著者

Chitose Ishikawa Takayoshi Tsutamoto Masanori Fujii Hiroshi Sakai Toshinari Tanaka Minoru Horie

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.70, no.7, pp.857-863, 2006 (Released:2006-06-25)

参考文献数

31

被引用文献数

36 50

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Background The prognostic role of serum C-reactive protein (CRP) in chronic heart failure (CHF) patients, especially those with nonischemic dilated cardiomyopathy (DCM), remains unknown. In the present study, whether CRP provides prognostic information in DCM patients was evaluated. Methods and Results Neurohumoral factors and hemodynamics in 84 consecutive DCM patients were measured and these patients were followed up for a mean period of 42 months. During the follow-up period, 23 patients developed cardiac events and 18 patients died of cardiac causes. Using stepwise multivariate Cox proportional hazards regression analyses, log brain natriuretic peptide (BNP) (p=0.007) and high-sensitivity CRP (hsCRP) >1 mg/L (p=0.008) were significant independent predictors of cardiac events. The patients were stratified into 4 groups based on the normal serum concentration of hsCRP (1 mg/L) and median plasma concentration of BNP (110 pg/ml). Survival rates were significantly higher in patients with hsCRP <1 mg/L and BNP <110 pg/ml. The hazard ratio of patients with BNP >110 pg/ml and hsCRP >1 mg/L was 15.8 (95% confidence interval, 1.9-127.2) compared with those with BNP <110 pg/ml and hsCRP <1 mg/L for cardiac death. Conclusions Serum hsCRP level is an independent prognostic predictor in patients with DCM and the combination of hsCRP and BNP may be useful for the management of CHF patients with DCM. (Circ J 2006; 70: 857 - 863)

著者

Toshiaki Ohkuma Hirofumi Tomiyama Toshiharu Ninomiya Kazuomi Kario Satoshi Hoshide Yoshikuni Kita Toyoshi Inoguchi Yasutaka Maeda Katsuhiko Kohara Yasuharu Tabara Motoyuki Nakamura Takayoshi Ohkubo Hirotaka Watada Masanori Munakata Mitsuru Ohishi Norihisa Ito Michinari Nakamura Tetsuo Shoji Charalambos Vlachopoulos Akira Yamashina on behalf of the Collaborative Group for Japan Brachial-Ankle pulse wave VELocity individual participant data meta-analysis of prospective studies (J-BAVEL)

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-17-0636, (Released:2017-08-24)

参考文献数

14

被引用文献数

38

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Background:The optimal cutoff values of the brachial-ankle pulse wave velocity (baPWV) for predicting cardiovascular disease (CVD) were examined in patients with hypertension.Methods and Results:A total of 7,656 participants were followed prospectively. The hazard ratio for the development of CVD increased significantly as the baPWV increased, independent of conventional risk factors. The receiver-operating characteristic curve analysis showed that the optimal cutoff values for predicting CVD was 18.3 m/s. This cutoff value significantly predicted THE incidence of CVD.Conclusions:The present analysis suggests that the optimal cutoff value for CVD in patients with hypertension is 18.3 m/s.

著者

Mari Matsumoto Manabu Sakaguchi Shuhei Okazaki Kazuo Hashikawa Tsutomu Takahashi Masayasu Matsumoto Toshiho Ohtsuki Takeshi Shimazu Toshiki Yoshimine Hideki Mochizuki Kazuo Kitagawa

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-16-0707, (Released:2017-01-31)

参考文献数

18

被引用文献数

1 7

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Background:In Japan, warfarin treatment at prothrombin time-international normalized ratio (PT-INR) of 1.60–2.60 is recommended for elderly patients with nonvalvular atrial fibrillation (NVAF). But it remains unknown whether PT-INR 1.60–1.99 has a similar effect on stroke severity as a value >2.0. The purpose of this study was to clarify the association between infarct volume and PT-INR levels.Methods and Results:The 180 patients (mean age, 76 years [SD, 10 years], 53% male) selected from 429 consecutive ischemic stroke patients admitted within 48 h of onset between 2004 and 2014 with NVAF were included. We classified them into 4 groups according to their PT-INR values on admission: no warfarin (NW), 129 patients; PT-INR <1.60 (poor control: PC), 29 patients; PT-INR 1.60–1.99 (low-intensity control: LC), 14 patients; and PT-INR ≥2.00 (high-intensity control: HC), 8 patients. Median (interquartile range: IQR) of infarct volume was 55 mL (IQR 14–175) in the NW, 42 mL (IQR 27–170) in the PC, 36 mL (IQR 6–130) in the LC, and 11 mL (IQR 0–39) in the HC groups. The infarct volume of the HC group was significantly smaller than in the other 3 groups, but no difference existed between the LC and PC groups or the LC and NW groups.Conclusions:Warfarin control at PT-INR of 1.60–1.99 is not effective for reducing the severity of ischemic stroke in NVAF patients.

著者

Deri Hwang Sunyoung Kim Hangseok Choi In-Hwan Oh Byung Sung Kim Hyun Rim Choi So Yeon Kim Chang Won Won

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-16-0692, (Released:2016-09-21)

参考文献数

29

被引用文献数

1 32

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Background:Some disagreements surround the effects of calcium-channel blockers (CCBs) on the risk of dementia. The purpose of this study was to investigate the protective effects of CCBs on dementia among elderly hypertensive Koreans.Methods and Results:We conducted a large population-based cohort study using the senior cohort database of the Korean National Health Insurance Service (2002–2013). Subjects were elderly hypertensive Koreans older than 60 years of age. A total of 18,423 patients (CCB user group: 13,692 patients; non-CCB antihypertensive user group: 4,731 patients) were statistically analyzed using the Cox proportional hazard regression model to estimate the adjusted hazard ratio (aHR) and confidence intervals (CIs) of dementia associated with CCB use. There were 2,881 cases (21.0%) of dementia in the CCB user group and 1,124 cases (23.8%) in the non-user group. CCB use significantly reduced the risk of total dementia (aHR 0.81, 95% CI 0.75–0.87, P<0.0001), Alzheimer’s dementia (aHR 0.80, 95% CI 0.72–0.88, P<0.0001), and vascular dementia (aHR 0.81, 95% CI 0.70–0.94, P=0.0067).Conclusions:CCB use had a protective effect on the risk of dementia among elderly hypertensive Koreans.

著者

Takeshi Yamashita Yukihiro Koretsune Yuejin Yang Shih-Ann Chen Namsik Chung Yuichi J. Shimada Tetsuya Kimura Koichi Miyazaki Kenji Abe Michele Mercuri Christian T. Ruff Robert P. Giugliano

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-15-1082, (Released:2016-02-16)

参考文献数

23

被引用文献数

13 75

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Background:In the multinational, double-blind, double-dummy ENGAGE AF-TIMI 48 phase 3 study, once-daily edoxaban was non-inferior to warfarin for prevention of stroke or systemic embolism event (SEE) in patients with non-valvular atrial fibrillation (AF). Here, we evaluated the efficacy and safety of edoxaban in patients from East Asia.Methods and Results:Patients aged ≥21 years with documented AF and CHADS score ≥2 were randomized to receive once-daily edoxaban higher-dose (60 mg) or lower-dose (30 mg) regimen or warfarin dose-adjusted to an international normalized ratio of 2.0–3.0. Patients with a creatinine clearance of 30–50 ml/min, weighing ≤60 kg, or receiving strong p-glycoprotein inhibitors at randomization or during the study received a 50% dose reduction of edoxaban or matched placebo. This prespecified subanalysis included 1,943 patients from Japan, China, Taiwan, and South Korea. The annualized rate of stroke/SEE for higher-dose edoxaban was 1.35% vs. 2.62% for warfarin (hazard ratio [HR], 0.53; 95% confidence interval [CI]: 0.31–0.90, P=0.02) and 2.52% for lower-dose edoxaban (HR, 0.98; 95% CI: 0.63–1.54, P=0.93). Compared with warfarin (4.80%), major bleeding was significantly reduced for the higher-dose (2.86%; HR, 0.61; 95% CI: 0.41–0.89, P=0.011) and lower-dose regimens (1.59%; HR, 0.34; 95% CI: 0.21–0.54, P<0.001).Conclusions:Once-daily edoxaban provided similar efficacy to warfarin while reducing major bleeding risk in the East Asian population.

著者

Carl Hayward Hitesh Patel Alexander Lyon

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.78, no.11, pp.2577-2587, 2014-10-24 (Released:2014-10-24)

参考文献数

53

被引用文献数

4 14

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The treatment of heart failure (HF) may be entering a new era with clinical trials currently assessing the value of gene therapy as a novel therapeutic strategy. If these trials demonstrate efficacy then a new avenue of potential treatments could become available to the clinicians treating HF. In principle, gene therapy allows us to directly target the underlying molecular abnormalities seen in the failing myocyte. In this review we discuss the fundamentals of gene therapy and the challenges of delivering it to patients with HF. The molecular abnormalities underlying HF are discussed along with potential targets for gene therapy, focusing on SERCA2a. We discuss the laboratory and early clinical evidence for the benefit of SERCA2a gene therapy in HF. Finally, we discuss the ongoing clinical trials of SERCA2a gene therapy and possible future directions for this treatment. (Circ J 2014; 78: 2577–2587)

著者

Hiroaki Shimokawa

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-66-0058, (Released:2012-12-28)

被引用文献数

1 2

著者

Hiroshi Inoue Hirotsugu Atarashi Ken Okumura Takeshi Yamashita Naoko Kumagai Hideki Origasa for the J-RHYTHM Registry 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-14-0507, (Released:2014-08-06)

参考文献数

25

被引用文献数

14 39

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Background:It is disputed whether the risk of cardiogenic embolism varies with type of atrial fibrillation (AF). Although several studies have found that the risk of cardiogenic embolism was similar among paroxysmal and persistent/permanent AF, a few studies have found that patients with paroxysmal AF had a lower rate of stroke and systemic embolism than those with persistent/permanent AF. In the present study, post-hoc analysis of the J-RHYTHM Registry was done to compare the risk of thromboembolic events among 3 types of non-valvular AF (NVAF).Methods and Results:A total of 7,406 NVAF patients were followed up prospectively for 2 years. At baseline, warfarin was used for 78.6%, 90.0%, and 91.8% of patients with paroxysmal, persistent, and permanent AF, respectively. There were 126 thromboembolic events during the follow-up period. The crude event rate was 2-fold higher among the patients with permanent NVAF (2.29%) than among those with paroxysmal (1.16%) or persistent (1.20%) NVAF (P=0.001). After adjusting for warfarin use and CHA2DS2-VASc score components, however, the hazard ratio for thromboembolism did not differ between paroxysmal (reference) and permanent NVAF (1.007; 95% confidence interval: 0.955–1.061).Conclusions:The crude rate of thromboembolic events was higher in permanent NVAF than in paroxysmal NVAF, but after adjusting for warfarin use and CHA2DS2-VASc score components, paroxysmal and permanent NVAF patients had similar risk of thromboembolism.

著者

Yoichi Takaya Reon Kumasaka Tetsuo Arakawa Takahiro Ohara Michio Nakanishi Teruo Noguchi Masanobu Yanase Hiroshi Takaki Yuhei Kawano Yoichi Goto

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-13-0779, (Released:2013-11-12)

参考文献数

36

被引用文献数

6 42

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Background: Although there is a general fear that exercise training might deteriorate renal function in chronic kidney disease (CKD) patients, the effect of cardiac rehabilitation (CR) on renal function in acute myocardial infarction (AMI) patients with CKD remains unknown. We sought to determine whether CR is associated with amelioration or deterioration of renal function in such patients. Methods and Results: We enrolled 528 AMI patients who participated in a 3-month CR program. Clinical data before and after CR were compared according to participation in CR and comorbidities. In patients without CKD (estimated glomerular filtration rate [eGFR] ≥60ml·min−1·1.73m−2, n=348), peak oxygen uptake (VO2) and B-type natriuretic peptide (BNP) improved without a change in eGFR. In contrast, in patients with CKD (eGFR <60ml·min−1·1.73m−2, n=180), eGFR improved (48±12 to 53±15ml·min−1·1.73m−2, P<0.001), together with improvements in peak VO2 and BNP. When patients with CKD were divided into non-active (≤1time/week, n=70) and active participants (≥1.1time/week, n=110) according to attendance in CR, active participants showed an improvement in eGFR (50±10 to 53±13ml·min−1·1.73m−2, P<0.001), whereas eGFR did not change in non-active participants. Similar results were obtained in each subgroup of patients with hypertension, dyslipidemia, or diabetes mellitus. Conclusions: In AMI patients with CKD, active participation in CR was associated with improved peak VO2, BNP, and eGFR.

著者

Naoaki Onishi Kazuaki Kaitani Yoshihisa Nakagawa Atsushi Kobori Koichi Inoue Toshiya Kurotobi Itsuro Morishima Yumie Matsui Hirosuke Yamaji Yuko Nakazawa Kengo Kusano Yukiko Shimizu Koji Hanazawa Toshihiro Tamura Chisato Izumi Takeshi Morimoto Koh Ono Takeshi Kimura Satoshi Shizuta on behalf of the KPAF Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0671, (Released:2024-01-11)

参考文献数

31

被引用文献数

1

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Background: Catheter ablation (CA) for atrial fibrillation (AF) in patients on hemodialysis (HD) is reported to have a high risk of late recurrence (LR). However, the relationship between early recurrence (ER) within a 90-day blanking period after CA in AF patients and LR in HD patients remains unclear.Methods and Results: Of the 5,010 patients in the Kansai Plus Atrial Fibrillation Registry, 5,009 were included in the present study. Of these patients, 4,942 were not on HD (non-HD group) and 67 were on HD (HD group). HD was an independent risk factor for LR after the initial CA (adjusted hazard ratio 1.6; 95% confidence interval 1.1–2.2; P=0.01). In patients with ER, the rate of sinus rhythm maintenance at 3 years after the initial CA was significantly lower in the HD than non-HD group (11.4% vs. 35.4%, respectively; log-rank P=0.004). However, in patients without ER, there was no significant difference in the rate of sinus rhythm maintenance at 3 years between the HD and non-HD groups (67.7% vs. 74.5%, respectively; log-rank P=0.62).Conclusions: ER in HD patients was a strong risk factor for LR. However, even HD patients could expect a good outcome without ER after the initial CA.

著者

Sachiyo Ono Shunsuke Kubo Kohei Osakada Takeshi Maruo Kazushige Kadota

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0714, (Released:2023-12-15)

参考文献数

1

著者

Shiro Nakahara

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0388, (Released:2023-06-27)

参考文献数

12

著者

Hidehiro Iwakawa Masateru Takigawa Junji Yamaguchi Claire A Martin Masahiko Goya Tasuku Yamamoto Miki Amemiya Takashi Ikenouchi Miho Negishi Iwanari Kawamura Kentaro Goto Takatoshi Shigeta Takuro Nishimura Tomomasa Takamiya Susumu Tao Shinsuke Miyazaki Hiroyuki Watanabe Tetsuo Sasano

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0574, (Released:2023-10-27)

参考文献数

28

被引用文献数

1

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Background: For lesion size prediction, each input parameter, including ablation energy (AE), and output parameter, such as impedance, is individually used. We hypothesize that using both parameters simultaneously may be more optimal.Methods and Results: Radiofrequency applications at a range of power (30–50 W), contact force (10 g and 20 g), duration (10–60 s), and catheter orientation with normal saline (NS)- or half-normal saline (HNS)-irrigation were performed in excised porcine hearts. The correlations, with lesion size of AE, absolute impedance drop (∆Imp-drop), relative impedance drop (%Imp-drop), and AE*%Imp-drop were examined. Lesion size was analyzed in 283 of 288 lesions (NS-irrigation, n=142; HNS-irrigation, n=141) without steam pops. AE*%Imp-drop consistently showed the strongest correlations with lesion maximum depth (NS-irrigation, ρ=0.91; HNS-irrigation, ρ=0.94), surface area (NS-irrigation, ρ=0.87; HNS-irrigation, ρ=0.86), and volume (NS-irrigation, ρ=0.94; HNS-irrigation, ρ=0.94) compared with the other parameters. Moreover, compared with AE alone, AE*%Imp-drop significantly improved the strength of correlation with lesion maximum depth (AE vs. AE*%Imp-drop, ρ=0.83 vs. 0.91, P<0.01), surface area (ρ=0.73 vs. 0.87, P<0.01), and volume (ρ=0.84 vs. 0.94, P<0.01) with NS-irrigation. This tendency was also observed with HNS-irrigation. Parallel catheter orientation showed a better correlation with lesion depth and volume using ∆Imp-drop, %Imp-drop, and AE*%Imp-drop than perpendicular orientation.Conclusions: The combination of input and output parameters is more optimal than each single parameter for lesion prediction.

著者

Shinya Suzuki

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0586, (Released:2023-08-30)

参考文献数

7

著者

Ahmed Arafa Yoshihiro Kokubo Rena Kashima Chisa Matsumoto Masayuki Teramoto Kengo Kusano

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0464, (Released:2023-09-22)

参考文献数

35

被引用文献数

1

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Background: Atrial fibrillation (AF) is the most diagnosed arrhythmia in clinical settings. The fatty liver index (FLI) is a marker of liver steatosis with potential cardiovascular implications. This study investigated whether FLI could predict the risk of AF.Methods and Results: We used data from the Suita Study, a Japanese population-based prospective cohort study. A total of 2,346 men and 3,543 women, aged 30–84 years, without prevalent AF were included and followed up. The diagnosis of AF was established during follow-up using electrocardiograms, hospital records, and death certificates. FLI was assessed during a baseline health checkup. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated for incident AF per FLI quintile and log-transformed FLI. Within a median 14.5 years of follow-up, 142 men and 105 women developed AF. Compared with women in the third (middle) FLI quintile, women in the first (lowest), fourth, and fifth (highest) quintiles showed a higher risk of AF, with multivariable-adjusted HRs of 2.37 (95% CI 1.06–5.31), 2.60 (95% CI 1.30–5.17), and 2.04 (95% CI 1.00–4.18), respectively. No corresponding associations were observed in men. The change in log-transformed FLI was not associated with the risk of AF in either sex.Conclusions: A U-shaped association between FLI and AF risk was detected in Japanese women. FLI could be a screening tool to detect women at high risk of developing AF.

著者

Yasuharu Matsunaga-Lee

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0727, (Released:2023-11-21)

参考文献数

11

著者

Keisuke Kuga Aiyan Li Masae Endo Bumpei Niho Akihiro Suzuki Mami Enomoto Miyako Kanemoto Iwao Yamaguchi

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.66, no.3, pp.236-240, 2002 (Released:2002-03-15)

参考文献数

13

被引用文献数

4 4

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Electrocardiographic recognition of the P' wave during tachycardia is very useful in the diagnosis of supraventricular tachycardias. In slow/fast (S/F) atrioventricular nodal reentrant tachycardia (AVNRT), no discrete P' waves are observed on ECG and pseudo r' deflection in lead V1 (pseudo r') is commonly recognized. However, the atrial components that contribute to the genesis of pseudo r' in lead V1 have not been described and this study aimed to clarify them by analysis of the whole activation sequence of the right atrium using Basket catheter isochronal mapping. The study group comprised 48 patients with AVNRT. Pseudo r' was defined as an upward deflection in the terminal portion of the QRS complex during tachycardia that was not recognized during sinus rhythm and it occurred in 45 patients (94%). During S/F AVNRT, the retrograde atrial activation was earliest on His bundle electrogram, followed by the coronary sinus ostium, distal coronary sinus and high right atrium. Only the high lateral aspect of the right atrium was activated after the end of the QRS complex. The interval between the onset of QRS in multiple surface ECG leads and the atrial activities on high right atrium was similar to the V-r' interval in lead V1 (111 ±20 ms, 117±11 ms) and correlated with the V-r' interval (r=0.56). Pseudo r' deflection in lead V1 is a highly sensitive indicator of S/F AVNRT, and appears to result from the activation of the superolateral aspect of the right atrium. (Circ J 2002; 66: 236 - 240)

著者

Ryu Takagi Takashi Kubo

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0689, (Released:2023-10-20)

参考文献数

12

被引用文献数

1

著者

Daigo Kachi Tetsumin Lee Michihito Naito Kazuki Matsuda Kodai Sayama Yuki Odanaka Mao Terui Tomoki Horie Shinichiro Okata Masashi Nagase Yuta Taomoto Toru Misawa Ryoichi Miyazaki Masakazu Kaneko Yasutoshi Nagata Toshihiro Nozato Takashi Ashikaga

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0391, (Released:2023-09-09)

参考文献数

1

著者

Kazuma Tashiro Hiroyoshi Mori Hiroshi Suzuki

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0611, (Released:2023-09-23)

参考文献数

11