Language：Japanese   Publisher：(一社)日本動脈硬化学会  

Language：Japanese   Publisher：(一社)日本動脈硬化学会  

Language：Japanese   Publisher：(一社)日本動脈硬化学会  

Language：Japanese   Publisher：BMJ Open  

Objectives This study aimed to develop risk prediction equations for the 5-year incidence of diabetes among the Japanese population using health check-up data. We hypothesised that demographic and laboratory data from health check-ups could predict diabetes onset with high accuracy. Design Retrospective cohort study. Setting Data from a health examination in Japan between 2008 and 2016. Participants Data were analysed from 31 084 participants aged 30-69 years. The presence of baseline diabetes and endocrine disease was included in the exclusion criteria, as were participants with missing data for the analysis. The study population was randomly divided into derivation and validation cohorts in a 1:1 ratio. Primary outcome measures The primary outcome was the incidence of diabetes at the 5-year follow-up, defined as a fasting blood glucose level ≥126 mg/dL, glycosylated haemoglobin A1c (National Glycohemoglobin Standardization Program (NGSP)) ≥6.5%, or initiation of diabetes treatment. Predictor variables included age, sex, body mass index, blood pressure, underlying diseases, lifestyle factors and laboratory measurements. The primary measure was the area under the receiver operating characteristic curve (AUC) for the predictive equations. Results In the derivation cohort, diabetes incidence was 5.0%. The prediction equation incorporating age, sex, body mass index, fasting blood glucose and glycosylated haemoglobin A1c showed good discriminatory ability with an AUC of 0.89, sensitivity of 0.81 and specificity of 0.81 in the validation cohort. Conclusions The equation with laboratory measures effectively predicted the 5-year diabetes risk in the general Japanese population. It has potential clinical utility for identifying individuals at high risk of diabetes and guiding preventive interventions.

DOI： 10.1136/bmjopen-2024-097005

Scopus

PubMed

Language：Japanese   Publisher：Psychogeriatrics  

Background: This study aimed to examine the association between depressive tendencies and bathing or hot spring bathing habits in community-dwelling individuals aged ≥ 40 years. Methods: This cross-sectional study included 542 participants from the Tarumizu Study 2021, in which the participants underwent health checks. The frequencies of bathing and hot spring bathing were assessed using a questionnaire. The frequency of bathing was classified into ‘< 7 times/week’ and ‘7 times/week’, whereas the frequency of hot spring bathing was classified into ‘< 1 time/week’ and ‘≥ 1 time/week’. Depressive tendencies were assessed using the 15-item Geriatric Depression Scale, with a score of ≥ 5 considered depressive tendencies. Results: Among the participants, 487 (89.9%) bathed 7 times/week, and 124 (22.9%) bathed in hot springs ≥ 1 time/week. The depressive tendency group included 95 (17.5%) participants. The proportion of participants who bathed in hot springs ≥ 1 time/week was significantly lower in the depressive tendency group (14.7%) than in the normal group (24.6%) (p = 0.038). Multivariable logistic regression analysis adjusted for age, sex, income-generating job, outing frequency, mobility problems, smoking history and alcohol intake demonstrated that the odds ratio for depressive tendency was significantly lower for hot spring bathing ≥ 1 time/week than for < 1 time/week (adjusted odds ratio: 0.51, 95% confidence interval: 0.27–0.95, p = 0.033). In contrast, no association was observed between depressive tendencies and bathing frequency. Conclusions: Hot spring bathing frequency of ≥ 1 time/week was significantly associated with depressive tendencies in community-dwelling middle-aged and older adults. However, depressive tendencies were not associated with bathing frequency. Further longitudinal studies are needed to examine the preventive effects of hot spring bathing on depressive tendencies.

DOI： 10.1111/psyg.70046

Scopus

PubMed

Language：English   Publisher：Nature Publishing Group  

中高年者における5年間の動脈壁硬化の進展に関わる因子について、上腕-足首脈波伝播速度(baPWV)を指標に検討した。2005～2019年の特定健診者のうち、初回と5(範囲3～7)年後のデータが比較可能で、かつ初回baPWV<1400cm/sの男性3394名および女性2710名を対象とした。多変量解析の結果、5年後baPWV≧1400cm/sの発生と関連する因子は、男性で年齢、BMI、収縮期・拡張期血圧、心拍数、空腹時血糖、トリグリセリド、女性で年齢、収縮期・拡張期血圧、心拍数、喫煙歴であった。これらの因子を用いて、5年後baPWV≧1400cm/sの発生リスクを予測するモデルを構築した。ROC解析による識別能(ROC曲線下面積)は、予測スコアが男性(6因子)で0.68、女性(4因子)で0.71、予測式が男性(7因子)で0.71、女性(5因子)で0.77であった。

Language：English   Publisher：John Wiley & Sons Australia, Ltd  

2021年のTarumizu研究に参加した40歳以上の地域在住中高年者542名(平均69.4±10.4歳、女性60.5%)を対象に横断研究を行い、抑うつ傾向と入浴または温泉浴習慣の関連性を評価した。質問票を用いて入浴および温泉浴の頻度を評価し、入浴習慣については週7回未満と週7回、温泉浴習慣については週1回未満と週1回以上に分類した。抑うつ傾向の評価には15項目の老年期うつ病尺度を用い、スコアが5以上の場合に抑うつ傾向とした。入浴習慣が週7回なのは487名(89.9%)、温泉浴習慣が週1回以上なのは124名(22.9%)で、抑うつ傾向は95名(17.5%)で認められた。抑うつ傾向を認めた中高年では、温泉浴習慣が週1回以上の割合が有意に低かった。年齢、性別、収入が得られる職業、外出頻度、移動問題、喫煙歴、飲酒量を調整した多変量ロジスティック回帰解析において、温泉浴習慣が週1回以上の場合は抑うつ傾向のリスクが有意に低かったが(調整オッズ比0.51)、抑うつ傾向と入浴頻度には有意な関連性は認められなかった。

Language：English   Publisher：Nature Publishing Group  

中高年者における5年間の動脈壁硬化の進展に関わる因子について、上腕-足首脈波伝播速度(baPWV)を指標に検討した。2005～2019年の特定健診者のうち、初回と5(範囲3～7)年後のデータが比較可能で、かつ初回baPWV<1400cm/sの男性3394名および女性2710名を対象とした。多変量解析の結果、5年後baPWV≧1400cm/sの発生と関連する因子は、男性で年齢、BMI、収縮期・拡張期血圧、心拍数、空腹時血糖、トリグリセリド、女性で年齢、収縮期・拡張期血圧、心拍数、喫煙歴であった。これらの因子を用いて、5年後baPWV≧1400cm/sの発生リスクを予測するモデルを構築した。ROC解析による識別能(ROC曲線下面積)は、予測スコアが男性(6因子)で0.68、女性(4因子)で0.71、予測式が男性(7因子)で0.71、女性(5因子)で0.77であった。

Language：English   Publisher：John Wiley & Sons Australia, Ltd  

2021年のTarumizu研究に参加した40歳以上の地域在住中高年者542名(平均69.4±10.4歳、女性60.5%)を対象に横断研究を行い、抑うつ傾向と入浴または温泉浴習慣の関連性を評価した。質問票を用いて入浴および温泉浴の頻度を評価し、入浴習慣については週7回未満と週7回、温泉浴習慣については週1回未満と週1回以上に分類した。抑うつ傾向の評価には15項目の老年期うつ病尺度を用い、スコアが5以上の場合に抑うつ傾向とした。入浴習慣が週7回なのは487名(89.9%)、温泉浴習慣が週1回以上なのは124名(22.9%)で、抑うつ傾向は95名(17.5%)で認められた。抑うつ傾向を認めた中高年では、温泉浴習慣が週1回以上の割合が有意に低かった。年齢、性別、収入が得られる職業、外出頻度、移動問題、喫煙歴、飲酒量を調整した多変量ロジスティック回帰解析において、温泉浴習慣が週1回以上の場合は抑うつ傾向のリスクが有意に低かったが(調整オッズ比0.51)、抑うつ傾向と入浴頻度には有意な関連性は認められなかった。

Language：Japanese   Publisher：(株)全日本病院出版会  

皮膚において動脈と静脈は血管吻合を形成し,温浴すると温熱刺激により血管は拡張し,動静脈シャントも開大し,血流は増加する.この血流増加により血管内皮への「ずり応力」が高まり,血管内皮の一酸化窒素合成酵素が活性化され,一酸化窒素により末梢血管抵抗が低下して血圧が低下する.温浴時には,静水圧により静脈還流量が増加し,心拍数も上昇し,心拍出量が増加するが,温熱の血管拡張作用による末梢血管抵抗の低下がそれを凌駕するために血圧は低下する.温浴による高血圧患者の降圧効果や温浴習慣により動脈硬化進展抑制効果や心血管疾患の発症低下など温浴の有用性が報告されている.温浴では入浴中は静水圧により心内圧は上昇するが,和温療法に用いられる低温サウナ浴(60℃,15分)では静水圧の影響を受けず,温熱刺激による血管拡張反応により心臓に対する前・後負荷を軽減し,心係数は増加し,心不全の治療に用いられている.(著者抄録)

Language：Japanese   Publisher：(株)全日本病院出版会  

皮膚において動脈と静脈は血管吻合を形成し,温浴すると温熱刺激により血管は拡張し,動静脈シャントも開大し,血流は増加する.この血流増加により血管内皮への「ずり応力」が高まり,血管内皮の一酸化窒素合成酵素が活性化され,一酸化窒素により末梢血管抵抗が低下して血圧が低下する.温浴時には,静水圧により静脈還流量が増加し,心拍数も上昇し,心拍出量が増加するが,温熱の血管拡張作用による末梢血管抵抗の低下がそれを凌駕するために血圧は低下する.温浴による高血圧患者の降圧効果や温浴習慣により動脈硬化進展抑制効果や心血管疾患の発症低下など温浴の有用性が報告されている.温浴では入浴中は静水圧により心内圧は上昇するが,和温療法に用いられる低温サウナ浴(60℃,15分)では静水圧の影響を受けず,温熱刺激による血管拡張反応により心臓に対する前・後負荷を軽減し,心係数は増加し,心不全の治療に用いられている.(著者抄録)

Language：English  

DOI： 10.1038/s41440-024-02057-z

PubMed

Language：Japanese   Publisher：JAPAN HEALTH MEDICINE ASSOCIATION  

<p>The present study aimed to clarify the correlation between prediabetes and objectively measured sedentary time in community-dwelling older adults. The participants were 198 of the 551 individuals who took part in the regional cohort study (Tarumizu 2021 study) conducted in Tarumizu City, Kagoshima Prefecture, and who were 65 years or older and consented to participate in the sleep/activity investigation.</p><p>The participants were divided into two groups based on HbA1c of 5.6% participants with HbA1c ≥ 5.6% were assigned to the prediabetes group (103 individuals), and those with HbA1c < 5.6% were assigned to the normal group (95 individuals). Body mass index (BMI), systolic blood pressure, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), sedentary time of 10 minutes or longer, and moderate-to-vigorous physical activity (MVPA) time were compared between two groups. The sedentary time and MVPA time were obtained by analysis of ActiGraphs. The prediabetes group showed significantly higher values for BMI (<i>p</i>＝0.001), TG (<i>p</i>＝0.020), and sedentary time of 10 minutes or longer (<i>p</i>＝0.003) than the normal group, while values for HDL-C (<i>p </i>＝ 0.002) were significantly lower in the prediabetes group. Next, logistic regression analysis was performed using HbA1c ≥ 5.6% as the dependent variable and sedentary time of 10 minutes or longer, age, sex, BMI, HDL-C, TG, and MVPA as the independent variables. The results revealed that sedentary time of 10 minutes or longer and BMI were significantly correlated with HbA1c ≥ 5.6% (sedentary time of 10 minutes or longer, OR : 1.01, 95% CI : 1.01-1.02, <i>p</i>＝0.012 ; BMI, OR : 1.12, 95% CI : 1.02-1.23, <i>p</i>＝0.022).</p>

DOI： 10.20685/kenkouigaku.33.4_528

CiNii Research

Language：Japanese   Publisher：日本健康医学会  

鹿児島県垂水市で行われた地域コホート研究(垂水研究2021年度)に参加した551名のうち,65歳以上の198名をHbA1cが≧5.6%の糖尿病予備群(103名)とHbA1cが<5.6%の正常群(95名)の2群に分け,Body Mass Index(BMI),収縮期血圧,血清トリグリセリド(TG),HDLコレステロール(HDL-C),LDLコレステロール,総座位時間,10分以上の座位持続時間,中等度以上の活動時間(MVPA)を比較した。座位時間は,ActiGraphを用いて客観的に測定した。糖尿病予備群は,正常群と比較してBMI(p=0.001),TG(p=0.020),10分以上の座位持続時間(p=0.003)が有意に高値を示し,HDL-Cは有意に低値を示した(p=0.002)。糖尿病予備群/正常群という群分けを従属変数,10分以上の座位持続時間,年齢,性別,BMI,HDL-C,TG,MVPAを独立変数としたロジスティック回帰分析を行い,糖尿病予備群に対するオッズ比(OR)を算出したところ,10分以上の座位持続時間(OR,1.01;95%CI:1.01-1.02;p=0.012)とBMI(OR,1.12;95%CI:1.02-1.23;p=0.022)が有意な関連を示した。(著者抄録)

Language：English   Publisher：International Heart Journal Association  

<p>No reports compared four indices of myocardial work based on aortic valve stenosis (AS) severity. This study aimed to characterize the four myocardial work indices and global longitudinal strain (GLS) in AS with left ventricular ejection fraction (LVEF) > 50%, and to investigate the association of these indices with severe AS.</p><p>We measured global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE), and GLS in 154 patients. These indices were compared among three groups: normal, mild-to-moderate, and severe AS.</p><p>GWI and GCW were significantly higher in mild-to-moderate and severe AS groups than in normal group. GWW was significantly higher in severe AS group than in normal and mild-to-moderate AS groups. GWE and GLS were significantly lower in severe AS group than in normal and mild-to-moderate AS groups. The ability to discriminate severe AS was examined using receiver operating characteristic analysis, and GWW demonstrated the largest area under the curve. Multivariate logistic regression analysis demonstrated that the four myocardial work indices and GLS were significantly associated with severe AS after adjusting for age, height, and brachial systolic blood pressure.</p><p>In conclusions, GWI, GCW, and GWW, were significantly higher, while GWE and GLS were significantly lower in the severe AS group than in the normal group. These findings suggest that the four indices of myocardial work are valuable in detecting the impairment of left ventricular myocardial workload due to severe AS in patients with preserved LVEF.</p>

DOI： 10.1536/ihj.25-050

Scopus

PubMed

CiNii Research

Language：Japanese   Publisher：Society of the Waon Therapy  

<p>This report summarizes the content of the keynote lecture delivered at the 3rd Annual Scientific Meeting of the Society of Warm Therapy, covering the theoretical background of Waon therapy, its multifaceted effects and mechanisms, and future research topics. The multifaceted effects of Waon therapy emerged from the experiences and findings of patients who responded positively to this therapy. As diverse clinical effects of Waon therapy, we have published many papers concerning chronic heart failure, vascular insufficiency, lower limb arterial disease, chronic obstructive pulmonary disease (COPD), mild depression, chronic pain, fibromyalgia, and chronic fatigue syndrome from Kagoshima University. The efficacy of Waon therapy has also been confirmed for postoperative ileus, skin ulcers in collagen diseases, and pruritus in hemodialysis patients. Regarding the mechanisms underlying the multifaceted effects of Waon therapy, we have reported pathways involving thermal stimulation, nitric oxide, and heat shock proteins. The temperature-sensitive TRP channels possess numerous subtypes, and they are also thought to contribute to some mechanisms of the diverse effects of Waon Therapy. Through our commitment to learning from patients, we anticipate that Waon therapy with pleiotropic effects will continue to evolve broadly from preventive medicine to disease treatment and rehabilitation.</p>

DOI： 10.82636/waon.3.0_3

CiNii Research

CiNii Research

Language：English   Publisher：(一社)日本心臓病学会  

カテーテルアブレーション(CA)後の医原性心房中隔欠損(iASD)の発症率と予測因子を検討した。2005年5月～2018年6月に当院で心房細動(AF)に対して初回CAを施行された639例(男性489例、女性150例、平均60.2±10.7歳)を対象に後ろ向き研究を行った。全例に対して術前経食道心エコー(プレTEE)、術前経胸部心エコー(プレTTE)、術後TTE(ポストTTE)を実施し、CAから6ヵ月後のiASDの発症率を評価した。プレTTEにおける平均左房径(LAD)は41.0±6.5mm、平均左室駆出率(LVEF)は64.6±10.3%、左室拡張末期径は30.1±5.8mmであり、高周波CAを行った453例のうち複雑性分裂心房電位(CFAE)アブレーションが258例、CFAEアブレーション+肺静脈隔離術(PVI)が109例、PVI単独が86例、クライオアブレーションが44例であった。ポストTTEでのiASDの検出率は59.6%(497例中296例)、6ヵ月後TTEでは4.6%(23例)であり、年齢、BMI、AFのタイプ、BNP値、プレTTE上のLAD、左房容積、LVEF、右室収縮期圧(RVSP)に関してiASD群と非iASD群との間に有意差はなかった。一方、iASDの発症率は高周波アブレーション群が3.3%、クライオアブレーション群が18.2%とクライオアブレーション群の方が有意に高く、高周波アブレーション群では2シース法の方が1シース法よりiASDの発症率が有意に高値を示していた。単変量解析ではiASD発症の有意な関連因子としてシース径、単一穿刺における2シースの使用が抽出された。

Language：English   Publisher：(一社)日本心臓病学会  

カテーテルアブレーション(CA)後の医原性心房中隔欠損(iASD)の発症率と予測因子を検討した。2005年5月～2018年6月に当院で心房細動(AF)に対して初回CAを施行された639例(男性489例、女性150例、平均60.2±10.7歳)を対象に後ろ向き研究を行った。全例に対して術前経食道心エコー(プレTEE)、術前経胸部心エコー(プレTTE)、術後TTE(ポストTTE)を実施し、CAから6ヵ月後のiASDの発症率を評価した。プレTTEにおける平均左房径(LAD)は41.0±6.5mm、平均左室駆出率(LVEF)は64.6±10.3%、左室拡張末期径は30.1±5.8mmであり、高周波CAを行った453例のうち複雑性分裂心房電位(CFAE)アブレーションが258例、CFAEアブレーション+肺静脈隔離術(PVI)が109例、PVI単独が86例、クライオアブレーションが44例であった。ポストTTEでのiASDの検出率は59.6%(497例中296例)、6ヵ月後TTEでは4.6%(23例)であり、年齢、BMI、AFのタイプ、BNP値、プレTTE上のLAD、左房容積、LVEF、右室収縮期圧(RVSP)に関してiASD群と非iASD群との間に有意差はなかった。一方、iASDの発症率は高周波アブレーション群が3.3%、クライオアブレーション群が18.2%とクライオアブレーション群の方が有意に高く、高周波アブレーション群では2シース法の方が1シース法よりiASDの発症率が有意に高値を示していた。単変量解析ではiASD発症の有意な関連因子としてシース径、単一穿刺における2シースの使用が抽出された。

Language：Japanese   Publisher：Journal of Clinical Lipidology  

BACKGROUND AND OBJECTIVE: Low high-density lipoprotein (HDL)-cholesterol and corneal opacity are associated with fish-eye disease (FED), familial lecithin:cholesterol acyltransferase (LCAT) deficiency (FLD), apolipoprotein AI deficiency, and Tangier disease. The differential diagnosis is made by clinical and biochemical tests. Measuring the LCAT activity is the ideal way to distinguish conditions caused by LCAT gene variants (FED and FLD) from the other 2 diseases. However, this is not accessible from all clinics. The cholesteryl ester/total cholesterol (CE/TC) ratio, which is below the reference range in most cases with LCAT gene variants, has been proposed as an alternative. We report a case of compound heterozygous FED with a CE/TC ratio within the reference range. METHODS: LCAT activity assays and genetic analyses were performed using patients’ blood samples. Identified LCAT gene variants were examined by an in vitro expression assay. RESULTS: The proband showed approximately 20% LCAT α-activity relative to the normolipidemic controls, whereas a patient with a typical FED-causing variant (p.Thr147Ile) showed only 3% activity. We identified compound heterozygous variants (c.101C > T/c.460A > G) resulting in a p.Pro34Leu/p.Asn154Asp amino acid residue substitution in the LCAT gene of the proband. The former variant has been reported previously, but the latter was newly identified. An in vitro expression assay demonstrated that the LCAT α-activity of the p.Asn154Asp variant significantly decreased regarding the wild type, but it was relatively well preserved compared to the typical FED-causing variants (p.Pro34Leu and p.Thr147Ile). CONCLUSION: These results suggest that the residual 20% LCAT α-activity is sufficient to normalize CE/TC, but not sufficient to prevent the development of corneal opacity in FED.

DOI： 10.1016/j.jacl.2024.09.013

Scopus

PubMed

CiNii Research

Language：Japanese   Publisher：Journal of Cardiology  

Background: The left atrium approach for atrial fibrillation (AF) ablation requires an atrial transseptal puncture that may cause an iatrogenic atrial septal defect (iASD). This study aimed to investigate the incidence and predictors of iASD in catheter ablation, assessed by transthoracic echocardiography (TTE), a relatively non-invasive technique frequently employed in follow-up. Methods: This retrospective study included 639 patients (489 male; 60.2 ± 10.7 years) who underwent initial catheter ablation for AF between May 2005 and June 2018. All patients underwent preprocedural transesophageal echocardiography (pre-TEE), preprocedural TTE (pre-TTE), and TTE one day after the procedure (post-TTE). iASD incidence after 6 months (6M), preprocedural characteristics, and procedure methods were evaluated. Results: Patent foramen ovale (PFO) was diagnosed in 42 patients (6.6 %) using pre-TEE and in 11 patients using pre-TTE (26.2 % of the patients with PFO in pre-TEE). Among the 597 patients without PFO, 497 underwent 6M-TTE. iASD was observed in 59.6 % of patients using post-TTE and 4.6 % using 6M-TTE. In the univariate logistic regression analysis, the total diameter of the sheath through the septum (odds ratio 1.15, p < 0.001) or two sheaths through a single puncture (odds ratio 4.17, p = 0.001) were independent risk factors on iASD incidence in 6M-TTE. iASD was also more likely to occur via cryoballoon ablation using a larger sheath than radiofrequency catheter ablation. Conclusions: iASD was not a rare complication. A larger sheath diameter or two sheaths through a single puncture were associated with the incidence of iASD.

DOI： 10.1016/j.jjcc.2024.06.007

Scopus

PubMed

Language：English   Publisher：(一社)日本動脈硬化学会  

Language：English   Publisher：(一社)日本動脈硬化学会  

Language：English   Publisher：International Heart Journal Association  

<p>Periodontitis is a common chronic infection and is associated with cardiovascular disease. This study evaluated whether basic oral care for periodontal disease could improve endothelial function in patients with acute coronary syndrome (ACS).</p><p>This study enrolled 54 patients with acute coronary syndrome admitted to Kagoshima City Hospital and who had undergone percutaneous coronary intervention. Flow-mediated endothelium-dependent dilatation (FMD) was measured before discharge (initial FMD) and at 8 months after percutaneous coronary intervention (follow-up FMD). The following periodontal characteristics were measured: periodontal pocket depth (PPD, mm), plaque control record (%), and bleeding on probing (%). All patients received basic oral care instructions from dentists. The oral health condition was generally poor in the participants and there were 24 patients (44.4%) who had severe PPD. Despite the intervention of basic oral care, the periodontal characteristics did not improve during the study period; initial FMD and follow-up FMD did not significantly differ (4.38 ± 2.74% versus 4.56 ± 2.51%, <i>P</i> = 0.562). However, the follow-up FMD was significantly lower in patients with severe PPD (≥ 6.0 mm, <i>n</i> = 24) than in patients without severe PPD (≤ 5.0 mm, <i>n</i> = 30) (FMD: 3.58 ± 1.91% versus 5.37 ± 2.67%, <i>P</i> = 0.007). FMD tended to be worse in patients with severe PPD than in patients without severe PPD (ΔFMD: -0.55 ± 2.12 versus 0.81 ± 2.77 %, <i>P</i> = 0.055). In conclusion, during the use of basic oral care, endothelial function improved in patients without severe PPD, while it worsened in patients with severe PPD.</p>

DOI： 10.1536/ihj.23-553

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CiNii Research

Language：Japanese   Publisher：(一社)日本透析医学会  

Language：English   Publisher：(一社)インターナショナルハートジャーナル刊行会  

経皮的冠動脈インターベンション(PCI)を施行した急性冠症候群患者54例を対象に、歯周病に対する基本的な口腔ケアが血管内皮機能に及ぼす影響を検討した。全例で入院時(ベースライン)に血流依存性血管拡張反応(FMD)およびニトログリセリン誘発性内皮非依存性血管拡張反応(NMD)を測定し、PCIから8ヵ月後(フォローアップ)に血管内皮機能検査を再施行した。歯周病および口腔ケアの指標として歯周ポケットの深さ(PPD)、プロービング時の出血(BOP)、磨き残した汚れの割合であるプラークコントロールレコード(PCR)、地域歯周疾患指数(CPI)を評価した。重度歯周病は24例で認め、平均PCRは48.9%であった。患者をPPDが6mm以上でCPIがcode 4の重度歯周病群24例(男性79.1%、平均64.1±8.9歳)と上記以外の非重度歯周病群30例(男性80%、平均64.6±12.8歳)に分類した。ベースラインのFMDに有意な群間差はなかったが、フォローアップ時のFMDは重度群の方が非重度群より有意に低かった。

Language：Japanese   Publisher：(一社)日本透析医学会  

Language：English   Publisher：(一社)インターナショナルハートジャーナル刊行会  

経皮的冠動脈インターベンション(PCI)を施行した急性冠症候群患者54例を対象に、歯周病に対する基本的な口腔ケアが血管内皮機能に及ぼす影響を検討した。全例で入院時(ベースライン)に血流依存性血管拡張反応(FMD)およびニトログリセリン誘発性内皮非依存性血管拡張反応(NMD)を測定し、PCIから8ヵ月後(フォローアップ)に血管内皮機能検査を再施行した。歯周病および口腔ケアの指標として歯周ポケットの深さ(PPD)、プロービング時の出血(BOP)、磨き残した汚れの割合であるプラークコントロールレコード(PCR)、地域歯周疾患指数(CPI)を評価した。重度歯周病は24例で認め、平均PCRは48.9%であった。患者をPPDが6mm以上でCPIがcode 4の重度歯周病群24例(男性79.1%、平均64.1±8.9歳)と上記以外の非重度歯周病群30例(男性80%、平均64.6±12.8歳)に分類した。ベースラインのFMDに有意な群間差はなかったが、フォローアップ時のFMDは重度群の方が非重度群より有意に低かった。

Language：Japanese   Publisher：Respirology Case Reports  

Cavitary lung lesions are uncommon radiological findings in cytomegalovirus pneumonia, and tissue biopsy is rarely performed for diagnosis. A 67-year-old man presented with a wet cough. Extensive white moss in the oral cavity was found on physical examination, and chest computed tomography revealed an approximately 4 cm cavitary lesion in the upper lobe of the right lung. Blood tests showed a critically low CD4⁺ T lymphocyte count and positivity for human immunodeficiency virus type 1 antibodies. A transbronchial biopsy of the cavitary lung lesion was performed, and inclusion bodies in the nuclei of enlarged alveolar epithelial cells were seen in the histopathological findings. Immunohistochemistry staining for cytomegalovirus was positive, and cytomegalovirus pneumonia was diagnosed. Ganciclovir treatment was initiated, and the symptoms and imaging findings resolved. Cytomegalovirus pneumonia can present as cavitary lung lesions in patients with acquired immunodeficiency syndrome, and a transbronchial biopsy is essentially useful for a definitive diagnosis.

DOI： 10.1002/rcr2.1392

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PubMed

Language：Japanese   Publisher：Scientific Reports  

Atrial fibrillation (AF) is an arrhythmic disease. Prediction of AF development in healthy individuals is important before serious complications occur. We aimed to develop a risk prediction score for future AF using participants’ data, including electrocardiogram (ECG) measurements and information such as age and sex. We included 88,907 Japanese participants, aged 30–69 years, who were randomly assigned to derivation and validation cohorts in a ratio of 1:1. We performed multivariate logistic regression analysis and obtained the standardised beta coefficient of relevant factors and assigned scores to them. We created a score based on prognostic factors for AF to predict its occurrence after five years and applied it to validation cohorts to assess its reproducibility. The risk score ranged from 0 to 17, consisting of age, sex, PR prolongation, QT corrected for heart rate prolongation, left ventricular hypertrophy, premature atrial contraction, and left axis deviation. The area under the curve was 0.75 for the derivation cohort and 0.73 for the validation cohort. The incidence of new-onset AF reached over 2% at 10 points of the risk score in both cohorts. Thus, in this study, we showed the possibility of predicting new-onset AF using ECG findings and simple information.

DOI： 10.1038/s41598-024-60219-y

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CiNii Research

Language：English   Publisher：Nature Publishing Group  

定期健診データを用い、ベースラインのBMI、腹囲、Body Roundness Index(BRI)、A Body Shape Index(ABSI)と5年後の高血圧の関連を、男女別および年代別に検討した。健診受診者41902名のうち7622名(18.2%)が5年後までに高血圧を発症した。多変量解析の結果、男女とも全年代(30歳代～60歳代)において、BMI、腹囲、BRIは高血圧発症と有意に関連し、そのオッズ比はいずれも男性より女性で、高年代より低年代で高かった。ABSIについては40代と50代の男性でのみ関連がみられた。非肥満者(BMI<25)の腹囲とBRIは高血圧と関連したが、肥満者ではいずれの指標も関連を示さなかった。ROC解析による曲線下面積は、BMI 0.56～0.80、腹囲0.56～0.77、BRI 0.57～0.77、ABSI 0.51～0.54であり、高血圧の予測におけるABSIの有用性は低いと思われた。

Language：English   Publisher：Nature Publishing Group  

定期健診データを用い、ベースラインのBMI、腹囲、Body Roundness Index(BRI)、A Body Shape Index(ABSI)と5年後の高血圧の関連を、男女別および年代別に検討した。健診受診者41902名のうち7622名(18.2%)が5年後までに高血圧を発症した。多変量解析の結果、男女とも全年代(30歳代～60歳代)において、BMI、腹囲、BRIは高血圧発症と有意に関連し、そのオッズ比はいずれも男性より女性で、高年代より低年代で高かった。ABSIについては40代と50代の男性でのみ関連がみられた。非肥満者(BMI<25)の腹囲とBRIは高血圧と関連したが、肥満者ではいずれの指標も関連を示さなかった。ROC解析による曲線下面積は、BMI 0.56～0.80、腹囲0.56～0.77、BRI 0.57～0.77、ABSI 0.51～0.54であり、高血圧の予測におけるABSIの有用性は低いと思われた。

CiNii Research

Language：Japanese   Publisher：(一社)日本臨床腎移植学会  

70歳男性。X-6年糖尿病性腎症よりの末期腎不全のため血液透析導入。X年血液型適合生体腎移植術(ドナー妻,ドナー特異的抗HLA抗体(DSA)(-))。X+5年10ヵ月,定期受診時に腎機能悪化(血清クレアチニン値(血清Cr)2.31mg/dL),移植腎水腎あり。Double J stent(D-J stent)挿入後水腎は改善したが,腎機能は徐々に悪化し,mPSL pulse療法後のX+5年11ヵ月移植腎生検にて血管炎を伴う混合型拒絶反応(chronic active T cell and active antibody mediated rejection)を認めた。X+6年,抗ヒト胸腺細胞ウサギ免疫グロブリン(ATG)投与を行ったが,急速に腎機能悪化し,X+6年1ヵ月血液透析再導入となった。この頃より発熱,汎血球減少を認めており,X+6年2ヵ月全身に発疹が出現し入院。血液検査で播種性血管内凝固,フェリチン高値(3,557.4ng/mL),可溶性IL-2受容体(sIL-2R)高値(13,991U/mL)を認めた。骨髄検査を施行するもdry tapで,骨髄生検を行った後PSL 40mg/日を開始したが,入院後6日目に永眠された。後日,骨髄検査の結果,T細胞性リンパ腫と診断した。皮膚生検は,T細胞主体の浸潤であった。拒絶反応による急速な腎機能悪化を伴い,診断に難渋したT細胞性リンパ腫の1例を報告する。(著者抄録)

Language：Japanese   Publisher：(一社)日本臨床腎移植学会  

70歳男性。X-6年糖尿病性腎症よりの末期腎不全のため血液透析導入。X年血液型適合生体腎移植術(ドナー妻,ドナー特異的抗HLA抗体(DSA)(-))。X+5年10ヵ月,定期受診時に腎機能悪化(血清クレアチニン値(血清Cr)2.31mg/dL),移植腎水腎あり。Double J stent(D-J stent)挿入後水腎は改善したが,腎機能は徐々に悪化し,mPSL pulse療法後のX+5年11ヵ月移植腎生検にて血管炎を伴う混合型拒絶反応(chronic active T cell and active antibody mediated rejection)を認めた。X+6年,抗ヒト胸腺細胞ウサギ免疫グロブリン(ATG)投与を行ったが,急速に腎機能悪化し,X+6年1ヵ月血液透析再導入となった。この頃より発熱,汎血球減少を認めており,X+6年2ヵ月全身に発疹が出現し入院。血液検査で播種性血管内凝固,フェリチン高値(3,557.4ng/mL),可溶性IL-2受容体(sIL-2R)高値(13,991U/mL)を認めた。骨髄検査を施行するもdry tapで,骨髄生検を行った後PSL 40mg/日を開始したが,入院後6日目に永眠された。後日,骨髄検査の結果,T細胞性リンパ腫と診断した。皮膚生検は,T細胞主体の浸潤であった。拒絶反応による急速な腎機能悪化を伴い,診断に難渋したT細胞性リンパ腫の1例を報告する。(著者抄録)

Language：Japanese   Publisher：Hypertension Research  

No existing reports demonstrate the association between anthropometric indices (body mass index, waist circumference, body roundness index, a body shape index) and hypertension according to sex and age in the general Japanese population. This retrospective analysis involved individuals aged 30–69 years who underwent annual medical checkups at Kagoshima Koseiren Hospital in 2005–2019, and who did not meet hypertension criteria at baseline. The outcome was hypertension incidence after 5 years, and its association with baseline anthropometric indices was evaluated using multivariable logistic regression analysis by sex and age. In 41,902 participants (age 52.3 ± 10.2 years, 47.7% men), 7622 individuals (18.2%) developed hypertension after 5 years. Body mass index, waist circumference, and body roundness index were significantly associated with the development of hypertension in both men and women across all age categories from 30 s to 60 s. In the population with a body mass index <25 kg/m², waist circumference and body roundness index were significantly associated with hypertension after 5 years. A body shape index was significantly associated with the development of hypertension in men in their 40 s and 50 s but not in women of any age group. The area under the curve values were lower for a body shape index than for body mass index, waist circumference, and body roundness index in both men and women of all age groups. A body shape index was not a stronger indicator for 5-year hypertension incidence than body mass index, waist circumference, or body roundness index in both men and women across age groups from their 30s–60 s. The results of this study will help to more efficiently identify populations at high risk of developing hypertension and provide preventive interventions. (Figure presented.).

DOI： 10.1038/s41440-023-01505-6

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Language：Japanese   Publisher：Journal of Cardiology  

Background: Early prediction of outcomes after cardiopulmonary arrest (CPA) is important for considering the best support. Our purpose was to evaluate predictors of the 30-day mortality in patients with CPA after return of spontaneous circulation (ROSC) and to assess an equation for calculating the 30-day mortality using clinical parameters. Methods: We retrospectively analyzed the data of 194 consecutive patients with CPA and ROSC in a derivation study (2015–2022). We compared clinical parameters between the survived (n = 78) and dead (n = 116) patients. We derived an equation for estimated probability of death based on clinical parameters, using multivariate logistic regression analysis. The reliability of the equation was validated in 80 additional patients with CPA. Results: The 30-day mortality was associated with sex, witnessed cardiac arrest, bystander cardiopulmonary resuscitation (CPR), CPA due to acute myocardial infarction, pupil diameter, Glasgow Coma Scale score (GCS), presence of light reflex, arterial or venous pH, lactate levels, initial ventricular fibrillation (VF), CPA time, and age. The derived logistic regression equation was as follows: Estimated probability of death = 1 / (1 + e-x), x = (0.25 × bystander CPR) + (0.44 × pupil diameter) – (0.14 × GCS) + (0.09 × lactate) – (1.87 × initial VF) + (0.07 × CPA time) + (0.05 × age) - 7.03. The cut-off value for estimated probability of death calculated by this equation was 54.5 %, yielding a sensitivity, specificity, and accuracy of 86.2 %, 80.8 %, and 84.5 %, respectively. In the validation model, these values were 81.8 %, 85.7 %, and 82.5 %, respectively. Conclusions: The 30-day mortality may be calculated after ROSC in patients with CPA using simple clinical parameters. This equation may facilitate further best support for patients with CPA.

DOI： 10.1016/j.jjcc.2023.01.006

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PubMed

Language：English   Publisher：(一社)日本心臓病学会  

心肺停止後に自己心拍再開(ROSC)を果たした患者の予測因子と30日死亡率を評価し、その結果を利用することで臨床パラメータから30日死亡率を算出する計算式を構築して、その性能を調べた。導出コホートは1病院で、検証コホートはそれとは異なる2病院で後ろ向きに組み入れた。どの患者も2015年4月～2022年3月に入院した18歳以上のROSC後症例とした。導出コホートでは死亡の転帰を辿った116名と生存例78名を比較した。30日死亡率と関連していた因子は、性別、年齢、心肺停止時の目撃者の存在、バイスタンダーによる心肺蘇生、急性心筋梗塞による心肺停止、瞳孔径、Glasgow Coma Scaleスコア、対光反射の存在、動脈血または静脈血のpH、乳酸濃度、初回の心室細動、心肺停止時間、であった。このうち7因子を使用し、死亡確率を推定するロジスティック回帰式を導出した。この式で算出された推定死亡確率のカットオフ値を54.5%に定めた場合、その感度は86.2%、特異度は80.8%、精度は84.5%となった。検証モデルではこれらの3値は同順で81.8、85.7、82.5%となった。このように、ROSC後の心肺停止患者では、簡単な臨床パラメータを使用して30日死亡率を算出できる可能性が示された。

Language：English   Publisher：(一社)日本心臓病学会  

心肺停止後に自己心拍再開(ROSC)を果たした患者の予測因子と30日死亡率を評価し、その結果を利用することで臨床パラメータから30日死亡率を算出する計算式を構築して、その性能を調べた。導出コホートは1病院で、検証コホートはそれとは異なる2病院で後ろ向きに組み入れた。どの患者も2015年4月～2022年3月に入院した18歳以上のROSC後症例とした。導出コホートでは死亡の転帰を辿った116名と生存例78名を比較した。30日死亡率と関連していた因子は、性別、年齢、心肺停止時の目撃者の存在、バイスタンダーによる心肺蘇生、急性心筋梗塞による心肺停止、瞳孔径、Glasgow Coma Scaleスコア、対光反射の存在、動脈血または静脈血のpH、乳酸濃度、初回の心室細動、心肺停止時間、であった。このうち7因子を使用し、死亡確率を推定するロジスティック回帰式を導出した。この式で算出された推定死亡確率のカットオフ値を54.5%に定めた場合、その感度は86.2%、特異度は80.8%、精度は84.5%となった。検証モデルではこれらの3値は同順で81.8、85.7、82.5%となった。このように、ROSC後の心肺停止患者では、簡単な臨床パラメータを使用して30日死亡率を算出できる可能性が示された。

Language：English   Publisher：International Heart Journal Association  

<p>Arterial stiffness has been reported to cause left atrial (LA) remodeling due to increased left ventricular filling pressure, resulting in atrial fibrillation (AF). This study aimed to evaluate the association between LA reverse remodeling (LARR) after AF ablation and cardio-ankle vascular index (CAVI), an indicator of arterial stiffness.</p><p>This study included 333 patients with AF (171 with paroxysmal AF and 162 with nonparoxysmal AF) and LA enlargement (LA volume index ≥ 34 mL/m²) who underwent AF ablation between December 2008 and July 2021. CAVI was evaluated preoperatively during AF (<i>n</i> = 155, 46.5%) or sinus rhythm (<i>n</i> = 178, 53.5%). Participants were divided into groups with LARR (<i>n</i> = 133, 39.9%) and without LARR (<i>n</i> = 200, 60.1%) according to whether the degree of decrease in LA volume index on transthoracic echocardiography 6 months after ablation was ≥ 15% or < 15%, respectively.</p><p>Sinus rhythm was maintained in 168 (50.5%) patients within 3-6 months after the index procedure. Univariate analysis revealed that preoperative CAVI (7.80 ± 1.22 versus 8.57 ± 1.09, <i>P</i> < 0.001) was significantly lower, and the maintenance of sinus rhythm (61.6% versus 43.0%, <i>P</i> = 0.0011) was higher in the group with LARR. Multivariate logistic regression analysis revealed that preoperative CAVI was independently associated with LARR (odds ratio, 0.60, 95% confidence interval, 0.46-0.78, <i>P</i> < 0.001).</p><p>In patients with AF and LA enlargement, CAVI is independently associated with LA reverse remodeling after catheter ablation.</p>

DOI： 10.1536/ihj.23-072

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CiNii Research

DOI： 10.1536/ihj.23-072.

Language：English   Publisher：(一社)インターナショナルハートジャーナル刊行会  

カテーテルアブレーションを施行した左房拡大を示す心房細動(AF)患者を対象に、術前の心臓足首血管指数(CAVI)がアブレーション後の左房リバースリモデリング(LARR)と関連するかどうか検討した。対象は左房容積係数が34mL/m2以上のAF患者333例で、171例が発作性AF、162例が非発作性AFであった。アブレーション施行から6ヵ月後に経胸壁心エコー検査を実施し、左房容積係数が15%以上減少した症例をLARRと定義した。患者をLARR陽性群133例(男性74.4%、平均60.1±9.3歳)と陰性群200例(男性71.0%、平均64.6±8.8歳)の2群に分類した。術前のCAVIはLARR陽性群(7.80±1.22)の方が陰性群(8.57±1.09)より有意に低かった(P<0.001)。洞調律を維持した患者は陽性群(61.6%)の方が陰性群(43.0%)より有意に多かった(P<0.001)。重回帰ロジスティック分析で術前のCAVIはアブレーション後のLARRを予測する独立因子であった(OR 0.60、95%CI 0.46～0.78、P<0.001)。

Language：Japanese   Publisher：Japan Health & Research Institute  

<p><b>【Background】</b></p><p>The purpose of the study was to examine the association between bathing habits and objectively assessed sleep or arterial stiffness.</p><p><b>【Methods】</b></p><p>Study 1 included 202 old adults aged 65 years or older, and Study 2 included 524 participants with CAVI (Cardio-Ankle Vascular Index) in Tarumizu Study 2021. Bathing habits were investigated by questionnaire, and objective sleep was assessed by wearing an ActiGraph for one week.</p><p><b>【Results】</b></p><p>In Study 1, there was no significant association between bathing habits (frequency of bathing at home or in hot springs, frequency of hot springs, and communication in hot springs) and sleep duration or sleep efficiency in old adults. In Study 2, CAVI value of the daily bathed group (n=472) was significantly lower than that of the non-daily bathed group (n=52) (8.6±1.1 vs. 9.3±1.4, p=0.002). There was no significant difference in CAVI values between the bathing hot spring at least once a week (n=124) and not (n=400).</p><p><b>【Conclusion】</b></p><p>No significant association was found between bathing habits and objectively assessed sleep duration or sleep efficiency in old persons. In a community-based cohort that included younger adults, the daily bathed group had lower arterial stiffness than the non-daily bathed group.</p>

DOI： 10.32279/jjhr.202344j02

CiNii Research

Language：Japanese   Publisher：(一財)日本健康開発財団  

背景・目的 研究の目的は、入浴習慣と客観的に評価した睡眠との関連、および動脈硬化との関連を検討することである。方法 研究1は、2021年度に開催された垂水市在住者の健康チェック(垂水研究2021年)に参加した65歳以上の高齢者202人、研究2は、垂水研究2021年の全参加者のうち、血管硬化度の指標であるCAVI(Cardio-Ankle Vascular Index)を解析できた524人を対象者とした。入浴習慣は質問票により調査し、客観的睡眠評価は、アクチグラムを1週間装着して評価した。結果 研究1:65歳以上の高齢者において、入浴習慣(自宅や温泉の入浴頻度、温泉の利用頻度、温泉でのコミュニケーション)とアクチグラフを用いて客観的に評価した睡眠時間や睡眠効率との関連を検討したが、有意な関連は認めなかった。研究2:自宅や温泉で毎日入浴する群(472人)のCAVI値は8.6±1.1であり、毎日入浴しない群(52人)のCAVI値9.3±1.4と比較して有意に低値を示した(p=0.002)。週1回以上温泉に行く群(124人)と週1回以上温泉に行かない群(400人)のCAVI値に有意差は認めなかった。結論 65歳以上の高齢者において、入浴習慣と客観的に評価した睡眠時間や睡眠効率との有意な関連は認めなかった。若年者も含めた地域在住コホートにおいて、自宅や温泉に毎日入浴する群は血管硬化度が低いことが示唆された。(著者抄録)

Language：English  

DOI： 10.1161/JAHA.122.028081

PubMed

Language：Japanese   Publisher：International Journal of Cardiology  

Background: Carotid plaque is a well-known prognostic factor for cardiovascular diseases. It is unclear which risk factors are associated with the transformation of carotid plaque over time. In this longitudinal study, we examined the risk factors related to carotid plaque progression. Methods: We enrolled 738 men without medication (mean age: 55 ± 10 years) who underwent the first and second health examinations. We measured carotid plaque thickness (PT) at three points of the right and left carotid artery. Plaque score (PS) was calculated by summing all the PTs. We divided the PS into three groups: None-group (PS <1.1), Early-group (1.1 ≤ PS <5.1), and Advanced-group (PS ≥5.1). We analyzed the relationship between PS progression and parameters such as age, body mass index, systolic blood pressure (SBP), fasting blood sugar, low-density lipoprotein cholesterol (LDL-C), and smoking and exercise habits. Results: In multivariable logistic regression analysis, age and SBP were independent factors for PS progression from none to early stages (age, OR 1.07, p = 0.002; SBP, 10 mmHg, OR 1.27, p = 0.041). Age, follow-up period and LDL-C were independently associated factors for PS progression from early to advanced stages (age, OR 1.08,p < 0.001; follow-up period OR1.19, p = 0.041; LDL-C, 10 mg/dL, OR 1.10, p = 0.049). Conclusions: SBP was independently associated with the progress of early atherosclerosis, while LDL-C was independently associated with the progression of advanced atherosclerosis in the general population. Further studies are needed to assess whether early control of SBP and LDL-C levels can reduce the occurrence of future cardiovascular events.

DOI： 10.1016/j.ijcard.2023.02.037

Scopus

PubMed

DOI： 10.5551/jat.63557.

Language：English   Publisher：Japan Atherosclerosis Society  

<p> <b>Aim:</b> In this study, we aim to analyze the correlation between brachial-ankle pulse wave velocity (baPWV) and Suita score or Framingham risk score and obtain the cutoff value of baPWV by sex and age for cardiovascular risk, as assessed by these scores in the large Japanese annual health checkup data.</p><p><b>Methods:</b> In total, 25,602 participants (14,539 men and 11,063 women), who had their annual health checkups, were included in this study. Cutoff values of baPWV for the moderate- and high-risk groups stratified by sex and age were obtained using a receiver operating characteristic (ROC) curve analysis.</p><p><b>Results:</b> As per our findings, the Suita score demonstrated better correlations with baPWV than the Framingham risk score in both sexes (men, Suita score R²=0.41 and Framingham risk score R²=0.37; women, Suita score R²=0.54 and Framingham risk score R²=0.33). The ROC curve analysis demonstrated the cutoff values of baPWV for moderate- and high-risk groups estimated using the Suita score, and they are as follows: in men, the baPWV cutoff values were 1,350 cm/s in the 40s, 1,430 cm/s in the 50s, 1,520 cm/s in the 60s, and 1,880 cm/s in the 70s. In women, the baPWV cutoff values were 1,350 cm/s in the 40s, 1,430 cm/s in the 50s, 1,570 cm/s in the 60s, and 1,800 cm/s in the 70s.</p><p><b>Conclusions:</b> We demonstrated that baPWV significantly correlated with the Suita score or Framingham risk score in both men and women, with the former presenting a stronger correlation than the latter. We propose the cutoff values of baPWV for moderate- and high-risk groups estimated using the Suita score.</p>

DOI： 10.5551/jat.63557

Scopus

PubMed

CiNii Research

Language：English   Publisher：(一社)日本動脈硬化学会  

一般日本人における上腕-足関節脈波伝播速度(baPWV)とSuitaスコアまたはFraminghamリスクスコアの関連を評価し、心血管リスクの男女別および年齢別のbaPWVカットオフ値を検討した。日本の単一施設で健康診断を行った25602名(男性14539名、女性11063名)の大規模データを用いて横断研究を行った。男女ともに、SuitaスコアはFraminghamリスクスコアよりもbaPWVとの関連性が良好であった。ROC曲線解析において、Suitaスコアを用いて推定した中等リスク～高リスク群についてのbaPWVカットオフ値は、男性では40歳代1350cm/s、50歳代1430cm/s、60歳代1520cm/s、70歳代1880cm/s、女性では40歳代1350cm/s、50歳代1430cm/s、60歳代1570cm/s、70歳代1800cm/sであった。

DOI： 10.1371/journal.pone.0284139.

Language：Japanese   Publisher：Plos One  

Background Predicting metabolic syndrome (MetS) is important for identifying high-risk cardiovascular disease individuals and providing preventive interventions. We aimed to develop and validate an equation and a simple MetS score according to the Japanese MetS criteria. Methods In total, 54,198 participants (age, 54.5±10.1 years; men, 46.0%), with baseline and 5-year follow-up data were randomly assigned to 'Derivation' and 'Validation' cohorts (ratio: 2:1). Multivariate logistic regression analysis was performed in derivation cohort and scores were assigned to factors corresponding to β-coefficients. We evaluated predictive ability of the scores using area under the curve (AUC), then applied them to validation cohort to assess reproducibility. Results The primary model ranged 0-27 points had an AUC of 0.81 (sensitivity: 0.81, specificity: 0.81, cut-off score: 14), and consisted of age, sex, blood pressure (BP), body mass index (BMI), serum lipids, glucose measurements, tobacco smoking, and alcohol consumption. The simplified model (excluding blood tests) ranged 0-17 points with an AUC of 0.78 (sensitivity: 0.83, specificity: 0.77, cut-off score: 15) and included: age, sex, systolic BP, diastolic BP, BMI, tobacco smoking, and alcohol consumption. We classified individuals with a score <15 and ≥15 points as low- and high-risk MetS, respectively. Furthermore, the equation model generated an AUC of 0.85 (sensitivity: 0.86, specificity: 0.55). Analysis of the validation and derivation cohorts yielded similar results. Conclusion We developed a primary score, an equation model, and a simple score. The simple score is convenient, well-validated with acceptable discrimination, and could be used for early detection of MetS in high-risk individuals. Copyright:

DOI： 10.1371/journal.pone.0284139

Scopus

PubMed

Language：English   Publisher：The Japanese Society of Balneology, Climatology and Physical Medicine  

DOI： 10.11390/onki.86_1.13

CiNii Research

Language：Japanese   Publisher：Frontiers in Cardiovascular Medicine  

Aim: Signal transducer and activator of transcription (STAT) signaling is critical for the pathogenesis of abdominal aortic aneurysms (AAAs). Though protein inhibitor of activated STAT3 (PIAS3) negatively modulates STAT3 activity, but its role in AAA disease remains undefined. Method: AAAs were induced in PIAS3 deficient (PIAS3−/−) and wild type (PIAS3+/+) male mice via transient intra-aortic elastase infusion. AAAs were assessed by in situ measurements of infrarenal aortic external diameters prior to (day 0) and 14 days after elastase infusion. Characteristic aneurysmal pathologies were evaluated by histopathology. Results: Fourteen days following elastase infusion, aneurysmal aortic diameter was reduced by an approximately 50% in PIAS3−/− as compared to PIAS3+/+ mice. On histological analyses, PIAS3−/− mice showed less medial elastin degradation (media score: 2.5) and smooth muscle cell loss (media score: 3.0) than those in PIAS3+/+ mice (media score: 4 for both elastin and SMC destruction). Aortic wall leukocyte accumulation including macrophages, CD4+ T cells, CD8+ T cells and B cells as well as mural neovessel formation were significantly reduced in PIAS3−/− as compared to PIAS3+/+ mice. Additionally, PIAS3 deficiency also downregulated the expression levels of matrix metalloproteinases 2 and 9 by 61% and 70%, respectively, in aneurysmal lesion. Conclusion: PIAS3 deficiency ameliorated experimental AAAs in conjunction with reduced medial elastin degradation and smooth muscle cell depletion, mural leukocyte accumulation and angiogenesis.

DOI： 10.3389/fcvm.2023.1092555

Scopus

PubMed

Language：English   Publisher：Japan Atherosclerosis Society  

<p> <b>Aim:</b> This study aims to investigate the association of the Cardio-Ankle Vascular Index (CAVI) with self-reported sleep duration and sleep quality in community-dwelling older adults aged ≥ 65 years.</p><p><b>Methods:</b> The Tarumizu Study was a cohort of community-based health checkups conducted in the Tarumizu City, Japan, in 2018 and 2019. In total, 997 participants aged ≥ 65 years (median age, 74 years) were examined. We obtained the average sleep duration and sleep quality using self-reported questionnaires and classified them into three separate groups according to sleep duration (＜6 h, 6–8 h, and ≥ 8 h) and sleep quality (good, medium, and poor). The arterial stiffness was measured using the CAVI.</p><p><b>Results:</b> As per our findings, the CAVI was significantly higher in the ≥ 8 h sleep group (CAVI=9.6±1.3) than in the ＜6 h (CAVI=9.1±1.1) or 6–8 h (CAVI=9.1±1.2) groups (<i>p</i>＜0.001). After adjustment for age, sex, systolic blood pressure, current smoking status, body mass index, frequency of exercise, educational background, frailty, sleep medication, sleep quality, and nap duration, multivariable regression analysis demonstrated that the CAVI was significantly higher in the ≥ 8 h group than in the 6–8 h group (<i>p</i>=0.016). In contrast, multivariable regression analysis showed that there was no significant association between sleep quality and CAVI.</p><p><b>Conclusions:</b> A significant association was noted between long sleep duration (≥ 8 h) and elevated CAVI in community-dwelling older adults aged ≥ 65 years. We, therefore, suggest that long sleep duration, not sleep quality, is correlated with arterial stiffness in older adults.</p>

DOI： 10.5551/jat.63594

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PubMed

CiNii Research

Language：Japanese   Publisher：Hypertension Research  

Hypertension is a risk factor for atherosclerosis. Achieving the therapeutic target value of blood pressure (BP) prevents the onset of cardiovascular events; however, it is not clear how antihypertensive drug use and BP control status relate to arterial stiffness. The purpose of this study is to investigate the relationship between BP control status with or without antihypertensive drugs and arterial stiffness. Nine hundred eighty individuals (mean age: 68 ± 11 years) who participated in a community-based cohort study were enrolled. Arterial stiffness was evaluated using the cardio-ankle vascular index (CAVI). Higher BP was defined as a systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg. Participants were divided into four groups: normal, non higher BP without antihypertensive drugs (n = 421); untreated, higher BP without antihypertensive drugs (n = 174); good control, non higher BP with antihypertensive drugs (n = 209); and poor control, higher BP with antihypertensive drugs (n = 176). In multivariable logistic analysis adjusted for age, sex, dyslipidemia and diabetes mellitus medication use, obesity, smoking, alcohol drinking, and heart rate at the CAVI measurement for a high CAVI—using a borderline cutoff value of 8.0—the other three groups were significantly associated with a high CAVI when compared with the normal group. By contrast, multivariable logistic analysis of a high CAVI using an abnormal cutoff value of 9.0 demonstrated that the poor control and untreated groups were significantly associated with a high CAVI, whereas the good control group was not. In conclusion, even with antihypertensive drugs, poor BP control is independently associated with a high CAVI.

DOI： 10.1038/s41440-022-01039-3

Scopus

PubMed

Language：English   Publisher：(一社)日本動脈硬化学会  

65歳以上の地域住民を対象に、心臓足首血管指数(CAVI)と自己報告による睡眠の時間・質の関連性を横断的に調査した。2018～2019年に健康診断を受けた鹿児島県垂水市の高齢者コホート(垂水研究)から、65歳以上の997名(女性622名、年齢中央値74歳)を解析に組み入れた。睡眠時間で3群に分類した。その結果、睡眠時間が8時間以上であった長睡眠群は110名(女性56名、年齢中央値77歳)、6～8時間の中睡眠群は438名(女性269名、年齢中央値74歳)、6時間未満の短睡眠群は449名(女性297名、年齢中央値73歳)であった。この3群で平均CAVIを比較すると、長睡眠群では9.6±1.3となり、中睡眠群(9.1±1.2)または短睡眠群(9.1±1.1)よりも有意に高かった(P<0.001)。各種の因子(年齢、性別、収縮期血圧、現喫煙状態、BMI、運動頻度、学歴、フレイル、睡眠薬、睡眠の質、昼寝時間)で調整を行った多変量回帰分析の結果、長睡眠群のCAVIは中睡眠群よりも有意に高い(p=0.016)ことが証明された。こうした結果とは対照的に、睡眠の質とCAVIの有意な関連性は示されなかった。本解析結果から、高齢者では睡眠時間が長いことが動脈硬化度と相関し、睡眠の質は相関しないことが示唆された。

Language：English   Publisher：Nature Publishing Group  

垂水市で行われた地域住民を対象とするコホート研究に参加した980名を対象に、降圧薬を用いた場合と用いない場合の血圧コントロール状況と動脈スティフネスとの関連性を評価した。動脈スティフネスの評価には心臓足首血管指数(CAVI)を用いた。高血圧の定義は、収縮期血圧140mmHg以上または拡張期血圧90mmHg以上とした。未治療コントロール良好群421名(平均64±11歳)、未治療コントロール不良群174名(平均67±11歳)、治療コントロール良好群209名(平均73±9歳)、治療コントロール不良群176名(平均73±9歳)に分類した。CAVI評価時の年齢、性別、脂質異常症治療薬使用、糖尿病治療薬使用、肥満、喫煙、飲酒、心拍数を調整後、CAVI高値のカットオフ値を8.0とした場合は未治療コントロール良好群に比べて他の3群でCAVIが有意に高値であり、カットオフ値を9.0とした場合は治療コントロール不良群と未治療コントロール不良群でCAVIが有意に高値であった。降圧薬治療を行っても、血圧コントロール不良はCAVI高値と独立して関連することが示された。

Language：English   Publisher：(一社)日本動脈硬化学会  

65歳以上の地域住民を対象に、心臓足首血管指数(CAVI)と自己報告による睡眠の時間・質の関連性を横断的に調査した。2018～2019年に健康診断を受けた鹿児島県垂水市の高齢者コホート(垂水研究)から、65歳以上の997名(女性622名、年齢中央値74歳)を解析に組み入れた。睡眠時間で3群に分類した。その結果、睡眠時間が8時間以上であった長睡眠群は110名(女性56名、年齢中央値77歳)、6～8時間の中睡眠群は438名(女性269名、年齢中央値74歳)、6時間未満の短睡眠群は449名(女性297名、年齢中央値73歳)であった。この3群で平均CAVIを比較すると、長睡眠群では9.6±1.3となり、中睡眠群(9.1±1.2)または短睡眠群(9.1±1.1)よりも有意に高かった(P<0.001)。各種の因子(年齢、性別、収縮期血圧、現喫煙状態、BMI、運動頻度、学歴、フレイル、睡眠薬、睡眠の質、昼寝時間)で調整を行った多変量回帰分析の結果、長睡眠群のCAVIは中睡眠群よりも有意に高い(p=0.016)ことが証明された。こうした結果とは対照的に、睡眠の質とCAVIの有意な関連性は示されなかった。本解析結果から、高齢者では睡眠時間が長いことが動脈硬化度と相関し、睡眠の質は相関しないことが示唆された。

Language：English   Publisher：Nature Publishing Group  

垂水市で行われた地域住民を対象とするコホート研究に参加した980名を対象に、降圧薬を用いた場合と用いない場合の血圧コントロール状況と動脈スティフネスとの関連性を評価した。動脈スティフネスの評価には心臓足首血管指数(CAVI)を用いた。高血圧の定義は、収縮期血圧140mmHg以上または拡張期血圧90mmHg以上とした。未治療コントロール良好群421名(平均64±11歳)、未治療コントロール不良群174名(平均67±11歳)、治療コントロール良好群209名(平均73±9歳)、治療コントロール不良群176名(平均73±9歳)に分類した。CAVI評価時の年齢、性別、脂質異常症治療薬使用、糖尿病治療薬使用、肥満、喫煙、飲酒、心拍数を調整後、CAVI高値のカットオフ値を8.0とした場合は未治療コントロール良好群に比べて他の3群でCAVIが有意に高値であり、カットオフ値を9.0とした場合は治療コントロール不良群と未治療コントロール不良群でCAVIが有意に高値であった。降圧薬治療を行っても、血圧コントロール不良はCAVI高値と独立して関連することが示された。

Language：Japanese   Publisher：International Journal of Environmental Research and Public Health  

Patients with heart disease are more likely to experience social frailty due to physical inactivity, which may affect meaningful activities such as hobbies. This study aimed to investigate (1) the association between heart disease and social frailty in community-dwelling older adults and (2) the characteristics of meaningful activities in community-dwelling older adults with heart disease. Data from 630 older adults who participated in a community-based health survey were obtained, including clinical history, meaningful activities, social frailty and psychosomatic functions. Participants were divided into two groups: those with heart disease (n = 79) and those without (n = 551), and comparisons were made. Social frailty was observed in 23.7% of participants with heart disease, and logistic regression revealed significant associations with heart disease and social frailty after adjusting for potential covariates (OR, 1.97; 95% CI, 1.06 3.67; p = 0.032). Participants with heart disease did not differ significantly in terms of satisfaction or performance; their frequency of engagement in meaningful activities was significantly lower than without heart disease (p = 0.041). These results suggest that heart disease and social frailty are associated in community-dwelling older adults, and that this demographic is inclined to engage in meaningful activities less frequently.

DOI： 10.3390/ijerph192215167

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PubMed

Language：Japanese   Publisher：(一社)日本心臓病学会  

Language：Japanese   Publisher：(一社)日本心臓病学会  

Language：English   Publisher：Japan Atherosclerosis Society  

<p> <b>Aim:</b> In this study, we aim to examine the clinical meaning of low-density lipoprotein cholesterol (LDL-C) ＜70 mg/dL as assessed by Friedewald equation [LDL-C (F)] and Martin method [LDL-C (M)] and non-high-density lipoprotein cholesterol (HDL-C) ＜100 mg/dL on the occurrence of new lesions among Japanese patients with stable angina who underwent percutaneous coronary intervention (PCI) and were prescribed with strong statins.</p><p><b>Methods:</b> Among the 537 consecutive stable angina patients who had underwent PCI and had been prescribed with strong statins, the association between the occurrence of new lesions with myocardial ischemia at the 9-month follow-up coronary angiography and ≤ 2 years after PCI and baseline characteristics were assessed.</p><p><b>Results:</b> New lesions appeared 9 months and ≤ 2 years after PCI in 31 and 90 patients, respectively. Multivariate logistic regression analysis revealed diabetes mellitus (DM) was significantly associated with the occurrence of new lesions ≤ 2 years after PCI [odds ratio (OR) 1.71, 95 % confidence interval (CI) 1.06–2.83, <i>p</i>=0.031], and only non-HDL-C ≥ 100 mg/dL was associated with the occurrence of new lesions both at 9 months and ≤ 2 years after PCI [OR 1.80, 95 % CI 1.10–3.00, <i>p</i>=0.021 and OR 1.85, 95 % CI 1.13–3.07, <i>p</i>=0.016].</p><p><b>Conclusions:</b> Non-HDL-C ≥ 100 mg/dL was determined to be the independent risk factor for the occurrence of new lesions 9 months and ≤ 2 years after PCI among stable angina patients with strong statins. Residual risk after PCI should be considered by assessing not only DM but also non-HDL-C beyond the scope of LDL-C-lowering therapy with strong statins.</p>

DOI： 10.5551/jat.62908

Scopus

PubMed

CiNii Research

Language：English   Publisher：(一社)日本動脈硬化学会  

ストロングスタチンを服用している安定狭心症患者537例(男性392例、女性145例)を対象に、non-HDLコレステロール(non-HDL-C)が経皮的冠動脈インターベンション(PCI)後の新たな冠動脈狭窄病変を予測するかどうかについて検討した。予測能をFridewald式およびMartin式で推算したLDLコレステロール(LDL-C)値と比較した。追跡期間は2年で、新たな狭窄病変(NL)は90例で検出された。患者をNL群90例(男性74%、年齢中央値66歳)と非NL群447例(男性73%、年齢中央値70歳)の2群に分類した。患者背景はNL群の方が若年で、糖尿病が有意に多かった。Fridewald(F)式およびMartin式による推算LDL-C値が70mg/dL以上、non-HDL-Cが100mg/dL以上の患者はNL群の方が多かった。単変量解析で糖尿病、F式とMartin式の推算LDL-C値が70mg/dL以上、non-HDL-Cが100mg/dL以上が新たな病変と有意に関連した。多変量解析では糖尿病、およびnon-HDL-Cが100mg/dL以上(OR:1.85、P=0.016)が新たな病変を予測する独立因子であった。

Language：English   Publisher：(一社)日本動脈硬化学会  

ストロングスタチンを服用している安定狭心症患者537例(男性392例、女性145例)を対象に、non-HDLコレステロール(non-HDL-C)が経皮的冠動脈インターベンション(PCI)後の新たな冠動脈狭窄病変を予測するかどうかについて検討した。予測能をFridewald式およびMartin式で推算したLDLコレステロール(LDL-C)値と比較した。追跡期間は2年で、新たな狭窄病変(NL)は90例で検出された。患者をNL群90例(男性74%、年齢中央値66歳)と非NL群447例(男性73%、年齢中央値70歳)の2群に分類した。患者背景はNL群の方が若年で、糖尿病が有意に多かった。Fridewald(F)式およびMartin式による推算LDL-C値が70mg/dL以上、non-HDL-Cが100mg/dL以上の患者はNL群の方が多かった。単変量解析で糖尿病、F式とMartin式の推算LDL-C値が70mg/dL以上、non-HDL-Cが100mg/dL以上が新たな病変と有意に関連した。多変量解析では糖尿病、およびnon-HDL-Cが100mg/dL以上(OR:1.85、P=0.016)が新たな病変を予測する独立因子であった。

Language：English   Publisher：International Heart Journal Association  

<p>This study aimed to determine independent factors for developing postoperative hypertension using 4 biomarkers in patients receiving oral and maxillofacial surgery under general anesthesia. Brain natriuretic peptide (BNP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity myocardial troponin T (hs-TnT), and high-sensitivity myocardial troponin I (hs-TnI) were measured and preoperative echocardiograms were examined. Episodes of systolic blood pressure (SBP) ≥ 170 mmHg or diastolic blood pressure ≥ 100 mmHg within 1 week after surgery were considered postoperative hypertension. We analyzed 213 (130 men; 83 women) patients, who were divided into a postoperative hypertension group (HT group, <i>n</i> = 32) and a normal group (N group, <i>n</i> = 181). The HT group showed a higher LVMI (113.5 versus 100.1), higher E/e' of the lateral wall (9.1 versus 7.7), and higher BNP (39.2 versus 22.9 pg/mL), NT-proBNP (400.1 versus 143.9 pg/mL), and hs-TnT (15.6 versus 10.3 ng/L) concentrations compared to the N group. NT-proBNP and hs-TnT concentrations positively associated with E/e', but BNP and hs-TnI did not. NT-proBNP (AUC = 0.64, cutoff value: 117.0 pg/mL) and hs-TnT (AUC = 0.61, cutoff value: 11.0 ng/L) concentrations were effective for discriminating E/e' ≥ 12. Multivariate logistic regression analyses showed that risk factors responsible for developing postoperative hypertension were NT-proBNP and hs-TnT using biomarkers and E/e' as independent variables, and NT-proBNP and SBP at admission using biomarkers and SBP at admission as independent variables. These findings suggest that NT-proBNP and hs-TnT concentrations, and SBP at admission, are useful to predict postoperative hypertension after minor to moderate surgery, and that left ventricular filling pressure is a primary factor associated with postoperative hypertension.</p>

DOI： 10.1536/ihj.22-074

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PubMed

CiNii Research

Language：Japanese   Publisher：Heliyon  

Objective: Vinegar has been reported to have a hypotensive effect. We aimed to investigate the relationship between the consumption of vinegar-based side dishes and blood pressure. Research methods & procedures: This cross-sectional study included 746 individuals (257 men and 489 women) aged ≥40 years from Tarumizu, Kagoshima, Japan. Nutrient intake was estimated based on the brief-type self-administered diet history questionnaire. The intake frequency of vinegar-based side dishes (Sunomono and pickles) was determined using a self-administered diet history questionnaire. Participants who did not consume vinegar-based side dishes for a month were defined as having no Sunomono or pickle eating habit. Blood pressure was categorized into four groups according to the Japanese Society of Hypertension Guidelines for the Management of Hypertension. The association between the intake of vinegar-based side dishes and blood pressure categories was analyzed using ordinal logistic regression analysis adjusted for age, body mass index, smoking history, excessive alcohol intake, living situation, energy intake, protein intake, sodium intake, potassium intake, and seaweed intake. Results: Approximately 13.6% men and 6.1% women had no Sunomono eating habits. In men, eating Sunomono, but not pickles, was significantly related to blood pressure categories (estimate, −0.702; 95% CI, −1.122 to −0.310), whereas more frequent consumption of Sunomono did not show an improvement in the blood pressure category. The relationship between eating Sunomono and blood pressure categories was not recognized in women. Conclusion: This was the first study assessing the association between consumption of vinegar-based side dishes and blood pressure categories. We highlighted the effect of Sunomono consumption on blood pressure categories in men. Consumption of Sunomono may improve blood pressure in men.

DOI： 10.1016/j.heliyon.2022.e09505

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PubMed

Language：English   Publisher：(一社)インターナショナルハートジャーナル刊行会  

全身麻酔による歯科口腔外科手術を施行した患者213例を対象に、術後高血圧症の関連因子について検討した。術後1週間以内に収縮期血圧が170mmHg以上または拡張期血圧が100mmHg以上を呈した症例を術後高血圧と定義した。術後高血圧は32例で認めた。患者を術後高血圧の陽性群32例(男性19例、女性13例、平均74.6±10.6歳)と陰性群181例(男性111例、女性70例、平均70.9±11.4歳)に分類した。左室心筋重量係数は術後高血圧群(113.5±31.3)の方が陰性群(100.1±24.6)より有意に高く(P=0.0072)、E/e'も術後高血圧群の方が有意に高かった。脳性ナトリウム利尿ペプチド(BNP)、NT-proBNP、高感度心筋トロポニンT(hs-TnT)は術後高血圧群の方が有意に高く、NT-proBNPおよびhs-TnTはE/e'と正に相関した。多重ロジスティック回帰分析でNT-proBNP(OR:1.0020、P=0.0496)、hs-TnT(OR:1.0658、P=0.0472)、入院時の収縮期血圧(OR:1.0348、P=0.0026)が術後高血圧の有意な関連因子であった。

Language：Japanese   Publisher：Hypertension Research  

Hypertension is a risk factor for cardiovascular disease. We developed a simple scoring method for predicting future hypertension using health checkup data. A total of 41,902 participants aged 30–69 years without baseline hypertension who underwent annual health checkups (mean age, 52.3 ± 10.2 years; male, 47.7%) were included. They were randomly assigned to derivation (n = 27,935) and validation cohorts (n = 13,967) at a ratio of 2:1. In the derivation cohort, we performed multivariable logistic regression analysis and assigned scores to each factor significantly associated with 5-year hypertension. We evaluated the predictive ability of the scores using area under the curve (AUC) analysis and then applied them to the validation cohort to assess their validity. The score including items requiring blood sampling ranged from 0 to 14 and included seven indicators (age, body mass index, blood pressure, current smoking, family history of hypertension, diabetes, and hyperuricemia). The score not including items requiring blood sampling ranged from 0 to 12 and included five indicators (the above indicators, except diabetes and hyperuricemia). The score not including items requiring blood sampling was better; blood sampling did not improve diagnostic ability. The AUC of the score not including items requiring blood sampling was 0.76, with a sensitivity and specificity of 0.82 and 0.60, respectively, for scores ≥6 points. The incidence of hypertension gradually and constantly increased (from 0.9 to 49.6%) as the score increased from 0 to ≥10. Analysis in the validation cohort yielded similar results. We developed a simple and useful clinical prediction model to predict the 5-year incidence of hypertension among a general Japanese population. The model had reasonably high predictive ability and reproducibility.

DOI： 10.1038/s41440-021-00831-x

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PubMed

Language：Japanese   Publisher：Heart and Vessels  

Red cell distribution width (RDW) is reportedly associated with cardiovascular events, including atrial fibrillation (AF). We investigated whether the RDW values were associated with the outcomes of catheter ablation for AF. This retrospective multicenter study included 501 patients with AF (239 paroxysmal AF cases, 196 persistent AF cases, and 66 long-standing persistent AF cases) who underwent initial AF ablation between March 2017 and May 2018. The RDW values were evaluated before and at 1–3 months after the procedure. The patients were stratified based on the recurrence of AF within 1 year after the index procedure with a blanking period of 3 months into recurrence group (107 patients, 21.4%) and no-recurrence group (394 patients, 78.6%). There were no significant differences in preoperative RDW values between the groups (p = 0.37). The RDW value did not change significantly after the ablation in the recurrence group (13.55–13.60%, p = 0.37), although it decreased significantly in the no-recurrence group (13.64–13.37%, p < 0.001). Multivariate Cox proportional hazards regression analyses revealed that a postoperative change in RDW (ΔRDW) was independently associated with AF recurrence (hazard ratio 2.00, 95% confidence interval 1.42–2.76, p < 0.001). Receiver operating characteristic curve analysis revealed that a ΔRDW cut-off value of − 0.1% provided a c-statistic of 0.65 for predicting AF recurrence. Decrease in RDW during the blanking period after ablation independently predicted the 1-year success of AF ablation.

DOI： 10.1007/s00380-021-01891-2

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PubMed

Language：English   Publisher：シュプリンガー・ジャパン(株)  

カテーテルアブレーション(CA)を施行した心房細動患者501例(男性378例、女性123例)を対象に、赤血球粒度分布幅(RDW)がCA後の転帰を予測するかどうかを検討した。心房細動患者の内訳は、発作性が239例、持続性が196例、永続性が66例であった。重度の貧血、腎機能低下、悪性腫瘍、血液疾患の既往患者は除外した。3ヵ月のブランキング期間後に心房細動の再発は107例で発生した(再発群)。患者を再発群107例(男性69.2%、平均64.6±10.2歳)と非再発群394例(男性77.2%、平均63.2±10.2歳)の2群に分類した。CA施行前の平均RDWは13.5%で、有意な群間差はなかった。再発群のRDWはベースライン(13.55%)とCA後(13.60%)で変化はなかったが、非再発群では術前(13.64%)に比べて術後(13.37%)に有意に低下した(P<0.001)。Cox比例ハザードモデルによる多変量解析の結果、CA後のRDW低下は心房細動再発の有無を予測する独立因子であった(HR:2.00、95%CI:1.42～2.76、P<0.001)。

Language：English   Publisher：シュプリンガー・ジャパン(株)  

カテーテルアブレーション(CA)を施行した心房細動患者501例(男性378例、女性123例)を対象に、赤血球粒度分布幅(RDW)がCA後の転帰を予測するかどうかを検討した。心房細動患者の内訳は、発作性が239例、持続性が196例、永続性が66例であった。重度の貧血、腎機能低下、悪性腫瘍、血液疾患の既往患者は除外した。3ヵ月のブランキング期間後に心房細動の再発は107例で発生した(再発群)。患者を再発群107例(男性69.2%、平均64.6±10.2歳)と非再発群394例(男性77.2%、平均63.2±10.2歳)の2群に分類した。CA施行前の平均RDWは13.5%で、有意な群間差はなかった。再発群のRDWはベースライン(13.55%)とCA後(13.60%)で変化はなかったが、非再発群では術前(13.64%)に比べて術後(13.37%)に有意に低下した(P<0.001)。Cox比例ハザードモデルによる多変量解析の結果、CA後のRDW低下は心房細動再発の有無を予測する独立因子であった(HR:2.00、95%CI:1.42～2.76、P<0.001)。

Language：Japanese   Publisher：International Journal of Environmental Research and Public Health  

The purpose of this cross-sectional study was to analyse the differences in meaningful activities and psychosomatic function depending on the driving status of community-dwelling older adults. Data from 594 older adults were obtained, including activities meaningful to individuals and psychosomatic functions, such as grip strength, depression, cognitive function, and ability of activity. Participants were divided into active driving (n = 549) and after driving cessation (n = 45) groups. In addition, the active driving group was operationally divided into three groups: high-frequency group (n = 387), medium group (n = 119), and infrequent group (n = 42). In the after driving cessation group, grip strength, and Japan Science and Technology Agency Index of Competence scores were significantly lower. Furthermore, the proportion of apathy and physical and social frailty was significantly higher in the after driving cessation group. Regarding meaningful activity, domestic life scores in the after driving cessation group were significantly higher than those of the active driving group. Decreased driving frequency in the active driving group was associated with weak muscle strength, lack of interest, and low activity. This study demonstrated that meaningful activity differed based on the driving status. Hence, we should support the activities of older adults who are considering driving cessation.

DOI： 10.3390/ijerph182413270

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PubMed

Language：Japanese   Publisher：鹿児島大学医学会  

緒言 近年の高齢者への医療は目覚ましく発達してきたが,高齢者は予備力が低くストレスや環境による変化に適応しにくいため入院を契機にフレイルに陥りやすい.自立した生活から要介護状態への移行を招く原因としてフレイルが注目されている.循環器疾患があるとフレイルの発症率は1.5倍となることが報告されている.地域在住高齢者におけるフレイルの研究は数多く報告されているが,循環器疾患をもつ高齢入院患者におけるフレイルの生活の中での関連要因についての報告は見当たらない.本研究では,循環器疾患をもつ高齢患者のフレイルに影響を及ぼす要因について,入院前の生活との関係および入院から退院後の生活との関係から検討する.方法 対象は2018年11月から2019年5月にA病院心臓血管内科B病棟に入院した75歳以上の患者31名のうち,本研究への参加同意が得られ,認知機能低下のない25名である.入院時,退院時,退院3ヵ月後の3回の時期に分けて質問紙調査を行った.フレイルの判定は,厚生労働省作成の基本チェックリストを用いて,総点7点以下を非フレイル,8点以上をフレイルと判定した.分析はフィッシャーの正確確率検定あるいはMann-Whitney U検定を用いた.危険率5%未満を有意水準とした.結果 分析対象者25名のうち,入院時の非フレイル群は15名(60%),フレイル群は10名(40%)であった.解析の結果,入院時のフレイル群は非フレイル群よりも有意に高齢であった.入院時の高齢者栄養評価,アルブミン値は有意に低値を示し,心不全の重症度NT-proBNPは高い傾向を示した.また,入院時にフレイル状態の高齢者は入院前の生活で家庭での役割の程度が少ない傾向があった.入院時にフレイル状態である高齢者は,入院期間が長い傾向があり,入院中臥床がちに過ごす割合が有意に高かった.退院時にフレイル状態である高齢者は,退院直後の生活では趣味の程度が少ない傾向があり,社会活動への参加が有意に少なかった.また,退院3ヵ月後の生活では,運動の程度が有意に少なく,家庭での役割の程度が少ない傾向があり,家で臥床がちに過ごす傾向があった.結論 循環器疾患をもつ高齢患者のフレイル状態は,年齢,NT-proBNP,栄養状態,家庭の役割や社会参加,運動など日常生活との関連が示唆された.よって,循環器疾患をもつ高齢患者のフレイル予防のためには心臓リハビリテーションにより活動耐性を高めながら日常生活を活発化させる支援を,入院前から多職種と連携しながら行っていく必要がある.(著者抄録)

Institutional Repository URL

Language：Japanese   Publisher：鹿児島大学医学会  

緒言 近年の高齢者への医療は目覚ましく発達してきたが,高齢者は予備力が低くストレスや環境による変化に適応しにくいため入院を契機にフレイルに陥りやすい.自立した生活から要介護状態への移行を招く原因としてフレイルが注目されている.循環器疾患があるとフレイルの発症率は1.5倍となることが報告されている.地域在住高齢者におけるフレイルの研究は数多く報告されているが,循環器疾患をもつ高齢入院患者におけるフレイルの生活の中での関連要因についての報告は見当たらない.本研究では,循環器疾患をもつ高齢患者のフレイルに影響を及ぼす要因について,入院前の生活との関係および入院から退院後の生活との関係から検討する.方法 対象は2018年11月から2019年5月にA病院心臓血管内科B病棟に入院した75歳以上の患者31名のうち,本研究への参加同意が得られ,認知機能低下のない25名である.入院時,退院時,退院3ヵ月後の3回の時期に分けて質問紙調査を行った.フレイルの判定は,厚生労働省作成の基本チェックリストを用いて,総点7点以下を非フレイル,8点以上をフレイルと判定した.分析はフィッシャーの正確確率検定あるいはMann-Whitney U検定を用いた.危険率5%未満を有意水準とした.結果 分析対象者25名のうち,入院時の非フレイル群は15名(60%),フレイル群は10名(40%)であった.解析の結果,入院時のフレイル群は非フレイル群よりも有意に高齢であった.入院時の高齢者栄養評価,アルブミン値は有意に低値を示し,心不全の重症度NT-proBNPは高い傾向を示した.また,入院時にフレイル状態の高齢者は入院前の生活で家庭での役割の程度が少ない傾向があった.入院時にフレイル状態である高齢者は,入院期間が長い傾向があり,入院中臥床がちに過ごす割合が有意に高かった.退院時にフレイル状態である高齢者は,退院直後の生活では趣味の程度が少ない傾向があり,社会活動への参加が有意に少なかった.また,退院3ヵ月後の生活では,運動の程度が有意に少なく,家庭での役割の程度が少ない傾向があり,家で臥床がちに過ごす傾向があった.結論 循環器疾患をもつ高齢患者のフレイル状態は,年齢,NT-proBNP,栄養状態,家庭の役割や社会参加,運動など日常生活との関連が示唆された.よって,循環器疾患をもつ高齢患者のフレイル予防のためには心臓リハビリテーションにより活動耐性を高めながら日常生活を活発化させる支援を,入院前から多職種と連携しながら行っていく必要がある.(著者抄録)

Language：Japanese   Publisher：JACC: Case Reports  

A 75-year-old man, who underwent inadvertent misplacement of pacemaker leads into the left coronary artery and left ventricle through the subclavian artery, was referred to our hospital. We safely performed percutaneous lead extraction in collaboration with surgeons and with the patient under general anesthesia. (Level of Difficulty: Advanced.)

DOI： 10.1016/j.jaccas.2021.08.003

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PubMed

Language：Japanese   Publisher：Digestive and Liver Disease  

Background: The clinical characteristics of IgG4-related sclerosing cholangitis (IgG4-SC) especially without autoimmune pancreatitis (AIP) have not been investigated in a large cohort. Aims: To clarify the clinical characteristics of IgG4-SC and IgG4-SC without AIP. Methods: We retrospectively reviewed imaging, serology, other organ involvement (OOI) and histology of 872 patients with IgG4-SC who participated in a Japanese nationwide survey in 2019, and compared these items between IgG4-SC with and without AIP. Results: AIP was present in 83.7% (730/872) of IgG4-SC. In IgG4-SC, bile duct wall thickening was observed on ultrasound (528/650; 81.2%), computed tomography (375/525; 71.4%) and magnetic resonance imaging or cholangiopancreatography (290/440; 65.9%). An elevated serum IgG4 level (≥ 135 mg/dL) was found in 88.0% (322/366). IgG4-related OOI other than AIP was observed in 25.2% (211/836). The proportion of females was significantly higher in IgG4-SC without AIP (28.9% vs. 20.1%; p = 0.025). Hilar stricture was the most common cholangiographic type in IgG4-SC without AIP (39/107; 36.4%).There were no significant differences between IgG4-SC with and without AIP in the rates of bile duct wall thickening, elevated serum IgG4 level, or IgG4-related OOI. Conclusions: The clinical characteristics of IgG4-SC was similar between IgG4-SC with and without AIP in a large cohort.

DOI： 10.1016/j.dld.2021.02.009

Scopus

Language：Japanese   Publisher：Biomolecules  

Objective: Epidemiological studies link hyperlipidemia with increased risk for abdominal aortic aneurysms (AAAs). However, the influence of lipid-lowering drugs statins on prevalence and progression of clinical and experimental AAAs varies between reports, engendering controversy on the association of hyperlipidemia with AAA disease. This study investigated the impact of hypercholesterolemia on elastase-induced experimental AAAs in mice. Methods: Both spontaneous (targeted deletion of apolipoprotein E) and induced mouse hypercholesterolemia models were employed. In male wild type (WT) C57BL/6J mice, hypercholesterolemia was induced via intraperitoneal injection of an adeno-associated virus (AAV) encoding a gain-of-function proprotein convertase subtilisin/kexin type 9 mutation (PCSK9) followed by the administration of a high-fat diet (HFD) (PCSK9+HFD) for two weeks. As normocholesterolemic controls for PCSK9+HFD mice, WT mice were infected with PCSK9 AAV and fed normal chow, or injected with phosphate-buffered saline alone and fed HFD chow. AAAs were induced in all mice by intra-aortic infusion of porcine pancreatic elastase and assessed by ultrasonography and histopathology. Results: In spontaneous hyper-and normo-cholesterolemic male mice, the aortic diameter enlarged at a constant rate from day 3 through day 14 following elastase infusion. AAAs, defined as a more than 50% diameter increase over baseline measurements, formed in all mice. AAA progression was more pronounced in male mice, with or without spontaneous hyperlipidemia. The extent of elastin degradation and smooth muscle cell depletion were similar in spontaneous hyper-(score 3.5 for elastin and 4.0 for smooth mus-cle) and normo-(both scores 4.0) cholesterolemic male mice. Aortic mural macrophage accumulation was also equivalent between the two groups. No differences were observed in aortic accumulation of CD4⁺ or CD8⁺ T cells, B cells, or mural angiogenesis between male spontaneous hyper-and normocholesterolemic mice. Similarly, no influence of spontaneous hypercholesterolemia on charac-teristic aneurysmal histopathology was noted in female mice. In confirmatory experiments, induced hypercholesterolemia also exerted no appreciable effect on AAA progression and histopathologies. Conclusion: This study demonstrated no recognizable impact of hypercholesterolemia on elastase-induced experimental AAA progression in both spontaneous and induced hypercholesterolemia mouse models. These results add further uncertainty to the controversy surrounding the efficacy of statin therapy in clinical AAA disease.

DOI： 10.3390/biom11101434

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PubMed

Language：Japanese   Publisher：大道学館出版部  

Language：Japanese   Publisher：一般社団法人 日本動脈硬化学会  

DOI： 10.5551/jat.ED147

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PubMed

CiNii Research

Language：English   Publisher：The Japanese Circulation Society  

DOI： 10.1253/circj.cj-21-0246

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PubMed

CiNii Research

Language：English   Publisher：Japan Atherosclerosis Society  

<p>Abdominal aortic aneurysm (AAA) is a chronic inflammatory degenerative aortic disease, which particularly affects older people. Nucleotide-binding oligomerization domain-like receptor family protein 3 (NLRP3) inflammasome is a multi-protein complex and mediates inflammatory responses by activating caspase 1 for processing premature interleukin (IL)-1β and IL-18. In this review, we first summarize the principle of NLRP3 inflammasome activation and the functionally distinct classes of small molecule NLRP3 inflammasome inhibitors. Next, we provide a comprehensive literature review on the expression of NLRP3 inflammasome effector mediators (IL-1β and IL-18) and components (caspase 1, apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC) and NLRP3) in clinical and experimental AAAs. Finally, we discuss the influence of genetic deficiency or pharmacological inhibition of individual effector mediators and components of NLRP3 inflammasome on experimental AAAs. Accumulating clinical and experimental evidence suggests that NLRP3 inflammasome may be a promise therapeutic target for developing pharmacological strategies for clinical AAA management.</p>

DOI： 10.5551/jat.RV17048

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PubMed

CiNii Research

Language：Japanese   Publisher：Journal of Interventional Cardiac Electrophysiology  

Background: The safety and efficacy of periprocedural use of direct oral anticoagulants (DOACs) for atrial fibrillation (AF) remain unclear. We compared the incidence of asymptomatic cerebral micro-thromboembolism and hemopericardium following AF ablation among patients receiving edoxaban, rivaroxaban, and warfarin and between normal- and low-dose use of edoxaban and rivaroxaban. Methods: This prospective randomized study included 170 consecutive AF patients. Patients taking DOACs upon admission to our hospital were randomly assigned to an edoxaban group or to a rivaroxaban group. Warfarin was continued in patients receiving warfarin at admission. All patients underwent AF ablation, and cerebral MRI was performed to evaluate asymptomatic cerebral micro-thromboembolism the day after the procedure. Results: Sixty-one patients were assigned to edoxaban and 63 to rivaroxaban. Warfarin was continued in 46 patients. Although asymptomatic cerebral micro-thromboembolism was detected in 25 patients (16.3%), there were no significant differences among the groups. Hemopericardium occurred in 2 patients (one each in the rivaroxaban and warfarin groups). The incidence of asymptomatic cerebral micro-thromboembolism was higher in the low-dose group (9 patients, 25.7%) than in the normal-dose group (8 patients, 10.0%) for patients prescribed either edoxaban or rivaroxaban (p < 0.05). The proportion of males (88.0%, 69.5%, p < 0.05), history of prior AF ablation (64.0%, 42.2%, p < 0.05), and hypertension (68.0%, 46.1%, p < 0.05) were significantly higher in patients with cerebral thromboembolism. Conclusions: The incidence of asymptomatic cerebral micro-thromboembolism and hemopericardium in AF ablation was similar among patients using edoxaban, rivaroxaban, and warfarin. However, low doses of DOACs may increase the risk of asymptomatic stroke.

DOI： 10.1007/s10840-020-00732-y

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CiNii Research

Publisher：(一社)日本温泉気候物理医学会  

平成26年の温泉法の改正によって、温泉入浴の禁忌から妊婦が削除されたが、一般への認知は十分ではない。本邦においては、妊婦の温泉浴の安全性について検証した報告は少なく、日本温泉気候物理医学会として妊婦の温泉浴の安全性について共同研究を行い、その結果を学会から発信するとともに、一般への啓発が必要であると考え、本学会において検討を行った。妊娠初期から分娩までの期間、温泉地(別府市、指宿市)に居住する妊産婦へ自記式調査票にて以下の調査を行った。1)年齢(妊娠終了時)、2)過去の出産回数、3)温泉入浴の状況:妊娠時期(初期・中期・後期)別に日常的な温泉入浴の有無と利用の頻度、内湯温泉や自宅外の温泉施設の利用の有無、4)妊娠中のトラブルの有無:流産(妊娠12週未満の早期流産は除外)、早産、切迫早産、妊娠中毒症・妊娠高血圧症(浮腫、高血圧)等について調査した。回収数は1,721例(回収率86%)であり、平均年齢は30.8歳(17〜49歳)、初妊婦643例(37.6%)、経妊婦1,078例(62.4%)であった。年齢と出産回数は、産科的トラブルとは関連なかった。妊娠の初期と中期において、産科的トラブルは、週1回以上の日常的な温泉入浴者と週1回未満の温泉入浴者の間に有意な差を認めなかった。妊娠後期においては、週1回以上の日常的な温泉入浴者は週1回未満の温泉入浴者に比べ、むしろ産科的トラブルが有意に少なかった(20.3% vs 25.9%、p=0.028)。また、里帰り妊婦に絞ってみても、妊娠の初期と中期においては、産科的トラブルの頻度は温泉入浴群と非温泉入浴群の間に有意差を認めなかった。一方、妊娠後期においては、温泉入浴群は非温泉入浴群と比較し、産科的トラブルが有意に少なかった(温泉入浴群13.0%vs非温泉入浴群24.5%、p=0.028)。日常的に温泉浴をする妊婦において、そうでない妊婦とくらべて、産科的トラブルが増加することはないことが確認できた。温泉の禁忌症から"妊婦"の項目が削除されたことは適正なことであったといえる。(著者抄録)

Language：English   Publishing type：Research paper (scientific journal)  

Publisher：The Japanese Society of Balneology, Climatology and Physical Medicine  

<p>  Pregnancy has been removed from the list of contraindications for hot spring bathing. Therefore, The Japanese Society of Balneology, Climatology and Physical Medicine has considered that it is necessary to conduct a joint research on the safety of hot spring bathing for pregnant women, publish the results extensively, and enlighten the public about this matter. Considering that only a small number of reports have been published in Japan about the safety of hot spring bathing for pregnant women, the Society has decided to study this subject. </p><p>  Expectant and nursing mothers living in hot spring towns, such as Beppu and Ibusuki City, have responded to questions about the period between the early stages of pregnancy and delivery via a self-administered questionnaire; The questions included: 1) age when the pregnancy ended, 2) number of previous deliveries, 3) details of hot spring bathing　habits (whether they bathed in hot springs on a daily basis, how often they bathed during the different [early, middle, and late] stages of pregnancy, and whether they used hot spring baths attached to their homes or hot spring facilities away from their homes), and 4) whether they had pregnancy complications such as miscarriages (excluding those occurring in the early stages of pregnancy), premature delivery, threatened premature delivery, or toxemia of pregnancy/pregnancy-induced hypertension (edema, hypertension).</p><p>  Total 1,721 responses were collected (86% reply rate). The mean participant age was 30.8 years. Importantly, there were 643 (37.6%) primigravid and 1,078 (62.4%) parous women. Age and gravidity were not associated with pregnancy complications. In the early and middle stages of pregnancy, there were no significant differences in the incidence of pregnancy complications between individuals who bathed ≥ once per week [hot spring bath (+)] group and those who bathed < once per week [hot spring bath (−)] group. In the late stages of pregnancy, the number of pregnancy complications were fewer in the hot spring bath (+) group (20.3%) than that in the hot spring bath (−) group (25.9%) (p = 0.028). In addition, there were no significant differences in the pregnancy complications between hot spring bathing (+) and hot spring bath (−) groups in the early and middle stages of pregnancy even if we focused on the homecoming pregnant women. Whereas, in the late stages of pregnancy, the number of pregnancy complications were fewer in the hot spring bath (+) group (13.0%) compared with the hot spring bath (−) group (24.5%) (p = 0.028) in the homecoming pregnant women.</p><p>  This study has confirmed that daily hot spring bathing during pregnancy does not increase the incidence of pregnancy complications. Furthermore, it can be stated that the removal of "pregnancy" from the contraindications of hot spring bathing was appropriate.</p>

DOI： 10.11390/onki.83_3.140

CiNii Research

Publisher：Heart and Vessels  

DOI： 10.1007/s00380-019-01373-6

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Language：English   Publishing type：Research paper (scientific journal)  

DOI： 10.1161/ATVBAHA.119.312497

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Publisher：Neurochemistry International  

DOI： 10.1016/j.neuint.2019.02.010

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Publisher：一般社団法人 日本循環器学会  

<p><b><i>Background:</i></b>Pulmonary hypertension (PH) is an important cause of morbidity in patients with connective tissue disease (CTD), and an early stage of PH could present as exercise-induced PH (EIPH). This study investigated the significant clinical indexes of EIPH in patients with CTD.</p><p><b><i>Methods and Results:</i></b>We enrolled 63 patients with CTD who did not have PH at rest. All patients underwent the 6-min walk test (6MWT), and systolic pulmonary artery pressure (SPAP) was evaluated on echocardiography before and after 6MWT. EIPH was defined as SPAP ≥40 mmHg after 6 WMT. Thirty-five patients had EIPH. On univariate logistic analysis, SPAP at rest, log brain natriuretic peptide (BNP), vital capacity (VC), and forced expiratory volume in 1 s (FEV1.0) were significantly correlated with EIPH. On multiple logistic analysis, SPAP at rest and VC were independent predictors of EIPH, whereas FEV1.0 and log BNP were not significantly associated with EIPH. The area under the receiver operating characteristics curve between EIPH and BNP, SPAP at rest, VC or FEV1.0 was 0.67, 0.76, 0.74, and 0.75, respectively.</p><p><b><i>Conclusions:</i></b>SPAP at rest and respiratory function, especially VC, could be independent predictors of EIPH in patients with CTD.</p>

DOI： 10.1253/circrep.CR-19-0087

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CiNii Research

Publisher：一般社団法人 インターナショナル・ハート・ジャーナル刊行会  

<p>Pulmonary hypertension (PH) with pulmonary vascular disease (PVD) is a progressive and debilitating disease associated with increased pulmonary vascular resistance (PVR). Biphasic right ventricular outflow tract (RVOT) Doppler flow is frequently seen in severe PH patients with PVD. In association with hemodynamics, the precise analysis of biphasic RVOT Doppler flow (RVDF) has not been fully elucidated. Therefore, the purpose of the present study is to analyze the relation between the hemodynamics and indices of biphasic RVDF in PH patients with PVD.</p><p>Seventy PH patients with biphasic RVDF were analyzed. All patients underwent transthoracic echocardiography and right heart catheterization. For the analysis of biphasic RVDF, the early waveform was determined as P₁ while the late waveform was determined as P₂. For each P₁ and P₂, the duration (D, seconds) and peak flow velocity (PFV, in m/second) were measured.</p><p>P₁D and P₂PFV were significantly correlated with PVR (P₁D: <i>r</i> = −0.542, <i>P</i> < 0.0001, P₂PFV: <i>r</i> = −0.513, <i>P</i> < 0.0001). Therefore, we propose a novel RVDF formula for estimation of PVR, as follows. PVR = 26 − 77 × P₁D - 14 × P₂PFV. The PVR could be estimated by this proposed formula (<i>r</i> = 0.649, <i>P</i> < 0.0001), which is derived from one Doppler image only unlike previously used PVR prediction formula.</p><p>P₁D and P₂PFV were associated with PVR. Moreover, this simple RVDF formula proposed herein can estimate PVR in PH patients with PVD.</p>

DOI： 10.1536/ihj.18-149

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Publisher：一般社団法人 日本温泉気候物理医学会  

DOI： 10.11390/onki.82_1.19

CiNii Research

Publisher：(一社)日本循環器学会  

定期検診を受診した一般集団被験者111566例(男性53416例、女性58150例、平均53.8±15.6歳)を対象に、尿酸値と心房細動の新規発症の関連を検討した。心不全、冠動脈疾患、甲状腺機能亢進症の患者は除外した。ベースラインの血清尿酸値は男性で5.9±1.3mg/dL、女性で4.4±1.0mg/dLであった。男性および女性被験者を尿酸値の3分位値でそれぞれ3群に分類した。追跡期間中央値は4.1年で、心房細動は女性で180例(0.31%)、男性で467例(0.87%)発生した。血清尿酸値で三分位に分けた心房細動の発症率は、女性では最低値の第1三分位群が0.20%、第2三分位群が0.31%、第3三分位群が0.49%であった。男性では有意な群間差はなかった。Cox比例ハザードモデルを用いた解析で、女性における第1三分位群を基準とした第3三分位群の心房細動発症の調整ハザード比は1.74(95%信頼区間1.15〜2.70、P=0.008)であった。男性および女性の第3三分位群ではベースラインに比べて尿酸値が0.3mg/dL以上増加した被験者における心房細動の発症率が有意に高かった。

Publisher：(一社)日本動脈硬化学会  

スタチン服用中の心血管疾患(CVD)患者において、LDLコレステロール(LDL-C)(M)をLDL-C(F)およびLDL-C(D)と比較することで、その妥当性を検証した。2013年5月〜2016年12月に当院に入院したスタチン服用中の心血管疾患(CVD)患者385例(男性268例、女性117例、平均69.8±9.8歳)を後ろ向きに評価した。平均LDL-C(D)、LDL-C(F)、LDL-C(M)はそれぞれ81.7±25.5、76.4±24.6、79.9±24.5mg/dLであった。全例でLDL-C(F)とLDL-C(M)のどちらもLDL-C(D)と有意な相関が認められた。LDL-C(D)<70mg/dLの患者では、LDL-C(M)はLDL-C(F)に比べてLDL-C(D)と良好な相関を認めた。これに対して、LDL-C(D)とLDL-C(M)またはLDL-C(F)との相関は、LDL-C(D)≧70mg/dLの患者において同様であった。スタチン服用中の日本人CVD患者において、この新規手法により推定されたLDL-C値は、Friedewald式を用いて推定された値よりも正確である可能性があることが示された。

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DOI： 10.1016/j.jvs.2016.12.110

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Publisher：一般社団法人 日本動脈硬化学会  

<p><b><i>Aim</i></b><b>:</b> Previous studies have reported a 10.2%–22% rate of silent cerebral infarction and a 0.1%–1% rate of symptomatic cerebral infarction after coronary angiography (CAG). However, the risk factors of cerebral infarction after CAG have not been fully elucidated. For this reason, we investigated the incidence and risk factors of CVD complications within 48 h after CAG using magnetic resonance imaging (MRI) (Diffusion-weighted MRI) at Kagoshima University Hospital.</p><p><b><i>Methods</i></b><b>: </b>From September 2013 to April 2015, we examined the incidence and risk factors, including procedural data and patients characteristics, of cerebrovascular disease after CAG in consecutive 61 patients who underwent CAG and MRI in our hospital.</p><p><b><i>Results</i></b><b>: </b>Silent cerebral infarction after CAG was observed in 6 cases (9.8%), and they should not show any neurological symptoms of cerebral infarction. Only prior coronary artery bypass grafting (CABG) was more frequently found in the stroke group (<i>n</i>=6) than that in the non-stroke group (<i>n</i>=55); however, no significant difference was observed (<i>P</i>=0.07). After adjusting for confounders, prior CABG was a significant independent risk factor for the incidence of stroke after CAG (odds ratio: 11.7, 95% confidence interval: 1.14–129.8, <i>P</i>=0.04).</p><p><b><i>Conclusions</i></b><b>: </b>We suggested that the incidence of cerebral infarction after CAG was not related to the catheterization procedure per se but may be caused by atherosclerosis with CABG.</p>

DOI： 10.5551/jat.41012

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Publisher：Current Drug Targets  

DOI： 10.2174/1389450119666180122155642

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Publisher：Theranostics  

DOI： 10.7150/thno.24475

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Publisher：Journal of Echocardiography  

DOI： 10.1007/s12574-017-0340-x

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Publisher：Therapeutic Angiogenesis  

DOI： 10.1007/978-981-10-2744-4_14

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Language：English   Publishing type：Research paper (scientific journal)  

Publisher：(一社)日本循環器学会  

慢性心不全患者に対する和温療法の短期効果を検討した前向き研究のサブ解析を行い、和温療法が神経内分泌性因子を調節するか検討した。被験者150例を、通常の心不全治療と2週間の和温療法を併用する和温療法群77例と、通常の心不全治療のみの対照群73例に無作為に割り付けた。治療前と2週間後に採血し、C型Na利尿ペプチド(CNP)、脳性Na利尿ペプチド(BNP)、アルドステロン(Aldo)を定量した。和温療法によりNYHA心機能と6分間歩行距離は有意に改善したが、CNP、BNP、Aldoに有意な群間差はなかった。背景因子別のサブ解析では、ARB/ACE阻害剤またはスピロノラクトンを服用する和温療法群の患者でBNPが改善した。糖尿病、高血圧症、強心薬の使用患者でAldoが改善し、eGFRが60mL/min/1.73m2未満の患者でCNPが改善したが、対照群ではこのような神経内分泌調節は見られなかった。

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Language：English   Publishing type：Research paper (scientific journal)  

Publisher：The Japanese Society of Balneology, Climatology and Physical Medicine  

<p><b>Pur</b><b>pose:</b> Bathing habits are said to be affected by the country of residence. We investigated and compared bathing habits between Japanese living in Kyoto and Japanese Americans living in Los Angeles. </p><p><b>Methods:</b> 488 subjects living in Kyoto (Japanese) and 539 subjects living in Los Angeles (Japanese Americans) were enrolled. The survey items for bathing habits were as follows: frequency (times per week) and time (morning, afternoon, evening) of taking baths and showers, other styles of bathing, and bathing duration (both baths and showers). We performed a simple tabulation and cross tabulation, calculated 95% confidential intervals by simple tabulation, and compared the results using chi-square analysis. The survey was conducted in Los Angeles in October 2010 and in Kyoto in December 2013.</p><p><b>Results:</b> The percentage of subjects who took baths was 92.8% for Japanese and 56.0% for Japanese Americans. The frequency of taking a bath was 36.8 points higher for Japanese compared with Japanese Americans. The percentage of subjects who took showers was 71.7% for Japanese and 82.6% for Japanese Americans. The frequency of taking a shower was 10.9 points higher for Japanese Americans compared with Japanese. The most common response for frequency of bathing was "every day", followed by "every other day" in both groups. The most common response for the time of taking a bath was "evening" in both groups. Among Japanese Americans, 21.8% took baths in the "morning". Most Japanese indicated they took a shower "less than once a week" (48.0%), whereas most Japanese Americans took a shower "every day" (78%). The timing of taking a shower was in the "evening" for most Japanese, but in the "morning" or "evening" for most Japanese Americans. The most common response for bathing duration (both baths and showers) was "26-30 min" among Japanese and "6-10 min" among Japanese Americans.</p><p><b>Discussion:</b> For Japanese Americans, the purpose of bathing was suggested to be cleaning the body since their main style of bathing was taking showers of a short duration in the morning or evening. On the other hand, for Japanese, the purpose of bathing was thought to be cleaning and healing the body, but also maintaining health since their main style of bathing was taking baths of a long duration in the evening. We speculate that the country of residence affects bathing habits and that there are differences among people of the same race living in different countries.</p><p><b>Conclusion:</b> Bathing habits such as bathing style, the time of bathing and bathing duration were different between Japanese and Japanese Americans.</p>

DOI： 10.11390/onki.2305

CiNii Research

Publisher：一般社団法人 日本循環器学会  

DOI： 10.1253/circj.CJ-17-0501

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Publisher：一般社団法人 日本循環器学会  

<p><b><i>Background:</i></b>Heart failure (HF) is a disease of neurohumoral dysfunction and current pharmacological therapies for HF have not improved mortality rates, thus requiring additional new strategies. Waon therapy for HF patients may be a complementary strategy with peripheral vasodilation via nitric oxide. We hypothesized that Waon therapy would improve neurohumoral factors, such as natriuretic peptides (NP) and the renin-angiotensin-aldosterone system (RAAS) in HF.</p><p><b><i>Methods and Results:</i></b>Plasma samples were collected from patients enrolled in the WAON-CHF Study (Waon therapy (n=77) or control (n=73)) before and after the treatment. B-type NP (BNP), C-type NP (CNP), and aldosterone (Aldo) levels were measured by respective specific radioimmunoassays. Although clinical parameters significantly improved in the Waon group compared with the control group, BNP, Aldo, and CNP levels were not statistically different between groups. On subanalysis with patient variables, BNP levels were improved in the Waon group treated with angiotensin-converting enzyme inhibitor/angiotensin-receptor blocker or spironolactone. In addition, Aldo levels were improved in the Waon group patients with diabetes mellitus, hypertension, and inotrope use, and CNP levels were improved in Waon group patients with estimated glomerular filtration rate <60 mL/min/1.73 m². These changes were not observed in the control group.</p><p><b><i>Conclusions:</i></b>Waon therapy may accelerate the favorable actions of RAAS modulators in HF. (WAON-CHF Study: UMIN000006705)</p>

DOI： 10.1253/circj.CJ-16-1117

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Publisher：一般社団法人 日本循環器学会  

<p><b><i>Background:</i></b>Although there have been several reports on the risk factors associated with intima-media thickness (IMT), many questions remain. The purpose of this study was to investigate the association between IMT and cardiovascular risk factors in a Japanese general population.</p><p><b><i>Methods and Results:</i></b>The study group consisted of 1,583 male subjects undergoing routine health checkups. IMT of the common carotid artery was measured by high-resolution ultrasonography. Brachial-ankle pulse wave velocity (baPWV) was measured using an automated device. Univariate analysis demonstrated that carotid IMT significantly associated with age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), baPWV, fasting glucose, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C). Multiple logistic regression analysis for carotid atherosclerosis (carotid IMT ≥1.0 mm) was performed using obesity (BMI ≥25.0 kg/m²), high BP (SBP ≥130 mmHg or DBP ≥85 mmHg), dyslipidemia (LDL-C ≥140 mg/dL, TG ≥150 mg/dL, or HDL-C <40 mg/dL), impaired fasting glucose (IFG) (fasting glucose ≥110 g/dL), and high baPWV (≥1,400 cm/s). Carotid atherosclerosis was significantly associated with only high baPWV (OR: 2.22, 95% CI: 1.24–4.17, P<0.01).</p><p><b><i>Conclusions:</i></b>High baPWV was a stronger predictor of early carotid atherosclerosis than high BP, dyslipidemia, or IFG in a Japanese general male population.</p>

DOI： 10.1253/circj.CJ-16-0687

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DOI： 10.1038/s41440-025-02226-8

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DOI： 10.1038/s41440-024-01911-4

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