著者

Fumio Terasaki Arata Azuma Toshihisa Anzai Nobukazu Ishizaka Yoshio Ishida Mitsuaki Isobe Takayuki Inomata Hatsue Ishibashi-Ueda Yoshinobu Eishi Masafumi Kitakaze Kengo Kusano Yasushi Sakata Noriharu Shijubo Akihito Tsuchida Hiroyuki Tsutsui Takatomo Nakajima Satoshi Nakatani Taiko Horii Yoshikazu Yazaki Etsuro Yamaguchi Tetsuo Yamaguchi Tomomi Ide Hideo Okamura Yasuchika Kato Masahiko Goya Mamoru Sakakibara Kyoko Soejima Toshiyuki Nagai Hiroshi Nakamura Takashi Noda Takuya Hasegawa Hideaki Morita Tohru Ohe Yasuki Kihara Yoshihiko Saito Yukihiko Sugiyama Shin-ichiro Morimoto Akira Yamashina 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

vol.83, no.11, pp.2329-2388, 2019-10-25 (Released:2019-10-25)

参考文献数

355

被引用文献数

95 243

著者

Makoto Watanabe Kazutaka Aonuma Toyoaki Murohara Yasuo Okumura Takeshi Morimoto Sadanori Okada Sunao Nakamura Shiro Uemura Koichiro Kuwahara Tadateru Takayama Naofumi Doi Tamio Nakajima Manabu Horii Kenichi Ishigami Kazumiki Nomoto Daisuke Abe Koji Oiwa Kentaro Tanaka Terumasa Koyama Akira Sato Tomoya Ueda Tsunenari Soeda Yoshihiko Saito PREVENT CINC-J Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0869, (Released:2022-04-22)

参考文献数

37

被引用文献数

2

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Background: Previous studies have reported that high-dose strong statin therapy reduces the incidence of contrast-induced nephropathy (CIN) in statin naïve patients; however, the efficacy of high-dose strong statins for preventing CIN in real-world clinical practice remains unclear. The aim of this study was to evaluate the efficacy of strong statin therapy in addition to fluid hydration for preventing CIN after cardiovascular catheterization.Methods and Results: This prospective, multicenter, randomized controlled trial included 420 patients with chronic kidney disease who underwent cardiovascular catheterization. They were assigned to receive high-dose pitavastatin (4 mg/day × 4 days) on the day before and of the procedure and 2 days after the procedure (Statin group, n=213) or no pitavastatin (Control group, n=207). Isotonic saline hydration combined with a single bolus of sodium bicarbonate (20 mEq) was scheduled for administration to all patients. In the control group, statin therapy was continued at the same dose as that before randomization. CIN was defined as a ≥0.5 mg/dL increase in serum creatinine or ≥25% above baseline at 48 h after contrast exposure. Before randomization, 83% of study participants were receiving statin treatment. The statin group had a higher incidence of CIN than the control group (3.0% vs. 0%, P=0.01). The 12-month rate of major adverse cardiovascular events was similar between the 2 groups.Conclusions: High-dose pitavastatin increases the incidence of CIN in this study population.

著者

Kenji Onoue Hitoshi Nakagawa Ayaka Keshi Junichi Sugiura Akihiko Okamura Koshiro Kanaoka Atsushi Kyodo Satoshi Terasaki Takuya Nakamura Hiroki Yano Kazutaka Nogi Satomi Ishihara Yukihiro Hashimoto Tomoya Ueda Ayako Seno Taku Nishida Tsunenari Soeda Makoto Watanabe Rika Kawakami Yoshihiko Saito

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0735, (Released:2021-10-06)

参考文献数

9

被引用文献数

2

著者

Yasushi Matsuzawa Masaaki Konishi Michikazu Nakai Yusuke Saigusa Masataka Taguri Masaomi Gohbara Toshiaki Ebina Masami Kosuge Kiyoshi Hibi Kunihiro Nishimura Yoshihiro Miyamoto Satoshi Yasuda Hisao Ogawa Yoshihiko Saito Naoki Nakayama Ichiro Takeuchi Kouichi Tamura Kazuo Kimura

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.84, no.7, pp.1140-1146, 2020-06-25 (Released:2020-06-25)

参考文献数

16

被引用文献数

16 15

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Background:Low population density may be associated with high mortality in acute myocardial infarction (AMI) patients. The purpose of this study was to investigate the effect of population density and hospital primary percutaneous coronary intervention (PCI) volume on AMI in-hospital mortality in Japan.Methods and Results:This is a retrospective study of 64,414 AMI patients transported to hospital by ambulances. The main outcome measure was in-hospital mortality. The median population density was 1,147 (interquartile range, 342–5,210) persons/km2. There was a significant negative relationship between population density and in-hospital mortality (OR for a quartile down in population density 1.086, 95% CI 1.042–1.132, P<0.001). Patients in less densely populated areas were more often transported to hospitals with a lower primary PCI volume, and they had a longer distance to travel. By using multivariable analysis, primary PCI volume was found to be significantly associated with in-hospital mortality, but distance to hospital was not. When divided into the low- and high-volume hospitals, using the cut-off value of 115 annual primary PCI procedures, the increase in in-hospital mortality associated with low population density was observed only in patients hospitalized in the low-volume hospitals.Conclusions:Increased in-hospital mortality related to low population density was observed only in AMI patients who were transported to the low primary PCI volume hospitals, but not in those who were transported to high-volume hospitals.

著者

Rina Onishi Koshiro Kanaoka Junichi Sugiura Motoko Tokunaga Yasuhiro Takemoto Kenji Onoue Yuta Yamamoto Manabu Horii Yoshihiko Saito

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.1177-18, (Released:2018-07-06)

参考文献数

11

被引用文献数

4 5

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Fabry disease is an X-linked lysosomal storage disorder caused by a deficiency of α-galactosidase A and is classified into two types: classical and variant. The classical type exhibits classic manifestations, but the variant type does not and is therefore difficult to identify sometimes. A 73-year-old woman with a first episode of heart failure was admitted to our hospital. Her left ventricular wall motion was mildly reduced without hypertrophy. Urine sediment revealed mulberry cells, leading to the diagnosis of Fabry disease. In cases without typical clinical findings, urinary mulberry cells may help diagnose Fabry disease.

著者

Koshiro Kanaoka Yoshitaka Iwanaga Michikazu Nakai Yoko Sumita Yoshihiko Saito Yoshihiro Miyamoto

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.64, no.1, pp.53-59, 2023-03-31 (Released:2023-03-31)

参考文献数

21

被引用文献数

1

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Cardiovascular diseases are a major cause of mortality worldwide. Nonetheless, the current trend in cardiology hospitals in Japan has not been comprehensively explored.This descriptive study used the Japanese Registry of All Cardiac and Vascular Diseases database during 2010-2019. The nationwide 10-year trend in cardiovascular medical care systems was described in detail corresponding to the regions in Japan.Cardiovascular facilities and the number of cardiology beds, hospitalized patients, and cardiologists increased during 2010-2019. There were regional differences in the number of patients and cardiologists per bed, but the differences in the number of hospitalized patients per cardiologist decreased among the regions. Of the three major acute cardiovascular diseases, patients hospitalized with heart failure per cardiologist have been increasing. However, the in-hospital mortality rates have not changed over the last decade (8.6% for acute myocardial infarction, 7.7% for heart failure, and 12.7% for acute aortic dissection in 2019).There was an increasing trend in the availability of cardiovascular care resources in Japan during 2010-2019. This study provides a comprehensive summary of the current cardiovascular care and the follow-up required in the future.

著者

Shin-ichi Momomura Yoshihiko Saito Yoshio Yasumura Kazuhiro Yamamoto Yasushi Sakata Masao Daimon Koichiro Kinugawa Hiroshi Okamoto Naoki Dohi Issei Komuro

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-0532, (Released:2017-08-02)

参考文献数

10

被引用文献数

5 8

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Background:TY-0201 (TY) is a transdermal formulation of bisoprolol that is the free base of bisoprolol fumarate (BO), a drug widely used to treat chronic heart failure (CHF). The objectives of this phase II study were to evaluate the efficacy and safety of TY when switching from oral BO to TY in patients with CHF whose drug therapy was optimized, and to determine the dose conversion rate of BO to TY.Methods and Results:The efficacy and safety of once daily TY patch use for 16 weeks was investigated in 40 patients with CHF who were stabilized with an optimized drug treatment, including BO, after switching from BO to TY at the dose conversion rate of 5:8. The pre-switch left ventricular ejection fraction was 50.13±11.09% (mean±SD). The post-switch value was 50.87±10.79% after 16 weeks, which was not significantly different, with similar results for other efficacy and safety parameters. The 16-week study was continued for all patients without changing doses after switching to TY. No cardiovascular deaths, hospitalizations for worsening HF, or significant safety concerns were observed.Conclusions:Efficacy was maintained without significant safety concerns in patients with CHF who were stabilized with BO treatment after switching to TY, suggesting the appropriateness of the dose conversion rate.

著者

Yousuke Hashimoto Yukio Ozaki Shino Kan Koichi Nakao Kazuo Kimura Junya Ako Teruo Noguchi Satoru Suwa Kazuteru Fujimoto Kazuoki Dai Takashi Morita Wataru Shimizu Yoshihiko Saito Atsushi Hirohata Yasuhiro Morita Teruo Inoue Atsunori Okamura Toshiaki Mano Minoru Wake Kengo Tanabe Yoshisato Shibata Mafumi Owa Kenichi Tsujita Hiroshi Funayama Nobuaki Kokubu Ken Kozuma Shiro Uemura Tetsuya Tobaru Keijiro Saku Shigeru Oshima Satoshi Yasuda Tevfik F Ismail Takashi Muramatsu Hideo Izawa Hiroshi Takahashi Kunihiro Nishimura Yoshihiko Miyamoto Hisao Ogawa Masaharu Ishihara on behalf of J-MINUET Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-1115, (Released:2021-06-03)

参考文献数

31

被引用文献数

19

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Background:The impact of chronic kidney disease (CKD) on long-term outcomes following acute myocardial infarction (AMI) in the era of modern primary PCI with optimal medical therapy is still in debate.Methods and Results:A total of 3,281 patients with AMI were enrolled in the J-MINUET registry, with primary PCI of 93.1% in STEMI. CKD stage on admission was classified into: no CKD (eGFR ≥60 mL/min/1.73 m2); moderate CKD (60>eGFR≥30 mL/min/1.73 m2); and severe CKD (eGFR <30 mL/min/1.73 m2). While the primary endpoint was all-cause mortality, the secondary endpoint was major adverse cardiac events (MACE), defined as a composite of all-cause death, cardiac failure, myocardial infarction (MI) and stroke. Of the 3,281 patients, 1,878 had no CKD, 1,073 had moderate CKD and 330 had severe CKD. Pre-person-days age- and sex-adjusted in-hospital mortality significantly increased from 0.014% in no CKD through 0.042% in moderate CKD to 0.084% in severe CKD (P<0.0001). Three-year mortality and MACE significantly deteriorated from 5.09% and 15.8% in no CKD through 16.3% and 38.2% in moderate CKD to 36.7% and 57.9% in severe CKD, respectively (P<0.0001). C-index significantly increased from the basic model of 0.815 (0.788–0.841) to 0.831 (0.806–0.857), as well as 0.731 (0.708–0.755) to 0.740 (0.717–0.764) when adding CKD stage to the basic model in predicting 3-year mortality (P=0.013; net reclassification improvement [NRI] 0.486, P<0.0001) and MACE (P=0.046; NRI 0.331, P<0.0001) respectively.Conclusions:CKD remains a useful predictor of in-hospital and 3-year mortality as well as MACE after AMI in the modern PCI and optimal medical therapy era.

著者

Atsushi Mizuno Chisa Matsumoto Daisuke Yoneoka Takuya Kishi Mari Ishida Shoji Sanada Memori Fukuda Yoshihiko Saito Keiko Yamauchi-Takihara Hiroyuki Tsutsui Keiichi Fukuda Issei Komuro Koichi Node

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.3, no.3, pp.137-141, 2021-03-10 (Released:2021-03-10)

参考文献数

21

被引用文献数

6

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Background:From the early phase of the Coronavirus disease-2019 (COVID-19) pandemic, cardiologists have paid attention not only to COVID-19-associated cardiovascular sequelae, but also to treatment strategies for rescheduling non-urgent procedures. The chief objective of this study was to explore confirmed COVID-19 cardiology case experiences and departmental policies, and their regional heterogeneity in Japan.Methods and Results:We performed a retrospective analysis of a nationwide survey performed by the Japanese Circulation Society on April 13, 2020. The questionnaire included cardiology department experience with confirmed COVID-19 cases and restriction policies, and was sent to 1,360 certified cardiology training hospitals. Descriptive analysis and spatial autocorrelation analysis of each response were performed to reveal the heterogeneity of departmental policies. The response rate was 56.8% (773 replies). Only 16% of all responding hospitals experienced a COVID-19 cardiology case. High-risk procedures were restricted in more than one-fifth of hospitals, including transesophageal echocardiography (34.9%) and scheduled catheterization (39.5%). The presence of a cardiologist in the COVID-19 team, the number of board-certified cardiologists, any medical resource shortage and a state of emergency were positively correlated with any type of restriction.Conclusions:We found both low clinical case experiences with COVID-19 and restrictions of cardiovascular procedures during the first COVID-19 wave in Japan. Restrictions arising as a result of COVID-19 were affected by hospital- and country-level variables, such as a state of emergency.

著者

Satomi Ishihara Rika Kawakami Maki Nogi Kaeko Hirai Yukihiro Hashimoto Yasuki Nakada Hitoshi Nakagawa Tomoya Ueda Taku Nishida Kenji Onoue Tsunenari Soeda Satoshi Okayama Makoto Watanabe Yoshihiko Saito

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0620, (Released:2019-12-26)

参考文献数

30

被引用文献数

8

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Background:Countermeasure development for early rehospitalization for heart failure (re-HHF) is an urgent and important issue in Western countries and Japan.Methods and Results:Of 1,074 consecutive NARA-HF study participants with acute decompensated HF admitted to hospital as an emergency between January 2007 and December 2016, we excluded 291 without follow-up data, who died in hospital, or who had previous HF-related hospitalizations, leaving 783 in the analysis. During the median follow-up period of 895 days, 241 patients were re-admitted for HF. The incidence of re-HHF was the highest within the first 30 days of discharge (3.3% [26 patients]) and remained high until 90 days, after which it decreased sharply. Within 90 days of discharge, 63 (8.0%) patients were re-admitted. Kaplan-Meier analysis revealed that patients with 90-day re-HHF had worse prognoses than those without 90-day re-HHF in terms of all-cause death (hazard ratio [HR] 2.321, 95% confidence interval [CI] 1.654–3.174; P<0.001) and cardiovascular death (HR 3.396, 95% CI 2.153–5.145; P<0.001). Multivariate analysis indicated that only male sex was an independent predictor of 90-day re-HHF.Conclusions:The incidence of early re-HHF was lower in Japan than in Western countries. Its predictors are not related to the clinical factors of HF, indicating that a new comprehensive approach might be needed to prevent early re-HHF.

著者

Yuji Mizuno Eisaku Harada Daisuke Katoh Yusuke Kashiwagi Yoshinobu Morikawa Hitoshi Nakagawa Michihiro Yoshimura Yoshihiko Saito Hirofumi Yasue

出版者

The Japan Endocrine Society

雑誌

Endocrine Journal (ISSN:09188959)

巻号頁・発行日

vol.60, no.1, pp.87-95, 2013 (Released:2013-01-31)

参考文献数

46

被引用文献数

16 27

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B-type natriuretic peptide (BNP) is produced by the heart and its plasma level is increased with the severity of left ventricular (LV) dysfunction/hypertrophy. The normal heart preferentially utilizes fatty acids as energy substrates. Plasma BNP levels are reported to be lower in obese individuals. We examined the relationship between BNP production and plasma free fatty acids (FFA), homeostasis model assessment of insulin resistance (HOMA-IR), and LV dysfunction/ hypertrophy. We examined the plasma BNP levels and FFA at the aortic root (AO) and coronary sinus (CS) as well as hemodynamic parameters in 62 patients (38 men and 24 women, 62.5±11.7 yrs) who underwent cardiac catheterization. Log BNP (AO) had a significant positive correlation with log BNP (CS-AO) (r=0.877, PPPPPPP=0.001). The multivariable regression analyses including log HOMA-IR, LVMI, and age as an independent variable revealed that HOMA-IR and LVMI were significant predictors of log BNP (CS-AO) or BNP production (P=0.001 and 0.004, respectively). We conclude that plasma BNP levels are determined primarily by cardiac production and that insulin resistance is a significant predictor of cardiac BNP production independent of LV hypertrophy in obese individuals.

著者

Yasuki Nakada Rika Kawakami Shouji Matsushima Tomomi Ide Koshiro Kanaoka Tomoya Ueda Satomi Ishihara Taku Nishida Kenji Onoue Tsunenari Soeda Satoshi Okayama Makoto Watanabe Hiroyuki Okura Miyuki Tsuchihashi-Makaya Hiroyuki Tsutsui Yoshihiko Saito

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.5, pp.1019-1024, 2019-04-25 (Released:2019-04-25)

参考文献数

22

被引用文献数

8 13

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Background: Prognosis after acute decompensated heart failure (ADHF) is poor. An appropriate risk score that would allow for improved care and treatment of ADHF patients after discharge, however, is lacking. Methods and Results: We used 2 HF cohorts, the NARA-HF study and JCARE-CARD, as derivation and validation cohorts, respectively. The primary endpoint was all-cause death during the 2-year follow-up, excluding in-hospital death. Age, hemoglobin (Hb), and brain natriuretic peptide (BNP) at discharge were identified as independent risk factors. We determined 3 categorizations on the basis of these parameters, termed A2B score: age (<65 years, 0; 65–74 years, 1; ≥75 years, 2), anemia (Hb <10 g/dL, 2; 10–11.9 g/dL, 1; ≥12 g/dL, 0) and BNP (<200 pg/mL, 0; 200–499 pg/mL, 1; ≥500 pg/mL, 2). We divided patients into 4 groups according to A2B score (extremely low, 0; low, 1–2; medium, 3–4; high, 5–6). For the extremely low-risk group, the 2-year survival rate was 97.8%, compared with 84.5%, 66.1%, and 45.2% for the low-, medium-, and high-risk groups, respectively. Using the JCARE-CARD as a validation model, for the extremely low-risk group, the 2-year survival was 95.4%, compared with 90.2%, 75.0%, and 55.6% for the low-, medium-, and high-risk groups, respectively. Conclusions: The user-friendly A2B score is useful for estimating survival rate in ADHF patients at discharge.

著者

Tomoya Ueda Rika Kawakami Manabu Horii Yu Sugawara Takaki Matsumoto Sadanori Okada Taku Nishida Tsunenari Soeda Satoshi Okayama Satoshi Somekawa Yukiji Takeda Makoto Watanabe Hiroyuki Kawata Shiro Uemura Yoshihiko Saito

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.77, no.11, pp.2766-2771, 2013 (Released:2013-10-25)

参考文献数

29

被引用文献数

35 43

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Background: Accumulating evidence suggests that hematopoiesis, especially erythropoiesis, is disturbed in heart failure (HF) for many reasons. Low hemoglobin and red blood cell distribution width have emerged as prognostic indicators of HF independent of classic predictors. The prognostic implication of mean corpuscular volume (MCV) in HF, however, is unknown. In this context, we investigated the relationship between MCV and prognosis of acute decompensated HF (ADHF). Methods and Results: This retrospective cohort study consisted of 458 consecutive patients with ADHF who had emergency admission to hospital. Patients were divided into 2 groups: MCV ≤100fl (non-macrocytic group, n=400); and MCV >100fl (macrocytic group, n=58). The relationship between MCV and all-cause death was tested using Cox proportional hazard models, adjusting for other predictors. Mean patient age was 72.4 years and mean MCV was 93.0±7.1fl. Hemoglobin was significantly lower in the macrocytic group than the non-macrocytic group. During the mean follow-up of 20.8 months, a total of 173 deaths (37.9%) occurred. Kaplan-Meier analysis showed that all-cause death was significantly higher in the macrocytic group (log-rank P<0.0001). Cox proportional hazards analysis indicated that macrocytosis was an independent predictor of all-cause death (hazard ratio, 2.288; 95% confidence interval: 1.390–3.643; P=0.0015) after adjustment in the multivariate model. Conclusions: It is proposed for the first time that MCV is an independent predictor of all-cause death in patients with ADHF.  (Circ J 2013; 77: 2766–2771)

著者

Masaharu Ishihara Koichi Nakao Yukio Ozaki Kazuo Kimura Junya Ako Teruo Noguchi Masashi Fujino Satoshi Yasuda Satoru Suwa Kazuteru Fujimoto Yasuharu Nakama Takashi Morita Wataru Shimizu Yoshihiko Saito Atsushi Hirohata Yasuhiro Morita Teruo Inoue Atsunori Okamura Masaaki Uematsu Kazuhito Hirata Kengo Tanabe Yoshisato Shibata Mafumi Owa Kenichi Tsujita Hiroshi Funayama Nobuaki Kokubu Ken Kozuma Tetsuya Tobaru Shigeru Oshima Michikazu Nakai Kunihiro Nishimura Yoshihiro Miyamoto Hisao Ogawa on behalf of J-MINUET Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.81, no.7, pp.958-965, 2017-06-23 (Released:2017-06-23)

参考文献数

24

被引用文献数

34 43

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Background:According to troponin-based criteria of myocardial infarction (MI), patients without elevation of creatine kinase (CK), formerly classified as unstable angina (UA), are now diagnosed as non-ST-elevation MI (NSTEMI), but little is known about their outcomes.Methods and Results:Between July 2012 and March 2014, 3,283 consecutive patients with MI were enrolled. Clinical follow-up data were obtained up to 3 years. The primary endpoint was a composite of all-cause death, non-fatal MI, non-fatal stroke, cardiac failure and urgent revascularization for UA. There were 2,262 patients with ST-elevation MI (STEMI), 563 NSTEMI with CK elevation (NSTEMI+CK) and 458 NSTEMI without CK elevation (NSTEMI-CK). From day 0, Kaplan-Meier curves for the primary endpoint began to diverge in favor of NSTEMI-CK for up to 30 days. The 30-day event rate was significantly lower in patients with NSTEMI-CK (3.3%) than in STEMI (8.6%, P<0.001) and NSTEMI+CK (9.9%, P<0.001). Later, the event curves diverged in favor of STEMI. The event rate from 31 days to 3 years was significantly lower in patients with STEMI (19.8%) than in NSTEMI+CK (33.6%, P<0.001) and NSTEMI-CK (34.2%, P<0.001). Kaplan-Meier curves from 31 days to 3 years were almost identical between NSTEMI+CK and NSTEMI-CK (P=0.91).Conclusions:Despite smaller infarct size and better short-term outcomes, long-term outcomes of NSTEMI-CK after convalescence were as poor as those for NSTEMI+CK and worse than for STEMI.

著者

Koshiro Kanaoka Satoshi Okayama Michikazu Nakai Yoko Sumita Kunihiro Nishimura Rika Kawakami Hiroyuki Okura Yoshihiro Miyamoto Satoshi Yasuda Hiroyuki Tsutsui Issei Komuro Hisao Ogawa Yoshihiko Saito

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.5, pp.1025-1031, 2019-04-25 (Released:2019-04-25)

参考文献数

21

被引用文献数

31 46

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Background: With aging of the population, the economic burden associated with heart failure (HF) is expected to increase. However, little is known about the hospitalization costs associated with HF in Japan. Methods and Results: In this cross-sectional study, using data from The Japanese Registry of All Cardiac and Vascular Diseases (JROAD) and JROAD-Diagnosis Procedure Combination databases between 2012 and 2014, we evaluated hospitalization costs for acute cardiovascular diseases (CVDs), including HF. A total of &#36;1,187 million/year (44% of the hospitalization costs for acute CVDs) was spent on patients with HF. We identified 273,865 patients with HF and the median cost per patient was &#36;8,089 (&#36;5,362–12,787) per episode. The top 1% of spenders accounted for 8% (&#36;80 million/year), and the top 5% of spenders accounted for 22% (&#36;229 million/year) of the entire cost associated with HF. The costs associated with HF for patients over 75 years of age accounted for 68% of the total cost. Conclusions: The costs associated with HF were higher than the hospitalization cost for any other acute CVD in Japan. Understanding how the total hospitalization cost is distributed may allow health providers to utilize limited resources more effectively for patients with HF.

著者

Koichiro Miura Katsuhisa Matsuura Yu Yamasaki Itoyama Daisuke Sasaki Takuma Takada Yoshiyuki Furutani Emiko Hayama Masamichi Ito Seitaro Nomura Hiroyuki Morita Masashi Toyoda Akihiro Umezawa Kenji Onoue Yoshihiko Saito Hiroyuki Aburatani Toshio Nakanishi Nobuhisa Hagiwara Issei Komuro Tatsuya Shimizu

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.63, no.2, pp.338-346, 2022-03-30 (Released:2022-03-30)

参考文献数

35

被引用文献数

5

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Dilated cardiomyopathy (DCM) is caused by various gene variants and characterized by systolic dysfunction. Lamin variants have been reported to have a poor prognosis. Medical and device therapies are not sufficient to improve the prognosis of DCM with the lamin variants. Recently, induced pluripotent stem (iPS) cells have been used for research on genetic disorders. However, few studies have evaluated the contractile function of cardiac tissue with lamin variants. The aim of this study was to elucidate the function of cardiac cell sheet tissue derived from patients with lamin variant DCM. iPS cells were generated from a patient with lamin A/C (LMNA) -mutant DCM (LMNA p.R225X mutation). After cardiac differentiation and purification, cardiac cell sheets that were fabricated through cultivation on a temperature-responsive culture dish were transferred to the surface of the fibrin gel, and the contractile force was measured. The contractile force and maximum contraction velocity, but not the maximum relaxation velocity, were significantly decreased in cardiac cell sheet tissue with the lamin variant. A qRT-PCR analysis revealed that mRNA expression of some contractile proteins, cardiac transcription factors, Ca2+-handling genes, and ion channels were downregulated in cardiac tissue with the lamin variant.Human iPS-derived bioengineered cardiac tissue with the LMNA p.R225X mutation has the functional properties of systolic dysfunction and may be a promising tissue model for understanding the underlying mechanisms of DCM.

著者

Atsushi Kyodo Makoto Watanabe Akihiko Okamura Saki Iwai Azusa Sakagami Kazutaka Nogi Daisuke Kamon Yukihiro Hashimoto Tomoya Ueda Tsunenari Soeda Hiroyuki Okura Yoshihiko Saito

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-0759, (Released:2021-01-27)

参考文献数

33

被引用文献数

4

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Background:The association between unfavorable post-stent optical coherence tomography (OCT) findings and subsequent stent thrombosis (ST) remains unclear. This study investigated the ST-related characteristics of post-stent OCT findings at index percutaneous coronary intervention (PCI).Methods and Results:Fifteen patients with ST onset after OCT-guided PCI (ST group) were retrospectively enrolled. Post-stent OCT findings in the ST group were compared with those in 70 consecutive patients (reference group) without acute coronary syndrome onset for at least 5 years after OCT-guided PCI. The incidence of acute myocardial infarction (AMI) was higher in the ST than reference group (60.0% vs. 17.1%, respectively; P=0.0005). The incidence of incomplete stent apposition (93.3% vs. 55.7%; P=0.0064), irregular protrusion (IP; 93.3% vs. 62.8%; P=0.0214), and thrombus (93.3% vs. 51.4%; P=0.0028) was significantly higher in the ST than reference group. The maximum median (interquartile range) IP arc was significantly larger in the ST than reference group (265° [217°–360°] vs. 128° [81.4°–212°], respectively; P<0.0001). In AMI patients, the incidence of a maximum IP arc >180° was significantly higher in the ST than reference group (100% vs. 58.3%, respectively; P=0.0265).Conclusions:IP with a large arc was a significant feature on post-stent OCT in patients with ST.

著者

Yoshinobu Morikawa Rika Kawakami Manabu Horii Yuta Yamamoto Matahiro Yabuta Yoshihiko Saito

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.62, no.1, pp.50-56, 2021-01-30 (Released:2021-01-30)

参考文献数

26

被引用文献数

3

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Diabetes mellitus (DM) is associated with an increased incidence of cardiovascular events and an elevated prevalence of sarcopenia. However, the relationship between cardiovascular events and sarcopenia in patients with DM remains unclear. This study examined this relationship and investigated the predictors of cardiovascular events in this population.This study enrolled 161 patients with DM and no history of cardiovascular diseases who were admitted to our hospital for the treatment of DM between September 2012 and December 2015. Patients were divided into sarcopenia and non-sarcopenia groups, and were followed until March 2019. The primary endpoint was major adverse cardiovascular events (MACE).The mean age was 65.9 ± 1.8 years old and the mean follow-up period was 4.1 ± 0.8 years. The log-rank test indicated that MACE differed significantly between the two groups (P < 0.0001). Multivariate Cox hazard analysis identified the cardio-ankle vascular index (CAVI) and handgrip strength as independent predictors of MACE (hazard ratio [HR] = 1.18, P = 0.039; and HR = 0.70, P = 0.016, respectively).Handgrip strength is an indicator of sarcopenia in diabetic patients, and together with CAVI it was independently associated with the incidence of MACE. This suggests that the handgrip strength test might be useful in the management of patients with DM at high risk of cardiovascular outcomes.

著者

Shiro Uemura Hiroshi Okamoto Michikazu Nakai Kunihiro Nishimura Yoshihiro Miyamoto Satoshi Yasuda Nobuhiro Tanaka Shun Kohsaka Kazushige Kadota Yoshihiko Saito Hiroyuki Tsutsui Issei Komuro Yuji Ikari Hisao Ogawa Masato Nakamura

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0004, (Released:2019-04-24)

参考文献数

33

被引用文献数

17

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Background:Primary percutaneous coronary intervention (pPCI) is strongly recommended by guidelines for patients presenting with acute myocardial infarction (AMI), but its applications in elderly patients are less clear.Methods and Results:The JROAD-DPC is a Japanese nationwide registry for patients with cardiovascular diseases combined with an administrative claim-based database. Among 2,369,165 records from 2012 to 2015, data for 115,407 AMI patients were extracted for this study. Elderly patients (≥75 years) comprised 45,645 subjects (39.6%), and received pPCI less frequently (62.2%) than younger patients (79.2%, P<0.001). Clinical variables such as higher age, female sex, higher Killip class, and renal dysfunction, but not functional status on admission, were predictors of non-application of pPCI. Endpoint 30-day mortality increased with aging, and was significantly higher in elderly patients (10.7%) than in younger patients (3.8%, P<0.001). Indeed, pPCI was independently associated with lower 30-day mortality only in subgroups of patients aged ≥60 years. Propensity score-matching analysis confirmed a similar reduction in endpoint 30-day mortality with pPCI in elderly patients. Duration of hospitalization was significantly shorter and functional ability on discharge was significantly better in elderly patients who underwent pPCI.Conclusions:Elderly patients with AMI underwent pPCI less frequently, but it was consistently associated with better clinical outcome in these patients. Our findings support the proactive application of pPCI for elderly AMI patients when they are eligible for an invasive strategy.

著者

Tetsuya Tatsumi Eishi Ashihara Toshihide Yasui Shinsaku Matsunaga Atsumichi Kido Yuji Sasada Satoshi Nishikawa Mitsuyoshi Hadase Masahiro Koide Reo Nakamura Hidekazu Irie Kazuki Ito Akihiro Matsui Hiroyuki Matsui Maki Katamura Shigehiro Kusuoka Satoaki Matoba Satoshi Okayama Manabu Horii Shiro Uemura Chihiro Shimazaki Hajime Tsuji Yoshihiko Saito Hiroaki Matsubara

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.71, no.8, pp.1199-1207, 2007 (Released:2007-07-25)

参考文献数

40

被引用文献数

59 73

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Background Transplantation of non-expanded peripheral blood mononuclear cells (PBMNCs) enhances neovessel formation in ischemic myocardium and limbs by releasing angiogenic factors. This study was designed to examine whether intracoronary transplantation of PBMNCs improves cardiac function after acute myocardial infarction (AMI). Methods and Results After successful percutaneous coronary intervention (PCI) for a ST-elevation AMI with occlusion of proximal left anterior descending coronary artery within 24 h, patients were assigned to either a control group or the PBMNC group that received intracoronary infusion of PBMNCs within 5 days after PCI. PBMNCs were obtained from patients by COBE spectra-apheresis and concentrated to 10 ml, 3.3 ml of which was infused via over-the-wire catheter. The primary endpoint was the global left ventricular ejection fraction (LVEF) change from baseline to 6 months' follow-up. The data showed that the absolute increase in LVEF was 7.4% in the control group and 13.4% (p=0.037 vs control) in the PBMNC group. Cell therapy resulted in a greater tendency of ΔRegional ejection fraction (EF) or significant improvement in the wall motion score index and Tc-99m-tetrofosmin perfusion defect score associated with the infarct area, compared with controls. Moreover, intracoronary administration of PBMNCs did not exacerbate either left ventricular (LV) end-diastolic and end-systolic volume expansion or high-risk arrhythmia, without any adverse clinical events. Conclusion Intracoronary infusion of non-expanded PBMNCs promotes improvement of LV systolic function. This less invasive and more feasible approach to collecting endothelial progenitor cells may provide a novel therapeutic option for improving cardiac function after AMI. (Circ J 2007; 71: 1199 - 1207)