著者
Kenshi Hayashi Toyonobu Tsuda Akihiro Nomura Noboru Fujino Atsushi Nohara Kenji Sakata Tetsuo Konno Chiaki Nakanishi Hayato Tada Yoji Nagata Ryota Teramoto Yoshihiro Tanaka Masa-aki Kawashiri Masakazu Yamagishi on behalf of the Hokuriku-Plus AF Registry Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-17-1085, (Released:2018-03-01)
参考文献数
22

Background:B-type natriuretic peptide (BNP) may be a predictor of stroke risk in patients with nonvalvular atrial fibrillation (NVAF); because heart failure is associated with the incidence of stroke in AF patients. However, limited data exist regarding the association between BNP at baseline and risks of thromboembolic events (TE) and death in NVAF patients.Methods and Results:We prospectively studied 1,013 NVAF patients (725 men, 72.8±9.7 years old) from the Hokuriku-plus AF Registry to determine the relationship between BNP at baseline and prognosis among Japanese NVAF patients. During the follow-up period (median, 751 days); 31 patients experienced TE and there were 81 cases of TE/all-cause death. For each endpoint we constructed receiver-operating characteristic curves that gave cutoff points of BNP for TE (170 pg/mL) and TE/all-cause death (147 pg/mL). Multivariate analysis with the Cox-proportional hazards model indicated that high BNP was significantly associated with risks of TE (hazard ratio [HR] 3.86; 95% confidence interval [CI] 1.83–8.67; P=0.0003) and TE/all-cause death (HR 2.27; 95% CI 1.45–3.56; P=0.0003). Based on the C-index and net reclassification improvement, the addition of BNP to CHA2DS2-VASc statistically improved the prediction of TE.Conclusions:In a real-world cohort of Japanese NVAF patients, high BNP was significantly associated with TE and death. Plasma BNP might be a useful biomarker for these adverse clinical events.
著者
Trung Quang PHAM Takayuki HOSHI Yoshihiro TANAKA Akihito SANO
出版者
公益社団法人 計測自動制御学会
雑誌
SICE Journal of Control, Measurement, and System Integration (ISSN:18824889)
巻号頁・発行日
vol.10, no.5, pp.426-432, 2017 (Released:2017-09-23)
参考文献数
24

Rapid adapting type-I (RA-I) receptor is one type of mechanoreceptors in the human skin. They are believed to be responsible for the detection of stimuli that produce minute skin motion (flutter, slip, microgeometric surface features). The neurophysiological experiments in the paper [J.R. Phillips et al. J. Neurophysiol., Vol. 46, pp. 1192-1203, 1981]raise a question about why the RA-I afferent (innervated into RA-I receptor) fails to represents the stimulus with the width less than 3mm and why their response is anisotropy. It is unclear whether the skin's mechanics or the specific afferent branching of mechanoreceptors themselves are accounted for these phenomena. The present work seeks an interpretation of the neurophysiological phenomena, using a biomechanical finite-element (FE) model with a transduction sub-layer and synthetic sub-model for afferent current. The predicted afferent current matched well with the neural recordings in previous reports. This result suggests a major role of afferent branching in regard to the neurophysiological phenomena.