著者
Rie Hayashi Hiroyasu Iso Kazumasa Yamagishi Hiroshi Yatsuya Isao Saito Yoshihiro Kokubo Ehab S. Eshak Norie Sawada Shoichiro Tsugane for the Japan Public Health Center-Based (JPHC) Prospective Study Group
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-18-0842, (Released:2019-03-06)
参考文献数
43
被引用文献数
1

Background: Evidence from prospective cohort studies regarding the relationship between working hours and risk of cardiovascular disease is limited Methods and Results: The Japan Public Health Center-Based Prospective Study Cohort II involved 15,277 men aged 40–59 years at the baseline survey in 1993. Respondents were followed up until 2012. During the median 20 years of follow up (257,229 person-years), we observed 212 cases of acute myocardial infarction and 745 stroke events. Cox proportional hazards models adjusted for sociodemographic factors, cardiovascular risk factors, and occupation showed that multivariable-adjusted hazard ratios (HRs) associated with overtime work of ≥11h/day were: 1.63 (95% confidence interval [CI] 1.01–2.63) for acute myocardial infarction and 0.83 (95% CI 0.60–1.13) for total stroke, as compared with the reference group (working 7 to <9 h/day). In the multivariable model, increased risk of acute myocardial infarction associated with overtime work of ≥11 h/day was more evident among salaried employees (HR 2.11, 95% CI 1.03–4.35) and men aged 50–59 years (HR 2.60, 95% CI 1.42–4.77). Conclusions: Among middle-aged Japanese men, working overtime is associated with a higher risk of acute myocardial infarction.
著者
Junya Sado Tetsuhisa Kitamura Yuri Kitamura Rong Liu Emiko Ando Tomotaka Sobue Yumi Sugawara Keitaro Matsuo Tomio Nakayama Ichiro Tsuji Hidemi Ito Takaichiro Suzuki Kota Katanoda Suketami Tominaga
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-18-0618, (Released:2019-03-08)
参考文献数
32
被引用文献数
1

Background: Coffee, which contains various bioactive compounds, is one of the most popular beverages. Further accumulation of evidence is needed, however, to confirm whether coffee consumption would be effective in preventing cardiovascular disease in the general Japanese population. Methods and Results: We evaluated the association between coffee consumption frequency (never, sometimes, 1–2 cups/day, 3–4 cups/day and ≥5 cups/day) and mortality from all causes, heart disease, and cerebrovascular disease, in 39,685 men and 43,124 women aged 40–79 years at baseline, in a 3-prefecture cohort study. The coffee consumption frequency was assessed on questionnaire. Cox proportional hazards regression modeling was used to assess the association between coffee consumption frequency and all-cause and cardiovascular disease mortality with adjustment for potential confounders. During 411,341 and 472,433 person-years in men and women, respectively, a total of 7,955 men and 5,725 women died. Coffee consumption frequency was inversely associated with all-cause mortality in both genders (P for trend<0.001). In addition, the risks of mortality from cerebrovascular disease in men (P for trend<0.001), and heart disease in women (P for trend=0.031) were inversely associated with coffee consumption. Conclusions: In this Japanese population, coffee drinking has a preventive effect on all-cause and on cardiovascular mortality in men and/or women.
著者
Junya Sado Tetsuhisa Kitamura Yuri Kitamura Rong Liu Emiko Ando Tomotaka Sobue Yumi Sugawara Keitaro Matsuo Tomio Nakayama Ichiro Tsuji Hidemi Ito Takaichiro Suzuki Kota Katanoda Suketami Tominaga
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.83, no.4, pp.757-766, 2019-03-25 (Released:2019-03-25)
参考文献数
32
被引用文献数
1

Background: Coffee, which contains various bioactive compounds, is one of the most popular beverages. Further accumulation of evidence is needed, however, to confirm whether coffee consumption would be effective in preventing cardiovascular disease in the general Japanese population. Methods and Results: We evaluated the association between coffee consumption frequency (never, sometimes, 1–2 cups/day, 3–4 cups/day and ≥5 cups/day) and mortality from all causes, heart disease, and cerebrovascular disease, in 39,685 men and 43,124 women aged 40–79 years at baseline, in a 3-prefecture cohort study. The coffee consumption frequency was assessed on questionnaire. Cox proportional hazards regression modeling was used to assess the association between coffee consumption frequency and all-cause and cardiovascular disease mortality with adjustment for potential confounders. During 411,341 and 472,433 person-years in men and women, respectively, a total of 7,955 men and 5,725 women died. Coffee consumption frequency was inversely associated with all-cause mortality in both genders (P for trend<0.001). In addition, the risks of mortality from cerebrovascular disease in men (P for trend<0.001), and heart disease in women (P for trend=0.031) were inversely associated with coffee consumption. Conclusions: In this Japanese population, coffee drinking has a preventive effect on all-cause and on cardiovascular mortality in men and/or women.
著者
Shamima Akter Tohru Nakagawa Toru Honda Shuichiro Yamamoto Keisuke Kuwahara Hiroko Okazaki Huanhuan Hu Teppei Imai Akiko Nishihara Toshiaki Miyamoto Naoko Sasaki Takayuki Ogasawara Akihiko Uehara Makoto Yamamoto Taizo Murakami Makiko Shimizu Masafumi Eguchi Takeshi Kochi Ai Hori Satsue Nagahama Kentaro Tomita Maki Konishi Ikuko Kashino Akiko Nanri Isamu Kabe Tetsuya Mizoue Naoki Kunugita Seitaro Dohi for the Japan Epidemiology Collaboration on Occupational Health Study Group
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.82, no.12, pp.3005-3012, 2018-11-24 (Released:2018-11-24)
参考文献数
28
被引用文献数
2

Background: The effect of smoking on mortality in working-age adults remains unclear. Accordingly, we compared the effects of cigarette smoking and smoking cessation on total and cause-specific mortality in a Japanese working population. Methods and Results: This study included 79,114 Japanese workers aged 20–85 years who participated in the Japan Epidemiology Collaboration on Occupational Health Study. Deaths and causes of death were identified from death certificates, sick leave documents, family confirmation, and other sources. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated via Cox proportional hazards regression. During a maximum 6-year follow-up, there were 252 deaths in total. Multivariable-adjusted HRs (95% CIs) for total mortality, cardiovascular disease (CVD) mortality, and tobacco-related cancer mortality were 1.49 (1.10–2.01), 1.79 (0.99–3.24), and 1.80 (1.02–3.19), respectively, in current vs. never smokers. Among current smokers, the risks of total, tobacco-related cancer, and CVD mortality increased with increasing cigarette consumption (Ptrend<0.05 for all). Compared with never smokers, former smokers who quit <5 and ≥5 years before baseline had HRs (95% CIs) for total mortality of 1.80 (1.00–3.25) and 1.02 (0.57–1.82), respectively. Conclusions: In this cohort of workers, cigarette smoking was associated with increased risk of death from all and specific causes (including CVD and tobacco-related cancer), although these risks diminished 5 years after smoking cessation.
著者
Muhammad Ayyaz Ul Haq Muhammad Rashid Ian C. Gilchrist Olivier Bertrand Chun Shing Kwok Chun Wai Wong Hossam M. Mansour Yasser Baghdaddy James Nolan Maarten A.H. van Leeuwen Mamas A. Mamas
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-18-0389, (Released:2018-09-22)
参考文献数
43

Background: We systematically reviewed the available literature on limb dysfunction after transradial access (TRA) or transfemoral access (TFA) cardiac catheterization. Methods and Results: MEDLINE and EMBASE were searched for studies evaluating any transradial or transfemoral procedures and limb function outcomes. Data were extracted and results were narratively synthesized with similar treatment arms. The TRA group included 15 studies with 3,616 participants and of these 3 reported nerve damage with a combined incidence of 0.16% and 4 reported sensory loss, tingling and numbness with a pooled incidence of 1.61%. Pain after TRA was the most common form of limb dysfunction (7.77%) reported in 3 studies. The incidence of hand dysfunction defined as disability, grip strength change, power loss or neuropathy was low at 0.49%. Although radial artery occlusion (RAO) was not a primary endpoint for this review, it was observed in 3.57% of the participants in a total of 8 studies included. The TFA group included 4 studies with 15,903,894 participants; the rates of peripheral neuropathy were 0.004%, sensory neuropathy caused by local groin injury and retroperitoneal hematomas were 0.04% and 0.17%, respectively, and motor deficit caused by femoral and obturator nerve damage was 0.13%. Conclusions: Limb dysfunction post cardiac catheterization is rare, but patients may have nonspecific sensory and motor complaints that resolve over a period of time.
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
vol.81, no.11, pp.1636-1646, 2017-10-25 (Released:2017-10-25)
参考文献数
27
被引用文献数
6 15

Background:This study determined the current status of the incidence, management, and prognosis of stroke in Japan using a population-based stroke registry.Methods and Results:Shiga Stroke Registry is an ongoing population-based registry that covers approximately 1.4 million residents of Shiga Prefecture. Cases of acute stroke were identified using standard definitions through surveillance of both all acute-care hospitals with neurology/neurosurgery facilities and death certificates in 2011. A total of 2,956 stroke cases and 2,176 first-ever stroke cases were identified. The age- and sex-adjusted incidence rate for first-ever stroke using the 2013 European Standard Population as standard was per 100,000 person-years: 91.3 for ischemic stroke, 36.4 for intracerebral hemorrhage, and 13.7 for subarachnoid hemorrhage. It was estimated that approximately 220,000 new strokes occurred in 2011 in Japan. Among the 2,956 cases, most stroke patients underwent neuroimaging, 268 received surgical or endovascular treatment, and 2,158 had rehabilitation therapy; 78 patients received intravenous thrombolysis. A total of 1,846 stroke patients had died or were dependent at hospital discharge, and 390 died within 28 days of onset.Conclusions:Incidence rates of stroke by subtypes were clarified and the total number of new strokes in Japan was estimated. More than half of stroke patients die or become dependent after a stroke. This study re-emphasized the importance of public health measures in reducing the burden of stroke in Japan.
著者
Kunio Yufu Tsuyoshi Shimomura Mami Fujinami Tatsunori Nakashima Shotaro Saito Reika Ayabe Kyoko Kawano Yumi Ishii Norihiro Okada Hidefumi Akioka Yasushi Teshima Teruo Sakamoto Mikiko Nakagawa Naohiko Takahashi
出版者
The Japanese Circulation Society
雑誌
Circulation Reports (ISSN:24340790)
巻号頁・発行日
vol.1, no.6, pp.241-247, 2019-06-10 (Released:2019-06-10)
参考文献数
13

Background:The mobile cloud electrocardiography (C-ECG) system is useful for reducing door-to-balloon (DTB) time in patients with acute coronary syndrome (ACS), but few studies have reported the usefulness of the C-ECG system across a wide provincial prefecture, such as Oita, in Japan.Methods and Results:On 17 April 2017, the C-ECG system was integrated into the Oita remote image transmission system, in 10 ambulances of 10 respective fire departments in Oita Prefecture. During 6 months, 162 ECG indicating suspected ACS were transmitted to 18 hospitals using the C-ECG system. Of 162 patients, 17 who received emergency percutaneous coronary intervention (PCI) were assigned to the cloud group (mean age, 71±11 years). The control group consisted of 29 consecutive ACS patients who were transported to Oita University Hospital without using the C-ECG system (mean age, 66±12 years). Another 40 consecutive patients were diagnosed with ACS before transportation to Oita University Hospital, and were assigned to the diagnosed group (mean age, 70±14 years). DTB time (70±26 min vs. 96±24 min, P<0.005) and door-to-catheterization laboratory time (33±20 min vs. 53±22 min, P<0.0001) were shorter in the cloud group than in the control group, respectively.Conclusions:C-ECG system integration in Oita Prefecture was useful to appropriately transfer ACS patients to hospital and to facilitate earlier PCI than in the conventional diagnostic system.
著者
Atsushi Sugiyama Sue Duval Yuji Nakamura Katsunori Yoshihara Demetris Yannopoulos
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.80, no.10, pp.2124-2132, 2016-09-23 (Released:2016-09-23)
参考文献数
42
被引用文献数
7 11

Background:The quality of cardiopulmonary resuscitation (CPR) has been recently shown to affect clinical outcome. The Resuscitation Outcomes Consortium (ROC) Prehospital Resuscitation Impedance Valve and Early Versus Delayed Analysis (PRIMED) trial showed no differences in outcomes with an active vs. sham impedance threshold device (ITD), a CPR adjunct that enhances circulation. It was hypothesized the active ITD would improve survival with favorable neurological outcomes in witnessed out-of-hospital cardiac arrest patients when used with high-quality CPR.Methods and Results:Using the publicly accessible ROC PRIMED database, a post-hoc analysis was performed on all witnessed subjects with both compression rate and depth data (n=1,808) who received CPR within the study protocol definition of adequate CPR quality (compression rate 80–120/min and depth 4–6 cm; n=929). Demographics were similar between sham and active ITD groups. In witnessed subjects who received quality CPR, survival with favorable neurological function was 11.9% for the active ITD subjects (56/470) vs. 7.4% for the sham (34/459) (odds ratio 1.69 [95% confidence interval 1.08, 2.64]). There were no statistically significant differences for this primary outcome when CPR was performed outside the boundaries of the definition of adequate CPR quality. Multivariable models did not change these associations.Conclusions:An active ITD combined with adequate-quality conventional CPR has the potential to significantly improve survival after witnessed cardiac arrest. (Circ J 2016; 80: 2124–2132)
著者
The Examination Committee of Criteria for `Obesity Disease' in Japan Japan Society for the Study of Obesity
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.66, no.11, pp.987-992, 2002 (Released:2002-10-25)
参考文献数
41
被引用文献数
655 909

The present study was designed to establish adequate criteria for categorizing `obesity disease' in Japan in relation to obesity-related complications. The subjects were 1,193 Japanese subjects (775 men, 418 women; age: 20-84 years old, body mass index (BMI): 14.9-56.4 kg/m2) including subjects undergoing a health examination and obese subjects visiting an obesity clinic. Visceral fat area (VFA) and subcutaneous fat area (SFA) were determined by computed tomography (CT) at the umbilical level. Anthropometric parameters, including BMI, waist circumference (W), waist/hip circumference (W/H), ratio and waist circumference/body height (W/BH) ratio, were measured. Hyperglycemia, dyslipidemia, and hypertension were evaluated as obesity-related complications. The relationship between each parameter and the prevalence of the complications was investigated. The number of complications increased in accordance with BMI and the average value was greater than 1.0 at a BMI of 25. The best combination of the sensitivity and specificity for detecting subjects with multiple risk factors was a BMI of 25. BMI showed a close positive correlation with SFA (r=0.82), even for BMI ≥25 (r=0.77), but had a weaker correlation with VFA (r=0.54). The obese subjects with a BMI ≥25 had no correlation between BMI and VFA because of the wide individual variation of VFA. The number of disorders was greater than 1.0 at 100 cm2 of VFA and the best combination of the sensitivity and specificity for determining subjects with multiple risk factors was 100 cm2 of VFA. Between the simple anthropometric values and measurement of VFA, it was proven that W had the closest relationship with VFA in both men (r=0.68) and women (r=0.65). The regression line obtained from simple correlation analyses indicated that the W corresponding to 100 cm2 of VFA was 84.4 cm in men and 92.5 cm in women. These data suggest that obesity is adequately specified as a BMI ≥25 in Japan where the prevalence and degree of obesity remains mild. It is reasonable to establish the cut-off point of VFA at 100 cm2 as indicative of the risk of obesity-related disorders and a waist circumference of 85 cm in men and 90 cm in women approximates to this visceral fat mass. (Circ J 2002; 66: 987 - 992)
著者
Satoshi Katano Akiyoshi Hashimoto Katsuhiko Ohori Ayako Watanabe Remi Honma Rimi Yanase Tomoyuki Ishigo Takefumi Fujito Hirofumi Ohnishi Kazufumi Tsuchihashi Sumio Ishiai Tetsuji Miura
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-17-1202, (Released:2018-04-07)
参考文献数
39
被引用文献数
2

Background:Whether the short-term effect of cardiac rehabilitation (CR) in elderly patients with heart failure (HF) is influenced by nutritional status is uncertain, so the present study investigated the effect of nutritional status on functional recovery after CR in elderly HF inpatients.Methods and Results:We enrolled 145 patients admitted for treatment of HF who were aged ≥65 years and had a low functional status defined as a Barthel index (BI) score ≤85 points at the commencement of CR. Nutritional status was assessed by the Mini Nutritional Assessment Short Form (MNA-SF) and total energy intake per day. The primary endpoint was functional status determined by the BI score at discharge. The median CR period was 20 days (interquartile range: 14–34 days), and 87 patients (60%) were functionally dependent (BI score ≤85) at discharge. Multivariate logistic regression analysis showed that MNA-SF score (odds ratio [OR]: 0.76, P=0.02) and total energy intake at the commencement of CR (OR: 0.91, P=0.02) were independent predictors of functional dependence after CR. MNA-SF score ≤7 and total energy intake ≤24.5 kcal/kg/day predicted functional dependence at discharge with moderate sensitivity and specificity.Conclusions:MNA-SF score and total energy intake at the commencement of CR are novel predictors of the extent of functional recovery of elderly HF inpatients after in-hospital CR.
著者
Nobuhiro Murata Yasuo Okumura Katsuaki Yokoyama Naoya Matsumoto Eizo Tachibana Keiichiro Kuronuma Koji Oiwa Michiaki Matsumoto Toshiaki Kojima Shoji Hanada Kazumiki Nomoto Ken Arima Fumiyuki Takahashi Tomobumi Kotani Yukitoshi Ikeya Seiji Fukushima Satoru Itoh Kunio Kondo Masaaki Chiku Yasumi Ohno Motoyuki Onikura Atsushi Hirayama for the SAKURA AF Registry Investigators
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.83, no.4, pp.727-735, 2019-03-25 (Released:2019-03-25)
参考文献数
27
被引用文献数
3

Background: Off-label dosing of direct oral anticoagulants (DOACs) is encountered clinically among patients with atrial fibrillation (AF), although data on the clinical outcomes of over- and under-dosing are lacking in Japan. Methods and Results: We examined the clinical outcomes of off-label DOAC dosing using the SAKURA AF Registry, a prospective multicenter registry in Japan. Among 3,237 enrollees, 1,676 under any of the 4 DOAC regimens were followed up for a median of 39.3 months: 746 (45.0%), appropriate standard-dose; 477 (28.7%), appropriate low-dose; 66 (4.0%), over-dose; and 369 (22.2%) under-dose. Compared with the standard-dose group, patients in the under- and over-dose groups were significantly older and had a higher stroke risk. After multivariate adjustment, stroke/systemic embolism (SE) and death events were equivalent between the standard- and under-dose groups, but major bleeding events tended to be lower in the under-dose group (hazard ratio [HR] 0.474, P=0.0739). Composite events (stroke/SE, major bleeding, or death) were higher in the over-dose than in the standard-dose group (HR 2.714, P=0.0081). Conclusions: Clinical outcomes were not worse for under-dose than for standard-dose users among patients with different backgrounds. Over-dose users, however, were at higher risk for all clinical events and required careful follow-up. Further studies are needed to clarify the safety and effectiveness of off-label DOAC dosing in Japan.
著者
Tirza Springeling Sharon W. Kirschbaum Alexia Rossi Timo Baks Yusuf Karamermer Carl Schulz Mohammed Ouhlous Dirk J. Duncker Adriaan Moelker Gabriel P. Krestin Patrick W.J.C. Serruys Pim de Feyter Robert-Jan M. van Geuns
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.77, no.1, pp.81-88, 2013 (Released:2012-12-25)
参考文献数
26
被引用文献数
20 23

Background: Primary percutaneous coronary intervention (PPCI) preserves function and improves survival. The late effects of PPCI on left ventricular remodeling, however, have not yet been investigated on cardiac magnetic resonance imaging (CMRI). Methods and Results: Twenty-five patients with acute myocardial infarction (AMI) treated with PPCI underwent CMRI within 10 days, at 4 months and at 5 years. Left ventricular ejection fraction (LVEF), end-diastolic volume (EDV) and end-systolic volume were quantified on cine images. Infarct mass and transmural extent of infarction were quantified on contrast-enhanced imaging. In all patients EDV increased significantly in the early phase (192±40ml to 211±49ml, P≤0.01) and LVEF improved significantly (42±9% to 46±9%, P=0.02). In the late phase (>4 months) no significant changes were observed (LVEF 44±9%, P=0.07; EDV 216±68ml, P=0.38). Three different groups could be identified. One-third (32%) had no dilatation at all; one-third (32%) had limited dilatation at 4 months without progression later; and 36% had progressive dilatation both at 4 months and at late follow-up. This third group had an average increase in EDV of 20% in the acute phase followed by an additional 13%. The strongest predictor for progressive dilatation was infarct mass. Conclusions: Even in the era of PPCI for AMI followed by optimal medical therapy, one-third of patients had progressive dilatation, which was best predicted by infarct mass.  (Circ J 2013; 77: 81–88)
著者
Sang-Hyun Ihm George Bakris Ichiro Sakuma Il Suk Sohn Kwang Kon Koh
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-18-1293, (Released:2018-12-29)
参考文献数
58
被引用文献数
1

Until the 2017 ACC/AHA Hypertension Guidelines were released, the target blood pressure (BP) for adults with hypertension (HTN) was 140/90 mmHg in most of the guidelines. The new 2018 ESC/ESH, Canadian, Korean, Japan, and Latin American hypertension guidelines have maintained the <140/90 mmHg for the primary target in the general population and encourage reduction to <130/80 if higher risk. This is more in keeping with the 2018 American Diabetes Association guidelines. However, the 2017 ACC/AHA guidelines classify HTN as BP ≥130/80 mmHg and generally recommend target BP levels below 130/80 mmHg for hypertensive patients independently of comorbid disease or age. Although the new guidelines mean that more people (nearly 50% of adults) will be diagnosed with HTN, the cornerstone of therapy is still lifestyle management unless BP cannot be lowered to this level; thus, more people will require BP-lowering medications. To date, there have been many controversies about the definition of HTN and the target BP. Targeting an intensive systolic BP goal can increase the adverse effects of multiple medications and the cardiovascular disease risk by excessively lowering diastolic BP, especially in patients with high risk, including those with diabetes, chronic kidney disease, heart failure, and coronary artery disease, and the elderly. In this review, we discuss these issues, particularly regarding the optimal target BP.
著者
Yasuaki Tanaka Atsushi Takahashi Takamitsu Takagi Jun Nakajima Katsumasa Takagi Hiroyuki Hikita Masahiko Goya Kenzo Hirao
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
pp.CJ-17-1352, (Released:2018-06-07)
参考文献数
27
被引用文献数
3

Background:The aim of this study was to categorize the conduction patterns between the right atrium (RA) and the superior vena cava (SVC), and to determine the ideal procedure for SVC isolation using a novel high-resolution mapping system.Methods and Results:RA-SVC conduction was evaluated using the RHYTHMIA system in 113 patients (age 62.8±11.5 years, paroxysmal: 67) with atrial fibrillation (AF) after pulmonary vein (PV) isolation. In 56 patients, a line of conduction block was found to run obliquely just above the sinus node (Block group). The remaining 57 patients did not have block (Non-block group). Non-PV foci were spontaneous or provoked with isoproterenol after electrical cardioversion of pacing-induced AF. In 43 patients with SVC foci (Block group: 22, Non-Block group: 21), SVC was isolated by radiofrequency applications delivered along the line connecting the open ends of the block line (Block group) or by conventional methods (Non-block group). The Block group required fewer radiofrequency deliveries for SVC isolation than the Non-Block group (4.2±0.9 vs. 10.2±2.8 times; P<0.0001). The isolated SVC area was larger in the Block group (15.7±3.7 vs. 10.5±3.1 cm2; P<0.0001).Conclusions:We found that approximately half of patients with AF had a diagonal line of block at the RA-SVC junction that could be utilized to isolate the SVC with fewer radiofrequency deliveries.
著者
Kazuomi Kario
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.76, no.3, pp.553-562, 2012 (Released:2012-02-24)
参考文献数
74
被引用文献数
29 42

The devastating Great East Japan Earthquake, which was 9.0 on the Richter scale, occurred on March 11, 2011. Japan experienced the Great Hanshin-Awaji Earthquake 16 years ago, and I was working at the epicenter, and reported the characteristics of the earthquake-associated cardiovascular risk and high blood pressure (BP) found during the continuous practice and clinical studies of Tsuna Medical Association before and after the quake. A major disaster increases thrombophilic tendency and BP, both of which trigger disaster-induced cardiovascular events such as stroke, cardiac events, etc. The high salt intake and the increased salt sensitivity caused by disrupted circadian rhythms are the 2 major leading causes of disaster hypertension (HT) through neurohumoral activation under stressful conditions. To better assess and reduce the risks for disaster-associated cardiovascular events, we introduced the web-based Disaster Cardiovascular Prevention (DCAP) network (which consists of DCAP risk and prevention score assessment, and self-measured BP monitoring at both the shelter and the home) to the survivors of the 2011 disaster, and frequently found newly developed HT. Here I review the recent evidence, possible mechanism and the management of "disaster HT" for effective prevention of disaster-induced cardiovascular events. (Circ J 2012; 76: 553-562)
著者
Yasuyuki Hayashi Taku Iwami Tetsuhisa Kitamura Tatsuya Nishiuchi Kentaro Kajino Tomohiko Sakai Chika Nishiyama Masahiko Nitta Atsushi Hiraide Tatsuro Kai
出版者
The Japanese Circulation Society
雑誌
Circulation Journal (ISSN:13469843)
巻号頁・発行日
vol.76, no.7, pp.1639-1645, 2012 (Released:2012-06-25)
参考文献数
35
被引用文献数
51 60

Background: The effectiveness of epinephrine administration for cardiac arrests has been shown in animal models, but the clinical effect is still controversial. Methods and Results: A prospective, population-based, observational study in Osaka involved consecutive out-of-hospital cardiac arrest (OHCA) patients from January 2007 through December 2009. We evaluated the outcomes among adult non-traumatic bystander-witnessed OHCA patients for whom the local protocol directed the emergency medical service personnel to administer epinephrine. After stratifying by first documented cardiac rhythm, outcomes were compared among the following groups: non-administration, ≤10, 11-20 and ≥21min as the time from emergency call to epinephrine administration. A total of 3,161 patients were eligible for our analyses, among whom 1,013 (32.0%) actually received epinephrine. The epinephrine group had a significantly lower rate of neurologically intact 1-month survival than the non-epinephrine group (4.1% vs. 6.1%, P=0.028). In cases of ventricular fibrillation (VF) arrest, patients in the early epinephrine group who received epinephrine administration within 10min had a significantly higher rate of neurologically intact 1-month survival compared with the non-epinephrine group (66.7% vs. 24.9%), though other epinephrine groups did not. In cases of non-VF arrest, the rate of neurologically intact 1-month survival was low, irrespective of epinephrine administration. Conclusions: The effectiveness of epinephrine after OHCA depends on the time of administration. When epinephrine is administered in the early phase, there is an improvement in neurological outcome from OHCA with VF.  (Circ J 2012; 76: 1639–1645)
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

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

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 6

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)