著者
Management of Elevated Cholesterol in the Primary Prevention Group of Adult Japanese (MEGA) Study Group
出版者
社団法人日本循環器学会
雑誌
Circulation journal : official journal of the Japanese Circulation Society (ISSN:13469843)
巻号頁・発行日
vol.68, no.9, pp.860-867, 2004-08-20
被引用文献数
9 40

Background Although cholesterol management reportedly reduces fatal and non-fatal coronary heart disease (CHD) events in subjects with or without evident atherosclerotic disease, it is still uncertain whether these benefits extend to Japanese. Methods and Results The study group comprised 8,009 subjects with mildly elevated total cholesterol who were randomized to treatment with 10-20 mg pravastatin plus diet (2,691 women, 1,267 men) or diet alone (2,758 women, 1,293 men). The groups were extremely well balanced with respect to baseline demographics and risk factors such as blood pressure and plasma lipids. Over a 5-year period of follow-up, the primary end-points will be a composite of fatal and non-fatal coronary events. Secondary end-points will include stroke and transient ischemic attack, all cardiovascular events and total mortality. Conclusions The 2 groups will be followed up until the end of March 2004 and end-points will be analyzed by full analysis set. (Circ J 2004 ; 68 : 860-867)
著者
Ehara Mariko Surmely Jean-Francois Kawai Masato Katoh Osamu Matsubara Tetsuo Terashima Mitsuyasu Tsuchikane Etsuo Kinoshita Yoshihisa Suzuki Tomomichi Ito Tatsuya Takeda Yoshihiro Nasu Kenya Tanaka Nobuyoshi Murata Akira Suzuki Yasuyuki Sato Koyo Suzuki Takahiko
出版者
社団法人日本循環器学会
雑誌
Circulation journal : official journal of the Japanese Circulation Society (ISSN:13469843)
巻号頁・発行日
vol.70, no.5, pp.564-571, 2006-04-20
参考文献数
23
被引用文献数
19 166

Background Multislice computed tomography (MSCT) is a promising noninvasive method of detecting coronary artery disease (CAD). However, most data have been obtained in selected series of patients. The purpose of the present study was to investigate the accuracy of 64-slice MSCT (64 MSCT) in daily practice, without any patient selection. Methods and Results Using 64-slice MSCT coronary angiography (CTA), 69 consecutive patients, 39 (57%) of whom had previously undergone stent implantation, were evaluated. The mean heart rate during scan was 72beats/min, scan time 13.6s and the amount of contrast media 72mL. The mean time span between invasive coronary angiography (ICAG) and CTA was 6 days. Significant stenosis was defined as a diameter reduction of >50%. Of 966 segments, 884 (92%) were assessable. Compared with ICAG, the sensitivity of CTA to diagnose significant stenosis was 90%, specificity 94%, positive predictive value (PPV) 89% and negative predictive value (NPV) 95%. With regard to 58 stented lesions, the sensitivity, specificity, PPV and NPV were 93%, 96%, 87% and 98%, respectively. On the patient-based analysis, the sensitivity, specificity, PPV and NPV of CTA to detect CAD were 98%, 86%, 98% and 86%, respectively. Eighty-two (8%) segments were not assessable because of irregular rhythm, calcification or tachycardia. Conclusion Sixty-four-MSCT has a high accuracy for the detection of significant CAD in an unselected patient population and therefore can be considered as a valuable noninvasive technique.
著者
ICHIDA Fukiko
出版者
社団法人日本循環器学会
雑誌
Circulation journal : official journal of the Japanese Circulation Society (ISSN:13469843)
巻号頁・発行日
vol.73, no.1, pp.19-26, 2009-01-20
参考文献数
62
被引用文献数
7 78

Left ventricular noncompaction (LVNC) is a recently defined cardiomyopathy characterized by a pattern of prominent trabecular meshwork and deep intertrabecular recesses, and is thought to be caused by arrest of normal endomyocardial morphogenesis. Although LVNC has been classified as a primary cardiomyopathy of genetic origin, its definition and diagnostic criteria are still being debated. Isolated LVNC was thought to be rare; however, heightened awareness has resulted in an increased detection of the morphological features of LVNC in routine clinical practice, especially in the adult population. Clinical manifestations are highly variable, ranging from no symptoms to disabling congestive heart failure, arrhythmias, and systemic thromboemboli. LVNC, like other forms of inherited cardiomyopathy, is genetically heterogeneous and can be inherited as an autosomal-dominant or X-linked recessive disorder. It has been linked to mutations in several genes, including LIM domain binding protein 3 (<i>ZASP</i>), &alpha;-dystrobrevin (<i>DTNA</i>), tafazzin (<i>TAZ/G4.5</i>) and those encoding sarcomeric proteins. However, the relatively small contribution of known mutations to the disease, compared with the higher proportion of familial cases suggests that other elusive genes remain to be identified. (<i>Circ J</i> 2009; <b>73:</b> 19 - 26)<br>
著者
WANG Mei YAN Guo-Hui YUE Wen-Sheng SIU Chung-Wah YIU Kai-Hang LEE Stephen W. L. LAU Chu Pak TSE Hung-Fat
出版者
一般社団法人 日本循環器学会
雑誌
Circulation journal : official journal of the Japanese Circulation Society (ISSN:13469843)
巻号頁・発行日
vol.76, no.3, pp.682-688, 2012-02-25
参考文献数
35
被引用文献数
1 3

<b><i>Background:</i></b> Left ventricular (LV) mechanical dyssynchrony can lead to impairment of LV function and is associated with adverse clinical outcomes in coronary artery disease (CAD) patients. The impact of LV dyssynchrony on exercise capacity (EC) in patients with CAD was investigated. <b><i>Methods and Results:</i></b> An echocardiographic examination with tissue Doppler imaging and exercise treadmill testing in 151 CAD patients with normal LV ejection fraction was performed. LV intra- and inter-ventricular dyssynchrony were defined by the standard deviation of time interval between LV 6 basal segments (Ts-SD), and the time interval from the right ventricular (RV) free wall to LV lateral wall (Ts-RV) respectively, and EC was measured as metabolic equivalents (METs) on the treadmill. Patients with impaired EC (defined by a METs &le;8, which is the mean MET of the study population) were older (71&plusmn;7 vs. 62&plusmn;2 years, P<0.01), however, there were no differences in gender and clinical status such as prevalence of prior myocardial infarction (MI), regional wall motion abnormality (RWMA), and coronary revascularization between patients with (n=90) or without (n=61) impaired EC. Univariate analysis showed that age, body mass index, LV systolic and diastolic volume, mitral inflow A velocity, and Ts-SD were all significantly associated with METs (all P<0.05). However, multivariate regression analysis revealed that old age (odd ratio [OR]: 1.136, 95% confidence interval [CI]: 1.080-1.196, P<0.001), and Ts-SD (OR: 1.026, 95%CI: 1.003-1.049, P=0.027) only were independent predictors for impaired EC. <b><i>Conclusions:</i></b> In patients with CAD, LV systolic dyssynchrony predicts impaired EC independently of history of previous MI or RWMA. (<i>Circ J</i> 2012; <b>76:</b> 682-688)<br>