- 著者
- Koichiro Kinugawa Yasushi Sakata Minoru Ono Shinichi Nunoda Koichi Toda Norihide Fukushima Akira Shiose Shogo Oishi Dai Yumino Teruhiko Imamura Miyoko Endo Yumiko Hori Koichi Kashiwa Kaoruko Aita Hiroyuki Kojin Yutaka Tejima Yoshiki Sawa
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.85, no.10, pp.1906-1917, 2021-09-24 (Released:2021-09-24)
- 参考文献数
- 21
- 被引用文献数
- 11
Destination therapy (DT) is the indication to implant a left ventricular assist device (LVAD) in a patient with stage D heart failure who is not a candidate for heart transplantation. The implantable LVAD has been utilized in Japan since 2011 under the indication of bridge to transplant (BTT). After almost 10 year lag, DT has finally been approved and reimbursed in May 2021 in Japan. To initiate the DT program in Japan, revision of the LVAD indication from BTT is necessary. Also, in-depth discussion of caregiver issues as well as end-of-life care is indispensable. For that purpose, we assembled a DT committee of multidisciplinary members in August 2020, and started monthly discussions via web-based communication during the COVID-19 pandemic. This is a summary of the consensus reached after 6 months’ discussion, and we have included as many relevant topics as possible. Clinical application of DT has just started, and we are willing to revise this consensus to meet the forthcoming issues raised during real-world clinical experience.
- 著者
- Kentaro Kamiya Takanobu Yamamoto Miyuki Tsuchihashi-Makaya Toshimi Ikegame Tetsuya Takahashi Yukihito Sato Norihiko Kotooka Yoshihiko Saito Hiroyuki Tsutsui Hiroaki Miyata Mitsuaki Isobe
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.83, no.7, pp.1546-1552, 2019-06-25 (Released:2019-06-25)
- 参考文献数
- 20
- 被引用文献数
- 15 70
Background:The purpose of this study was to clarify the implementation rate of multidisciplinary heart failure (HF) care and cardiac rehabilitation (CR) in Japan, as well as the relationship between implementation rates and characteristics of the facility.Methods and Results:Survey participants were cardiologists who are members of the Japan Heart Failure Society and belonged to 1 of 845 medical institutions that are members of the Japan Heart Failure Society, as of April 2016. A total of 288 institutions (34.1%) returned the questionnaire. The percentages of hospitals implementing multidisciplinary HF care were 78.5% for inpatients and 32.6% for outpatients with HF. Inpatient and outpatient CR for HF had implementation rates of 80.4% and 56.5%, respectively. In addition, very few HF patients (7.3%, 3,741/51,323 patients) received outpatient CR. Both the presence of nurses certified in chronic HF care and registered CR instructors on staff were consistently associated with implementation of multidisciplinary HF care, and Japanese Circulation Society training hospitals, lower number of hospital beds, and presence of registered CR instructors on staff were consistently associated with implementation of CR.Conclusions:This first nationwide survey demonstrated that the implementation rates of multidisciplinary care and CR for HF, especially for outpatients, are low in Japan. Skilled healthcare professionals are expected to play important roles in the widespread implementation of this type of HF care in Japan.
- 著者
- Hiroshi Koiwaya Nozomi Watanabe Kensaku Nishihira Yuhei Goriki Yoshisato Shibata
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Reports (ISSN:24340790)
- 巻号頁・発行日
- vol.3, no.5, pp.304-305, 2021-05-10 (Released:2021-05-10)
- 参考文献数
- 1
- 著者
- Nobuyuki Enzan Shouji Matsushima Tomomi Ide Hidetaka Kaku Takeshi Tohyama Kouta Funakoshi Taiki Higo Hiroyuki Tsutsui for the Research Group of Idiopathic Cardiomyopathy
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Reports (ISSN:24340790)
- 巻号頁・発行日
- vol.3, no.3, pp.142-152, 2021-03-10 (Released:2021-03-10)
- 参考文献数
- 34
- 被引用文献数
- 7
Background:The clinical features of patients with cardiomyopathy, including dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), or restrictive cardiomyopathy (RCM), have not been recently elucidated in Japan.Methods and Results:We collected individual patient data regarding demographics, echocardiogram, and treatment in DCM from 2003 to 2014 and in HCM and RCM from 2009 to 2014 from the national registry of clinical personal records organized by the Japanese Ministry of Health, Labour and Welfare. In all, 44,136 patients were included in this registry: 40,537 with DCM, 3,553 with HCM, and 46 with RCM. The median age at diagnosis was older for DCM and HCM than RCM (54 and 55 vs. 42 years, respectively). Male patients accounted for 74.6%, 58.7%, and 60.9% of the DCM, HCM, and RCM groups, respectively. NYHA functional Class III–IV was found in 26.9%, 11.3%, and 58.1% of patients in the DCM, HCM, and RCM groups, respectively. In the DCM group, the rates of β-blocker and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker prescription were 69% and 76%, respectively. In regional subgroup analysis, the median age at diagnosis of DCM and HCM was younger in the Kanto region. A family history of HCM was less frequent in the Hokkaido/Tohoku region.Conclusions:The national registry of clinical personal records of cardiomyopathy could provide important information regarding the demographics, clinical characteristics, and management of cardiomyopathy throughout Japan.
- 著者
- Hiroshi Kadowaki Junichi Ishida Hiroshi Akazawa Hiroki Yagi Akiko Saga-Kamo Masahiko Umei Ryo Matsuoka Qing Liu Hiroshi Matsunaga Hisataka Maki Yusuke Sato Haruki Kume Issei Komuro
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Reports (ISSN:24340790)
- 巻号頁・発行日
- pp.CR-21-0008, (Released:2021-03-10)
- 参考文献数
- 24
- 被引用文献数
- 6
Background:Axitinib is a tyrosine kinase inhibitor (TKI) that inhibits vascular endothelial growth factor receptor signaling and is approved for second-line treatment of advanced renal cell carcinoma (RCC). Although the occurrence of hypertension with axitinib use has been documented, it is unclear whether a first-line TKI regimen can significantly affect the development of hypertension when axitinib is used as second-line therapy.Methods and Results:In this single-center retrospective study, advanced RCC patients treated with axitinib after first-line chemotherapy were divided into 2 groups according to the use of TKIs as part of first-line treatment before the initiation of axitinib. Clinical outcomes were compared between patients who were treated with (TKI(+); n=11) or without (TKI(–); n=11) a TKI. Although 63.6% of all patients had hypertension at baseline, axitinib-induced hypertension developed in 81.8% of patients, and 36.4% of patients experienced Grade 3 hypertension. After initiation of axitinib, both systolic and diastolic blood pressures and the hypertension grade were significantly elevated both in the TKI(+) and TKI(–) groups, and the number of antihypertensive drugs was significantly increased among all patients.Conclusions:This study suggests the need for proper monitoring and management of blood pressure in RCC patients treated with axitinib, regardless of a prior regimen with or without TKIs.
6 0 0 0 OA Cancer-Associated Venous Thromboembolism in the Real World ― From the COMMAND VTE Registry ―
- 著者
- Jiro Sakamoto Yugo Yamashita Takeshi Morimoto Hidewo Amano Toru Takase Seiichi Hiramori Kitae Kim Maki Oi Masaharu Akao Yohei Kobayashi Mamoru Toyofuku Toshiaki Izumi Tomohisa Tada Po-Min Chen Koichiro Murata Yoshiaki Tsuyuki Syunsuke Saga Yuji Nishimoto Tomoki Sasa Minako Kinoshita Kiyonori Togi Hiroshi Mabuchi Kensuke Takabayashi Yusuke Yoshikawa Hiroki Shiomi Takao Kato Takeru Makiyama Koh Ono Toshihiro Tamura Yoshihisa Nakagawa Takeshi Kimura on behalf of the COMMAND VTE Registry Investigators
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-19-0515, (Released:2019-09-20)
- 参考文献数
- 28
- 被引用文献数
- 5 57
Background:There is a paucity of data on the management and prognosis of cancer-associated venous thromboembolism (VTE), leading to uncertainty about optimal management strategies.Methods and Results:The COMMAND VTE Registry is a multicenter registry enrolling 3,027 consecutive acute symptomatic VTE patients in Japan between 2010 and 2014. We divided the entire cohort into 3 groups: active cancer (n=695, 23%), history of cancer (n=243, 8%), and no history of cancer (n=2089, 69%). The rate of anticoagulation discontinuation was higher in patients with active cancer (43.5%, 27.0%, and 27.0%, respectively, at 1 year, P<0.001). The cumulative 5-year incidences of recurrent VTE, major bleeding, and all-cause death were higher in patients with active cancer (recurrent VTE: 17.7%, 10.2%, and 8.6%, P<0.001; major bleeding: 26.6%, 8.8%, and 9.3%, P<0.001; all-cause death: 73.1%, 28.6%, 14.6%, P<0.001). Among the 4 groups classified according to active cancer status, the cumulative 1-year incidence of recurrent VTE was higher in the metastasis group (terminal stage group: 6.4%, metastasis group: 22.1%, under chemotherapy group: 10.8%, and other group: 5.8%, P<0.001).Conclusions:In a current real-world VTE registry, patients with active cancer had higher risk for VTE recurrence, bleeding, and death, with variations according to cancer status, than patients without active cancer. Anticoagulation therapy was frequently discontinued prematurely in patients with active cancer in discordance with current guideline recommendations.
- 著者
- Kazuhiro Yamamoto Miyuki Tsuchihashi-Makaya Yoshiharu Kinugasa Yuki Iida Kentaro Kamiya Yasuki Kihara Yuji Kono Yukihito Sato Norio Suzuki Harumi Takeuchi Taiki Higo Yasushi Miyazawa Isao Miyajima Akira Yamashina Katsushi Yoshita Koichi Washida Masafumi Kuzuya Tetsuya Takahashi Yutaka Nakaya Naoyuki Hasebe Hiroyuki Tsutsui on behalf of The Japanese Heart Failure Society Expert Consensus Writing Committee
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-20-0322, (Released:2020-07-10)
- 参考文献数
- 206
- 被引用文献数
- 21
- 著者
- Hideo Izawa Toshiko Yoshida Toshimi Ikegame Kazuhiro P. Izawa Yoshihiro Ito Hideo Okamura Naohiko Osada Shintaro Kinugawa Takuro Kubozono Yuji Kono Kiyonori Kobayashi Kazuhiko Nishigaki Taiki Higo Akihiro Hirashiki Yasushi Miyazawa Yuji Morio Masanobu Yanase Sumio Yamada Hisao Ikeda Shin-ichi Momomura Yasuki Kihara Kazuhiro Yamamoto Yoichi Goto Shigeru Makita the Japanese Association of Cardiac Rehabilitation Standard Cardiac Rehabilitation Program Planning Committee
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-19-0670, (Released:2019-11-09)
- 参考文献数
- 21
- 被引用文献数
- 52
- 著者
- Takaaki Sakai Shinichiro Miura
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Reports (ISSN:24340790)
- 巻号頁・発行日
- vol.1, no.7, pp.286-295, 2019-07-10 (Released:2019-07-10)
- 参考文献数
- 47
- 被引用文献数
- 24
Background:Pathogenesis of heart failure with preserved ejection fraction (HFpEF) may involve endothelial dysfunction and abnormal vascular structure. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have beneficial cardiovascular effects and may improve vascular function in patients with HFpEF.Methods and Results:We recruited 184 patients with type 2 diabetes and HFpEF (mean age, 66.0±14.4 years) who were scheduled for treatment with SGLT2 inhibitors, had transthoracic echocardiogram to identify diastolic function, and flow-mediated dilation (FMD) to evaluate endothelial function, and assessed cardio-ankle vascular index (CAVI) and carotid intima-media thickness as indices of vascular function and vascular structure, respectively. Body weight, systolic blood pressure, diastolic blood pressure, triglycerides, remnant lipoprotein cholesterol, fasting plasma glucose, hemoglobin A1c, urinary albumin/creatinine ratio, and insulin resistance (IR) decreased, hematocrit and FMD increased significantly, and CAVI decreased significantly, after 12-week treatment (P<0.05). Short-term SGLT2 inhibitors improved diastolic function, significantly reducing the mitral ratios of septal E/early septal annular tissue Doppler velocity (P=0.003) and lateral E/early lateral e' (P=0.044). On multiple regression statistically significant associations were seen between ∆mean E/e' and ∆FMD, ∆CAVI, and ∆IR.Conclusions:SGLT2 inhibitors can improve diastolic function in patients with type 2 diabetes, suggesting that current treatment policies for diabetes should be re-examined. Further prospective studies with larger sample sizes could provide mechanistic insights into the benefits of SGLT2 inhibitors.
- 著者
- Taishi Okuno Jiro Aoki Kengo Tanabe Koichi Nakao Yukio Ozaki Kazuo Kimura Junya Ako Teruo Noguchi Satoshi Yasuda Satoru Suwa Kazuteru Fujimoto Yasuharu Nakama Takashi Morita Wataru Shimizu Yoshihiko Saito Atsushi Hirohata Yasuhiro Morita Teruo Inoue Atsunori Okamura Toshiaki Mano Kazuhito Hirata Yoshisato Shibata Mafumi Owa Kenichi Tsujita Hiroshi Funayama Nobuaki Kokubu Ken Kozuma Shiro Uemura Tetsuya Tobaru Keijiro Saku Shigeru Ohshima Kunihiro Nishimura Yoshihiro Miyamoto Hisao Ogawa Masaharu Ishihara on behalf of J-MINUET investigators
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-18-0995, (Released:2019-03-30)
- 参考文献数
- 40
- 被引用文献数
- 7
Background: Beta-blockers are standard therapy for acute myocardial infarction (AMI). However, despite current advances in the management of AMI, it remains unclear whether all AMI patients benefit from β-blockers. We investigated whether admission heart rate (HR) is a determinant of the effectiveness of β-blockers for AMI patients. Methods and Results: We enrolled 3,283 consecutive AMI patients who were admitted to 28 participating institutions in the Japanese Registry of Acute Myocardial Infarction Diagnosed by Universal Definition (J-MINUET) study. According to admission HR, we divided patients into 3 groups: bradycardia (HR <60 beats/min, n=444), normocardia (HR 60 to ≤100 beats/min, n=2,013), and tachycardia (HR >100 beats/min, n=342). The primary endpoint was major adverse cardiac events (MACE), including all-cause death, non-fatal MI, non-fatal stroke, heart failure (HF), and urgent revascularization for unstable angina, at 3-year follow-up. Beta-blocker at discharge was significantly associated with a lower risk of MACE in the tachycardia group (23.6% vs. 33.0%; P=0.033), but it did not affect rates of MACE in the normocardia group (17.8% vs. 18.4%; P=0.681). In the bradycardia group, β-blocker use at discharge was significantly associated with a higher risk of MACE (21.6% vs. 12.7%; P=0.026). Results were consistent for multivariable regression and stepwise multivariable regression. Conclusions: Admission HR might determine the efficacy of β-blockers for current AMI patients.
- 著者
- Sok-Sithikun Bun Decebal Gabriel Latcu Tahar Delassi Mohammed El Jamili Alaa Al Amoura Nadir Saoudi
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.80, no.3, pp.579-586, 2016-02-25 (Released:2016-02-25)
- 参考文献数
- 34
- 被引用文献数
- 3 22
The advantages of ultra-high-definition (UHD) mapping are presented in the context of different atrial arrhythmias, whether focal or macroreentrant. Not only are these sophisticated systems time-saving, but they also allow accurate identification of the substrate (scar quantification), as well as a more precise characterization of the critical isthmuses or focal sources of the atrial circuits. UHD mapping may become a standard approach for their curative treatment. This new technology allows automatic acquisition and accurate annotation of the electrograms, without the need for manual correction. Owing to better resolution, critical isthmuses and low-voltage regions of interest may now be successfully targeted without the need for entrainment maneuvers. Finally, the system also allows rapid assessment of the completeness of the lesions once delivered. (Circ J 2016; 80: 579–586)
- 著者
- Myung-Jin Cha Youngjin Cho Il-Young Oh Eue-Keun Choi Seil Oh
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-18-0218, (Released:2018-10-04)
- 参考文献数
- 37
- 被引用文献数
- 12
Background: There is little evidence that focuses on the ethnic variability of clinical risk factors for thromboembolism (TE) in atrial fibrillation (AF). We aimed to investigate the effect of each traditional risk factor in the Korean AF population. Methods and Results:Medical records of 12,876 consecutive patients (aged >18 years) newly diagnosed and followed up with non-valvular AF from 2000 to 2013 were reviewed. TE events, including ischemic stroke and systemic embolism, were investigated for risk factor validation. Among the total of 12,876 patients, 1,390 (10.8%) had TE events. In univariate/multivariate analysis adjusting for clinical factors and antithrombotic medications, traditional risk factors included in the CHA2DS2-VASc scheme showed statistical significance, except for female sex, which was not a predictor of events. Additionally, chronic kidney disease (CKD; hazard ratio 1.62, P<0.001) was shown to be an independent predictor of TE events. Based on the analysis, we developed a novel stratification system, CHA2DS2-VAK, omitting the female sex category and adding CKD. The new scoring system showed greater discrimination in event rates between score 0 and 1 patients. Conclusions: Female sex was not associated with TE events in a Korean non-valvular AF population. The novel CHA2DS2-VAK scoring system, with substitution of CKD for female sex, might be more appropriate for the Korean population.
- 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
- pp.CJ-18-0346, (Released:2018-07-27)
- 参考文献数
- 23
- 被引用文献数
- 15
Background:Stroke is one of the leading causes of disability and mortality in Japan. The aim of the present analysis was to determine the non-acute survival rate after first-ever stroke using data from a large-scale population-based stroke registry in Japan.Methods and Results:Shiga Stroke Registry is an ongoing population-based registry of stroke, which covers approximately 1.4 million residents of Shiga Prefecture in central Japan. A total of 2,176 first-ever stroke patients, who were registered in 2011, were followed up until December 2013. The 2-year cumulative survival rates were estimated using Kaplan-Meier method according to index stroke subtype. Cox proportional hazards models were used to assess predictors of all-cause death. During a 2-year follow-up period, 663 patients (30.5%) died. The 2-year cumulative survival rate after first-ever stroke was 69.5%. There was heterogeneity in 2-year cumulative survival according to stroke subtype: lacunar infarction, 87.2%; large artery infarction, 76.1%; cardioembolic infarction, 55.4%; intracerebral hemorrhage, 65.9%; and subarachnoid hemorrhage, 56.7%. Older age, male sex, medical history, higher Japan coma scale score on admission, and stroke subtype were associated with risk of all-cause death in ≤2 years.Conclusions:In the present population-based stroke registry with a real-world setting in Japan, 2-year cumulative mortality after first-ever stroke is still high (>30%), particularly for cardioembolic infarction, subarachnoid hemorrhage and intracerebral hemorrhage.
- 著者
- Daisuke Yamasawa Hideki Ozawa Shinichi Goto
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-23-0857, (Released:2023-12-05)
- 参考文献数
- 12
- 被引用文献数
- 1
- 著者
- Yoshitsugu Nogimori Ryo Inuzuka
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-23-0655, (Released:2023-10-05)
- 参考文献数
- 11
- 著者
- Hiroshi Kadowaki Hiroshi Akazawa Akito Shindo Tomomi Ueda Junichi Ishida Issei Komuro
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-23-0838, (Released:2023-12-12)
- 参考文献数
- 82
Epidemiological evidence of increased risks of cancer in heart failure (HF) patients and HF in cancer patients has suggested close relationships between the pathogenesis of both diseases. Indeed, HF and cancer share common risk factors, including aging and unhealthy lifestyles, and underlying mechanisms, including activation of the sympathetic nervous system and renin-angiotensin-aldosterone system, chronic inflammation, and clonal hematopoiesis of indeterminate potential. Mechanistically, HF accelerates cancer development and progression via secreted factors, so-called cardiokines, and epigenetic remodeling of bone marrow cells into an immunosuppressive phenotype. Reciprocally, cancer promotes HF via cachexia-related wasting and metabolic remodeling in the heart, and possibly via cancer-derived extracellular vesicles influencing myocardial structure and function. The novel concept of the “heart-cancer axis” will help in our understanding of the shared and reciprocal relationships between HF and cancer, and provide innovative diagnostic and therapeutic approaches for both diseases.
- 著者
- Yoichi Sugiyama Noriaki Moriyama Hirokazu Miyashita Hiroaki Yokoyama Tomoki Ochiai Koki Shishido Mikko Jalanko Futoshi Yamanaka Tommi Vähäsilta Mika Laine Shigeru Saito
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-23-0593, (Released:2023-11-28)
- 参考文献数
- 23
- 被引用文献数
- 1
Background: Transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic stenosis (AS), but despite estimates of life expectancy after TAVI being essential in heart team discussion, these data are scarce. Therefore, the current study sought to assess long-term survival and its trends in relation to chronological age, surgical risk, and treatment period.Methods and Results: We included 2,414 consecutive patients who underwent TAVI for severe symptomatic AS between 2008 and 2021 at 2 international centers. For the analysis, long-term survival was evaluated according to age, surgical risk, and treatment period categorized into 3 groups, respectively. The longest follow-up was 13.5 years. Overall survival was 67.6% at 5 years and 26.9% at 10 years. Younger patients, lower surgical risk, and later treatment period showed better survival (log-rank P<0.001, respectively). In the multivariate analysis, age <75years, lower surgical risk, and later time period were significantly associated with better survival. The incidence of paravalvular leakage ≥moderate, red blood cell transfusion, and acute kidney injury were independently associated with increasing risk of 5-year death.Conclusions: In a real-world registry, survival was substantial following TAVI, especially in younger and lower surgical-risk patients, with improving outcomes over time. This should be considered in heart team discussions of life-long management for AS patients after TAVI.
- 著者
- Jihoon Kim Minjung Bak Sung-Ji Park Dong Seop Jeong Suryeun Chung Darae Kim Eun Kyoung Kim Sung-A Chang Jin-Oh Choi Sang-Chol Lee Seung Woo Park
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-23-0040, (Released:2023-06-27)
- 参考文献数
- 32
- 被引用文献数
- 2
Background: There are limited data about predictors of atrial fibrillation (AF) recurrence after totally thoracoscopic ablation (TTA). This study investigated the clinical implication of left atrial appendage emptying velocity (LAAV) in patients undergoing TTA.Methods and Results: Patients who underwent TTA between 2012 and 2015 at a tertiary hospital were prospectively enrolled in this study. LAAV was measured and averaged over five heart beats from preoperative transesophageal echocardiography. The primary outcome was a freedom from recurrent AF or atrial flutter (AFL) detected on 24-h Holter monitoring or an electrocardiogram over a 3-year period after TTA. In all, 129 patients were eligible for analysis in this study. The mean (±SD) patient age was 54.4±8.8 years, and 95.3% were male. During the 3 years after TTA, the overall event-free survival rate was 65.3%. LAAV was an independent predictor of recurrent AF/AFL during the 3-year period after TTA (per 1-cm/s increase, adjusted hazard ratio [aHR] 0.95; 95% confidence interval [CI] 0.91–0.99; P=0.016). Event-free survival was significantly lower among patients with a low LAAV (<20 cm/s; n=21) compared with those with a normal (≥40 cm/s; n=38; aHR 6.11; 95% CI 1.42–26.15; P=0.015) or intermediate (LAAV ≥20 and <40 cm/s; n=70; aHR 2.74, 95% CI 1.29–5.83; P=0.009) LAAV.Conclusions: In patients with AF, LAAV was significantly associated with the risk of long-term recurrence of AF after TTA.
- 著者
- Eiichi Watanabe
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-23-0573, (Released:2023-09-07)
- 参考文献数
- 14
- 著者
- Megumi Fukuyama Minoru Horie Koichi Kato Hisaaki Aoki Shuhei Fujita Yoko Yoshida Hisanori Sakazaki Takako Toda Michihiko Ueno Gaku Izumi Nobuo Momoi Jun Muneuchi Takeru Makiyama Yoshihisa Nakagawa Seiko Ohno
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-23-0195, (Released:2023-06-28)
- 参考文献数
- 38
- 被引用文献数
- 1
Background: Cardiac calmodulinopathy, characterized by a life-threatening arrhythmia and sudden death in the young, is extremely rare and caused by genes encoding calmodulin, namely calmodulin 1 (CALM1), CALM2, and CALM3.Methods and Results: We screened 195 symptomatic children (age 0–12 years) who were suspected of inherited arrhythmias for 48 candidate genes, using a next-generation sequencer. Ten probands were identified as carrying variants in any of CALM1–3 (5%; median age 5 years), who were initially diagnosed with long QT syndrome (LQTS; n=5), catecholaminergic polymorphic ventricular tachycardia (CPVT; n=3), and overlap syndrome (n=2). Two probands harbored a CALM1 variant and 8 probands harbored 6 CALM2 variants. There were 4 clinical phenotypes: (1) documented lethal arrhythmic events (LAEs): 4 carriers of N98S in CALM1 or CALM2; (2) suspected LAEs: CALM2 p.D96G and D132G carriers experienced syncope and transient cardiopulmonary arrest under emotional stimulation; (3) critical cardiac complication: CALM2 p.D96V and p.E141K carriers showed severe cardiac dysfunction with QTc prolongation; and (4) neurological and developmental disorders: 2 carriers of CALM2 p.E46K showed cardiac phenotypes of CPVT. Beta-blocker therapy was effective in all cases except cardiac dysfunction, especially in combination with flecainide (CPVT-like phenotype) and mexiletine (LQTS-like).Conclusions: Calmodulinopathy patients presented severe cardiac features, and their onset of LAEs was earlier in life, requiring diagnosis and treatment at the earliest age possible.