著者
Rie Hayashi Hiroyasu Iso Kazumasa Yamagishi Hiroshi Yatsuya Isao Saito Yoshihiro Kokubo Ehab S. Eshak Norie Sawada Shoichiro Tsugane for the Japan Public Health Center-Based (JPHC) Prospective Study Group
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-18-0842, (Released:2019-03-06)
参考文献数
43
被引用文献数
2

Background: Evidence from prospective cohort studies regarding the relationship between working hours and risk of cardiovascular disease is limited Methods and Results: The Japan Public Health Center-Based Prospective Study Cohort II involved 15,277 men aged 40–59 years at the baseline survey in 1993. Respondents were followed up until 2012. During the median 20 years of follow up (257,229 person-years), we observed 212 cases of acute myocardial infarction and 745 stroke events. Cox proportional hazards models adjusted for sociodemographic factors, cardiovascular risk factors, and occupation showed that multivariable-adjusted hazard ratios (HRs) associated with overtime work of ≥11h/day were: 1.63 (95% confidence interval [CI] 1.01–2.63) for acute myocardial infarction and 0.83 (95% CI 0.60–1.13) for total stroke, as compared with the reference group (working 7 to <9 h/day). In the multivariable model, increased risk of acute myocardial infarction associated with overtime work of ≥11 h/day was more evident among salaried employees (HR 2.11, 95% CI 1.03–4.35) and men aged 50–59 years (HR 2.60, 95% CI 1.42–4.77). Conclusions: Among middle-aged Japanese men, working overtime is associated with a higher risk of acute myocardial infarction.
著者
Junya Sado Tetsuhisa Kitamura Yuri Kitamura Rong Liu Emiko Ando Tomotaka Sobue Yumi Sugawara Keitaro Matsuo Tomio Nakayama Ichiro Tsuji Hidemi Ito Takaichiro Suzuki Kota Katanoda Suketami Tominaga
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-18-0618, (Released:2019-03-08)
参考文献数
32
被引用文献数
3

Background: Coffee, which contains various bioactive compounds, is one of the most popular beverages. Further accumulation of evidence is needed, however, to confirm whether coffee consumption would be effective in preventing cardiovascular disease in the general Japanese population. Methods and Results: We evaluated the association between coffee consumption frequency (never, sometimes, 1–2 cups/day, 3–4 cups/day and ≥5 cups/day) and mortality from all causes, heart disease, and cerebrovascular disease, in 39,685 men and 43,124 women aged 40–79 years at baseline, in a 3-prefecture cohort study. The coffee consumption frequency was assessed on questionnaire. Cox proportional hazards regression modeling was used to assess the association between coffee consumption frequency and all-cause and cardiovascular disease mortality with adjustment for potential confounders. During 411,341 and 472,433 person-years in men and women, respectively, a total of 7,955 men and 5,725 women died. Coffee consumption frequency was inversely associated with all-cause mortality in both genders (P for trend<0.001). In addition, the risks of mortality from cerebrovascular disease in men (P for trend<0.001), and heart disease in women (P for trend=0.031) were inversely associated with coffee consumption. Conclusions: In this Japanese population, coffee drinking has a preventive effect on all-cause and on cardiovascular mortality in men and/or women.
著者
Tadafumi Sugimoto Atsushi Mizuno Takuya Kishi Naoya Ito Chisa Matsumoto Memori Fukuda Nobuyuki Kagiyama Tatsuhiro Shibata Takashi Ohmori Shogo Oishi Jun Fuse Keisuke Kida Fujimi Kawai Mari Ishida Shoji Sanada Issei Komuro Koichi Node
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-20-0302, (Released:2020-04-29)
参考文献数
37

Background:Despite the rapidly increasing attention being given to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, more commonly known as coronavirus disease 2019 (COVID-19), the relationship between cardiovascular disease and COVID-19 has not been fully described.Methods and Results:A systematic review was undertaken to summarize the important aspects of COVID-19 for cardiologists. Protection both for patients and healthcare providers, indication for treatments, collaboration with other departments and hospitals, and regular update of information are essentials to front COVID-19 patients.Conclusions:Because the chief manifestations of COVID-19 infection are respiratory and acute respiratory distress syndrome, cardiologists do not see infected patients directly. Cardiologists need to be better prepared regarding standard disinfection procedures, and be aware of the indications for extracorporeal membrane oxygenation and its use in the critical care setting.
著者
Junya Sado Tetsuhisa Kitamura Yuri Kitamura Rong Liu Emiko Ando Tomotaka Sobue Yumi Sugawara Keitaro Matsuo Tomio Nakayama Ichiro Tsuji Hidemi Ito Takaichiro Suzuki Kota Katanoda Suketami Tominaga
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.83, no.4, pp.757-766, 2019-03-25 (Released:2019-03-25)
参考文献数
32
被引用文献数
3

Background: Coffee, which contains various bioactive compounds, is one of the most popular beverages. Further accumulation of evidence is needed, however, to confirm whether coffee consumption would be effective in preventing cardiovascular disease in the general Japanese population. Methods and Results: We evaluated the association between coffee consumption frequency (never, sometimes, 1–2 cups/day, 3–4 cups/day and ≥5 cups/day) and mortality from all causes, heart disease, and cerebrovascular disease, in 39,685 men and 43,124 women aged 40–79 years at baseline, in a 3-prefecture cohort study. The coffee consumption frequency was assessed on questionnaire. Cox proportional hazards regression modeling was used to assess the association between coffee consumption frequency and all-cause and cardiovascular disease mortality with adjustment for potential confounders. During 411,341 and 472,433 person-years in men and women, respectively, a total of 7,955 men and 5,725 women died. Coffee consumption frequency was inversely associated with all-cause mortality in both genders (P for trend<0.001). In addition, the risks of mortality from cerebrovascular disease in men (P for trend<0.001), and heart disease in women (P for trend=0.031) were inversely associated with coffee consumption. Conclusions: In this Japanese population, coffee drinking has a preventive effect on all-cause and on cardiovascular mortality in men and/or women.
著者
Shin Kawasoe Takuro Kubozono Shiro Yoshifuku Satoko Ojima Naoya Oketani Masaaki Miyata Hironori Miyahara Shigeho Maenohara Mitsuru Ohishi
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-16-0766, (Released:2016-11-03)
参考文献数
48
被引用文献数
12

Background:The association between serum uric acid (UA) levels and atrial fibrillation (AF) in the general population in Japan is not well known.Methods and Results:In total, 285,882 consecutive subjects (men, 130,897; women, 154,985; age, 58±15 years) not receiving treatment for hyperuricemia who underwent health checkups were enrolled. Subjects were stratified into deciles according to age, body mass index, estimated glomerular filtration rate, systolic blood pressure, and UA level. AF prevalence was calculated for each decile. The odds ratio that defined the decile with the lowest AF prevalence as reference was calculated in each sex. In men, the mean UA was 6.0±1.4 mg/dl; AF prevalence was 1.8% and was lowest in the decile with UA 4.4–4.9 mg/dl. Deciles with both high and low UA (5.4–5.6 mg/dl to >7.8 mg/dl and <4.3 mg/dl) were associated with significantly higher AF prevalence. In women, the mean UA was 4.5±1.1 mg/dl; AF prevalence was 0.7% and was lowest in the decile with UA 3.6–3.8 mg/dl. Deciles with highest UA (5.0–5.2 mg/dl to >5.9 mg/dl) were associated with significantly higher AF prevalence. The analysis adjusted for other clinical covariates demonstrated an independent association between UA and AF in both sexes.Conclusions:In a representative Japanese general population, UA level was significantly associated with AF, independently of other cardiovascular risk factors.
著者
Priscilla Gross Isabelle Six Said Kamel Ziad A. Massy
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-14-0735, (Released:2014-07-31)
参考文献数
92
被引用文献数
8 27

Chronic kidney disease (CKD) is characterized by high cardiovascular morbidity/mortality, which is linked in part to vascular calcification (VC) and endothelial dysfunction (ED). Hyperphosphatemia, a feature of CKD, is a well-known inducer of VC in preclinical models and is associated with poor outcomes in epidemiological studies. However, it remains to be seen whether lowering phosphate levels in CKD patients reduces VC and the morbidity/mortality rate. Furthermore, it is now clear from preclinical and clinical studies that phosphate is involved in ED. The present article reviews the direct and indirect mechanisms (eg, via fibroblast growth factor 23 and/or parathyroid hormone) by which hyperphosphatemia influence the onset of VC and ED in CKD.
著者
Shamima Akter Tohru Nakagawa Toru Honda Shuichiro Yamamoto Keisuke Kuwahara Hiroko Okazaki Huanhuan Hu Teppei Imai Akiko Nishihara Toshiaki Miyamoto Naoko Sasaki Takayuki Ogasawara Akihiko Uehara Makoto Yamamoto Taizo Murakami Makiko Shimizu Masafumi Eguchi Takeshi Kochi Ai Hori Satsue Nagahama Kentaro Tomita Maki Konishi Ikuko Kashino Akiko Nanri Isamu Kabe Tetsuya Mizoue Naoki Kunugita Seitaro Dohi for the Japan Epidemiology Collaboration on Occupational Health Study Group
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.82, no.12, pp.3005-3012, 2018-11-24 (Released:2018-11-24)
参考文献数
28
被引用文献数
7

Background: The effect of smoking on mortality in working-age adults remains unclear. Accordingly, we compared the effects of cigarette smoking and smoking cessation on total and cause-specific mortality in a Japanese working population. Methods and Results: This study included 79,114 Japanese workers aged 20–85 years who participated in the Japan Epidemiology Collaboration on Occupational Health Study. Deaths and causes of death were identified from death certificates, sick leave documents, family confirmation, and other sources. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated via Cox proportional hazards regression. During a maximum 6-year follow-up, there were 252 deaths in total. Multivariable-adjusted HRs (95% CIs) for total mortality, cardiovascular disease (CVD) mortality, and tobacco-related cancer mortality were 1.49 (1.10–2.01), 1.79 (0.99–3.24), and 1.80 (1.02–3.19), respectively, in current vs. never smokers. Among current smokers, the risks of total, tobacco-related cancer, and CVD mortality increased with increasing cigarette consumption (Ptrend<0.05 for all). Compared with never smokers, former smokers who quit <5 and ≥5 years before baseline had HRs (95% CIs) for total mortality of 1.80 (1.00–3.25) and 1.02 (0.57–1.82), respectively. Conclusions: In this cohort of workers, cigarette smoking was associated with increased risk of death from all and specific causes (including CVD and tobacco-related cancer), although these risks diminished 5 years after smoking cessation.
著者
Rachel R. Huxley Yochiro Hirakawa Mohammad Akhtar Hussain Wichai Aekplakorn Xin Wang Sanne AE Peters Abdullah Mamun Mark Woodward
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-15-0661, (Released:2015-07-07)
参考文献数
36
被引用文献数
8 20

Cardiovascular disease (CVD) is the leading cause of mortality worldwide, causing an estimated 18 million deaths annually. Much of the burden of CVD resides in lower- and middle-income countries, particularly those Asian countries comprising the Western Pacific Region. Epidemiological studies have convincingly shown that up to 90% of all CVD can be explained by a small number of modifiable risk factors, including blood pressure, smoking, diabetes, total cholesterol and excess body weight. However, the relationship between these risk factors and coronary artery disease and stroke often differ by age and sex, and yet these differences are often overlooked in burden of disease estimations. As such, that can result in either an over- or under-estimation of the disease burden in specific population subgroups, which may affect resource allocation of healthcare. In this review, we derive the most reliable and previously unpublished estimates of the age- and sex-specific burden of vascular disease attributable to the aforementioned risk factors for 10 of the most populous Asian countries in the Western Pacific Region. Understanding how the burden of vascular disease is distributed within and between populations is crucial for developing appropriate health policies and effective treatment strategies, particularly in resource-poor settings.
著者
Yoshihiro Kokubo Makoto Watanabe Aya Higashiyama Yoko M Nakao Kengo Kusano Yoshihiro Miyamoto
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-17-0277, (Released:2017-05-25)
参考文献数
50
被引用文献数
23

Background:An atrial fibrillation (AF) risk score for a non-Western general population has not been established.Methods and Results:A total of 6,898 participants (30–79 years old) initially free of AF have been prospectively followed for incident AF since 1989. AF was diagnosed when AF or atrial flutter was present on ECG at a biannual health examination; was indicated as a current illness; or was in the medical records during follow-up. Cox proportional hazard ratios were analyzed after adjusting for cardiovascular risk factors at baseline. During the 95,180 person-years of follow-up, 311 incident AF events occurred. We developed a scoring system for each risk factor as follows: 0/−5, 3/0, 7/5, and 9/9 points for men/women in their 30 s–40 s, 50 s, 60 s, and 70 s, respectively; 2 points for systolic hypertension, overweight, excessive drinking, or coronary artery disease; 1 point for current smoking; −1 point for moderate non-high-density lipoprotein-cholesterol; 4 points for arrhythmia; and 8, 6, and 2 points for subjects with cardiac murmur in their 30 s–40 s, 50 s, and 60 s, respectively (C-statistic 0.749; 95% confidence interval, 0.724−0.774). Individuals with score ≤2, 10–11, or ≥16 points had, respectively, ≤1%, 9%, and 27% observed probability of developing AF in 10 years.Conclusions:We developed a 10-year risk score for incident AF using traditional risk factors that are easily obtained in routine outpatient clinics/health examinations without ECG.
著者
Takeshi Yamauchi Yasuhiko Sakata Masanobu Miura Takeo Onose Kanako Tsuji Ruri Abe Takuya Oikawa Shintaro Kasahara Masayuki Sato Kotaro Nochioka Takashi Shiroto Jun Takahashi Satoshi Miyata Hiroaki Shimokawa on behalf of the CHART-2 Investigators
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-16-0759, (Released:2017-01-14)
参考文献数
52
被引用文献数
8

Background:The prognostic impact of atrial fibrillation (AF) among patients at high risk for heart failure (HF) remains unclear. In addition, there is no risk estimation model for AF development in these patients.Methods and Results:The present study included 5,382 consecutive patients at high risk of HF enrolled in the CHART-2 Study (n=10,219). At enrollment, 1,217 (22.6%) had AF, and were characterized, as compared with non-AF patients, by higher age, lower estimated glomerular filtration rate, higher B-type natriuretic peptide (BNP) level and lower left ventricular ejection fraction. A total of 116 non-AF patients (2.8%) newly developed AF (new AF) during the median 3.1-year follow-up. AF at enrollment was associated with worse prognosis for both all-cause death and HF hospitalization (adjusted hazard ratio (aHR) 1.31, P=0.027 and aHR 1.74, P=0.001, for all-cause death and HF hospitalization, respectively) and new AF was associated with HF hospitalization (aHR 4.54, P<0.001). We developed a risk score with higher age, smoking, pulse pressure, lower eGFR, higher BNP, aortic valvular regurgitation, LV hypertrophy, and left atrial and ventricular dilatation on echocardiography, which effectively stratified the risk of AF development with excellent accuracy (AUC 0.76).Conclusions:These results indicated that AF is associated with worse prognosis in patients at high risk of HF, and our new risk score may be useful to identify patients at high risk for AF onset.
著者
Satoshi Ogawa Yukihiro Koretsune Masahiro Yasaka Yoshifusa Aizawa Hirotsugu Atarashi Hiroshi Inoue Shiro Kamakura Koichiro Kumagai Hideo Mitamura Ken Okumura Kaoru Sugi Takeshi Yamashita
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.75, no.7, pp.1539-1547, 2011 (Released:2011-06-24)
参考文献数
59
被引用文献数
33 40

Atrial fibrillation (AF) is the most common cardiac rhythm disorder and a major risk factor for stroke. For more than 60 years, warfarin has been the only approved anticoagulant for prevention of stroke in patients with AF. Although highly effective, it has many limitations that make its use difficult. Therefore, several novel anticoagulants are under development to overcome the limitations of warfarin, and some of these have entered phase III clinical trials. Dabigatran is an oral, reversible direct thrombin inhibitor approved in Europe and in several other countries for the prevention of venous thromboembolism after elective knee and hip replacement surgery. It has also been approved in the United States and Japan for the prevention of stroke and systemic embolism in patients with nonvalvular AF. In this review, the mechanism of action and pharmacological properties of new anticoagulants are described in detail, and the correct use of dabigatran in clinical practice is discussed. (Circ J 2011; 75: 1539-1547)
著者
Muhammad Ayyaz Ul Haq Muhammad Rashid Ian C. Gilchrist Olivier Bertrand Chun Shing Kwok Chun Wai Wong Hossam M. Mansour Yasser Baghdaddy James Nolan Maarten A.H. van Leeuwen Mamas A. Mamas
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-18-0389, (Released:2018-09-22)
参考文献数
43
被引用文献数
3

Background: We systematically reviewed the available literature on limb dysfunction after transradial access (TRA) or transfemoral access (TFA) cardiac catheterization. Methods and Results: MEDLINE and EMBASE were searched for studies evaluating any transradial or transfemoral procedures and limb function outcomes. Data were extracted and results were narratively synthesized with similar treatment arms. The TRA group included 15 studies with 3,616 participants and of these 3 reported nerve damage with a combined incidence of 0.16% and 4 reported sensory loss, tingling and numbness with a pooled incidence of 1.61%. Pain after TRA was the most common form of limb dysfunction (7.77%) reported in 3 studies. The incidence of hand dysfunction defined as disability, grip strength change, power loss or neuropathy was low at 0.49%. Although radial artery occlusion (RAO) was not a primary endpoint for this review, it was observed in 3.57% of the participants in a total of 8 studies included. The TFA group included 4 studies with 15,903,894 participants; the rates of peripheral neuropathy were 0.004%, sensory neuropathy caused by local groin injury and retroperitoneal hematomas were 0.04% and 0.17%, respectively, and motor deficit caused by femoral and obturator nerve damage was 0.13%. Conclusions: Limb dysfunction post cardiac catheterization is rare, but patients may have nonspecific sensory and motor complaints that resolve over a period of time.
著者
Naoyuki Takashima Hisatomi Arima Yoshikuni Kita Takako Fujii Naomi Miyamatsu Masaru Komori Yoshihisa Sugimoto Satoru Nagata Katsuyuki Miura Kazuhiko Nozaki
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.81, no.11, pp.1636-1646, 2017-10-25 (Released:2017-10-25)
参考文献数
27
被引用文献数
6 28

Background:This study determined the current status of the incidence, management, and prognosis of stroke in Japan using a population-based stroke registry.Methods and Results:Shiga Stroke Registry is an ongoing population-based registry that covers approximately 1.4 million residents of Shiga Prefecture. Cases of acute stroke were identified using standard definitions through surveillance of both all acute-care hospitals with neurology/neurosurgery facilities and death certificates in 2011. A total of 2,956 stroke cases and 2,176 first-ever stroke cases were identified. The age- and sex-adjusted incidence rate for first-ever stroke using the 2013 European Standard Population as standard was per 100,000 person-years: 91.3 for ischemic stroke, 36.4 for intracerebral hemorrhage, and 13.7 for subarachnoid hemorrhage. It was estimated that approximately 220,000 new strokes occurred in 2011 in Japan. Among the 2,956 cases, most stroke patients underwent neuroimaging, 268 received surgical or endovascular treatment, and 2,158 had rehabilitation therapy; 78 patients received intravenous thrombolysis. A total of 1,846 stroke patients had died or were dependent at hospital discharge, and 390 died within 28 days of onset.Conclusions:Incidence rates of stroke by subtypes were clarified and the total number of new strokes in Japan was estimated. More than half of stroke patients die or become dependent after a stroke. This study re-emphasized the importance of public health measures in reducing the burden of stroke in Japan.
著者
Yumiko Imai Keiji Kuba Takayo Ohto-Nakanishi Josef M. Penninger
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.74, no.3, pp.405-410, 2010 (Released:2010-02-25)
参考文献数
66
被引用文献数
29 39

Angiotensin-converting enzyme 2 (ACE2), a first homolog of ACE, regulates the renin-angiotensin system by counterbalancing ACE activity. Accumulating evidence in recent years has demonstrated a physiological and pathological role of ACE2 in the cardiovascular, renal and respiratory systems. For instance, in the acute respiratory distress syndrome (ARDS), ACE, AngII, and AT1R promote the disease pathogenesis, whereas ACE2 and the AT2R protect from ARDS. Importantly, ACE2 has been identified as a key SARS-coronavirus receptor and plays a protective role in SARS pathogenesis. Furthermore, the recent explosion of research into the ACE2 homolog, collectrin, has revealed a new physiological function of ACE2 as an amino acid transporter, which explains the pathogenic role of gene mutations in Hartnup disorder. This review summarizes and discusses the recently unveiled roles for ACE2 in disease pathogenesis. (Circ J 2010; 74: 405 - 410)
著者
Atsushi Sugiyama Sue Duval Yuji Nakamura Katsunori Yoshihara Demetris Yannopoulos
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.80, no.10, pp.2124-2132, 2016-09-23 (Released:2016-09-23)
参考文献数
42
被引用文献数
7 12

Background:The quality of cardiopulmonary resuscitation (CPR) has been recently shown to affect clinical outcome. The Resuscitation Outcomes Consortium (ROC) Prehospital Resuscitation Impedance Valve and Early Versus Delayed Analysis (PRIMED) trial showed no differences in outcomes with an active vs. sham impedance threshold device (ITD), a CPR adjunct that enhances circulation. It was hypothesized the active ITD would improve survival with favorable neurological outcomes in witnessed out-of-hospital cardiac arrest patients when used with high-quality CPR.Methods and Results:Using the publicly accessible ROC PRIMED database, a post-hoc analysis was performed on all witnessed subjects with both compression rate and depth data (n=1,808) who received CPR within the study protocol definition of adequate CPR quality (compression rate 80–120/min and depth 4–6 cm; n=929). Demographics were similar between sham and active ITD groups. In witnessed subjects who received quality CPR, survival with favorable neurological function was 11.9% for the active ITD subjects (56/470) vs. 7.4% for the sham (34/459) (odds ratio 1.69 [95% confidence interval 1.08, 2.64]). There were no statistically significant differences for this primary outcome when CPR was performed outside the boundaries of the definition of adequate CPR quality. Multivariable models did not change these associations.Conclusions:An active ITD combined with adequate-quality conventional CPR has the potential to significantly improve survival after witnessed cardiac arrest. (Circ J 2016; 80: 2124–2132)
著者
Mahmoud M. Ramadan Essam M. Mahfouz Gamal F. Gomaa Tarek A. El-Diasty Louie Alldawi Taruna Ikrar Ding Limin Makoto Kodama Yoshifusa Aizawa
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.72, no.5, pp.778-785, 2008 (Released:2008-04-25)
参考文献数
40
被引用文献数
25 24

Background Coronary calcification has been correlated with the presence and extent of coronary artery disease (CAD), so in the present study the associations between coronary artery calcification score (CACS) and endothelial dysfunction, as well as the important inflammatory markers C-reactive protein (CRP), interleukin (IL)-6, and oxidized low-density lipoprotein (OxLDL), were studied in asymptomatic individuals at intermediate risk for CAD. Methods and Results The study group comprised 177 subjects (103 males) aged 50.6±5.9 years. CACS was measured by multidetector computed tomography using the Agatston method. Endothelium-dependent flow-mediated dilatation (FMD) and endothelium-independent nitroglycerin-mediated dilatation (NMD) were measured by high-resolution external brachial ultrasound. Coronary artery calcification (CAC) was detected in 82 subjects (52 males), and the median CACS was 143 [31-311.25] units. After adjusting for gender and body mass index, log (CACS +1) correlated positively with age (r=0.401, p<0.001) and IL-6 levels (r=0.442, p<0.001), and negatively with FMD (r=-0.511, p<0.001). The correlations of log (CACS +1) with CRP and OxLDL levels, and with NMD, were non-significant. In a multivariate-adjusted logistic regression model, age (odds ratio (OR) =1.083 [1.014-1.156]), serum IL-6 level (OR=3.837 [2.166-6.798]) and FMD (OR=0.851 [0.793-0.913]) were significantly and independently associated with CAC. Conclusions Peripheral endothelial function inversely correlated with CACS, whereas IL-6 level was associated with CACS. Testing for endothelial function and IL-6 level may improve cardiovascular risk assessment and help target the therapeutic strategies in asymptomatic patients at intermediate CAD risk. (Circ J 2008; 72: 778 - 785)
著者
Kazuomi Kario
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.76, no.3, pp.553-562, 2012 (Released:2012-02-24)
参考文献数
74
被引用文献数
44 46

The devastating Great East Japan Earthquake, which was 9.0 on the Richter scale, occurred on March 11, 2011. Japan experienced the Great Hanshin-Awaji Earthquake 16 years ago, and I was working at the epicenter, and reported the characteristics of the earthquake-associated cardiovascular risk and high blood pressure (BP) found during the continuous practice and clinical studies of Tsuna Medical Association before and after the quake. A major disaster increases thrombophilic tendency and BP, both of which trigger disaster-induced cardiovascular events such as stroke, cardiac events, etc. The high salt intake and the increased salt sensitivity caused by disrupted circadian rhythms are the 2 major leading causes of disaster hypertension (HT) through neurohumoral activation under stressful conditions. To better assess and reduce the risks for disaster-associated cardiovascular events, we introduced the web-based Disaster Cardiovascular Prevention (DCAP) network (which consists of DCAP risk and prevention score assessment, and self-measured BP monitoring at both the shelter and the home) to the survivors of the 2011 disaster, and frequently found newly developed HT. Here I review the recent evidence, possible mechanism and the management of "disaster HT" for effective prevention of disaster-induced cardiovascular events. (Circ J 2012; 76: 553-562)
著者
Misa Takegami Yoshihiro Miyamoto Satoshi Yasuda Michikazu Nakai Kunihiro Nishimura Hisao Ogawa Ken-ichi Hirata Ryuji Toh Yoshihiro Morino Motoyuki Nakamura Yasuchika Takeishi Hiroaki Shimokawa Hiroaki Naito
出版者
日本循環器学会
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.79, no.5, pp.1000-1008, 2015-04-24 (Released:2015-04-24)
参考文献数
27
被引用文献数
1 14

Background:Large earthquakes have been associated with cardiovascular disease (CVD) mortality. In Japan, the 1995 Great Hanshin-Awaji (H-A) Earthquake was an urban-underground-type earthquake, whereas the 2011 Great East Japan (GEJ) Earthquake was an ocean-trench type. In the present study, we examined how these different earthquake types affected CVD mortality.Methods and Results:We examined death certificate data from 2008 to 2012 for 131 municipalities in Iwate, Miyagi, and Fukushima prefectures (n=320,348) and from 1992 to 1996 for 220 municipalities in Hyogo, Osaka, and Kyoto prefectures (n=592,670). A Poisson regression model showed significant increases in the monthly numbers of acute myocardial infarction (AMI)-related deaths (incident rate ratio [IRR] GEJ=1.34, P=0.001; IRR of H-A=1.57, P<0.001) and stroke-related deaths (IRR of GEJ=1.42, P<0.001; IRR of H-A=1.33, P<0.001) after the earthquakes. Two months after the earthquakes, AMI deaths remained significant only for H-A (IRR=1.13, P=0.029). When analyzing the standardized mortality ratio (SMR) after the earthquakes using the Cochran-Armitage trend test, seismic intensity was significantly associated with AMI mortality for 2 weeks after both the GEJ (P for trend=0.089) and H-A earthquakes (P for trend=0.005).Conclusions:Following the GEJ and H-A earthquakes, there was a sharp increase in CVD mortality. The effect of the disaster was sustained for months after the H-A earthquake, but was diminished after the GEJ Earthquake. (Circ J 2015; 79: 1000–1008)