著者

Hirotoshi Watanabe Takeshi Morimoto Ko Yamamoto Yuki Obayashi Masahiro Natsuaki Kyohei Yamaji Manabu Ogita Satoru Suwa Tsuyoshi Isawa Takenori Domei Kenji Ando Shojiro Tatsushima Hiroki Watanabe Masanobu Oya Kazushige Kadota Hideo Tokuyama Tomohisa Tada Hiroki Sakamoto Hiroyoshi Mori Hiroshi Suzuki Tenjin Nishikura Kohei Wakabayashi Takeshi Kimura for the STOPDAPT-2 ACS Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0650, (Released:2022-12-08)

参考文献数

28

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Background: The REAL-CAD trial, reported in 2017, demonstrated a significant reduction in cardiovascular events with high-intensity statins in patients with chronic coronary syndrome. However, data are scarce on the use of high-intensity statins in Japanese patients with acute coronary syndrome (ACS).Methods and Results: In STOPDAPT-2 ACS, which exclusively enrolled ACS patients between March 2018 and June 2020, 1,321 (44.2%) patients received high-intensity statins at discharge, whereas of the remaining 1,667 patients, 96.0% were treated with low-dose statins. High-intensity statins were defined as the maximum approved doses of strong statins in Japan. The incidence of the cardiovascular composite endpoint (cardiovascular death, myocardial infarction, definite stent thrombosis, stroke) was significantly lower in patients with than without high-intensity statins (1.44% vs. 2.69% [log-rank P=0.025]; adjusted hazard ratio [aHR] 0.48, 95% confidence interval [CI] 0.24–0.94, P=0.03) and the effect was evident beyond 60 days after the index percutaneous coronary intervention (log-rank P=0.01; aHR 0.38, 95% CI 0.17–0.86, P=0.02). As for the bleeding endpoint, there was no significant difference between the 2 groups (0.99% vs. 0.73% [log-rank P=0.43]; aHR 0.96, 95% CI 0.35–2.60, P=0.93).Conclusions: The prevalence of high-intensity statins has increased substantially in Japan. The use of the higher doses of statins in ACS patients recommended in the guidelines was associated with a significantly lower risk of the primary cardiovascular composite endpoint compared with lower-dose statins.

著者

上杉 邦憲 平尾 邦雄 林 友直 原 宏徳 山本 東光 升本 喜就 折井 武 上村 正幸 UESUGI Kuninori HIRAO Kunio HAYASHI Tomonao HARA Hironori YAMAMOTO Harumitsu MASUMOTO Yoshinari ORII Takeshi KAMIMURA Masayuki

出版者

宇宙科学研究所

雑誌

宇宙科学研究所報告. 特集: ハレー彗星探査計画報告 (ISSN:02859920)

巻号頁・発行日

vol.19, pp.17-31, 1987-03

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「さきがけ」, 「すいせい」両探査機に対する科学観測ミッションからの要求, 重量, 電力, 通信, 熱設計等工学上の諸要求と制限を考慮したシステム設計及び打上げ後の運用結果によるその評価について述べる。

著者

山本 由紀子 YAMAMOTO Yukiko

出版者

京都

雑誌

総合文化研究所紀要 = Bulletin of Institute for Interdisciplinary Studies of Culture Doshisha Women’s College of Liberal Arts (ISSN:09100105)

巻号頁・発行日

vol.32, pp.132-141, 2015-07-16

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研究ノート

著者

Hiroyuki Yamamoto Tomofumi Takaya Nobuyuki Takahashi Hiroshi Tsunamoto Hirohisa Murakami Hiroya Kawai

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.4, no.7, pp.333-334, 2022-07-08 (Released:2022-07-08)

著者

芦原 佑樹 山本 衛 石坂 圭吾 熊本 篤 白澤 秀剛 頭師 孝拓 ASHIHARA Yuki YAMAMOTO Mamoru ISHISAKA Keigo KUMAMOTO Atsushi SHIRASAWA Hidetatka ZUSHI Takahiro

出版者

宇宙航空研究開発機構宇宙科学研究所(JAXA)(ISAS)

雑誌

観測ロケットシンポジウム2020 講演集 = Proceedings of Sounding Rocket Symposium 2020

巻号頁・発行日

2021-03

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第3回観測ロケットシンポジウム(2021年3月24-25日. オンライン開催)

著者

山本 絢佳 Ayaka YAMAMOTO

出版者

愛知県立大学日本文化学部国語国文学科内あいち国文の会

雑誌

あいち国文 (ISSN:18821979)

巻号頁・発行日

no.8, pp.166-153, 2014-09-30

著者

Akio Honzawa Miho Nishitani-Yokoyama Kazunori Shimada Mitsuhiro Kunimoto Tomomi Matsubara Rie Matsumori Hiroki Kasuya Kei Fujiwara Mayumi Doi Kana Takagi-Kawahara Abidan Abulimiti Jianying Xu Akie Shimada Taira Yamamoto Atsushi Amano Tohru Asai Hiroyuki Daida Tohru Minamino

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

pp.CR-22-0008, (Released:2022-06-08)

参考文献数

32

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Background: Frailty is an important prognostic factor in patients with cardiovascular diseases (CVD), and patients with CVD have a high rate of concurrent psycho-emotional stress, as well as depressive mood and anxiety symptoms. Despite this, few reports have examined the effects of the efficacy of Phase II cardiac rehabilitation (CR) in frail patients, including improvements in anxiety levels.Methods and Results: In all, 137 patients (mean [±SD] age 65.8±13.0 years; 71% male) who participated in Phase II CR and were assessed after CR completion were included in this study. Patients were evaluated using the Kihon Checklist (KCL) form at the beginning of CR and were divided into the 3 groups according to KCL scores: frail (n=34, 25%), pre-frail (n=40, 29%), and non-frail (n=63, 46%). Physical function and anxiety levels were compared among the 3 groups. The pre-frail and frail groups had significantly higher state anxiety and trait anxiety than the non-frail group (P<0.01). At the end of Phase II CR, all 3 groups showed significant improvements in the 6-min walking distance (P<0.05). State anxiety improved significantly in the non-frail and pre-frail groups, whereas trait anxiety only improved in the non-frail group.Conclusions: Physical function was improved in frail patients who participated in Phase II CR. However, there was no significant improvement in their level of anxiety.

著者

Keisuke Anan Yuki Kataoka Kazuya Ichikado Kodai Kawamura Takeshi Johkoh Kiminori Fujimoto Kazunori Tobino Ryo Tachikawa Hiroyuki Ito Takahito Nakamura Tomoo Kishaba Minoru Inomata Yosuke Yamamoto

出版者

Society for Clinical Epidemiology

雑誌

Annals of Clinical Epidemiology (ISSN:24344338)

巻号頁・発行日

pp.22008, (Released:2022-02-09)

被引用文献数

4

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Background: This study aimed to develop criteria for identifying patients with acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) from Japanese administrative data and validate the pre-existing criteria.Methods: This retrospective, multi-center validation study was conducted at eight institutes in Japan to verify the diagnostic accuracy of the disease name for AE-IPF. We used the Japanese Diagnosis Procedure Combination data to identify patients with a disease name that could meet the diagnostic criteria for AE-IPF, who were admitted to the eight institutes from January 2016 to February 2019. As a reference standard, two respiratory physicians performed a chart review to determine whether the patients had a disease that met the diagnostic criteria for AE-IPF. Furthermore, two radiologists interpreted the chest computed tomography findings of cases considered AE-IPF and confirmed the diagnosis. We calculated the positive predictive value (PPV) for each disease name and its combination. Results: We included 830 patients; among them, 216 were diagnosed with AE-IPF through the chart review. We combined the groups of disease names and yielded two criteria: the criteria with a high PPV (0.72 [95% confidence interval 0.62 to 0.81]) and that with a slightly less PPV (0.61 [0.53 to 0.68]) but more true positives. Pre-existing criteria showed a PPV of 0.40 (0.31 to 0.49).Conclusion: The criteria derived in this study for identifying AE-IPF from Japanese administrative data show a fair PPV. Although these criteria should be carefully interpreted according to the target population, our findings could be utilized in future database studies on AE-IPF.

著者

Ryohei Ikejiri Ryota Yamamoto Seiko Nakano Kenzo Yoneda Yuhei Yamauchi

出版者

Japan Society for Educational Technology/Japanese Society for Information and Systems in Education

雑誌

Information and Technology in Education and Learning (ISSN:24361712)

巻号頁・発行日

vol.1, no.1, pp.Pra-p001, 2021 (Released:2021-09-22)

参考文献数

20

被引用文献数

1

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This study designed and evaluated a project-based learning (PjBL) technique that promotes the social construction of knowledge by overcoming dissonance using G Suite for Education. The core aspects of the design include controlling the discussion process by setting a task with the same directionality in terms of its solution while including two conflicting positions and using a synchronous system to provide real-time feedback from a teacher to control the discussion process. A four-part model of PjBL was presented to overcome dissonance. To evaluate the effects of this model, PjBL lessons were conducted with high-school students in which the topic led them to consider ideas to support people living in shelters for 3 months following an earthquake. Consequently, the effects of the core aspects of the design were partially confirmed.

著者

Toshihiro Ohigashi Shuya Kawaguchi Kai Kobayashi Hayato Kimura Tatsuya Suzuki Daichi Okabe Takuya Ishibashi Hiroshi Yamamoto Maki Inui Ryo Miyamoto Kazuyoshi Furukawa Tetsuya Izu

出版者

Information Processing Society of Japan

雑誌

Journal of Information Processing (ISSN:18826652)

巻号頁・発行日

vol.29, pp.548-558, 2021 (Released:2021-09-15)

参考文献数

19

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In 2018, Takita et al. proposed a construction method of a fake QR code by adding stains to a target QR code, that probabilistically leads users to a malicious website. The construction abused the error-correction of error-correcting code used in the QR code, namely, the added stains induce decoding errors in black and white detection by a camera, so that the decoded URL leads to the malicious website. Also, the same authors proposed a detection method against such fake QR codes by comparing decoded URLs among multiple QR code readings since the decoded URLs may differ because of its probabilistic property. However, the detection method cannot work well over a few readings. Moreover, the proposed detection method does not consider the environmental or accidental changes such as sudden sunshine or reflection, nor recognizes the fake QR code as non-fake when the probability is low. This paper proposes new detection methods for such fake QR codes by analyzing information obtained from the error-correcting process. This paper also reports results from implementing the new detection methods on an Android smartphone. Results show that a combination of these detection methods works very well compared to when using only a single detection method.

著者

Kensuke Oshima Tsuyoshi Asai Hisumi Esaki Satoru Kameyama Junshiro Yamamoto

出版者

The Society of Physical Therapy Science

雑誌

Journal of Physical Therapy Science (ISSN:09155287)

巻号頁・発行日

vol.33, no.9, pp.621-626, 2021 (Released:2021-09-01)

参考文献数

14

被引用文献数

4

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[Purpose] In this study, we verified the validity of the step time and walking speed obtained from the smartphone gait analysis application CareCoaching. [Participants and Methods] The participants were 66 independent, community-dwelling adults aged 65 years or older who performed a 10-m walking test twice each under preferred- and slow-speed conditions. We concurrently measured gait motions using CareCoaching and the OptoGait system for reference data. Both systems compute walking speed and step time as gait parameters. We examined the concurrent validity of these parameters by using intra-class correlation coefficients (ICCs) and limits of agreement (LOAs) with Bland−Altman analyses. [Results] In the preferred walking speed condition, the ICCs of walking speed and step times between the CareCoaching and the OptoGait system were 0.67 and 0.93, respectively. In the slow walking speed condition, the ICCs for walking speed and step time were 0.78 and 0.97, respectively. In addition, the LOAs for step time were −0.0941 to 0.1160 for preferred walking speed and −0.0596 to 0.0883 for slow walking speed. The LOAs for walking speed were −0.4158 to 0.0568 for preferred walking speed and −0.3348 to 0.0523 for slow walking speed. [Conclusion] CareCoaching showed excellent agreement for step time and moderate-to-good agreement for walking speed in independent, community-dwelling older adults.

著者

山本 欣司 ヤマモト キンジ Yamamoto Kinji

出版者

弘前大学教育学部

雑誌

弘前大学教育学部紀要 (ISSN:04391713)

巻号頁・発行日

no.87, pp.11-21, 2002-03-28

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「たけくらべ」をめぐる論争をたどりながら明らかになったのは、美登利の変貌の原因を初潮とする見解の背後に、性的な「成熟」によって(子ども)/ (大人)を分割する近代的パラダイムがひそんでいるということである。初潮を迎え(大人)になるまで美登利は無垢で、娼妓の世界-の参入を猶予されているとアプリオリに前提されてきた。ところが、佐多稲子氏は初潮にそれほど大きな意味はないとして、女性のセクシュアリティをめぐる神話に疑問を投げ掛けた。暴力による変貌を主張した《水揚げ説》は強い説得力を持つ。だが、これまでの議論には、娼妓になるべき娘として、実際に美登利にどのような立場の変化があり得たか一という視点が欠けていた。日本近代公娼制をめぐる歴史的事実に目を向けたとき、娼妓とは売られた娘であったことがわかる。私は、美登利の変貌が「身売り」によるものであり、「たけくらべ」の合意する残酷さから目をそらしてはならないと主張した。

著者

Gaku Yamamoto Sho Toshino

出版者

The Plankton Society of Japan, The Japanese Association of Benthology

雑誌

Plankton and Benthos Research (ISSN:18808247)

巻号頁・発行日

vol.16, no.2, pp.129-138, 2021-05-27 (Released:2021-06-11)

参考文献数

32

被引用文献数

1

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A new hydromedusa belonging to the order Anthoathecata is reported from Sagami Bay, eastern Japan. Tiaricodon orientalis sp. nov. can be distinguished from other Tiaricodon species by the umbrella size of the medusa, manubrium length, interradial peaks in the subumbrella, and a red band on the upper part of the manubrium. A comparative table of the primary diagnostic characters of the genus is provided. Our morphological and molecular phylogenetic analyses suggest that Tiaricodon from China is not Tiaricodon coeruleus but Tiaricodon orientalis.

著者

Junya Matsuda Hitoshi Takano Masaki Morooka Yoichi Imori Jun Nakata Mitsunobu Kitamura Shuhei Tara Yukichi Tokita Takeshi Yamamoto Morimasa Takayama Wataru Shimizu

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-1191, (Released:2021-04-24)

参考文献数

28

被引用文献数

4

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Background:Alcohol septal ablation (ASA) is a treatment option in patients with drug-refractory symptomatic hypertrophic obstructive cardiomyopathy (HOCM). In many patients, right bundle branch block (RBBB) develops during ASA because septal branches supply the right bundle branch. However, the clinical significance of procedural RBBB is uncertain.Methods and Results:We retrospectively reviewed 184 consecutive patients with HOCM who underwent ASA. We excluded 40 patients with pre-existing RBBB (n=10), prior pacemaker implantation (n=15), mid-ventricular obstruction type (n=10), and those lost to follow-up (n=5), leaving 144 patients for analysis. Patients were divided into 2 groups according to the development (n=95) or not (n=49) of procedural RBBB. ASA conferred significant decreases in the left ventricular pressure gradient (LVPG) in both the RBBB and no-RBBB group (from 74±48 to 27±27 mmHg [P<0.001] and from 75±45 to 31±33 mmHg [P<0.001], respectively). None of the RBBB patients developed further conduction system disturbances. The percentage reduction in LVPG at 1 year after the procedure was significantly greater in the RBBB than no-RBBB group (66±24% vs. 49±45%; P=0.035). Procedural RBBB was not associated with pacemaker implantation after ASA, but was associated with reduction in repeat ASA (odds ratio 0.34; 95% confidence interval 0.13–0.92; P=0.045).Conclusions:Although RBBB frequently occurs during the ASA procedure, it does not adversely affect clinical outcomes.

著者

Koh Ono Satoshi Shizuta Erika Yamamoto Naritatsu Saito Neiko Ozasa Takao Kato Eri Kato Takahiro Horie Junichi Tazaki Hiroki Shiomi Shin Watanabe Hirotoshi Watanabe Yugo Yamashita Yusuke Yoshikawa Hideyuki Kinoshita Takeru Makiyama Yoshinori Yoshida Noboru Ashida Yasuaki Nakagawa Yasuhiro Nakashima Osamu Baba Hirohiko Kohjitani Masahiro Kimura Hideaki Inazumi Takashi Yoshizawa Akihiro Komasa Takeshi Kimura

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0041, (Released:2021-01-30)

参考文献数

10

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Due to the COVID-19 pandemic, the 84thAnnual Meeting of the Japanese Circulation Society (JCS) was held in a web-based format for the first time in its history as “The Week for JCS 2020” from Monday, July 27 to Sunday, August 2, 2020. All sessions, including general abstracts, were streamed live or on-demand. The main theme of the meeting was “Change Practice!” and the aim was to organize the latest findings in the field of cardiovascular medicine and discuss how to change practice. The total number of registered attendees was over 16,800, far exceeding our expectations, and many of the sessions were viewed by far more people than at conventional face-to-face scientific meetings. At this conference, the power of online information dissemination was fully demonstrated, and the evolution of online academic meetings will be a direction that cannot be reversed in the future. The meeting was completed with great success, and we express our heartfelt gratitude to all affiliates for their enormous amount of work, cooperation, and support.

著者

Torahiko TERADA Ryûzô YAMAMOTO

出版者

The Japan Academy

雑誌

Proceedings of the Imperial Academy (ISSN:03699846)

巻号頁・発行日

vol.11, no.6, pp.214-215, 1935 (Released:2008-03-19)

参考文献数

2

被引用文献数

31 34

著者

Yuya Matsue Yoshiharu Kinugasa Takeshi Kitai Shogo Ohishi Kazuhiro Yamamoto Hiroyuki Tsutsui

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

pp.CR-20-0081, (Released:2020-08-13)

参考文献数

18

被引用文献数

3

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Background:The effect of the COVID-19 pandemic on the respiratory management strategy with regard to the use of non-invasive positive pressure ventilation (NPPV) and high-flow nasal cannula (HFNC) in patients with acute heart failure (AHF) in Japan is unclear.Methods and Results:This cross-sectional study used a self-reported online questionnaire, with responses from 174 institutions across Japan. More than 60% of institutions responded that the treatment of AHF patients requiring respiratory management became fairly or very difficult during the COVID-19 pandemic than earlier, with institutions in alert areas considering such treatment significantly more difficult than those in non-alert areas (P=0.004). Overall, 61.7% and 58.8% of institutions changed their indications for NPPV and HFNC, respectively. Significantly more institutions in the alert area changed their practices for the use of NPPV and HFNC during the COVID-19 pandemic (P=0.004 and P=0.002, respectively). When there was insufficient time or information to determine whether AHF patients may have concomitant COVID-19, institutions in alert areas were significantly more likely to refrain from using NPPV and HFNC than institutions in non-alert areas.Conclusions:The COVID-19 pandemic has compelled healthcare providers to change the respiratory management of AHF, especially in alert areas.

著者

Koichiro Fujisue Kenshi Yamanaga Suguru Nagamatsu Hideki Shimomura Takuro Yamashita Koichi Nakao Sunao Nakamura Masaharu Ishihara Kunihiko Matsui Naritsugu Sakaino Takashi Miyazaki Nobuyasu Yamamoto Shunichi Koide Toshiyuki Matsumura Kazuteru Fujimoto Ryusuke Tsunoda Yasuhiro Morikami Koushi Matsuyama Shuichi Oshima Kenji Sakamoto Yasuhiro Izumiya Koichi Kaikita Seiji Hokimoto Hisao Ogawa Kenichi Tsujita

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.54726, (Released:2020-05-20)

参考文献数

29

被引用文献数

6

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Aim: Coronary plaque regression is weak in acute coronary syndrome (ACS) patients with diabetes mellitus (DM). We evaluated whether dual lipid-lowering therapy (DLLT) with ezetimibe and atorvastatin attenuates coronary plaques in ACS patients with DM. Methods: The prospective, randomized controlled, multicenter PRECISE-IVUS (Plaque Regression with Cholesterol Absorption Inhibitor or Synthesis Inhibitor Evaluated by Intravascular Ultrasound) trial assigned 246 patients undergoing percutaneous coronary intervention to DLLT or atorvastatin monotherapy and evaluated IVUS-derived changes in percent atheroma volume (ΔPAV), at baseline and 9-12-month follow-up, in 126 ACS cases, including 25 DM patients. The atorvastatin dose was up-titrated to achieve low-density lipoprotein cholesterol (LDL-C) <70 mg/dL. Results: In DM patients, the monotherapy group (n=13) and the DLLT group (n=12) showed a similar prevalence of coronary risks and baseline lipid profiles. During the study, the change in LDL-C level was similar between DM and non-DM patients. Compared with non-DM patients, DM patients showed weaker regression of ΔPAV by DLLT than those who underwent monotherapy (DM: −2.77±3.47% vs. −0.77±2.51%, P=0.11; non-DM: −2.01±3.36% vs. −0.08±2.66%, P=0.008). The change in LDL-C level was not correlated with ΔPAV in non-DM patients, but there was significant correlation between the change in LDL-C level and ΔPAV in DM patients (r=0.52, P=0.008). Conclusions: ACS patients with DM showed weaker coronary plaque regression than their counterparts. A significant correlation between the change in LDL-C level and ΔPAV in DM patients suggested that more intensive lipid-lowering therapy is required in ACS patients with DM.

著者

Kyohei Marume Seiji Takashio Masato Nishi Kyoko Hirakawa Masahiro Yamamoto Shinsuke Hanatani Seitaro Oda Daisuke Utsunomiya Shinya Shiraishi Mitsuharu Ueda Taro Yamashita Kenji Sakamoto Eiichiro Yamamoto Koichi Kaikita Yasuhiro Izumiya Yasuyuki Yamashita Yukio Ando Kenichi Tsujita

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.8, pp.1698-1708, 2019-07-25 (Released:2019-07-25)

参考文献数

30

被引用文献数

31

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Background:A recent study revealed a high prevalence of transthyretin (TTR) cardiac amyloidosis (CA) in elderly patients. 99 mTc-labeled pyrophosphate (99 mTc-PYP) scintigraphy is a remarkably sensitive and specific modality for TTR-CA, but is only available in specialist centres; thus, it is important to raise the pretest probability. The aim of this study was to evaluate the characteristics of patients with 99 mTc-PYP positivity and make recommendations about patient selection for 99 mTc-PYP scintigraphy.Methods and Results:We examined 181 consecutive patients aged ≥70 years who underwent 99 mTc-PYP scintigraphy at Kumamoto University Hospital between January 2012 and December 2018. Logistic regression analyses showed that high-sensitivity cardiac troponin T (hs-cTnT) ≥0.0308 ng/mL, left ventricular posterior wall thickness ≥13.6 mm, and wide QRS (QRS ≥120 ms) were strongly associated with 99 mTc-PYP positivity. We developed a new index for predicting 99 mTc-PYP positivity by adding 1 point for each of the 3 factors. The 99 mTc-PYP positive rate increased by a factor of 4.57 for each 1-point increase (P<0.001). Zero points corresponded to a negative predictive value of 87% and 3 points corresponded to a positive predictive value of 96% for 99 mTc-PYP positivity.Conclusions:The combination of biochemical (hs-cTnT), physiological (wide QRS), and structural (left ventricular posterior wall thickness) findings can raise the pretest probability for 99 mTc-PYP scintigraphy. It can assist clinicians in determining management strategies for elderly patients with suspected CA.

著者

Taro Temma Toshiyuki Nagai Masaya Watanabe Rui Kamada Yumi Takahashi Hikaru Hagiwara Taro Koya Motoki Nakao Kazunori Omote Kiwamu Kamiya Hiroyuki Iwano Kazuhiro Yamamoto Tsutomu Yoshikawa Yoshihiko Saito Toshihisa Anzai

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0963, (Released:2020-02-01)

参考文献数

31

被引用文献数

9

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Background:Atrial fibrillation (AF) is an important prognostic determinant in heart failure (HF) with preserved ejection fraction (HFpEF). However, it is unclear which HFpEF phenotypes are affected by AF in terms of long-term clinical outcomes because HFpEF is a heterogeneous syndrome with comorbidities such as coronary artery disease (CAD). In this study we determined the differential prognostic significance of AF in HFpEF patients according to CAD status.Methods and Results:Data for 408 hospitalized HFpEF patients enrolled in the Japanese Heart Failure Syndrome with Preserved Ejection Fraction Nationwide Multicenter Registry were analyzed. Patients were divided into 4 groups according to the presence of AF and CAD. The primary outcome was the composite of all-cause death and HF rehospitalization. The incidence of adverse events was higher in the AF–non-CAD than non-AF–non-CAD group (P=0.004). On multivariable Cox regression analysis with prespecified confounders, AF–non-CAD was significantly associated with an increased risk of adverse events than non-AF–non-CAD (adjusted HR, 1.91; 95% CI: 1.02–3.92) regardless of the type of AF. In contrast, risk was comparable between the AF–CAD and non-AF–CAD groups (adjusted HR, 1.24; 95% CI: 0.64–2.47).Conclusions:In HFpEF patients without CAD, AF was independently related to adverse events, indicating that intensive management of AF would have more beneficial effects particularly in HFpEF patients without CAD.