633, respectively). These findings indicate that both elevated serum cTnT and cTnI might be associated with cardiac dysfunction in patients with HCM, resulting from the impairment of mitochondrial function and Ca2+-handling protein.