著者

Hirokai Kitaoka Hiroyuki Tsutsui Toru Kubo Tomomi Ide Taishiro Chikamori Keiichi Fukuda Noboru Fujino Taiki Higo Mitsuaki Isobe Chizuko Kamiya Seiya Kato Yasuki Kihara Koichiro Kinugawa Shintaro Kinugawa Shigetoyo Kogaki Issei Komuro Nobuhisa Hagiwara Minoru Ono Yuichiro Maekawa Shigeru Makita Yoshiro Matsui Shouji Matsushima Yasushi Sakata Yoshiki Sawa Wataru Shimizu Kunihiko Teraoka Miyuki Tsuchihashi-Makaya Hatsue Ishibashi-Ueda Masafumi Watanabe Michihiro Yoshimura Arata Fukusima Satoshi Hida Shungo Hikoso Teruhiko Imamura Hiroko Ishida Makoto Kawai Toshiro Kitagawa Takashi Kohno Satoshi Kurisu Yoji Nagata Makiko Nakamura Hiroyuki Morita Hitoshi Takano Tsuyoshi Shiga Yasuyoshi Takei Shinsuke Yuasa Teppei Yamamoto Tetsu Watanabe Takashi Akasaka Yoshinori Doi Takeshi Kimura Masafumi Kitakaze Masami Kosuge Morimasa Takayama Hitonobu Tomoike 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-20-0910, (Released:2021-07-22)

参考文献数

687

被引用文献数

47

著者

Keitaro Akita Yutaro Kaneko Ryota Sato Keisuke Iguchi Kenichiro Suwa Yuichiro Maekawa

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0922, (Released:2021-12-02)

参考文献数

1

著者

Yutaro Kaneko Yoshihisa Naruse Taro Narumi Makoto Sano Yuichiro Maekawa

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-22-0488, (Released:2023-01-14)

参考文献数

2

著者

Nobuhiro Ikemura Mitsuaki Sawano Yasuyuki Shiraishi Ikuko Ueda Hiroaki Miyata Yohei Numasawa Shigetaka Noma Masahiro Suzuki Yukihiko Momiyama Taku Inohara Kentaro Hayashida Shinsuke Yuasa Yuichiro Maekawa Keiichi Fukuda Shun Kohsaka

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.81, no.6, pp.815-822, 2017-05-25 (Released:2017-05-25)

参考文献数

37

被引用文献数

12

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Background:Door-to-balloon (DTB) time ≤90 min is an important quality indicator in the management of ST-elevation myocardial infarction (STEMI), but a considerable number of patients still do not meet this goal, particularly in countries outside the USA and Europe.Methods and Results:We analyzed 2,428 STEMI patients who underwent primary PCI ≤12 h of symptom onset who were registered in an ongoing prospective multicenter database (JCD-KiCS registry), between 2008 and 2013. We analyzed both the time trend in DTB time within this cohort in the registry, and independent predictors of delayed DTB time >90 min. Median DTB time was 90 min (IQR, 68–115 min) during the study period and there were no significant changes with year. Predictors for delay in DTB time included peripheral artery disease, prior revascularization, off-hour arrival, age >75 years, heart failure at arrival, and use of IABP or VA-ECMO. Notably, high-volume PCI-capable institutions (PCI ≥200/year) were more adept at achieving shorter DTB time compared with low-volume institutions (PCI <200/year).Conclusions:Half of the present STEMI patients did not achieve DTB time ≤90 min. Targeting the elderly and patients with multiple comorbidities, and PCI performed in off-hours may aid in its improvement.

著者

Takenori Ikoma Taro Narumi Keitaro Akita Ryota Sato Takayuki Masuda Hanami Kaneko Masahiro Toda Satoshi Mogi Makoto Sano Kenichiro Suwa Yoshihisa Naruse Hayato Ohtani Masao Saotome Yuichiro Maekawa

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.0697-22, (Released:2022-11-30)

参考文献数

34

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Objective The cardiac function, blood distribution, and oxygen extraction in the muscles as well as the pulmonary function determine the oxygen uptake (VO2) kinetics at the onset of exercise. This factor is called the VO2 time constant, and its prolongation is associated with an unfavorable prognosis for heart failure (HF). The mitochondrial function of skeletal muscle is known to reflect exercise tolerance. Morphological changes and dysfunction in cardiac mitochondria are closely related to HF severity and its prognosis. Although mitochondria play an important role in generating energy in cardiomyocytes, the relationship between cardiac mitochondria and the VO2 time constant has not been elucidated. Methods We calculated the ratio of abnormal cardiac mitochondria in human myocardial biopsy samples using an electron microscope and measured the VO2 time constant during cardiopulmonary exercise testing. The VO2 time constant was normalized by the fat-free mass index (FFMI). Patients Fifteen patients with non-ischemic cardiomyopathy (NICM) were included. Patients were divided into two groups according to their median VO2 time constant/FFMI value. Results Patients with a low VO2 time constant/FFMI value had a lower abnormal mitochondria ratio than those with a high VO2 time constant/FFMI value. A multiple linear regression analysis revealed that the ratio of abnormal cardiac mitochondria was independently associated with a high VO2 time constant/FFMI. Conclusions An increased abnormal cardiac mitochondria ratio might be associated with a high VO2 time constant/FFMI value in patients with NICM.

著者

Yoshinori Katsumata Fumiya Sano Takayuki Abe Tomoyoshi Tamura Taishi Fujisawa Yasuyuki Shiraishi Shun Kohsaka Ikuko Ueda Koichiro Homma Masaru Suzuki Shigeo Okuda Yuichiro Maekawa Eiji Kobayashi Shingo Hori Junichi Sasaki Keiichi Fukuda Motoaki Sano

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.81, no.7, pp.940-947, 2017-06-23 (Released:2017-06-23)

参考文献数

28

被引用文献数

18 49

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Background:Hydrogen gas inhalation (HI) reduced infarct size and mitigated adverse left ventricular (LV) remodeling in a rat model of acute myocardial infarction (AMI). We designed a prospective, open-label, rater-blinded clinical pilot study in patients experiencing ST-elevated MI (STEMI).Methods and Results:The 20 patients with an initial diagnosis of STEMI were assigned to either an HI group (1.3% H2with 26% oxygen) or a control group (26% oxygen). There were no HI-related severe adverse events. In the full analysis set, the cardiac salvage index as evaluated using cardiac magnetic resonance imaging at 7 days after primary percutaneous coronary intervention (PCI), showed no significant between-group difference (HI: 50.0±24.3%; control: 60.1±20.1%; P=0.43). However, the improvement from day 7 in the HI group was numerically greater than that in the control group in some of the surrogate outcomes at 6-month follow-up, including the LV stroke volume index (HI: 9.2±7.1 mL/m2; control: −1.4±7.2 mL/m2; P=0.03) and the LV ejection fraction (HI: 11.0%±9.3%; control: 1.7%±8.3%; P=0.11).Conclusions:The first clinical study has shown that HI during PCI is feasible and safe and may also promote LV reverse remodeling at 6 months after STEMI. The study was not powered to test efficacy and a further large-scale trial is warranted. (Clinical trials registration: UMIN00006825)

著者

Masaki Kodaira Hiroaki Miyata Yohei Numasawa Ikuko Ueda Yuichiro Maekawa Koichiro Sueyoshi Shiro Ishikawa Takahiro Ohki Kouji Negishi Keiichi Fukuda Shun Kohsaka

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-16-0032, (Released:2016-05-27)

参考文献数

40

被引用文献数

2 13

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Background:The “smoker’s paradox” is an otherwise unexplained phenomenon in which the mortality of smokers after acute myocardial infarction is reduced, contrary to expectations. It has been suggested that an association with antiplatelet agents exists, but the true mechanism remains largely unidentified.Methods and Results:The analysis included 6,195 consecutive patients who underwent percutaneous coronary intervention (PCI) for acute coronary syndrome, registered in the Japanese multicenter PCI registry. Smokers were significantly younger and had less comorbidity than non-smokers. Unadjusted in-hospital mortality rate, general complication rate, and bleeding complication rate were lower in smokers than in non-smokers. After adjustment, the trend persisted and smoking was not associated with overall mortality (odds ratio [OR], 0.90; 95% confidence interval [CI]: 0.61–1.34; P=0.62), and was associated with lower overall (P=0.032) and bleeding complication events (P=0.040). Clopidogrel effectively reduced the occurrence of in-hospital complications and major adverse cardiac events in smokers compared with non-smokers (OR, 0.55; 95% CI: 0.53–0.98 vs. OR, 1.20; 95% CI: 0.87–1.67; and OR, 0.37; 95% CI: 0.20–0.70 vs. OR, 1.48; 95% CI: 0.90–2.43, respectively).Conclusions:The smoker’s paradox was largely explained by confounding factors related to the lower risk profile of smokers, and they benefited from a positive modification of the efficacy of clopidogrel.

著者

Yukinori Ikegami Shun Kohsaka Hiroaki Miyata Ikuko Ueda Jun Fuse Munehisa Sakamoto Yasuyuki Shiraishi Yohei Numasawa Koji Negishi Iwao Nakamura Yuichiro Maekawa Yukihiko Momiyama Keiichi Fukuda

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-15-0484, (Released:2015-10-07)

参考文献数

30

被引用文献数

3 7

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Background:Preprocedural dual antiplatelet therapy (DAPT) in percutaneous coronary interventions (PCI) has been shown to improve outcomes; however, the efficacy of the procedure and its complications in Japanese patients remain largely unexplored, so we examined the risks and benefits of DAPT before PCI and its association with in-hospital outcomes.Methods and Results:We analyzed data from patients who had undergone PCI at 12 centers within the metropolitan Tokyo area between September 2008 and September 2013.Our study group comprised 6,528 patients, of whom 2,079 (31.8%) were not administered preprocedural DAPT. Non-use of preprocedural DAPT was associated with death, postprocedural shock, or heart failure (odds ratio [OR]: 1.47, 95% confidence interval [CI]: 1.10–1.96, P=0.009), and postprocedural myocardial infarction (OR: 1.41, 95% CI: 1.18–1.69, P<0.001) after adjusting propensity scores for known predictors of in-hospital complications. Non-use of DAPT was not associated with procedure-related bleeding complications (OR: 0.98, 95% CI: 0.71–1.59, P=0.764).Conclusions:Approximately one-third of the patients who underwent PCI did not receive preprocedural DAPT despite guideline recommendations. Our results indicate that patients undergoing PCI with DAPT have a lower risk of postprocedural cardiac events without any increased bleeding risk. Further studies are needed to implement the use of DAPT in real-world PCI.