著者
Miho Nishitani-Yokoyama Katsumi Miyauchi Kazunori Shimada Takayuki Yokoyama Shohei Ouchi Tatsuro Aikawa Mitsuhiro Kunimoto Miki Yamada Akio Honzawa Shinya Okazaki Hiroyuki Daida
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.83, no.1, pp.101-109, 2018-12-25 (Released:2018-12-25)
参考文献数
23
被引用文献数
1 13

Background:Cardiac rehabilitation (CR) is an established multidisciplinary secondary preventive program. We investigated the effects of CR involving intensive physical activity (PA) on coronary plaque volume and components in patients with acute coronary syndrome (ACS).Methods and Results:We enrolled 32 consecutive patients with ACS in early phase II CR and randomly assigned them to an intensive CR group (n=18; CR participation ≥twice/week, daily PA ≥9,000 steps) or a standard CR group (n=14; CR participation ≥once/2weeks, daily PA ≥6,000 steps). Serial integrated backscatter intravascular ultrasound was performed for non-culprit lesions at baseline and after 8 months. Baseline clinical data were identical between the 2 groups. Unexpectedly, CR participation and PA did not differ significantly between the 2 groups, and there was no significant difference in plaque volume (PV) or components between the 2 groups. Subsequently, we classified the patients into 2 groups according to median PA (7,000 steps). There were significant differences in percent change of PV and of lipid volume between these 2 groups. In addition, these changes were negatively and independently correlated with PA.Conclusions:No significant difference was observed in PV or components between the intensive CR and the standard CR groups. Intensive PA, however, may retard coronary PV and ameliorate lipid component in patients with ACS participating in late phase II CR.
著者
Yasuaki Takeji Tomohiko Taniguchi Takeshi Morimoto Shinichi Shirai Takeshi Kitai Hiroyuki Tabata Kazuki Kitano Nobuhisa Ono Ryosuke Murai Kohei Osakada Koichiro Murata Masanao Nakai Hiroshi Tsuneyoshi Tomohisa Tada Masashi Amano Hiroki Shiomi Hirotoshi Watanabe Yusuke Yoshikawa Ko Yamamoto Mamoru Toyofuku Shojiro Tatsushima Norino Kanamori Makoto Miyake Hiroyuki Nakayama Kazuya Nagao Masayasu Izuhara Kenji Nakatsuma Moriaki Inoko Takanari Fujita Masahiro Kimura Mitsuru Ishii Shunsuke Usami Kenichiro Sawada Fumiko Nakazeki Marie Okabayashi Manabu Shirotani Yasutaka Inuzuka Tatsuhiko Komiya Kenji Minatoya Takeshi Kimura on behalf of the CURRENT AS Registry-2 Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-21-1062, (Released:2022-04-19)
参考文献数
29
被引用文献数
2

Background: There is scarce data evaluating the current practice pattern and clinical outcomes for patients with severe aortic stenosis (AS), including both those who underwent surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) and those who were managed conservatively in the TAVI era.Methods and Results: The Contemporary outcomes after sURgery and medical tREatmeNT in patients with severe Aortic Stenosis (CURRENT AS) Registry-2 is a prospective, physician-initiated, multicenter registry enrolling consecutive patients who were diagnosed with severe AS between April 2018 and December 2020 among 21 centers in Japan. The rationale for the prospective enrollment was to standardize the assessment of symptomatic status, echocardiographic evaluation, and other recommended diagnostic examinations such as computed tomography and measurement of B-type natriuretic peptide. Moreover, the schedule of clinical and echocardiographic follow up was prospectively defined and strongly recommended for patients who were managed conservatively. The entire study population consisted of 3,394 patients (mean age: 81.6 years and women: 60%). Etiology of AS was degenerative in 90% of patients. AS-related symptoms were present in 60% of patients; these were most often heart failure symptoms. The prevalence of high- and low-gradient AS was 58% and 42%, respectively, with classical and paradoxical low-flow low-gradient AS in 4.5% and 6.7%, respectively.Conclusions: The CURRENT AS Registry-2 might be large and meticulous enough to determine the appropriate timing of intervention for patients with severe AS in contemporary clinical practice.
著者
Yoshiaki Okuma Kenji Suda Hideyuki Nakaoka Yasuhiro Katsube Yoshihide Mitani Yukako Yoshikane Fukiko Ichida Takeji Matsushita Hiroyuki Shichino Isao Shiraishi Jun Abe Michiaki Hiroe Toshimichi Yoshida Kyoko Imanaka-Yoshida
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.80, no.11, pp.2376-2381, 2016-10-25 (Released:2016-10-25)
参考文献数
46
被引用文献数
23 25

Background:Tenascin-C (TN-C) is an extracellular matrix glycoprotein that is heavily upregulated at sites of inflammation. We conducted a retrospective study to assess the utility of TN-C as a novel biomarker to predict the risk of developing coronary artery lesions (CAL) and resistance to intravenous immunoglobulin (IVIG) in patients with Kawasaki disease (KD).Methods and Results:We collected blood samples of 111 KD patients (IVIG-responder: 89, IVIG-resistant: 22; CAL: 8) and 23 healthy controls, and measured the serum levels of TN-C. TN-C levels on admission were significantly higher in patients than in healthy controls and in patients during convalescence after IVIG administration (69.6 vs. 20.4 vs. 39.7 ng/ml, respectively; P<0.001), and correlated positively with C-reactive protein (P<0.001), neutrophil (percentage; P=0.005), and ALT (P<0.001), and negatively with platelet count (P=0.023) and sodium level (P=0.025). On admission, TN-C levels in patients who later developed CAL were significantly higher than in those without CAL (P=0.010), and significantly higher in IVIG-resistant subjects than in IVIG-responders (P=0.003). The accuracy of TN-C testing for the prediction of IVIG resistance was comparable to that of the Kobayashi score.Conclusions:Serum TN-C could be a biomarker for predicting the risk of developing CAL and IVIG resistance during the acute phase of KD. (Circ J 2016; 80: 2376–2381)
著者
Eline H Ploumen Rosaly A Buiten Paolo Zocca Carine JM Doggen Adel Aminian Carl E Schotborgh Gillian AJ Jessurun Ariel Roguin Peter W Danse Edouard Benit Clemens von Birgelen
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-21-0292, (Released:2021-07-13)
参考文献数
31
被引用文献数
13

Background:At 1 year, the international randomized BIONYX trial (ClinicalTrials.gov:NCT02508714) established non-inferiority regarding safety and efficacy of the novel Resolute Onyx zotarolimus-eluting stent (RO-ZES) vs. the Orsiro sirolimus-eluting stent (O-SES). Although the RO-ZES is used in daily practice, no clinical results have been published beyond 2 years.Methods and Results:We assessed 3-year clinical outcomes of 2,488 all-comers after percutaneous coronary intervention (PCI) with RO-ZES vs. O-SES. The main endpoint was target vessel failure (TVF), a composite of cardiac death, target vessel myocardial infarction (MI), or target vessel revascularization. Time-to-endpoints was assessed by Kaplan-Meier methods and between-group comparisons by log-rank tests. Follow-up was available in 2,433/2,488 (97.8%) patients. There was no significant between-stent difference in TVF (RO-ZES 112/1,243 [9.2%] vs. O-SES 109/1,245 [8.9%], hazard ratio [HR]: 1.03, 95% confidence interval [CI] 0.79–1.34; Plog-rank=0.85) and its individual components. The all-cause mortality was significantly lower after PCI with RO-ZES (3.7% vs.5.4%, HR: 0.67, 95% CI 0.46–0.97; Plog-rank=0.034), but cardiac mortality did not differ significantly (1.1% vs.1.9%, HR: 0.56, 95% CI 0.28–1.11; Plog-rank=0.09). Definite-or-probable stent thrombosis rates were low for both groups (0.6% vs.1.2%, HR: 0.46, 95% CI 0.19–1.14; Plog-rank=0.09).Conclusions:This first 3-year randomized assessment of the RO-ZES showed a favorable rate of TVF that matched the outcomes of patients treated with O-SES. We observed a lower rate of all-cause death in the RO-ZES group, but long-term clinical follow-up is of interest.
著者
Yugo Yamashita Ryuji Uozumi Yasuhiro Hamatani Masahiro Esato Yeong-Hwa Chun Hikari Tsuji Hiromichi Wada Koji Hasegawa Hisashi Ogawa Mitsuru Abe Satoshi Morita Masaharu Akao
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.81, no.9, pp.1278-1285, 2017-08-25 (Released:2017-08-25)
参考文献数
27
被引用文献数
108

Background:The current status and outcomes of direct oral anticoagulant (DOAC) use have not been widely evaluated in unselected patients with atrial fibrillation (AF) in the real world.Methods and Results:The Fushimi AF Registry is a community-based prospective survey of AF patients who visited the participating medical institutions (n=80) in Fushimi, Kyoto, Japan. Follow-up data with oral anticoagulant (OAC) status were available for 3,731 patients by the end of November 2015. We evaluated OAC status and clinical outcomes according to OAC status. The number (incidence rate) of stroke/systemic embolism (SE) and major bleeding events during the median follow-up of 3.0 years was 224 (2.3%/year) and 177 (1.8%/year), respectively. After the release of DOAC, the prevalence of DOAC use increased gradually and steadily, and that of warfarin, DOAC and no OAC was 37%, 26% and 36%, respectively in 2015. On Cox proportional hazards modeling incorporating change in OAC status as a time-dependent covariate for stroke/SE and major bleeding events, use of DOAC compared with warfarin was not associated with stroke/SE events (HR, 0.95; 95% CI: 0.59–1.51, P=0.82) or major bleeding events (HR, 0.82; 95% CI: 0.50–1.36, P=0.45).Conclusions:In real-world clinical practice, there were no significant differences in stroke/SE events or major bleeding events for DOAC compared with warfarin in patients with AF.
著者
Richard E. Gilbert
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.77, no.4, pp.849-856, 2013 (Released:2013-03-25)
参考文献数
64
被引用文献数
34 42

Although seemingly diverse, the tissue injury at sites of diabetic complications, whether in the heart, kidneys or eyes, shares the common histopathological feature of endothelial cell loss, a consequence of both increased cell death and deficient regeneration. In medium-sized and larger arteries the loss of the protective lining contributes to the atherosclerotic process, while at sites of microvascular disease endothelial cell loss leads to capillary rarefaction and ischemia. The pathophysiology of these changes and their consequences on organ structure and function in diabetes are reviewed, and the potential for endothelial regenerative strategies to enhance repair and ameliorate the long-term complications of diabetes is explored.  (Circ J 2013; 77: 849–856)
著者
Kensuke Matsushita Lucie Lachmet-Thébaud Benjamin Marchandot Antonin Trimaille Chisato Sato Charlotte Dagrenat Stephane Greciano Fabien De Poli Pierre Leddet Marilou Peillex Sébastien Hess Adrien Carmona Charline Jimenez Joe Heger Antje Reydel Patrick Ohlmann Laurence Jesel Olivier Morel
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-20-1116, (Released:2021-04-06)
参考文献数
25
被引用文献数
8

Background:Although there is an apparent rapid and spontaneous recovery of left ventricular ejection fraction (LVEF) in patients with Takotsubo syndrome (TTS), recent studies have demonstrated a long-lasting functional impairment in those patients. The present study sought to evaluate the predictors of incomplete recovery following TTS and its impact on cardiovascular mortality.Methods and Results:Patients with TTS between 2008 and 2018 were retrospectively enrolled at 3 different institutions. After exclusion of in-hospital deaths, 407 patients were split into 2 subgroups according to whether their LVEF was >50% (recovery group; n=341), or ≤50% (incomplete recovery group; n=66) at the chronic phase. Multivariate logistic regression analysis found that LVEF (odds ratio [OR]: 0.94; 95% confidence interval [CI]: 0.91–0.98; P<0.001) and C-reactive protein levels (OR: 1.11; 95% CI: 1.02–1.22; P=0.02) at discharge were independent predictors of incomplete recovery. At a median follow up of 52 days, a higher cardiovascular mortality was evident in the incomplete recovery group (16% vs. 0.6%; P<0.001).Conclusions:This study demonstrated that incomplete recovery after TTS is characterized by residual systemic inflammation and an increased cardiac mortality at follow up. Altogether, the present study findings determined that patients with persistent inflammation are a high-risk subgroup, and should be targeted in future clinical trials with specific therapies to attenuate inflammation.
著者
Kengo Kusano Nobuyoshi Sugishita Masaharu Akao Hikari Tsuji Kunihiko Matsui Shinya Hiramitsu Yutaka Hatori Hironori Odakura Hiroyuki Kamada Koji Miyamoto Hisao Ogawa
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-20-1244, (Released:2021-04-02)
参考文献数
23
被引用文献数
4

Background:Direct oral anticoagulants have become a standard therapy for non-valvular atrial fibrillation (NVAF). However, little is known about their effectiveness/safety when prescribed by general practitioners to treat high-risk populations such as the elderly, those who are frail or have cognitive dysfunction.Methods and Results:In this multicenter, prospective study, a total of 5,717 NVAF patients (mean age 73.9 years) receiving rivaroxaban were registered by general practitioners, with a maximum 3-year follow up (mean 2.0±0.5 years). The primary endpoint was a composite of stroke and systemic embolism (SE). The annual incidence (per 100 person-years) of stroke/SE was 1.23% and for major bleeding, it was 0.63%. Multivariate analyses identified age ≥75 years (hazard ratio [HR]; 2.67, P<0.001) and history of ischemic stroke (HR; 1.89, P=0.005) as significant risk factors of stroke/SE, with history of major bleeding (HR; 14.9, P<0.001) and warfarin use (HR; 2.15, P=0.002) as risk factors for major bleeding events. Neither cognitive dysfunction, defined by the receipt of anti-dementia medications, nor frailty, evaluated by the classification of the Japanese Long-term Care Insurance system, correlated with stroke/SE or major bleeding events.Conclusions:The low incidence of adverse events, including stroke/SE and bleeding, in patients prescribed rivaroxaban by general practitioners supports its use as a safe and efficacious treatment in the standard clinical care of high-risk patient populations.
著者
Nicholas WS Chew Ching-Hui Sia Hwee-Lin Wee Loh Jia-Da Benedict Saurabh Rastogi Pipin Kojodjojo Wei Ping Daniel Chor Benjamin Sieu-Hon Leong Brandon Chi-Ping Koh Howen Tam Lit-Sin Quek Winnie CH Sia Kalyar Win Saw Benjamin Wei-Liang Tung Zan Zhe-Yan Ng Anand Ambhore Edgar Lik-Wui Tay Koo-Hui Chan Chi-Hang Lee Joshua Ping-Yun Loh Adrian Fatt-Hoe Low Mark Yan-Yee Chan Tiong-Cheng Yeo Huay-Cheem Tan Poay-Huan Loh
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-20-0800, (Released:2020-11-07)
参考文献数
26
被引用文献数
45

Background:Little is known about the effect of the coronavirus disease 2019 (COVID-19) pandemic and the outbreak response measures on door-to-balloon time (D2B). This study examined both D2B and clinical outcomes of patients with STEMI undergoing primary percutaneous coronary intervention (PPCI).Methods and Results:This was a retrospective study of 303 STEMI patients who presented directly or were transferred to a tertiary hospital in Singapore for PPCI from October 2019 to March 2020. We compared the clinical outcomes of patients admitted before (BOR) and during (DOR) the COVID-19 outbreak response. The study outcomes were in-hospital death, D2B, cardiogenic shock and 30-day readmission. For direct presentations, fewer patients in the DOR group achieved D2B time <90 min compared with the BOR group (71.4% vs. 80.9%, P=0.042). This was more apparent after exclusion of non-system delay cases (DOR 81.6% vs. BOR 95.9%, P=0.006). Prevalence of both out-of-hospital cardiac arrest (9.5% vs. 1.9%, P=0.003) and acute mitral regurgitation (31.6% vs. 17.5%, P=0.006) was higher in the DOR group. Mortality was similar between groups. Multivariable regression showed that longer D2B time was an independent predictor of death (odds ratio 1.005, 95% confidence interval 1.000–1.011, P=0.029).Conclusions:The COVID-19 pandemic and the outbreak response have had an adverse effect on PPCI service efficiency. The study reinforces the need to focus efforts on shortening D2B time, while maintaining infection control measures.
著者
Chun-Ka Wong Hayes Kam-Hei Luk Wing-Hon Lai Yee-Man Lau Ricky Ruiqi Zhang Antonio Cheuk-Pui Wong George Chi-Shing Lo Kwok-Hung Chan Ivan Fan-Ngai Hung Hung-Fat Tse Patrick Chiu-Yat Woo Susanna Kar-Pui Lau Chung-Wah Siu
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-20-0881, (Released:2020-09-26)
参考文献数
10
被引用文献数
33

Background:SARS-CoV-2 infection is associated with myocardial injury, but there is a paucity of experimental platforms for the condition.Methods and Results:Human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) infected by SARS-CoV-2 for 3 days ceased beating and exhibited cytopathogenic changes with reduced viability. Active viral replication was evidenced by an increase in supernatant SARS-CoV-2 and the presence of SARS-CoV-2 nucleocaspid protein within hiPSC-CMs. Expressions of BNP, CXCL1, CXCL2, IL-6, IL-8 and TNF-α were upregulated, while ACE2 was downregulated.Conclusions:Our hiPSC-CM-based in-vitro SARS-CoV-2 myocarditis model recapitulated the cytopathogenic effects and cytokine/chemokine response. It could be exploited as a drug screening platform.
著者
Atsushi Hozawa Aaron R. Folsom A. Richey Sharrett Thomas J Payne Lloyd E. Chambless
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.70, no.9, pp.1105-1110, 2006 (Released:2006-08-25)
参考文献数
31
被引用文献数
11 11

Background The association of smoking with coronary heart disease (CHD) occurrence has been reported to be weaker for populations with lower plasma cholesterol levels. Recent studies suggest that low-density lipoprotein cholesterol (LDL-C) and smoking contribute to different stages of atherosclerosis, so the present study was designed to test the hypothersis that smoking is a stronger risk factor for CHD when LDL-C is high. Methods and Results The study group of 13,410 middle-aged adults who were initially free of stroke and CHD were followed and over 13.3 years there were 932 incident CHD events. Tests for multiplicative interaction were performed using proportional hazards models. Both smoking and increased LDL-C were risk factors for CHD incidence. The relative hazard (RH) of CHD in relation to smoking tended to be larger among higher LDL-C categories compared with lower LDL-C categories. For example, when the participants were dichotomized into 4 categories, using smoking ≥15 cigarettes per day and LDL-C ≥130 mg/dl as cutoffs, those with high LDL-C and heavier cigarette smoking showed a very high RH of CHD (RH =2.81) compared with that expected from the product of the RHs of high LDL-C (RH =1.15) only × heavy smoking only (RH =1.71) (p for interaction =0.04). Conclusions These results suggest positive multiplicative interactions between smoking and LDL-C for CHD incidence. (Circ J 2006; 70: 1105 - 1110)