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

vol.84, no.3, pp.427-435, 2020-02-25 (Released:2020-02-25)

参考文献数

21

被引用文献数

17

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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

Norimichi Koitabashi Masaru Obokata Masahiko Kurabayashi

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.84, no.3, pp.380-381, 2020-02-25 (Released:2020-02-25)

参考文献数

15

被引用文献数

2

著者

Hiroto Kano Akira Koike Masayo Hoshimoto-Iwamoto Osamu Nagayama Koji Sakurada Takeya Suzuki Hidekazu Tsuneoka Hitoshi Sawada Tadanori Aizawa Karlman Wasserman

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.1111011451, (Released:2011-11-16)

参考文献数

23

被引用文献数

13 11

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Background: The aim of the present study was to compare the end-tidal O2 pressure (PETO2) to end-tidal CO2 pressure (PETCO2) in cardiac patients during rest and during 2 states of exercise: at anaerobic threshold (AT) and at peak. The purpose was to see which metabolic state, PETO2 or PETCO2, best correlated with exercise limitation. Methods and Results: Thirty-eight patients with left ventricular (LV) ejection fraction <40% underwent cardiopulmonary exercise testing (CPX). PETO2 and PETCO2 were measured during CPX, along with peak O2 uptake (VO2), AT, slope of the increase in ventilation (VE) relative to the increase in CO2 output (VCO2) (VE vs. VCO2 slope), and the ratio of the increase in VO2 to the increase in work rate (ΔVO2/ΔWR). Both PETO2 and PETCO2 measured at AT were best correlated with peakVO2, AT, ΔVO2/ΔWR and VE vs. VCO2 slope. PETO2 at AT correlated with reduced peak VO2 (r=-0.60), reduced AT (r=-0.52), reduced ΔVO2/ΔWR (r=-0.55) and increased VE vs. VCO2 slope (r=0.74). PETCO2 at AT correlated with reduced peak VO2 (r=0.67), reduced AT (r=0.61), reduced ΔVO2/ΔWR (r=0.58) and increased VE vs. VCO2 slope (r=-0.80). Conclusions: PETCO2 and PETO2 at AT correlated with peak VO2, AT and ΔVO2/ΔWR, but best correlated with increased VE vs. VCO2 slope. PETO2 and PETCO2 at AT can be used as a prime index of impaired cardiopulmonary function during exercise in patients with LV failure.

著者

Yuko Ishizaka Nobukazu Ishizaka Eiko Takahashi Tadao Unuma Ei-ichi Tooda Hideki Hashimoto Ryozo Nagai Minoru Yamakado

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.67, no.1, pp.26-30, 2003 (Released:2002-12-25)

参考文献数

18

被引用文献数

78 94

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A link between certain infectious microorganisms and an increased risk of atherosclerotic disease has been suggested. By analyzing the data of subjects who had undergone general health-screening tests, a possible association between carotid atherosclerosis and seropositivity of antibody against hepatitis C virus (HCV) has been previously reported. In the present study, a possible link between carotid atherosclerosis and HCV core protein positivity was assessed, because it is postulated to be a better marker of viremia and thus persistent infection. Of the 1992 enrolled subjects, 496 (25%) had carotid artery plaque, and 25 (1.3%) were positive for HCV core protein. Carotid artery plaque was positive in 480/1967 (24%) and 16/25 (64%) of the core protein-negative and core protein-positive subjects, respectively (p<0.0001 by χ2 test). Serum concentrations of transaminases were higher in core protein-positive subjects, but albumin concentrations were not significantly different between the 2 groups. Multivariate logistic regression analysis showed that HCV core protein positivity is an independent predictor of carotid plaque with an odds ratio of 5.61 (95% confidence interval 2.06-15.26, p<0.001). These data further support the possible link between persistent HCV infection and carotid atherosclerosis in the subjects without severe liver dysfunction. (Circ J 2003; 67: 26 - 30)

著者

YUKIO YAMORI MASAHIRO KIHARA JUN FUJIKAWA YASUNARI SOH YASUO NARA MICHIYA OHTAKA RYOICHI HORIE TOKUGORO TSUNEMATSU SHlNYA NOTE MASAICHI FUKASE

出版者

The Japanese Circulation Society

雑誌

JAPANESE CIRCULATION JOURNAL (ISSN:00471828)

巻号頁・発行日

vol.46, no.9, pp.933-938, 1982-09-20 (Released:2008-04-14)

参考文献数

20

被引用文献数

15 18

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In our attempt to design a method which would be more reliable than dietary survey interviews when estimating salt and protein intakes in a population survey, a urinalysis-related study was done on volunteers. Urinary sodium (Na), urea nitrogen (UN) and inorganic sulfate (SO4), all indices of dietary salt, protein and sulfoamino acids, respectively, were confirmed to reflect the nutritional condition. Interaction between salt and protein was not observed at least at the dietary levels used in the present study (for salt, 0.33 and 0.1 g/kg body weight/day; for protein, 1.6 and 0.7 g/kg body weight/day). Excretion of components was delayed several days or more after dietary ingestion, and nutritional estimation by urinalysis, therefore, may not be so much affected by daily variables in the diet intake. Further, partial urine samples proved to have a highly significant correlation with 24-hour (hr) urine, as for urinary Na, potassium (K), SO4, UN and their creatinine (Cr) ratios, thus indicating the availability of partial urine samples as substitutes for 24-hr urine specimens. Thus, urinalysis is a more readily facilitated, more scientific and more quantitative method for epidemiological nutritional surveys.

著者

Noriko Inoue Tomoko Ohkusa Tomoko Nitta Masahiko Harada Kazuya Murata Masunori Matsuzaki

出版者

The Japanese Circulation Society

雑誌

JAPANESE CIRCULATION JOURNAL (ISSN:00471828)

巻号頁・発行日

vol.65, no.11, pp.1001-1003, 2001 (Released:2001-10-25)

参考文献数

5

被引用文献数

1

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A 26-year-old man had a loss consciousness for a few minutes while smoking in the standing position, and was referred to hospital. No abnormalities were found in a computed tomography examination of his head, in a 24-h electrocardiogram or in an exercise tolerance test. The head-up tilt test (HUT) while tobacco smoking elicited a positive response in the tilted position, but the HUT without tobacco smoking was negative. The most noteworthy effect of tobacco smoking during the HUT was the high level of plasma epinephrine compared to the levels seen during supine smoking or the HUT alone. Syncope induced by tobacco smoking in the standing position is rare and the mechanism may be the same as that underlying neurally mediated syncope. (Jpn Circ J 2001; 65: 1001 - 1003)

著者

竹越 襄

出版者

The Japanese Circulation Society

雑誌

JAPANESE CIRCULATION JOURNAL (ISSN:00471828)

巻号頁・発行日

vol.32, no.9, pp.1331-1346, 1968-10-20 (Released:2008-04-14)

参考文献数

14

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In recent years the hemodynamics in hypertensive subjects have become a focus of interest to many cardiologists. However, the relation of acid-base equilibrium to the regulation of hemodynamics in hypertensives has not received much attention. Some investigators have studied about the hemodynamics in respiratory acidosis and alkalosis, but none in metabolic acid-base disturbances. This study therefore was carried out to elucidate the influences of metabolic acidosis and alkalosis on the hemodynamics in normotensive and hypertensive subjects. Materials and Methods Three hundred ml of 0.01 N hydrochloric acid solution was injected intravenously in 10 normotensive and 6 hypertensive subjects to induce metabolic acidosis and one hundred and fifty ml of 7 per cent sodium bicarbonate solution was injected intravenously in 7 normotensive and S hypertensive subjects to induce metabolic alkalosis. Pulse rate and blood pressure were measured before and every 5 minutes after the infusion of acidotic and alkalotic solution, for 45 minutes in the former and 30 minutes in the latter. Arterial pH, plasma volume, cardiac output, stroke volume and total peripheral resistance were measured before and after the infusion. Results Changes in metabolic acidosis : Arterial blood pH fell after the intravenous infusion of 0.01 N hydrochloric acid solution. Pulse rate showed a slight fall both in normotensive and hypertensive subjects, but to an insignificant extent. Systolic, diastolic and mean blood pressures indicated no significant changes after the in-fusion in normotensive and hypertensive subjects. Extracellular plasma volume did not show any changes in both groups. Cardiac output showed a slight increase in both groups after the infusion. Total peripheral resistance indicated no significant elevation after the infusion in normotensive subjects, while it showed a moderate increase in hypertensive ones, but the difference between both groups were not significant.

著者

Yasuo Okumura Koichi Nagashima Masaru Arai Ryuta Watanabe Katsuaki Yokoyama Naoya Matsumoto Takayuki Otsuka Shinya Suzuki Akio Hirata Masato Murakami Mitsuru Takami Masaomi Kimura Hidehira Fukaya Shiro Nakahara Takeshi Kato Wataru Shimizu Yu-ki Iwasaki Hiroshi Hayashi Tomoo Harada Ikutaro Nakajima Ken Okumura Junjiroh Koyama Michifumi Tokuda Teiichi Yamane Yukihiko Momiyama Kojiro Tanimoto Kyoko Soejima Noriko Nonoguchi Koichiro Ejima Nobuhisa Hagiwara Masahide Harada Kazumasa Sonoda Masaru Inoue Koji Kumagai Hidemori Hayashi Kazuhiro Satomi Yoshinao Yazaki Yuji Watari on behalf of the AF Ablation Frontier Registry

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.12, pp.2418-2427, 2019-11-25 (Released:2019-11-25)

参考文献数

27

被引用文献数

17

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Background:The safety of discontinuing oral anticoagulant (OAC) after ablation for atrial fibrillation (AF) in Japanese patients has not been clarified.Methods and Results:A study based on the Atrial Fibrillation registry to Follow the long-teRm Outcomes and use of aNTIcoagulants aftER Ablation (AF Frontier Ablation Registry) was conducted. Data were collected from 3,451 consecutive patients (74.1% men; age, 63.3±10.3 years) who had undergone AF ablation at any of 24 cardiovascular centers in Japan between August 2011 and July 2017. During a 20.7-month follow-up period, OAC therapy was discontinued in 1,836 (53.2%) patients; 51 patients (1.5%) suffered a stroke/transient ischemic attack (TIA), 71 (2.1%) suffered major bleeding, and 36 (1.0%) died. Patients in whom OAC therapy was discontinued were significantly younger than those in whom OACs were continued, and their CHA2DS2-VASc scores were significantly lower. The incidences of stroke/TIA, major bleeding, and death were significantly lower among these patients. Upon multivariate adjustment, stroke events were independently associated with relatively high baseline CHA2DS2-VASc scores but not with OAC status.Conclusions:Although the incidences of stroke/TIA, major bleeding, and death were relatively low among patients for whom OAC therapy was discontinued, stroke/TIA occurrence was strongly associated with a high baseline stroke risk rather than with OAC status. Thus, discontinuation of OAC therapy requires careful consideration, especially in patients with a high baseline stroke risk.

著者

Jin Endo Motoaki Sano Yasuhiro Izumiya Kenichi Tsujita Kazufumi Nakamura Nobuhiro Tahara Koichiro Kuwahara Takayuki Inomata Mitsuharu Ueda Yoshiki Sekijima Yukio Ando Hiroyuki Tsutsui Mitsuaki Isobe Keiichi Fukuda

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0811, (Released:2019-11-16)

参考文献数

4

被引用文献数

18

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Transthyretin cardiac amyloidosis is a progressive and life-threating disease that is significantly underdiagnosed, and the actual number of patients with the disease is presently unknown. Accumulation of wild-type transthyretin-derived amyloid in the heart is a common finding in very elderly patients. Recent clinical trials demonstrated that tafamidis reduced all-cause death and the number of cardiovascular hospitalizations when compared with placebo. The Japanese Ministry of Health, Labour and Welfare approved tafamidis (Vyndaqel®, Pfizer Inc.) for the treatment of cardiomyopathy caused by both wild-type and mutated transthyretin-derived amyloidoses. This scientific statement on transthyretin-derived cardiac amyloidosis summarizes the conditions for reimbursement of the cost of tafamidis therapy, and the institutional and physician requirements for the introduction of tafamidis.

著者

Kenta Nakamura Charles E. Murry

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0567, (Released:2019-11-13)

参考文献数

151

被引用文献数

41

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The investment of nearly 2 decades of clinical investigation into cardiac cell therapy has yet to change cardiovascular practice. Recent insights into the mechanism of cardiac regeneration help explain these results and provide important context in which we can develop next-generation therapies. Non-contractile cells such as bone marrow or adult heart derivatives neither engraft long-term nor induce new muscle formation. Correspondingly, these cells offer little functional benefit to infarct patients. In contrast, preclinical data indicate that transplantation of bona fide cardiomyocytes derived from pluripotent stem cells induces direct remuscularization. This new myocardium beats synchronously with the host heart and induces substantial contractile benefits in macaque monkeys, suggesting that regeneration of contractile myocardium is required to fully recover function. Through a review of the preclinical and clinical trials of cardiac cell therapy, distinguishing the primary mechanism of benefit as either contractile or non-contractile helps appreciate the barriers to cardiac repair and establishes a rational path to optimizing therapeutic benefit.

著者

Fikri Taufiq Peili Li Junichiro Miake Ichiro Hisatome

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.11, pp.469-473, 2019-11-08 (Released:2019-11-08)

参考文献数

54

被引用文献数

8

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Among the several independent risk factors for atrial fibrillation (AF), hyperuricemia has been widely accepted as associated with the incidence of paroxysmal or persistent AF, as well as with the risk of AF in patients undergoing cardiovascular surgery. The electrophysiological mechanism of AF involves electrical remodeling of the arrhythmogenic substrate and abnormal automaticity as trigger. Both electrical and structural remodeling mediated by oxidative stress derived from either xanthine oxidoreductase (XOR), soluble uric acid (UA) or monosodium urate (MSU) crystals might be plausible explanations for the association of AF with hyperuricemia. XOR generates reactive oxygen species (ROS) that lead to atrial structural remodeling via inflammation. Soluble UA accumulates intracellularly through UA transporters (UAT), shortening the atrial action potential via enhanced expression and activity of Kv1.5 channel proteins. Intracellular accumulation of soluble UA generates ROS in atrial myocytes via nicotinamide adenine dinucleotide phosphate oxidase, which phosphorylates ERK/Akt and heat shock factor 1 (HSF1), thereby increasing transcription and translation of Hsp70, which stabilizes Kv1.5. In macrophages, MSU activates the NLRP3 inflammasome and proteolytic processing mediated by caspase-1 with enhanced interleukin (IL)-1β and IL-18 secretion. Use of an XOR inhibitor, antioxidants, a UAT inhibitor such as a uricosuric agent, and an NLRP3 inflammasome inhibitor, might become a potential strategy to reduce the risk of hyperuricemia-induced AF, and control serum UA level.

著者

Junko Naito Hiroshige Ohashi Michiya Ohno Masafumi Sugiyama Kazuyoshi Hayakawa Akihisa Kunishima Nobuyuki Takada Tatsuya Kariya Koshi Goto Hisato Takatsu Toshiki Ohira Koji Nakahara Ichijiro Murata Shingo Minatoguchi Gakuro Yoshida Hiroyuki Okura Shinya Minatoguchi

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.11, pp.508-516, 2019-11-08 (Released:2019-11-08)

参考文献数

31

被引用文献数

2

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Background:Levocarnitine has been reported to improve the left ventricular (LV) systolic function and decrease LV hypertrophy in hemodialysis (HD) patients. Its effect on LV diastolic dysfunction, however, has not yet been clarified.Methods and Results:HD patients (n=88) were given levocarnitine i.v. 1,000 mg for 12 months at the end of every dialysis session through the dialysis circuit of the venous site. LV ejection fraction (EF), E/A, E/e’, left atrial volume index (LAVI) and LV mass index (LVMI) were measured before and 3, 6, 9, and 12 months after the start of levocarnitine on echocardiography. We regarded E/A≤0.8, E/e’>14 and LAVI>34 mL/m2as LV diastolic dysfunction, and LVEF<55% as LV systolic dysfunction. We also investigated the effect of levocarnitine on HFpEF. Plasma brain natriuretic peptide, total carnitine, free carnitine, and acyl-carnitine and biochemistry parameters were measured. Levocarnitine significantly improved LV diastolic function in HD patients with LV diastolic dysfunction, but did not affect LV diastolic function in those with normal LV diastolic function. Levocarnitine significantly improved HFpEF. Levocarnitine significantly improved the LV systolic function in HD patients with LV systolic dysfunction but did not affect the LV systolic function in those with normal LV systolic function. Levocarnitine significantly decreased LVMI and increased plasma total, free, and acyl-carnitine.Conclusions:Levocarnitine ameliorates LV diastolic as well as LV systolic dysfunction in HD patients.

著者

Keigo Yamashita Takehisa Abe Yoshihiro Hayata Tomoaki Hirose Shigeki Taniguchi

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.11, pp.2222-2228, 2019-10-25 (Released:2019-10-25)

参考文献数

26

被引用文献数

2

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Background:Pulmonary arterial capacitance (PAC) is a determinant of right ventricular afterload and a strong independent predictor of unfavorable outcomes in advanced heart failure (HF) with pulmonary hypertension (PH). We aimed to test the hypothesis that preoperative PAC may affect postoperative clinical outcomes in patients undergoing aortic valve replacement (AVR) for severe aortic valve stenosis (AS), even in the absence of PH.Methods and Results:We studied 116 patients who underwent AVR for severe AS between January 2005 and December 2017. Right heart catheterization was performed for all patients prior to surgery. PAC and pulmonary vascular resistance (PVR) fit well to a hyperbolic relationship (PAC=0.23/PVR, R2=0.73). PAC also showed an inverse relationship with pulmonary capillary wedge pressure (PCWP) (r=−0.15) and mean pulmonary arterial pressure (r=−0.29) and provided a stronger prediction of death or HF admission than PCWP or PVR (area under the ROC curve of 0.74 vs. 0.40 and 0.41, respectively, P=0.002). During a median follow-up of 36 months, PAC (hazard ratio, 0.48; 95% confidence interval, 0.30–0.78; P=0.003) was an independent predictor of death or hospitalization for HF.Conclusions:In these patients undergoing AVR for severe AS, even in the absence of PH, preoperative reduced PAC was independently associated with adverse surgical outcomes. It seems that preoperative PAC has potential as an independent predictor of long-term prognosis after AVR for severe AS.

著者

Keiko Yamasaki Hiroyuki Sawatari Nao Konagai Chizuko A. Kamiya Jun Yoshimatsu Jun Muneuchi Mamie Watanabe Terunobu Fukuda Atsushi Mizuno Ichiro Sakamoto Kenichiro Yamamura Tomoko Ohkusa Hiroyuki Tsutsui Koichiro Niwa Akiko Chishaki

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.11, pp.2257-2264, 2019-10-25 (Released:2019-10-25)

参考文献数

38

被引用文献数

5

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Background:The average maternal age at delivery, and thus the associated maternal risk are increasing including in women with congenital heart disease (CHD). A comprehensive management approach is therefore required for pregnant women with CHD. The present study aimed to investigate the factors determining peripartum safety in women with CHD.Methods and Results:We retrospectively collected multicenter data for 217 pregnant women with CHD (age at delivery: 31.4±5.6 years; NYHA classifications I and II: 88.9% and 7.4%, respectively). CHD severity was classified according to the American College of Cardiology/American Heart Association guidelines as simple (n=116), moderate complexity (n=69), or great complexity (n=32). Cardiovascular (CV) events (heart failure: n=24, arrhythmia: n=9) occurred in 30 women during the peripartum period. Moderate or great complexity CHD was associated with more CV events during gestation than simple CHD. CV events occurred earlier in women with moderate or great complexity compared with simple CHD. Number of deliveries (multiparity), NYHA functional class, and severity of CHD were predictors of CV events.Conclusions:This study identified not only the severity of CHD according to the ACC/AHA and NYHA classifications, but also the number of deliveries, as important predictive factors of CV events in women with CHD. This information should be made available to women with CHD and medical personnel to promote safe deliveries.

著者

Toru Miyoshi Hiroyuki Hao Akira Oshita Hideo Kawakami Toshiharu Maeda Hiroshi Matsuoka

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0543, (Released:2019-09-28)

著者

Genichi Sakaguchi Hiroaki Miyata Noboru Motomura Chikara Ueki Eriko Fukuchi Hiroyuki Yamamoto Shinichi Takamoto Akira Marui

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-19-0593, (Released:2019-09-11)

参考文献数

20

被引用文献数

27

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Background:Ventricular septal defect (VSD) after myocardial infarction (MI) is a rare but fatal complication. We report patients’ characteristics and operative outcomes after surgical repair of post-MI VSD using a national database of Japan.Methods and Results:This was a retrospective review of the Japan Adult Cardiovascular Surgery Database (JCVSD) to identify adults (age ≥18 years) who underwent surgical repair of post-MI VSD between 2008 and 2014. The primary outcome was operative death. We identified 1,397 patients (671 male [48%], 74.1±9.3 years old) undergoing surgical repair of post-MI VSD among 288,736 patients undergoing cardiac surgery enrolled in the JCVSD during the same period. Of these, 1,075 (77.0%) were supported preoperatively with an intra-aortic balloon pump. Surgical status was urgent in 391 (28.0%) and emergency/salvage in 731 (52.3%). Concomitant coronary artery bypass grafting was performed in 475 (34.0%). Overall 30-day and operative mortalities were 24.3% and 33.0%, respectively. Operative mortality varied according to surgical status: 15.6% in elective, 30.9% in urgent, and 40.6% in emergency/salvage cases. Multivariable analysis identified advanced age and emergency/salvage status as being strongly associated with increased odds of operative death.Conclusions:Post-MI VSD remains a devastating complication in Japan as well as in the USA and Europe.

著者

Takanori Ikeda Tsuyoshi Shiga Wataru Shimizu Koichiro Kinugawa Atsuhiro Sakamoto Ryozo Nagai Takashi Daimon Kaori Oki Haruka Okamoto Takeshi Yamashita The J-Land II Study Investigators

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.7, pp.1456-1462, 2019-06-25 (Released:2019-06-25)

参考文献数

9

被引用文献数

18

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Background:We aimed to investigate the efficacy and safety of landiolol in Japanese patients with recurrent hemodynamically unstable ventricular tachycardia or recurrent ventricular fibrillation (recurrent VT/VF).Methods and Results:This was an open-label, uncontrolled, multicenter study. Patients with hemodynamically unstable VT or VF 24 h prior to providing informed consent, and who were refractory to class III antiarrhythmic drugs, were enrolled. Landiolol was started at a dose of 1 μg/kg/min, after VT/VF was suppressed with electrical defibrillation. Landiolol was titrated up to 10 μg/kg/min in 1 h and adjusted between 1 and 40 μg/kg/min for the efficacy assessment (1–49 h). The primary efficacy endpoint was the proportion of patients free from recurrent VT/VF. Secondary efficacy endpoints included the number of recurrent VT/VF events and the survival rate 30 days after the start of landiolol treatment. Adverse events (AEs) were assessed for safety; 27 and 29 patients were analyzed for efficacy and safety, respectively. The proportion of patients free from recurrent VT/VF was 77.8% (95% CI 57.1–89.3). The mean (±standard deviation) number of recurrent VT/VF events was 9.3±7.9. The survival rate was 96.3%. The overall incidence of AEs and of serious AEs was 72.4% and 6.9%, respectively.Conclusions:Landiolol may be useful for Japanese patients with recurrent VT/VF who do not respond to class III antiarrhythmic drugs.

著者

大野 猛

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.23, no.1, pp.51-64, 1959-04-20 (Released:2008-04-14)

参考文献数

126

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In the Part I. I have reported that there were observed the respiratory changes i.e. tachynea and labored respioration in rabbits, into which cervical subarachnoid space almina-cream were injected, but its pathogenesis has been difinitely unknown.Now in this study I examined the respiratory responses upon the electrical stimulation of spinal cord at the cervical (C. 3-4) or thoracic (D. 1-5), adding some spinal transection or vagal section. Electrical stimuli were given in the form of thyratron discharges (50 cps) or an alternating commercial current (60 cps). Their output voltage was between 1.5 V. and 10 V.Results obtained are as follows.1. Electrical stimulation at the cervical level resulted in the inspiratory, midpositional and expiratory apnea or tachypnea.2. Stimulation at the thoracic level resulted in either apnea or tachypnea, but in most cases the latter ones.3. By the additional stimulation at the thoracic level, the apneustic responses upon the stimulation at the cervical level relieved and respiratory movements reappeared.4. During the tachypnea or apnea evoked by stimuli at the cervical level (C. 3-4), electrical discharges of the external intercostal muscles increased. Such discharges suddenly initiated with the maximal intensity, continued during a long inspiratory phase and further remained for the short expiratory phase.5. When the electrical stimuli were applied in the dorsal areas of the spinal cord after section of both vagal section, the rate and the amplitude of the respiration extremely increased.6. After only one spinal segment was isolated by spinal transection, the stimulation of this segment at the ventral area resulted in apneustic responses but at the dorsal area resulted in no remarkable respiratory responses.

著者

Toyoaki Murohara

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.83, no.9, pp.1811-1816, 2019-08-23 (Released:2019-08-23)

著者

Ryu Matsuo Masahiro Kamouchi

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

vol.81, no.2, pp.151-152, 2017-01-25 (Released:2017-01-25)

参考文献数

14