著者

唐川 正典 胡田 光信 依藤 進 井口 松三

出版者

THE JAPANESE CIRCULATION SOCIETY

雑誌

日本循環器學誌 (ISSN:00471828)

巻号頁・発行日

vol.19, no.7, pp.321-325, 1955-10-20 (Released:2008-04-14)

参考文献数

8

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The authors at first made formula from which assumed normal cardiac size could be calculated in reference to body-weight and length. Actual cardiac size/assumed normal cardiac size was called dilatation-gradient : actual cardiac size was measured by planimeter in its shadow in the direct postero-anterior projection of X-ray. Relatiohship between circulation time and dilatation-gradient was investigated in cases of congestive heart failure and non-congestive cardiac disease, and linear relationship was demonstrated between them. This does not mean that prolongation of real circulation time (decrease of blood velocity) is due to dilatation of heart. Because circulation-time, clinically used, shows not only the blood velocity but also the degree how much the drug injected is diluted by blood.

著者

Takayuki Yoshinaga Satoshi Ikeda Masahiro Shikuwa Yoshiyuki Miyahara Shigeru Kohno

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.67, no.3, pp.229-232, 2003 (Released:2003-02-25)

参考文献数

25

被引用文献数

17 23

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Pulmonary thromboembolism (PTE) is associated with various electrocardiogram (ECG) abnormalities, but the utility of evaluating the severity of PTE based on ECG abnormalities alone has not been investigated in Japanese patients previously. The purpose of this study was to examine the relationship between ECG abnormalities and the mean pulmonary artery pressure (MPAP) in patients with acute massive PTE (AMPTE). ECG examination of 21 patients, who were diagnosed with AMPTE by pulmonary arteriography, found that S1Q3T 3 was the most frequently observed abnormality (in 67% of the patients), followed by negative T (62%), clockwise rotation (57%), and ST elevation (48%). When these patients were divided into 2 groups based on the level of MPAP, 8 of the 11 ECG findings, which were associated with PTE in a previous report, were more frequently observed in Group H (MPAP ≥40 mmHg) than in Group L (MPAP <40 mmHg). MPAP correlated significantly with the total number of ECG abnormalities (r=0.82, p<0.001). In particular, at least 5 ECG abnormalities were noted in patients with MPAP ≥45 mmHg. These results suggested that the total number of ECG abnormalities in patients with AMPTE can be used to evaluate the severity of APTE, including PAP level. (Circ J 2003; 67: 229 - 232)

著者

Masami Kosuge Kazuo Kimura Toshiyuki Ishikawa Toshiaki Ebina Kiyoshi Hibi Kengo Tsukahara Masahiko Kanna Noriaki Iwahashi Jyun Okuda Naoki Nozawa Hiroyuki Ozaki Hideto Yano Tatuya Nakati Ikuyoshi Kusama Satoshi Umemura

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.70, no.6, pp.750-755, 2006 (Released:2006-05-25)

参考文献数

27

被引用文献数

31 35

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Background The significance of inverted T waves remains unclear in patients with acute pulmonary embolism (PE). Methods and Results The relationship of the number of leads with inverted T waves to the severity of PE in 40 patients with acute PE was studied. Patients were classified into 3 groups according to the number of leads with inverted T waves on the admission electrocardiogram (ECG): 15 patients, ≤3 leads (group L); 12 patients, 4-6 leads (group M); and 13 patients, ≥7 leads (group H). In groups L, M and H, the rates of right ventricular dysfunction on echocardiography were 47%, 92% and 100% (p<0.01), respectively, and the rates of in-hospital complicated events (including death or the need for catecholamine support, cardiopulmonary resuscitation or mechanical cardiovascular support because of hemodynamic instability) were 0%, 8% and 46% (p=0.004), respectively. On multivariate analysis, arterial hypotension at presentation (odds ratio (OR) 8.96, p=0.049) and inverted T waves in ≥7 leads on the admission ECG (OR 16.8, p=0.037) were the only independent predictors of in-hospital complicated events. Conclusions The number of leads with inverted T waves may be a useful and simple marker of increased risk for early complications in patients with acute PE. (Circ J 2006; 70: 750 - 755)

著者

Yoshitake Yamada Shigeo Okuda Masaharu Kataoka Akihiro Tanimoto Yuichi Tamura Takayuki Abe Tomonori Okamura Keiichi Fukuda Toru Satoh Sachio Kuribayashi

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.1204091687, (Released:2012-04-12)

参考文献数

24

被引用文献数

26 33

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Background: Because few have reported the prognostic significance of cardiac magnetic resonance imaging (CMR) for idiopathic pulmonary arterial hypertension (IPAH), in this study we evaluated the value of CMR measurements as a prognostic predictor of IPAH before starting intravenous prostacyclin therapy. Methods and Results: A total of 121 consecutive CMR studies for evaluating right ventricular (RV) function were reviewed. Forty-one patients were diagnosed with IPAH and served as the study group. Factors, such as age, sex, New York Heart Association functional class (NYHAFC), 6-min walk test, plasma brain natriuretic peptide level, serum uric acid level and CMR measurements were analyzed as predictors of first hospitalization and death. The mean follow-up period was 1,350±769 days. Nine patients were hospitalized because of heart failure, and 4 patients died from cardiopulmonary causes. The univariate analyses suggested that the left ventricular (LV) mass index, the left and right ventricular end-diastolic volume indices (LVEDVI, RVEDVI), the LV and RV end-systolic volume indices (LVESVI, RVESVI) and NYHAFC predicted the risk for hospitalization and that RVEDVI, RVESVI and NYHAFC predicted mortality. The multivariate analyses suggested that RVEDVI and NYHAFC are independent predictors of both hospitalization and mortality. The effects of RVEDVI and NYHAFC on hospitalization were not substantially affected by the concomitant medication. Conclusions: In IPAH patients, the RVEDVI predicts both hospitalization for right heart failure and mortality before initiating intravenous prostacyclin therapy.

著者

Hiroki Taguchi Masaharu Kataoka Ryoji Yanagisawa Takashi Kawakami Yuichi Tamura Keiichi Fukuda Hideaki Yoshino Toru Satoh

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.1203131639, (Released:2012-03-16)

参考文献数

30

被引用文献数

15 21

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Background: The recent development of various effective drugs, such as epoprostenol, sildenafil, and bosentan, has improved the prognosis for patients with idiopathic pulmonary arterial hypertension (IPAH). This study sought to determine survival rates and to identify predictive prognostic factors in patients with IPAH in the current era of combination therapy with new and more effective vasodilators. Methods and Results: In 65 consecutive IPAH patients treated from 2004 to 2009, hemodynamic parameters were significantly improved and brain natriuretic peptide was significantly decreased by combination therapy (observation period: 35±18 months). The Kaplan-Meier survival curves were determined, and 22 prognostic variables, including 9 hemodynamic variables and 6 biomarkers, were evaluated to obtain the best variables. The 1-year and 3-year survival rates were 98% and 86%, respectively. Only the platelet level was correlated with death (P<0.05), and the platelet level was significantly correlated with mean pulmonary arterial pressure (P<0.01). Patients with a lower platelet level (<20×104/μl (median value)) before treatment had a higher mortality rate compared to the other patients (78% vs. 95% for 3-year survival, P<0.01). Conclusions: Combination therapy contributed to an improvement in the prognosis of IPAH patients. Platelet level is a significant prognostic predictor in this new treatment era.

著者

Hidekazu Tanaka Kazuhiro Tatsumi Sei Fujiwara Takayuki Tsuji Akihiro Kaneko Keiko Ryo Yuko Fukuda Kensuke Matsumoto Mayumi Shigeru Akihiro Yoshida Hiroya Kawai Ken-ichi Hirata

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.76, no.2, pp.382-389, 2012 (Released:2012-01-25)

参考文献数

28

被引用文献数

33 38

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Background: Dyssynchrony has various detrimental effects on cardiac function, but its effect on cardiac sympathetic activity is not fully understood. Methods and Results: We studied 50 heart failure patients who underwent cardiac resynchronization therapy (CRT). Cardiac sympathetic activity was assessed by 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy as the delayed heart-to-mediastinum ratio (H/M ratio). Echocardiography was performed before and 7 months after CRT, and response was defined as a ≥15% decrease in end-systolic volume. Dyssynchrony was determined by the time difference between the anteroseptal-to-posterior wall using speckle-tracking radial strain (≥130ms predefined as significant). H/M ratio in patients with dyssynchrony was less than that in patients without dyssynchrony (1.62±0.31 vs. 1.82±0.36, P<0.05), even though ejection fraction was not significantly different (24±6% vs. 25±7%). Patients with dyssynchrony and H/M ratio ≥1.6 had a higher frequency of response to CRT (94%) and favorable long-term outcome over 3.0 years. In contrast, patients without dyssynchrony and H/M ratio <1.6 were more likely to show a lower frequency of response to CRT (0%) and unfavorable long-term outcome after CRT. Conclusions: Dyssynchrony is associated with cardiac sympathetic activity, and 123I-MIBG scintigraphy may be valuable for predicting the response to CRT. (Circ J 2012; 76: 382-389)

著者

Nobuo Nyui Osamu Yamanaka Riichiro Nakayama Masato Sawano Sachio Kawai

出版者

The Japanese Circulation Society

雑誌

JAPANESE CIRCULATION JOURNAL (ISSN:00471828)

巻号頁・発行日

vol.64, no.9, pp.715-719, 2000 (Released:2001-05-31)

参考文献数

24

被引用文献数

31 32

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During admission for investigation of dysphagia, an 82-year-old woman suddenly complained of dyspnea, which was followed by cardiogenic shock. Her symptoms, electrocardiogram, echocardiogram and laboratory data were compatible with an extensive acute anterior myocardial infarction. Emergency cardiac catheterization showed no atheromatous narrowing in any coronary artery. However, the contractions of the left and right ventricles were diffusely and severely impaired, except for some hyperkinesis of the basal area. The asynergy, as well as the abnormalities on the ECG, improved almost to normal by the 35th hospital day. An endomyocardial biopsy from the right ventricle during the acute phase showed atypical myocardial damage with proliferation of fine collagen fibers and small round-cell infiltration including polymorphologic leukocytes. This type of transient cardiac disorder has recently been described in Japan, and is called ‘Tako-tsubo cardiomyopathy’ because of the characteristic appearance of the left ventricular asynergy. In the present case, ventricular asynergy was not limited to the left ventricle, but was also present in the right ventricle.

著者

Masahito Sato Satoru Fujita Atushi Saito Yoshio Ikeda Hitoshi Kitazawa Minoru Takahashi Junji Ishiguro Masaaki Okabe Yuichi Nakamura Tsuneo Nagai Hiroshi Watanabe Makoto Kodama Yoshifusa Aizawa

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.70, no.8, pp.947-953, 2006 (Released:2006-07-25)

参考文献数

24

被引用文献数

70 91

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Background On October 23, 2004, a major earthquake, which registered 6.8 on the Richter scale, occurred in Niigata Prefecture in Japan. Emotional stress is important as a trigger of transient left ventricular apical ballooning (so-called `Takotsubo' cardiomyopathy), but its incidence and clinical profile immediately after a natural disaster have not been fully elucidated. Methods and Results `Takotsubo' cardiomyopathy was diagnosed in 16 patients (1 man, 15 women, mean age 71.5 years) within 1 month after the earthquake. Of them, 13 (81%) lived in areas where the Japan Meteorological Agency seismic intensity scale registered 6 or above, and 11 (69%) developed symptoms on the day of the earthquake. The incidence of `Takotsubo' cardiomyopathy 1 month after the earthquake was approximately 24-fold higher near the epicenter than that before the earthquake. Conclusion `Takotsubo' cardiomyopathy can occur on the day of the earthquake in elderly women living near the epicenter. (Circ J 2006; 70: 947 - 953)

著者

Naohito Tanabe Hiroyasu Iso Katsutoshi Okada Yasuyuki Nakamura Akiko Harada Yasuo Ohashi Takashi Ando Hirotsugu Ueshima The Japan Arteriosclerosis Longitudinal Study Group

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.74, no.7, pp.1346-1356, 2010 (Released:2010-06-25)

参考文献数

60

被引用文献数

77 79

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Background: Few Japanese studies have compared serum non-high-density lipoprotein (non-HDL) cholesterol with serum total cholesterol as factors for predicting risk of cardiovascular events. Currently, few tools accurately estimate the probability of developing cardiovascular events for the Japanese general population. Methods and Results: A total of 22,430 Japanese men and women (aged 40-89 years) without a history of cardiovascular events from 10 community-based cohorts were followed. In an average 7.6-year follow up, 104 individuals experienced acute myocardial infarction (AMI) and 339 experienced stroke. Compared to serum total cholesterol, serum non-HDL cholesterol was more strongly associated with risk of AMI in a dose-response manner (multivariable adjusted incidence rate ratio per 1 SD increment [95% confidence interval] =1.49 [1.24-1.79] and 1.62 [1.35-1.95], respectively). Scoring systems were constructed based on multivariable Poisson regression models for predicting a 5-year probability of developing AMI; the non-HDL cholesterol model was found to have a better predictive ability (area under the receiver operating curve [AUC] =0.825) than the total cholesterol model (AUC =0.815). Neither total nor non-HDL serum cholesterol levels were associated with any stroke subtype. Conclusions: The risk of AMI can be more reliably predicted by serum non-HDL cholesterol than serum total cholesterol. The scoring systems are useful tools to predict risk of AMI. Neither total nor non-HDL serum cholesterol can predict stroke risk in the Japanese general population.  (Circ J 2010; 74: 1346 - 1356)

著者

Masahiro Jinzaki Kozo Sato Yutaka Tanami Minoru Yamada Sachio Kuribayashi Toshihisa Anzai Yasushi Asakura Satoshi Ogawa

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.70, no.12, pp.1661-1662, 2006 (Released:2006-11-25)

参考文献数

7

被引用文献数

23 24

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Background A method of displaying coronary computed tomography (CT) angiography, which enables evaluation of coronary artery disease (CAD) with fewer images and is understandable to the third person, is preferable. Methods and Results A maximum intensity projection image was created in which contrast media in the ventricles is eliminated, enabling an overview of CAD in a single 3-dimensional (D) image that can be rotated to be viewed at various angles and is easily understood by a third person. Conclusions A novel method of displaying coronary CT angiography in a single 3-D image has been developed and we believe it should become available for many workstations. (Circ J 2006; 70: 1661 - 1662)

著者

Tohru Satoh Tsutomu Saji Hiroshi Watanabe Satoshi Ogawa Kazuhiko Takehara Nobuhiro Tanabe Norikazu Yamada Atsushi Yao Katsumasa Miyaji Norifumi Nakanishi Yumiko Suzuki Tadami Fujiwara Takayuki Kuriyama

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.75, no.3, pp.677-682, 2011 (Released:2011-02-25)

参考文献数

28

被引用文献数

13 11

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Background: There is evidence that phosphodiesterase type-5 is effective for the treatment of pulmonary arterial hypertension (PAH). Methods and Results: A phase III, multicenter, open-label clinical trial of sildenafil 20mg t.i.d. was conducted in 21 Japanese patients with PAH to examine its efficacy, safety, and pharmacokinetics. The present trial consisted of a screening period and 12-week treatment. Patients who were enrolled in the present trial increased their 6-min walking distance of administration increased at week 12 by 84.2m from baseline. Hemodynamic parameters (eg, mean pulmonary artery pressure and pulmonary vascular resistance), Borg dyspnea scores, and plasma brain natriuretic peptide concentrations also improved compared to baseline. Most patients improved or sustained WHO functional class. Seven subjects, who were examined for the pharmacokinetics of sildefanil, showed relatively large interindividual variations in the Cmax, AUC0-8, Css,av, and Ctrough of the drug. Any serious adverse events, severe adverse events, and deaths were not observed. Most of events of undeniable causality were mild or moderate in severity. Sildefanil was well tolerated by the subjects. Conclusions: Sildenafil 20mg t.i.d. was effective and safe for Japanese patients with PAH. (Circ J 2011; 75: 677-682)