著者

Atsushi Mizuno Chisa Matsumoto Takuya Kishi Mari Ishida Shoji Sanada Memori Fukuda Issei Komuro Kenichi Hirata Koichi Node

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.3, no.2, pp.100-104, 2021-02-10 (Released:2021-02-10)

参考文献数

14

被引用文献数

5

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Background:Cardiovascular department restriction policies on procedures resulting from the COVID-19 pandemic have not been fully evaluated.Methods and Results:We performed a retrospective analysis of a nationwide survey performed by the Japanese Circulation Society in August 2020. The total response rate was 48.9% (651/1,331). The rate of restriction of cardiovascular procedures peaked in April. Exacerbations of heart failure due to hospital restrictions were noted in 43.8% of departments.Conclusions:Many departments restricted their cardiological procedures, and this rate changed according to the pandemic situation. The exacerbation of cardiovascular disease resulting from pandemic restrictions should not be ignored.

著者

Koh Ono Satoshi Shizuta Erika Yamamoto Naritatsu Saito Neiko Ozasa Takao Kato Eri Kato Takahiro Horie Junichi Tazaki Hiroki Shiomi Shin Watanabe Hirotoshi Watanabe Yugo Yamashita Yusuke Yoshikawa Hideyuki Kinoshita Takeru Makiyama Yoshinori Yoshida Noboru Ashida Yasuaki Nakagawa Yasuhiro Nakashima Osamu Baba Hirohiko Kohjitani Masahiro Kimura Hideaki Inazumi Takashi Yoshizawa Akihiro Komasa Takeshi Kimura

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-21-0041, (Released:2021-01-30)

参考文献数

10

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Due to the COVID-19 pandemic, the 84thAnnual Meeting of the Japanese Circulation Society (JCS) was held in a web-based format for the first time in its history as “The Week for JCS 2020” from Monday, July 27 to Sunday, August 2, 2020. All sessions, including general abstracts, were streamed live or on-demand. The main theme of the meeting was “Change Practice!” and the aim was to organize the latest findings in the field of cardiovascular medicine and discuss how to change practice. The total number of registered attendees was over 16,800, far exceeding our expectations, and many of the sessions were viewed by far more people than at conventional face-to-face scientific meetings. At this conference, the power of online information dissemination was fully demonstrated, and the evolution of online academic meetings will be a direction that cannot be reversed in the future. The meeting was completed with great success, and we express our heartfelt gratitude to all affiliates for their enormous amount of work, cooperation, and support.

著者

Takayuki Inomata Yuki Ikeda Keisuke Kida Yugo Shibagaki Naoki Sato Yuji Kumagai Hisahito Shinagawa Junya Ako Tohru Izumi for the Kanagawa Aquaresis Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.82, no.1, pp.159-167, 2017-12-25 (Released:2017-12-25)

参考文献数

32

被引用文献数

21 54

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Background:Although diuretic resistance leading to residual congestion is a known predictor of a poorer heart failure (HF) prognosis, better therapeutic strategies for effective and safe decongestion have not been established.Methods and Results:In this study, 81 HF patients with fluid retention (despite taking ≥40 mg/day furosemide (FUR)), with an estimated glomerular filtration rate <45 mL/min/1.73 m2, were randomized into 2 groups and administered either ≤15 mg/day additive tolvaptan (TLV) or ≤40 mg/day increased FUR for 7 days. Changes in urine volume between baseline and mean urine volume during treatment were significantly higher in the TLV than FUR group (P=0.0003). Although there was no significant decrease in body weight or improved signs and symptoms of congestion between the 2 groups, the increase in serum creatinine on Day 7 from baseline was significantly smaller in the TLV than FUR group (P=0.038). Multiple logistic regression analysis revealed that additive TLV (odds ratio 0.157, 95% confidence interval 0.043–0.605, P=0.001) was an independent clinical factor for improved renal function during treatment compared with increased FUR.Conclusions:In HF patients with residual congestion and renal dysfunction refractory to standard therapy, additive TLV increased urine volume without further renal impairment compared with patients who received an increased dose of FUR.

著者

Masaya Sugimoto Kei Ota Aya Kajihama Kouichi Nakau Hiromi Manabe Hiroki Kajino

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.75, no.9, pp.2213-2219, 2011 (Released:2011-08-25)

参考文献数

44

被引用文献数

32 44

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Background: Cardiac troponin I (cTnI) is currently considered to be the most sensitive and specific biochemical marker of acute coronary syndrome and acute myocardial infarction. However, few reports have described the use of cTnI assays for evaluating abnormal hemodynamic load in children with congenital heart disease (CHD). It was hypothesized that significant hemodynamic overload due to a left-to-right shunt induces myocardial injury. Methods and Results: A highly sensitive cTnI assay was used to measure the serum cTnI levels in 30 children with atrial septal defect (ASD), 32 children with ventricular septal defect (VSD), and 350 healthy children. Cardiac catheterization was performed in the children with ASD and VSD to determine the ratio of pulmonary to systemic blood flow, the ratio of pulmonary to systemic arterial pressure (Pp/Ps), the pulmonary vascular resistance index, and the right and left ventricular end-diastolic volume. Serum cTnI levels in both the ASD and VSD children were significantly higher than those in healthy children (P<0.05 and P<0.01, respectively). Furthermore, serum cTnI levels significantly correlated with Pp/Ps (r=0.745, P<0.001) in VSD children. Conclusions: Significant volume and pressure overload due to a left-to-right shunt induce myocardial injury and might eventually cause irreversible myocardial remodeling in children with CHD. The serum cTnI level is a useful biomarker for evaluating myocardial damage associated with pulmonary hypertension in VSD children. (Circ J 2011; 75: 2213-2219)

著者

Kazunori Toyoda Shinichiro Uchiyama Yasushi Hagihara Takahiro Kuwashiro Takahisa Mori Kenji Kamiyama Yasuhisa Urano Atsushi Taniguchi Kenma Nozaki Lisa Cronin Claudia Grauer Martina Brueckmann Hans-Christoph Diener

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-0563, (Released:2020-10-30)

参考文献数

18

被引用文献数

11

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Background:The international Randomized, Double-Blind, Evaluation in Secondary Stroke Prevention Comparing the EfficaCy and Safety of the Oral Thrombin Inhibitor Dabigatran Etexilate versus Acetylsalicylic Acid in Patients with Embolic Stroke of Undetermined Source (RE-SPECT ESUS) trial did not demonstrate superiority of dabigatran over aspirin for reduction of recurrent strokes in patients with embolic strokes of undetermined source (ESUS). Based on pre-defined subanalyses, the safety and efficacy of dabigatran vs. aspirin in Japanese patients was assessed.Methods and Results:ESUS patients were randomized to receive either dabigatran (150 or 110 mg twice daily) or aspirin (100 mg once daily). Of 5,390 patients randomized, 594 were Japanese. Most Japanese patients (99.8%) underwent brain magnetic resonance imaging for trial screening, compared to 76.8% of non-Japanese (P<0.0001). In the Japanese cohort, over a 19.4-month median follow-up period, recurrent stroke as the primary outcome occurred in 20/294 patients (4.3%/year) in the dabigatran group and 38/300 (8.3%/year) in the aspirin group (hazard ratio [HR], 0.55; 95% confidence interval [CI], 0.32–0.94). Major bleeding occurred in 12 patients (2.5%/year) and 17 patients (3.5%/year), respectively (HR, 0.72; 95% CI, 0.34–1.52). In contrast, in the non-Japanese cohort, recurrent stroke occurred in 4.1%/year and 4.3%/year, respectively, showing no apparent difference in recurrent stroke for dabigatran vs. aspirin (HR, 0.91; 95% CI, 0.74–1.14). The P-interaction for treatment and region did not reach statistical significance (P=0.09).Conclusions:Dabigatran was putatively associated with a lower relative risk of recurrent stroke compared with aspirin in Japanese ESUS patients.

著者

Ki-Hun Kim Kyoung-Min Park Gi-Byoung Nam Dae-Kyeong Kim Minkyung Oh HyungOh Choi Taek Jong Hong Bo-Min Park Guang-Won Seo Pil-Sang Song Dong-Kie Kim Sang-Hoon Seol Doo-IL Kim You-Ho Kim Kee-Joon Choi

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.78, no.4, pp.865-871, 2014 (Released:2014-03-25)

参考文献数

18

被引用文献数

9 28

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Background: Long-term data on lead complication rates are limited for both the axillary and subclavian venous approaches for permanent pacemaker implantation. Methods and Results: We conducted a single-center, retrospective, nonrandomized comparison. We reviewed the patients who had consented to receiving a permanent pacemaker implant. A superficial landmark or radiographic contrast guiding was used for the axillary venous approach, whereas conventional landmarks were used for the subclavian venous approach. From January 1992 to December 2005, we analyzed 1,161 permanent pacemaker leads in 655 patients [subclavian venous approach (group I: 338 patients, 542 leads) and axillary venous approach (group II: 317 patients, 619 leads)]. Baseline characteristics of the patients did not differ. However, DDD-pacemakers and atrial leads were used more often in group II than in group I (94% vs. 62% and 49% vs. 40%, P<0.01). During the 8-year follow-up, lead complication rates were lower in group II (17 leads, 3%) than in group I (31 leads, 6%) (P=0.03), and group II had a better complication-free survival curve than group I with a 49% relative risk reduction in lead complication rates (hazard ratio =0.51; 95% confidence interval, 0.27–0.94; P=0.03). Conclusions: The axillary venous approach for permanent pacemaker implantation has better long-term efficacy and lower lead complication rates than the subclavian venous approach.  (Circ J 2014; 78: 865–871)

著者

Michito Murayama Hiroyuki Iwano Miwa Sarashina Toshihisa Anzai

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-0678, (Released:2020-09-24)

被引用文献数

2

著者

Yuya Matsue Yoshiharu Kinugasa Takeshi Kitai Shogo Ohishi Kazuhiro Yamamoto Hiroyuki Tsutsui

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

pp.CR-20-0081, (Released:2020-08-13)

参考文献数

18

被引用文献数

3

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Background:The effect of the COVID-19 pandemic on the respiratory management strategy with regard to the use of non-invasive positive pressure ventilation (NPPV) and high-flow nasal cannula (HFNC) in patients with acute heart failure (AHF) in Japan is unclear.Methods and Results:This cross-sectional study used a self-reported online questionnaire, with responses from 174 institutions across Japan. More than 60% of institutions responded that the treatment of AHF patients requiring respiratory management became fairly or very difficult during the COVID-19 pandemic than earlier, with institutions in alert areas considering such treatment significantly more difficult than those in non-alert areas (P=0.004). Overall, 61.7% and 58.8% of institutions changed their indications for NPPV and HFNC, respectively. Significantly more institutions in the alert area changed their practices for the use of NPPV and HFNC during the COVID-19 pandemic (P=0.004 and P=0.002, respectively). When there was insufficient time or information to determine whether AHF patients may have concomitant COVID-19, institutions in alert areas were significantly more likely to refrain from using NPPV and HFNC than institutions in non-alert areas.Conclusions:The COVID-19 pandemic has compelled healthcare providers to change the respiratory management of AHF, especially in alert areas.

著者

Hiroshi Imamura Yukio Sekiguchi Tomomi Iwashita Hiroshi Dohgomori Katsunori Mochizuki Kazunori Aizawa Shin-ichi Aso Yuichi Kamiyoshi Uichi Ikeda Jun Amano Kazufumi Okamoto

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.75, no.1, pp.59-66, 2011 (Released:2010-12-24)

参考文献数

37

被引用文献数

45 64 29

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Background: Acute aortic dissection (AAD) classically presents as sudden, severe chest, back, or abdominal pain. However, there have been several documented cases presenting with atypical features. The clinical characteristics and outcomes of patients with painless AAD were investigated. Methods and Results: The study group comprised 98 patients (53 males, 45 females; 66±12 years) with AAD admitted to hospital from 2002 to 2007: 16 patients (17%) had no pain (Painless group) and 82 patients had pain (Painful group). In 81% of the Painless group and 70% of the Painful group there was a type A dissection. The Painless group more frequently had a persistent disturbance of consciousness (44% vs. 6%, P<0.001), syncope (25% vs. 1%, P<0.001) and a focal neurologic deficit (19% vs. 2%, P=0.006) as presenting symptoms. Imaging study findings were not significantly different. Cerebral ischemia (50% vs. 1%, P<0.001) and cardiac tamponade (38% vs. 13%, P=0.01) were more frequent complications in the Painless group. In-hospital mortality was not significantly different (19% vs. 15%). However, the Painless group had a more unfavorable functional outcome on overall performance category (P<0.001). Conclusions: Painless AAD may be more frequent than previously reported. Painless AAD patients often present with a disturbance of consciousness or a neurologic deficit, and have a higher morbidity than painful AAD patients. (Circ J 2011; 75: 59-66)

著者

Hiroki Nakano Kazunori Omote Toshiyuki Nagai Michikazu Nakai Kunihiro Nishimura Yasuyuki Honda Satoshi Honda Naotsugu Iwakami Yasuo Sugano Yasuhide Asaumi Takeshi Aiba Teruo Noguchi Kengo Kusano Hiroyuki Yokoyama Satoshi Yasuda Hisao Ogawa Taishiro Chikamori Toshihisa Anzai on behalf of the NaDEF Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.3, pp.614-621, 2019-02-25 (Released:2019-02-25)

参考文献数

36

被引用文献数

2 6

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Background: The ideal mortality prediction model (MPM) for acute heart failure (AHF) patients would have sufficient and stable predictive ability for long-term as well as short-term mortality. However, published MPMs for AHF predominantly predict short-term mortality up to 90 days, and their prognostic performance for long-term mortality remains unclear. Methods and Results: We analyzed 609 AHF patients in a prospective registry from January 2013 to May 2016. We compared the prognostic performance for long-term mortality among 8 systematically identified MPMs for AHF that predict short-term mortality up to 90 days from admission. The PROTECT 7-day model showed the highest c-index for long-term as well as short-term mortality among the studied MPMs. Sensitivity analyses revealed serum albumin and total cholesterol to be the most important variables, as dropping these variables resulted in a significant decline in c-index, when compared with other variables specific to the PROTECT 7-day model. Furthermore, significant improvements in c-index and net reclassification were observed when serum albumin or serum albumin plus total cholesterol was added to the studied MPMs, other than the PROTECT 7-day model. Conclusions: The PROTECT 7-day model demonstrated the highest predictive performance for long-term as well as short-term mortality in AHF patients among the published MPMs. Our findings indicate the importance of accounting for nutritional status such as serum albumin and total cholesterol in AHF patients when developing a MPM.

著者

Atsushi Mizuno Koichiro Niwa Kozo Matsuo Masaaki Kawada Aya Miyazaki Yoshiki Mori Norifumi Nakanishi Hideo Ohuchi Mamie Watanabe Atsushi Yao Kei Inai

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.77, no.12, pp.2942-2947, 2013 (Released:2013-11-25)

参考文献数

33

被引用文献数

16 21

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Background: Although the survival rate for repaired Tetralogy of Fallot (TOF) is dramatically improving, anatomical and functional residua and sequelae followed by arrhythmias and sudden death are still challenging issues to be resolved. Reoperation can reduce the incidence of arrhythmias and sudden death, but there is no consensus on the indications of reoperation for patients with TOF, especially in Japan. Methods and Results: A cross-sectional questionnaire survey of reoperation indications in patients with TOF was performed through a Japanese multicenter study. The questionnaire, which focused on the number of repaired TOF patients aged >15 years old, reoperation indications and management, was sent to the institutions belonging to Japanese Society for Adult Congenital Heart Disease. In total, 41.5% (78/188) of the institutions replied. The total number of repaired TOF patients was 4,010, and sudden cardiac death was observed in 45.236/4,010 (5.9%) experienced reoperation. Pulmonary stenosis (32%) and pulmonary regurgitation (29%) were the most common reasons for reoperation. There were only 2 implantable cardioverter defibrillator or resynchronization therapy defibrillator implantations. The physiological/anatomical indications of reoperation differed among the hospitals. Conclusions: Approximately 1.1% of patients suffered sudden death and 6% of repaired TOF patients had reoperation. The indications of reoperation, however, varied among the institutions. Therefore, detailed information for each case of sudden death or reoperation should be collected and analyzed in order to establish guidelines for reoperation.  (Circ J 2013; 77: 2942–2947)

著者

Sho Okada Togo Iwahana Yoshio Kobayashi

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-0198, (Released:2020-07-31)

参考文献数

15

被引用文献数

2

著者

Hiroyuki Tsutsui Tomomi Ide Yasushi Kawasaki

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-20-0590, (Released:2020-07-31)

参考文献数

7

被引用文献数

2

著者

Tsuyoshi Nozue

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.80, no.2, pp.323-324, 2016-01-25 (Released:2016-01-25)

参考文献数

15

被引用文献数

2 8

著者

Toru Kubota Genya Sunagawa Daisuke Nagatomo Yoshitomo Tsutsui Hiroyuki Tsutsui

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0992, (Released:2020-02-27)

参考文献数

2

被引用文献数

3

著者

Kyohei Marume Seiji Takashio Masato Nishi Kyoko Hirakawa Masahiro Yamamoto Shinsuke Hanatani Seitaro Oda Daisuke Utsunomiya Shinya Shiraishi Mitsuharu Ueda Taro Yamashita Kenji Sakamoto Eiichiro Yamamoto Koichi Kaikita Yasuhiro Izumiya Yasuyuki Yamashita Yukio Ando Kenichi Tsujita

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.8, pp.1698-1708, 2019-07-25 (Released:2019-07-25)

参考文献数

30

被引用文献数

31

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Background:A recent study revealed a high prevalence of transthyretin (TTR) cardiac amyloidosis (CA) in elderly patients. 99 mTc-labeled pyrophosphate (99 mTc-PYP) scintigraphy is a remarkably sensitive and specific modality for TTR-CA, but is only available in specialist centres; thus, it is important to raise the pretest probability. The aim of this study was to evaluate the characteristics of patients with 99 mTc-PYP positivity and make recommendations about patient selection for 99 mTc-PYP scintigraphy.Methods and Results:We examined 181 consecutive patients aged ≥70 years who underwent 99 mTc-PYP scintigraphy at Kumamoto University Hospital between January 2012 and December 2018. Logistic regression analyses showed that high-sensitivity cardiac troponin T (hs-cTnT) ≥0.0308 ng/mL, left ventricular posterior wall thickness ≥13.6 mm, and wide QRS (QRS ≥120 ms) were strongly associated with 99 mTc-PYP positivity. We developed a new index for predicting 99 mTc-PYP positivity by adding 1 point for each of the 3 factors. The 99 mTc-PYP positive rate increased by a factor of 4.57 for each 1-point increase (P<0.001). Zero points corresponded to a negative predictive value of 87% and 3 points corresponded to a positive predictive value of 96% for 99 mTc-PYP positivity.Conclusions:The combination of biochemical (hs-cTnT), physiological (wide QRS), and structural (left ventricular posterior wall thickness) findings can raise the pretest probability for 99 mTc-PYP scintigraphy. It can assist clinicians in determining management strategies for elderly patients with suspected CA.

著者

Ekrem Üçer Sabine Fredersdorf Joachim Seegers Florian Poschenrieder Christian Hauck Lars Maier Carsten Jungbauer

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.84, no.3, pp.404-410, 2020-02-25 (Released:2020-02-25)

参考文献数

20

被引用文献数

4

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Background:We recently demonstrated that the acute reconnection rate detected with adenosine provocation test (APT) was significantly lower after pulmonary vein isolation (PVI) with visually guided laser balloon ablation (VGLB) than with RF ablation (RF). We evaluated the recurrence rate of atrial arrhythmias at 12 months after VGLB vs. RF and the significance of APT results for the outcome.Methods and Results:Fifty patients with paroxysmal AF were randomized to either RF or VGLB ablation in a 1 : 1 fashion. After PVI each PV underwent an APT. All patients underwent a 3-day Holter and clinical follow-up every 3 months. Significantly less PVs reconnected during APT in the VGLB-arm (10 PV (10.8%) vs. 29 PV (30.9%); P=0.001). Significantly less patients had a recurrence of atrial arrhythmia in the VGLB-arm (3 vs. 9; P=0.047). In the VGLB-arm no recurrence was seen in those patients with a negative APT (negative predictive value (NPV)=100%). Only 3 of the 8 patients with a positive APT in the VGLB-arm had a recurrence (positive PV (PPV)=37%). Recurrences in the RF-arm were seen in 3 patients with positive APT as well as in 6 patients with negative APT (PPV=18% and NPV=33%).Conclusions:There was significantly less recurrence of atrial arrhythmias at 12 months after PVI with VGLB. A negative APT after PVI with VGBL predicted freedom from AF with a very high NPV meaning that the high acute efficiency of the VGLB persisted long term.

著者

Akihiro Tani Kenya Kusunose Kazuhisa Matsumoto Hirotsugu Yamada Masataka Sata

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.2, no.3, pp.207-208, 2020-03-10 (Released:2020-03-10)

参考文献数

1

著者

Hideki Origuchi Haruki Itoh Shin-ichi Momomura Ryuji Nohara Hiroyuki Daida Takashi Masuda Masahiro Kohzuki Shigeru Makita Kenji Ueshima Masatoshi Nagayama Kazuto Omiya Hitoshi Adachi Yoichi Goto

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0650, (Released:2020-02-08)

参考文献数

21

被引用文献数

16

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Background:There is little evidence regarding the effect of outpatient cardiac rehabilitation (CR) on exercise capacity or the long-term prognosis in patients after coronary artery bypass graft surgery (CABG). This study aimed to determine whether participation in outpatient CR improves exercise capacity and long-term prognosis in post-CABG Japanese patients in a multicenter cohort.Methods and Results:We enrolled 346 post-CABG patients who underwent cardiopulmonary exercise testing during early (2–3 weeks) and late (3–6 months) time points after surgery. They formed the Active (n=240) and Non-Active (n=106) CR participation groups and were followed for 3.5 years. Primary endpoint was a major adverse cardiac event (MACE): all-cause death or rehospitalization for acute myocardial infarction/unstable angina/worsening heart failure. Peak oxygen uptake at 3–5 months from baseline was significantly more increased in Active than in Non-Active patients (+26±24% vs. +19±20%, respectively; P<0.05), and the MACE rate was significantly lower in Active than Non-Active patients (3.4% vs. 10.5%, respectively; P=0.02). Multivariate Cox proportional hazard analysis showed that participation in outpatient CR was a significant prognostic determinant of MACE (P=0.03).Conclusions:This unique study showed that a multicenter cohort of patients who underwent CABG and actively participated in outpatient CR exhibited greater improvement in exercise capacity and better survival without cardiovascular events than their counterparts who did not participate.

著者

Taro Temma Toshiyuki Nagai Masaya Watanabe Rui Kamada Yumi Takahashi Hikaru Hagiwara Taro Koya Motoki Nakao Kazunori Omote Kiwamu Kamiya Hiroyuki Iwano Kazuhiro Yamamoto Tsutomu Yoshikawa Yoshihiko Saito Toshihisa Anzai

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0963, (Released:2020-02-01)

参考文献数

31

被引用文献数

9

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Background:Atrial fibrillation (AF) is an important prognostic determinant in heart failure (HF) with preserved ejection fraction (HFpEF). However, it is unclear which HFpEF phenotypes are affected by AF in terms of long-term clinical outcomes because HFpEF is a heterogeneous syndrome with comorbidities such as coronary artery disease (CAD). In this study we determined the differential prognostic significance of AF in HFpEF patients according to CAD status.Methods and Results:Data for 408 hospitalized HFpEF patients enrolled in the Japanese Heart Failure Syndrome with Preserved Ejection Fraction Nationwide Multicenter Registry were analyzed. Patients were divided into 4 groups according to the presence of AF and CAD. The primary outcome was the composite of all-cause death and HF rehospitalization. The incidence of adverse events was higher in the AF–non-CAD than non-AF–non-CAD group (P=0.004). On multivariable Cox regression analysis with prespecified confounders, AF–non-CAD was significantly associated with an increased risk of adverse events than non-AF–non-CAD (adjusted HR, 1.91; 95% CI: 1.02–3.92) regardless of the type of AF. In contrast, risk was comparable between the AF–CAD and non-AF–CAD groups (adjusted HR, 1.24; 95% CI: 0.64–2.47).Conclusions:In HFpEF patients without CAD, AF was independently related to adverse events, indicating that intensive management of AF would have more beneficial effects particularly in HFpEF patients without CAD.