記述言語：英語   出版者・発行元：HeartRhythm Case Reports  

DOI： 10.1016/j.hrcr.2023.10.023

Scopus

PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： https://doi.org/10.1016/j.jccase.2023.12.002

Web of Science

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.hrcr.2023.10.023.

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：JACC: Clinical Electrophysiology  

Background: Advances in catheter ablation (CA) for atrial fibrillation (AF) have improved the prognosis of patients with heart failure (HF) and AF. However, its optimal timing remains to be fully elucidated. Objectives: The aim of this study was to investigate the prognostic impact of early CA in patients with HF and AF hospitalized for worsening HF. Methods: From JROADHF (Japanese Registry of Acute Decompensated Heart Failure) (n = 13,238), patients with HF and AF who underwent CA within 90 days after admission for HF (early CA; n = 103) and those who did not (control; n = 2,683) were identified. Mortality was compared between these groups in the crude cohort, as well as in the propensity-matched cohort (n = 83 in each group). Results: In the crude cohort, all-cause mortality was significantly lower in the early CA group than in the control group (log-rank P < 0.001; HR: 0.38; 95% CI: 0.24-0.60). In the matched cohort, all-cause mortality was likewise significantly lower in the early CA group (log-rank P = 0.014; HR: 0.47; 95% CI: 0.25-0.88). Cardiovascular death and HF mortality were significantly lower in both cohorts (crude: Gray’ test: P < 0.001 and P = 0.005; subdistribution HR: 0.28 [95% CI: 0.13-0.63] and HR: 0.31 [95% CI: 0.13-0.75]; matched: Gray's test: P = 0.006 and P = 0.017; subdistribution HR: 0.24 [95% CI: 0.08-0.70] and HR: 0.28 [95% CI: 0.09-0.84], respectively). Conclusions: In a nationwide representative real-world cohort, CA for AF within 90 days after admission for HF was associated with improved long-term outcomes, including cardiovascular and HF death in patients with HF and AF.

DOI： 10.1016/j.jacep.2023.05.038

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PubMed

記述言語：英語   出版者・発行元：(一社)日本動脈硬化学会  

冠動脈ステント留置術を受けた冠動脈疾患の患者をスタチン(S)またはSとエゼチミブの併用(S+E)で治療するCuVIC試験から、治療前と6～8ヵ月追跡調査後の非責任病変の血管内超音波(IVUS)画像が得られた79症例(S群39名、S+E群40名)を抽出し解析した。治療期間後のS+E群のLDL-コレステロール(LDL-C)値はS群と比べて有意に低かった。S+E群ではコレステロール吸収のマーカーであるcampesterol、オキシステロール(β-epoxycholesterol、4β-hydroxycholesterol、27-hydroxycholesterol)も低かった。IVUS解析でS+E群のプラーク退縮率はS群と比べて大きかった。campesterolおよび27-hydroxycholesterolの低下はプラーク退縮と正相関し、LDL-Cの低下は相関しなかった。

記述言語：英語   出版者・発行元：Nutrients  

Oxysterols have been implicated in the pathogenesis of cardiovascular diseases. Serum levels of oxysterols could be positively correlated with cholesterol absorption and synthesis. However, physiological regulation of various serum oxysterols is largely unknown. The aim of this study was to investigate the relationship between clinical factors and cholesterol metabolism markers, and identify oxysterols associated with cholesterol absorption and synthesis in patients with coronary artery disease. Subjects (n = 207) who underwent coronary stenting between 2011 and 2013 were studied cross-sectionally. We measured lipid profiles including serum oxysterols. As for the serum biomarkers of cholesterol synthesis and absorption, oxysterol levels were positively correlated with campesterol and lathosterol. Covariance structure analysis revealed that dyslipidemia and statin usage had a positive correlation with “cholesterol absorption”. Statin usage also had a positive correlation with “cholesterol synthesis”. Several oxysterols associated with cholesterol absorption and/or synthesis. In conclusion, we elucidated the potential clinical factors that may affect cholesterol metabolism, and the associations between various oxysterols with cholesterol absorption and/or synthesis in patients with coronary artery disease.

DOI： 10.3390/nu15132997

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.3390/nu15132997.

記述言語：日本語   出版者・発行元：一般社団法人 日本超音波検査学会  

DOI： 10.11272/jssabst.48.0_s127

CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：一般社団法人 日本動脈硬化学会  

Aim: Several clinical trials using intravascular ultrasound (IVUS) evaluation have demonstrated that intensive lipid-lowering therapy by statin or a combination therapy with statin and ezetimibe results in significant regression of coronary plaque volume. However, it remains unclear whether adding ezetimibe to statin therapy affects coronary plaque composition and the molecular mechanisms of plaque regression. We conducted this prospective IVUS analysis in a subgroup from the CuVIC trial. Methods: The CuVIC trial was a prospective randomized, open, blinded-endpoint trial conducted among 11 cardiovascular centers, where 260 patients with coronary artery disease who received coronary stenting were randomly allocated into either the statin group (S) or the combined statin and ezetimibe group (S＋E). We enrolled 79 patients (S group, 39 patients; S＋E group, 40 patients) in this substudy, for whom serial IVUS images of nonculprit lesion were available at both baseline and after 6–8 months of follow-up. Results: After the treatment period, the S＋E group had significantly lower level of low-density lipoprotein cholesterol (LDL-C; 80.9±3.7 vs. 67.7±3.8 mg/dL, p=0.0143). Campesterol, a marker of cholesterol absorption, and oxysterols (β-epoxycholesterol, 4β-hydroxycholesterol, and 27-hydroxycholesterol) were also lower in the S ＋E group. IVUS analyses revealed greater plaque regression in the S＋E group than in the S group (−6.14% vs. −1.18% for each group, p =0.042). It was noteworthy that the lowering of campesterol and 27-hydroxycholesterol, but not LDL-C, had a significant positive correlation with plaque regression. Conclusions: Compared with statin monotherapy, ezetimibe in combination with statin achieved significantly lower LDL-C, campesterol, and 27-hydroxycholesterol, which resulted in greater coronary plaque regression.

DOI： 10.5551/jat.63507

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PubMed

CiNii Research

記述言語：英語   出版者・発行元：Journal of Arrhythmia  

Background: Focal Purkinje ventricular arrhythmias (VAs) might originate from the vicinity of the proximal portion of the cardiac conducting system. This study aimed to clarify the features associated with focal Purkinje VAs originating from the proximal conduction system. Methods: A total of 18 patients with focal Purkinje VAs undergoing radiofrequency catheter ablation (RFCA) were retrospectively examined and divided into the proximal type or the non-proximal type. The proximal type was defined as having the origin at the proximal half of the interventricular septum, or the proximal half and the septal side of the anterior wall. The 12-lead electrocardiogram and electrophysiological findings were investigated. Results: Seven patients met criteria for proximal type of focal Purkinje VA. Out of the 7, 4 patients with proximal VAs had multiple QRS morphologies of VAs clinically, whereas out of 11 patients with non-proximal VAs, only 1 had multiple morphologies (p =.047). VA QRS duration was shorter in the proximal type than in the non-proximal type (111.2 ± 19.8 ms vs. 135.7 ± 17.7 ms; p =.003). The absolute axis difference between sinus rhythm and VA was smaller in the proximal type (80.4 ± 46.1°vs. 138.8 ± 59.6°; p =.014). The absolute axis difference ≤134° was useful in distinguishing the two types. Recurrence of VA was recorded in 3 proximal type patients and 3 non-proximal type patients. No procedure-related conduction block was observed. Conclusion: A VA of absolute axis difference ≤134°, and multiple QRS morphologies of clinical VAs indicate a proximal origin. Focal Purkinje VAs from proximal origins can be suppressed by RFCA without severe conduction disturbance.

DOI： 10.1002/joa3.12787

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PubMed

記述言語：英語   出版者・発行元：(一社)日本不整脈心電学会  

伝導系の近位部から発する巣状プルキンエ心室不整脈(FPVA)に関連してみられる所見を明らかにした。2008～2020年に5病院でFPVAと診断され高周波カテーテルアブレーション(RFCA)が行われた患者18名(男性11名、年齢18～75歳)を後方視的に検討した。そのFPVAの起源が心臓伝導系の近位部にあると判定された近位群は7名存在した。臨床的に心室不整脈(VA)と考えられた時の心電図で複数のQRS形態が観察されたのは、近位群の7名中4名、非近位群の11名中では1名のみであった(p=0.047)。VA時のQRS幅は非近位群に比べ近位群で有意に短縮していた。洞調律時とVA時で電気軸角度にみられた差の絶対値は、近位群で80.4±46.1度、非近位群では138.8±59.6度となり(p=0.003)、この絶対差が134度以下という基準を定めると両群を識別するのに有用であった。VAの再発は両群で3名ずつに発生した。RFCA処置に関連した伝導ブロックの例は観察されなかった。以上のように、臨床的VAで多様なQRS形態が観察されること、およびVA時に変化した電気軸角度の絶対差が134度以下であることは、FPVAの起源が伝導系近位部にあることを指し示していた。RFCAを行うことで、重度の伝導障害を起こすことなく近位部起源のFPVAを抑制できると結論された。

記述言語：英語   掲載種別：研究論文（学術雑誌）  

Web of Science

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Cardiovascular Electrophysiology  

We report a 28-year-old female patient with congenital type 2 long QT syndrome (LQTS) in which mexiletine shortened corrected QT interval (QTc) and effectively prevented refractory Torsade de Pointes (TdP) and ventricular fibrillation (VF). She developed TdP and VF, and was subsequently diagnosed with congenital type 2 LQTS. She had refractory TdP and VF every day despite medical therapy including β-blocker. They were completely suppressed after the initiation of mexiletine with shorting of QTc interval.

DOI： 10.1111/jce.15517

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Cardiovascular Electrophysiology  

Introduction: Ectopic beats originating from the pulmonary vein (PV) trigger atrial fibrillation (AF). The purpose of this study was to clarify the electrophysiological determinant of AF initiation from the PVs. Methods: Pacing studies were performed with a single extra stimulus mimicking an ectopic beat in the left superior PVs (LSPVs) in 62 patients undergoing AF ablation. Inducibility of AF, effective refractory period (ERP), and conduction properties within the PVs were analyzed. Results: A single extra stimulus in LSPV induced AF in 20 patients (32% of all patients) at the mean coupling interval (CI) of 172 ms. A CI-dependent anisotropic conduction at the AF onset was visualized in a three-dimensional mapping. Onset of AF was site-specific with reproducibility in each individual. Mean ERP in LSPV in the AF-inducible group was shorter than that in the AF-noninducible group (182 ± 55 vs. 254 ± 51 ms, p <.0001). LSPV ERP dispersion was greater in the AF-inducible group than in the AF-noninducible group (45 ± 28 vs. 27 ± 19 ms, p <.01). Circumferential intra-PV conduction time (IPVCT) exhibited decremental properties in response to shortening of CI and the prolongation of IPVCT in the AF-inducible site was greater than that in the AF-noninducible site (p <.05) in each individual. Conclusions: Location and CI of an ectopic excitation ultimately determine the initiation of AF from the PVs. ERP dispersion and circumferential conduction delay may lead to anisotropic conduction and reentry within the PVs that initiate AF.

DOI： 10.1111/jce.15371

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PubMed

記述言語：英語   出版者・発行元：(一社)日本動脈硬化学会  

左冠動脈の狭窄病変に対してステント留置術を施行した患者112例(男性86例、女性26例)を対象に、ベアメタルステントまたは第2世代薬剤溶出性ステントの留置が冠動脈内皮機能障害に及ぼす影響を比較した。対象はコレステロール吸収阻害薬による冠動脈ステント標的血管の機能改善効果(CuVIC)試験に登録された患者で、標的血管不全を呈した症例は除外した。患者を留置ステントに応じて、ベアメタルステント(BMS)群53例(男性87%、平均64±11歳)と第2世代薬剤溶出性ステント(DES)群59例(男性68%、平均67±9歳)の2群に分類した。患者背景に有意な群間差はなかった。アセチルコリン負荷下でステント留置した標的血管と非標的血管における攣縮性を比較したところ、BMS群は標的血管(50±18%)の方が非標的血管(42±20%)より冠攣縮が有意に高かったが(P=0.002)、DES群で有意差はなかった。大動脈および冠静脈洞で採血した末梢血単核球のRho kinase活性はBMS群とDES群の間に有意差はなかった。BMS群で標的血管における冠攣縮の関連因子として、晩期内腔損失と冠症候群の既往が同定された。

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   出版者・発行元：PLoS ONE  

Background Pulmonary vein isolation (PVI) is an established ablation procedure for atrial fibrillation (AF), however, PVI alone is insufficient to suppress AF recurrence. Non-pulmonary vein (non-PV) trigger ablation is one of the promising strategies beyond PVI and has been shown to be effective in refractory/persistent AF cases. To make non-PV trigger ablation more standardized, it is essential to develop a simple method to localize the origin of non-PV triggers. Methods We retrospectively analyzed 37 non-PV triggers in 751 ablation sessions for symptomatic AF from January 2017 to December 2020. Regarding non-PV triggers, intra-atrial activation interval from the earliest in right atrium (RA) to proximal coronary sinus (CS) (RA-CSp) and that from the earliest in RA to distal CS (RA-CSd) obtained by a basically-positioned duodecapolar RA-CS catheter were compared among 3 originating non-PV areas [RA, atrial septum (SEP) and left atrium (LA)]. Results RA-CSp of RA non-PV trigger (56.4 ± 23.4 ms) was significantly longer than that of SEP non-PV (14.8 ± 25.6 ms, p = 0.019) and LA non-PV (-24.9 ± 27.9 ms, p = 0.0004). RA-CSd of RA non-PV (75.9 ± 32.1 ms) was significantly longer than that of SEP non-PV (34.2 ± 32.6 ms, p = 0.040) and LA non-PV (-13.3 ± 41.2 ms, p = 0.0008). RA-CSp and RA-CSd of SEP non-PV were significantly longer than those of LA non-PV (p = 0.022 and p = 0.016, respectively). Sensitivity and specificity of an algorithm to differentiate the area of non-PV trigger using RA-CSp (cut-off value: 50 ms) and RA-CSd (cut-off value: 0 ms) were 88% and 97% for RA non-PV, 81% and 73% for SEP non-PV, 65% and 95% for LA non-PV, respectively. Conclusions The analysis of intra-atrial activation sequences was useful to differentiate non-PV trigger areas. A simple algorithm to localize the area of non-PV trigger would be helpful to identify non-PV trigger sites in AF ablation.

DOI： 10.1371/journal.pone.0264894

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PubMed

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：一般社団法人 日本動脈硬化学会  

Aims: Previous studies suggested that implantation with a 1st-generation DES was associated with coronary endothelial dysfunction, which was associated with Rho-kinase activation. Second-generation drug-eluting stents (DESs) may preserve coronary endothelial function in stented coronary arteries; however, because of method-ological limitations, further study is needed to clarify the association between 2nd-generation DESs and coronary endothelial dysfunction. Methods: We retrospectively analysed the CuVIC trial database, where we identified 112 patients who under-went coronary stenting in the left coronary arteries with either a bare metal stent (BMS, n=53) or 2nd-generation DES (n =59). We compared vasomotions of target vessels with stents and non-target vessels without stents. Fur-thermore, we measured the Rho-kinase activation detected in mononucleocytes from aortic and coronary sinus blood. Results: ACh-induced vasoconstrictive responses of target vessels were not enhanced with a 2nd-generation DES (45±21% vs. 44±20%, P=0.56, paired t-test), but significantly enhanced in the coronary arteries with a BMS (50±18% vs. 42±20%, P =0.002). Rho-kinase activation did not differ between patients with a BMS and 2nd-generation DES. In the target vessels with a BMS, large late lumen loss and acute coronary syndrome (ACS) at the index percutaneous coronary intervention (PCI) were associated with ACh-induced enhanced coronary vaso-constrictive responses. Conclusions: Evaluation of ACh-induced vasomotion of target vessels comparing with non-target vessels revealed that 2nd-generation DESs were not associated with coronary endothelial dysfunction in target vessels, nor activation of Rho-kinase in the coronary sinus blood 6-8 months after stenting.

DOI： 10.5551/jat.61366

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CiNii Research

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1038/s41598-019-48669-1

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1161/ATVBAHA.117.309301

記述言語：英語   掲載種別：研究論文（学術雑誌）  

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1161/ATVBAHA.116.308388

記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1093/ajh/hpu196

開催年月日： 2023年3月

記述言語：日本語  

国名：日本国  

開催年月日： 2023年3月

記述言語：日本語  

国名：日本国  

開催年月日： 2023年1月 - 2022年1月

記述言語：日本語  

国名：日本国  

開催年月日： 2022年1月

記述言語：日本語  

国名：日本国  

開催年月日： 2022年1月

記述言語：日本語  

国名：日本国  

開催年月日： 2021年7月

記述言語：日本語  

国名：日本国  

開催年月日： 2021年7月

記述言語：日本語  

国名：日本国  

開催年月日： 2021年4月

記述言語：日本語  

国名：日本国  

開催年月日： 2021年4月

記述言語：日本語  

国名：日本国  

記述言語：英語  

記述言語：英語  

記述言語：英語  

記述言語：英語