著者

Yuji Nagatomo Tsutomu Yoshikawa Hiroshi Okamoto Akira Kitabatake Masatsugu Hori on behalf of J-CHF Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.2, no.3, pp.143-151, 2020-03-10 (Released:2020-03-10)

参考文献数

27

被引用文献数

1

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Background:Heart rate (HR) reduction by β-blocker might not benefit patients with heart failure and reduced ejection fraction (HFrEF) with atrial fibrillation (AF).Methods and Results:The J-CHF study was a prospective randomized multicenter trial that assigned 360 HFrEF patients to a 2.5 mg/5 mg/20 mg target dose of carvedilol. Carvedilol was uptitrated over 8 weeks and then the dose was fixed. Of 321 patients available for analysis, AF was identified in 65 (20%). Using the median absolute change in HR at 32 weeks (∆HR), the subjects were further divided into group A (∆HR >−6 beats/min) and B (∆HR ≤−6 beats/min). Both in sinus rhythm (SR) and AF, baseline characteristics and achieved carvedilol dose were similar between groups A and B. In SR, the time-dependent change in left ventricular EF (LVEF) and LV end-diastolic dimension (LVEDD) over 56 weeks was more favorable in B compared with A (∆LVEF, P=0.036; ∆LVEDD, P=0.047), and ∆HR was independently associated with ∆LVEF (P=0.040). Group B had a lower rate of the primary endpoint, defined as a composite of death and hospitalization due to cardiovascular causes including acute decompensated HF at 3 years (P=0.002). ∆HR was an independent predictor of the primary endpoint (P=0.01), but this was not observed in AF.Conclusions:Response to the carvedilol HR reduction might differ in HFrEF between SR and AF.

著者

Fikri Taufiq Peili Li Junichiro Miake Ichiro Hisatome

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.11, pp.469-473, 2019-11-08 (Released:2019-11-08)

参考文献数

54

被引用文献数

8

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Among the several independent risk factors for atrial fibrillation (AF), hyperuricemia has been widely accepted as associated with the incidence of paroxysmal or persistent AF, as well as with the risk of AF in patients undergoing cardiovascular surgery. The electrophysiological mechanism of AF involves electrical remodeling of the arrhythmogenic substrate and abnormal automaticity as trigger. Both electrical and structural remodeling mediated by oxidative stress derived from either xanthine oxidoreductase (XOR), soluble uric acid (UA) or monosodium urate (MSU) crystals might be plausible explanations for the association of AF with hyperuricemia. XOR generates reactive oxygen species (ROS) that lead to atrial structural remodeling via inflammation. Soluble UA accumulates intracellularly through UA transporters (UAT), shortening the atrial action potential via enhanced expression and activity of Kv1.5 channel proteins. Intracellular accumulation of soluble UA generates ROS in atrial myocytes via nicotinamide adenine dinucleotide phosphate oxidase, which phosphorylates ERK/Akt and heat shock factor 1 (HSF1), thereby increasing transcription and translation of Hsp70, which stabilizes Kv1.5. In macrophages, MSU activates the NLRP3 inflammasome and proteolytic processing mediated by caspase-1 with enhanced interleukin (IL)-1β and IL-18 secretion. Use of an XOR inhibitor, antioxidants, a UAT inhibitor such as a uricosuric agent, and an NLRP3 inflammasome inhibitor, might become a potential strategy to reduce the risk of hyperuricemia-induced AF, and control serum UA level.

著者

Junko Naito Hiroshige Ohashi Michiya Ohno Masafumi Sugiyama Kazuyoshi Hayakawa Akihisa Kunishima Nobuyuki Takada Tatsuya Kariya Koshi Goto Hisato Takatsu Toshiki Ohira Koji Nakahara Ichijiro Murata Shingo Minatoguchi Gakuro Yoshida Hiroyuki Okura Shinya Minatoguchi

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.11, pp.508-516, 2019-11-08 (Released:2019-11-08)

参考文献数

31

被引用文献数

2

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Background:Levocarnitine has been reported to improve the left ventricular (LV) systolic function and decrease LV hypertrophy in hemodialysis (HD) patients. Its effect on LV diastolic dysfunction, however, has not yet been clarified.Methods and Results:HD patients (n=88) were given levocarnitine i.v. 1,000 mg for 12 months at the end of every dialysis session through the dialysis circuit of the venous site. LV ejection fraction (EF), E/A, E/e’, left atrial volume index (LAVI) and LV mass index (LVMI) were measured before and 3, 6, 9, and 12 months after the start of levocarnitine on echocardiography. We regarded E/A≤0.8, E/e’>14 and LAVI>34 mL/m2as LV diastolic dysfunction, and LVEF<55% as LV systolic dysfunction. We also investigated the effect of levocarnitine on HFpEF. Plasma brain natriuretic peptide, total carnitine, free carnitine, and acyl-carnitine and biochemistry parameters were measured. Levocarnitine significantly improved LV diastolic function in HD patients with LV diastolic dysfunction, but did not affect LV diastolic function in those with normal LV diastolic function. Levocarnitine significantly improved HFpEF. Levocarnitine significantly improved the LV systolic function in HD patients with LV systolic dysfunction but did not affect the LV systolic function in those with normal LV systolic function. Levocarnitine significantly decreased LVMI and increased plasma total, free, and acyl-carnitine.Conclusions:Levocarnitine ameliorates LV diastolic as well as LV systolic dysfunction in HD patients.

著者

Naoki Tamada Kazuhiko Nakayama Kenichi Yanaka Hiroyuki Onishi Yuto Shinkura Yu Taniguchi Hiroto Kinutani Yasunori Tsuboi Kazuhiro P. Izawa Seimi Satomi-Kobayashi Hiromasa Otake Hiroshi Tanaka Toshiro Shinke Yutaka Okita Noriaki Emoto Ken-ichi Hirata

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.5, pp.228-234, 2019-05-10 (Released:2019-05-10)

参考文献数

27

被引用文献数

3

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Background:While hemodynamics and exercise capacity in patients with chronic thromboembolic pulmonary hypertension (CTEPH) can be improved by invasive therapy such as pulmonary endarterectomy (PEA) and balloon pulmonary angioplasty (BPA), there has been little data on the health-related quality of life (HRQOL) in such patients.Methods and Results:This single-center and observational study compared the impact of invasive therapy on HRQOL. We utilized the Medical Outcome Study 36-Item Short Health Survey (SF-36) to measure HRQOL and compared HRQOL changes after PEA and BPA. A total of 48 patients were diagnosed with CTEPH. Of these, 39 patients completed questionnaires before and after invasive therapy. The PEA group (n=15) and the BPA group (n=24) had similar improvements in clinical parameters. With regard to HRQOL score, both groups had fairly low scores in physical functioning (PF), role physical (RP), general health (GH), social functioning (SF), role emotional (RE), and physical component summary (PCS) at baseline. PF, GH, vitality (VT), mental health (MH), and PCS had significant improvements in the PEA group while PCS and all subscales except for bodily pain (BP) had significant improvements in the BPA group. Furthermore, changes between baseline and follow-up were not significantly different between the 2 groups.Conclusions:BPA for patients who are ineligible for PEA can recover HRQOL to a similar level to that achieved by PEA.

著者

Koutaro Yokote Junya Ako Kazuo Kitagawa Hyoe Inomata Toshihiko Sugioka Keiko Asao Yasuhiko Shinmura Junichiro Shimauchi Tamio Teramoto

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.5, pp.219-227, 2019-05-10 (Released:2019-05-10)

参考文献数

15

被引用文献数

4

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Background:Evolocumab is the first monoclonal antibody against proprotein convertase subtilisin/kexin type 9 (PCSK9) approved in Japan for the treatment of patients with familial hypercholesterolemia (FH) and hypercholesterolemia (HC). This study assessed the 12-week effectiveness and safety of low-density lipoprotein cholesterol (LDL-C)-lowering therapy by PCSK9 inhibition in patients with FH (homozygous [HoFH] or heterozygous [HeFH]) and HC by analyzing evolocumab data collected in the real-world setting in Japan.Methods and Results:Overall, 427 patients (mean±SD age, 61.6±13.8 years; female, 38.4%; 28 HoFH, 320 HeFH, 79 HC), enrolled from 299 clinical sites, were included in the safety analysis set. The major cardiovascular risk factors were coronary artery disease (77.3%), diabetes mellitus/impaired glucose tolerance (38.6%), and hypertension (65.1%). Median follow-up duration was 85.0 days. After 12 weeks of evolocumab treatment, the mean±SD percent change from baseline in LDL-C was −45.5%±27.0% (n=23) in HoFH (P<0.001 vs. baseline; t-test), −54.2%±29.0% (n=280) in HeFH (P<0.001), and −64.6%±22.4% (n=72) in HC (P<0.001) patients. The incidence of adverse drug reactions was 5.4% (23/427).Conclusions:Results suggest that patients receiving evolocumab treatment in the real-world setting were predominantly those with FH and HC in the secondary prevention group. LDL-C-lowering effectiveness with evolocumab was observed in FH (both HoFH and HeFH) and HC patients.

著者

Jeff Z. Chen Hisashi Sawada Jessica J. Moorleghen Mackenzie Weiland Alan Daugherty Mary B. Sheppard

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

pp.CR-18-0012, (Released:2019-04-27)

参考文献数

32

被引用文献数

24

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Background:High-frequency ultrasound has facilitated in vivo measurement of murine ascending aorta, allowing aortic strain to be determined from 2-D imaging. Thoracic aortic aneurysms associated with mutations infibrillin-1(FBN1) display elastin fragmentation, which may affect aortic strain. In this study, we determined the relationship between elastin fragmentation and aortic circumferential strain in wild-type (WT) and fibrillin-1 hypomorphic (FBN1mgR/mgR) mice.Methods and Results:Luminal diameter of the ascending aorta from WT andFBN1mgR/mgRmice was measured in systole and diastole. Expansion of the ascending aorta during systole in male and female WT mice was 0.21±0.02 mm (16.3%) and 0.21±0.01 mm (17.0%), respectively, while expansion in male and femaleFBN1mgR/mgRmice was 0.11±0.04 mm (4.9%) and 0.07±0.02 mm (4.5%), respectively. Reduced circumferential strain was observed inFBN1mgR/mgRmice compared with WT littermates. Elastin fragmentation was inversely correlated to circumferential strain (R2=0.628, P=0.004) and significantly correlated with aortic diameter (systole, R2=0.397, P=0.038; diastole, R2=0.515, P=0.013).Conclusions:FBN1mgR/mgRmice had increased aortic diameter, reduced circumferential strain, and increased elastin fragmentation. Elastin fragmentation inFBN1mgR/mgRand their WT littermates was correlated with reduced circumferential strain.

著者

Akinori Higaki Katsuji Inoue Masaki Kinoshita Shuntaro Ikeda Osamu Yamaguchi

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.4, pp.197, 2019-04-10 (Released:2019-04-10)

参考文献数

3

被引用文献数

5

著者

Toru Miyoshi Hideo Kawakami Yusuke Kono Akira Oshita Hiroshi Matsuoka

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

pp.CR-19-0014, (Released:2019-03-20)

参考文献数

1

著者

Shigeru Miyagawa Kyongsun Pak Shungo Hikoso Tomohito Ohtani Eisuke Amiya Yasushi Sakata Shinichiro Ueda Masahiro Takeuchi Issei Komuro Yoshiki Sawa

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.1, pp.29-34, 2019-01-10 (Released:2019-01-10)

参考文献数

20

被引用文献数

7

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Background: Accurate prognosis for heart failure (HF) survival is important for quality of life, treatment decisions, and early evaluation of new therapies and devices. Here, we developed a multivariate risk model for predicting survival in Japanese patients with HF, using parameters that are readily observable in a clinical setting. Methods and Results: We analyzed data for 1,214 adults with HF (EF <35%). Of 424 available clinical baseline factors in the derivation dataset, 17 candidate predictors were identified on Cox proportional hazards regression. These predictors were assessed for clinical relevance and tested in candidate models using cross-validated 5-year C-statistics. This process yielded a set of 14 covariates with good accuracy for predicting actual 5-year survival: age; LVEF; albumin; BMI; Hb; sodium; history of renal dysfunction, diabetes, or chronic dialysis; times HF recurred or required readmission to the hospital; use of cardiac drip, thiazide diuretic, or per oral inotropic agent; and loop diuretic dosage. These 14 variables were used to establish the Japan Heart Failure Model (JHFM) for predicting survival in patients with HF. When applied to an independent validation dataset, the results from the JHFM were closer to actual survival than those of the Seattle Heart Failure Model. Conclusions: JHFM predictions for 5-year survival had good accuracy for Japanese patients with HF. The JHFM uses parameters that can be measured at any hospital.

著者

Sho Suzuki Hirohiko Motoki Yusuke Kanzaki Takuya Maruyama Naoto Hashizume Ayako Kozuka Kumiko Yahikozawa Koichiro Kuwahara

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.3, pp.137-141, 2019-03-08 (Released:2019-03-08)

参考文献数

24

被引用文献数

1

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Background: Clinical evidence of the effects of loop diuretics in patients with heart failure with preserved ejection fraction (HFpEF) is lacking. Thus, we compared the impact of azosemide and furosemide, long- and short-acting loop diuretics, in patients with HFpEF. Methods and Results: A prospective multicenter cohort study was conducted between July 2014 and July 2018. We enrolled 301 consecutive patients with HFpEF (median age, 84 years; IQR, 79–88 years; 54.8% female). Azosemide was used in 127 patients (azosemide group), and furosemide in 174 (furosemide group). We constructed Cox models for a composite of cardiac death, non-fatal myocardial infarction, non-fatal stroke, and HF hospitalization (primary endpoints). During a median follow-up of 317 days (IQR, 174–734 days), the primary endpoint occurred in 112 patients (37.2%). On multivariate inverse probability of treatment weighted (IPTW) Cox modeling, the azosemide group had a significantly lower incidence of adverse events than the furosemide group (hazard ratio [HR], 0.46; 95% confidence interval [CI]: 0.27–0.80; P=0.006). Furthermore, on multivariate IPTW Cox modeling for the secondary endpoints, cardiac death (HR, 0.38; 95% CI: 0.17–0.89; P=0.025) and unplanned hospitalization for decompensated HF (HR, 0.50; 95% CI: 0.28–0.89; P=0.018) were also reduced in the azosemide group. Conclusions: Azosemide significantly reduced the risk of adverse events compared with furosemide in HFpEF patients.

著者

Yuhei Nojima Hidenori Adachi Madoka Ihara Tetsuya Kurimoto Shinsuke Nanto

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.2, pp.118, 2019-02-08 (Released:2019-02-08)

参考文献数

1

著者

Masaomi Gohbara Kunihiro Nishimura Michikazu Nakai Yoko Sumita Tsutomu Endo Yasushi Matsuzawa Masaaki Konishi Masami Kosuge Toshiaki Ebina Kouichi Tamura Kazuo Kimura

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.1, pp.20-28, 2019-01-10 (Released:2019-01-10)

参考文献数

30

被引用文献数

6

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Background: The aim of this study was to clarify the clinical impact of activities of daily living (ADL) using the Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure Combination (JROAD-DPC) database. Methods and Results: From April 2012 to March 2014, the JROAD-DPC database included 206,643 patients with acute coronary syndrome (ACS; n=49,784), heart failure (HF; n=136,878), or aortic aneurysm/dissection (Aorta; n=19,981). We divided them into 3 categories with regard to age (low, 20–59 years; middle, 60–79 years; high, ≥80 years) and admission ADL (low, Barthel index [BI] 0–70; middle, BI 75–95; high, BI 100). ACS, HF, and Aorta patients with low ADL had higher in-hospital mortality rates (18.3%, 16.7%, and 33.4%) than those with middle or high ADL (P<0.001, χ2 test). On multivariable analysis, BI on admission was associated with in-hospital mortality of ACS (OR, 0.986 per 1 BI; P<0.001), HF (OR, 0.986 per 1 BI; P<0.001), and Aorta (OR, 0.986 per 1 BI; P<0.001), adjusted for gender, age, body mass index, hypertension, diabetes mellitus, dyslipidemia, and the Charlson comorbidity index. Moreover, patients with low age and low ADL had a higher in-hospital mortality rate than those with high age and high ADL in regard to HF (8.6% vs. 6.0%). Conclusions: According to JROAD-DPC data, assessment of admission ADL is important in patients with cardiovascular disease.

著者

Takashi Oki Hirokazu Miyoshi Yoshifumi Oishi Arata Iuchi Kenya Kusunose Hirotsugu Yamada Allan L. Klein

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.1, pp.8-16, 2019-01-10 (Released:2019-01-10)

参考文献数

67

被引用文献数

4

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At present, heart failure with preserved ejection fraction (HFpEF) is a commonly accepted condition in HF patients. In contrast to HF with reduced EF (HFrEF), HFpEF is strongly associated with aging, and vascular, metabolic, neurohormonal, and systemic inflammatory comorbidities. Two major hypotheses explain the pathophysiology of HFpEF (stages C,D in the American College of Cardiology Foundation/American Heart Association HF staging system): (1) impaired active relaxation and increased passive stiffness of the left ventricular (LV) myocardium during diastole (left atrial [LA]-LV coupling); and (2) LV and arterial stiffening during systole (LV-arterial coupling). Cardiac structural and functional abnormalities can be evaluated using non-invasive measures, such as 2-D, flow velocity Doppler, and tissue Doppler echocardiography, to estimate LV filling pressure and afterload mismatch. The clinical application of 2-D speckle-tracking echocardiography (2D-STE) is feasible for earlier diagnosis of functional abnormalities of the LA, LV, and elastic arteries in asymptomatic patients with cardiovascular risk factors (stages A,B). The goal of this review is to highlight the role of 2D-STE to detect impairment of LA-LV-arterial coupling beyond diastolic function earlier, because it may provide important information on the pathophysiology and prevention of HFpEF.

著者

Shingo Minatoguchi Takahiro Ando Toshiki Tanaka Yoshihisa Yamada Hiromitsu Kanamori Masanori Kawasaki Kazuhiko Nishigaki Shinya Minatoguchi

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.1, pp.17-19, 2019-01-10 (Released:2019-01-10)

参考文献数

9

被引用文献数

3

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Background: It is still unclear whether dynamic exercise increases the number of Muse cells, pluripotent stem cells, in the peripheral blood. Methods and Results: The number of Muse cells, SSEA3+ and CD105+ double-positive cells, in the peripheral blood was measured using FACS before and after 40 min of cardiac rehabilitation with dynamic exercise in 6 patients with heart disease. The number of Muse cells significantly increased after cardiac rehabilitation in all patients. Muse cell mobilization may be related to the beneficial clinical outcome of cardiac rehabilitation. Conclusions: Cardiac rehabilitation increases the number of Muse cells in the peripheral blood.