記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: In the modern US cardiovascular intensive care unit (CICU), the incidence of non-cardiovascular disorders has increased and non-cardiovascular disorders are associated with an increase in morbidity and mortality. In Japan, however, data regarding the association between non-cardiovascular disorders and outcomes in the CICU are limited. METHODS: This study examined 490 consecutive admissions to a closed CICU at the Nippon Medical School Hospital from January to December 2017. Characteristics, diagnoses, treatments, and outcomes of admitted patients were identified. RESULTS: The most common primary diagnosis was acute coronary syndrome (50.4%), followed by acute heart failure (20.0%), arrhythmia (6.7%), and non-cardiovascular diseases (3.7%). The mortality rate and median length of stay (LOS) in the CICU were 4.7% and 4 (interquartile range, 2-8) days, respectively. Of all patients, 42.2% (n = 207) developed non-cardiovascular complications such as acute respiratory failure, acute kidney injury, or sepsis during CICU stay. Multivariate logistic regression analysis revealed that acute respiratory failure and sepsis were significantly associated with mortality in the CICU (odds ratio, 11.014 and 25.678, respectively; both p<0.05). The multiple linear regression analysis showed that acute kidney injury was significantly associated with LOS in the CICU (β=0.144, p = 0.002). CONCLUSIONS: Approximately half of patients admitted to the CICU had non-cardiovascular disorders including non-cardiovascular disease and non-cardiovascular complications, which were significantly associated with mortality and LOS in the CICU.

DOI： 10.1016/j.jjcc.2021.03.002

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Patients admitted on weekends have higher mortality than those admitted on weekdays. However, whether the "weekend effect" results in a higher mortality after admission for acute aortic dissection (AAD),-classified according to Stanford types-remains unclear. This study aimed to examine the association between admission day and in-hospital mortality in AAD Type A and B. METHODS: We used data from the Japanese registry of all Cardiac and Vascular Diseases Diagnostic Procedure Combination, a nationwide claim-based database with data from 953 certified hospitals, and enrolled in-patients with AAD admitted between April 1, 2012, and March 31, 2016. Based on the admission day, we stratified patients into groups (Weekdays, Saturdays, and Sundays/holidays). The influence of the admission day on in-hospital mortality was assessed via multi-level logistic regression analysis. We also performed a Stanford type-based stratified analysis. RESULTS: Among the included 25,641 patients, in-hospital mortality was 16.0%. The prevalence of patients admitted with AAD was relatively higher on weekdays. After adjustment for covariates, patients admitted on a Sunday/holiday showed an increased risk of in-hospital mortality (odds ratio [OR] 1.20; 95% confidence interval [CI] 1.07-1.33, p<0.001) than patients admitted on weekdays. Among patients admitted on a Sunday/holiday, only the subgroup of Stanford Type A showed a significantly increased risk of in-hospital mortality. (Stanford Type A, non-surgery vs. surgery groups: 95% CI 1.06-1.48 vs. 1.17-1.68, p<0.001 for both groups, OR 1.25 vs. 1.41, respectively, Stanford Type B, non-surgery vs. surgery groups: 95% CI 0.64-1.09 vs. 0.40-2.10; p = 0.182 vs. 0.846; OR 0.84 vs. 0.92). CONCLUSIONS: In conclusion, patients with AAD Type A admitted on a Sunday/holiday may have an increased in-hospital mortality risk.

DOI： 10.1371/journal.pone.0260152

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

In the present study, we investigated the role of Nrf2 in airway immune responses induced by diesel exhaust (DE) inhalation in mice. C57BL/6J Nrf2+/+ and Nrf2-/- mice were exposed to DE or clean air for 8 h/day and 6 days/week for 4 weeks. After DE exposure, the number of neutrophils and macrophage inflammatory protein (MIP)-2 level in bronchoalveolar lavage fluid (BALF) and interleukin (IL)-17 level in the lung tissue increased in Nrf2-/- mice compared with Nrf2+/+ mice; however, the lack of an increase in the level of tumor necrosis factor (TNF)-α in the lung tissue in Nrf2+/+ mice and mild suppression of the level of TNF-α in Nrf2-/- mice were observed; the level of granulocyte macrophage colony-stimulating factor (GM-CSF) in the lung tissue decreased in Nrf2-/- mice than in Nrf2+/+ mice; the number of DE particle-laden alveolar macrophages in BALF were larger in Nrf2-/- mice than in Nrf2+/+ mice. The results of electron microscope observations showed alveolar type II cell injury and degeneration of the lamellar body after DE exposure in Nrf2-/- mice. Antioxidant enzyme NAD(P)H quinone dehydrogenase (NQO)1 mRNA expression level was higher in Nrf2+/+ mice than in Nrf2-/- mice after DE exposure. Our results suggested that Nrf2 reduces the risk of pulmonary disease via modulating the airway innate immune response caused by DE in mice.

DOI： 10.3390/biomedicines8100443

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Existing studies have yielded conflicting results regarding the relationship between the time of occurrence of out-of-hospital cardiac arrests and the associated outcomes. We examined whether the one-month survival rate for out-of-hospital cardiac arrests differed depending on whether the cardiac arrest occurred during the day or night. Further, we examined whether this rate differed when comparing the period succeeding the 2005 International Resuscitation Guidelines (2006-2010) with that following the 2010 guidelines (2011-2015). METHOD: Using data from the All-Japan Utstein Registry for 2006-2015, adult out-of-hospital cardiac arrest patients whose collapse was witnessed and for whom the collapse-to-hospital-arrival interval was shorter than 120 min were included in this study. Patients were categorized in terms of whether their arrest occurred during the post-2005- or post-2010-guideline period. The primary measure was the one-month survival with a favorable neurological outcome. RESULTS: Of 481,624 cases analyzed, 20% occurred at night. For both guideline periods, nighttime out-of-hospital cardiac arrests were associated with significantly lower one-month survival rates than daytime incidents (used as a reference; adjusted odds ratio: 0.69 and 0.63, 95% confidence interval: 0.65-0.73 and 0.60-0.65, and P < 0.001 and <0.001 for the 2005 and 2010 guideline periods, respectively). CONCLUSIONS: One-month survival with a favorable neurological outcome was significantly lower for patients who experienced nighttime out-of-hospital cardiac arrests, compared to daytime out-of-hospital cardiac arrests. This could be addressed by improving cardiopulmonary resuscitation training for bystanders and expanding and improving nighttime emergency medical services.

DOI： 10.1016/j.ijcard.2020.09.043

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The cardio-ankle vascular index (CAVI) has been proposed as a useful parameter for arteriosclerotic diseases. However, whether it is associated with stroke risk in Japanese subjects remains unclear. METHODS: In total, 280 Japanese subjects (92 females, 52.6 ± 5 years old) underwent a medical check-up. CAVI value and risk factors for arterial dysfunction were evaluated; the predicted 10-year stroke risk was measured by the Japan Public Health Center study. RESULTS: Age, sex, body mass index, and systolic blood pressure were significant independent predictors of CAVI. CAVI values were significantly elevated in the high, compared with the medium-low and low predicted risk groups. A significant odds ratio (OR) for the high-risk group was noted in the highest quartile of CAVI values (OR, 14.67; 95% confidence interval [CI], 3.17-68.0), compared with the lowest quartile, after adjusting for potential confounders. A significant OR for very high predicted stroke risk was also found for each quartile increase (OR, 3.04; 95% CI, 1.87-4.94) and 1-standard deviation increase (OR, 2.24; 95% CI, 1.52-3.30) in CAVI value. CONCLUSION: Elevated CAVI values were related to an elevated predicted stroke risk, suggesting that CAVI could be a suitable surrogate marker for finding subjects at an increased risk of first-ever stroke.

DOI： 10.1016/j.jns.2020.116862

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIMS: Prediabetes is a precursor of diabetes and increases the risk of cardiovascular disease. Individuals with prediabetes reportedly have higher C-reactive protein levels, which is a risk factor for diabetes, relative to individuals with normal glucose regulation. Inflammation may play a role in the very early-phase deterioration of glucose metabolism, although there is insufficient knowledge regarding this relationship. Thus, we examined the association between serum C-reactive protein level and the development of three prediabetes markers. METHODS: This study included 743 subjects with normal glucose regulation at baseline who completed oral glucose tolerance tests at baseline and after approximately 5 years. Subjects with a history of cardiovascular disease were excluded. RESULTS: During the 5-year follow-up, 55 subjects developed isolated impaired glucose tolerance (IGT; 2h-plasma glucose levels of 7.8-11.0 mmol/L), 24 subjects developed isolated impaired fasting glucose (IFG; fasting plasma glucose levels of 6.1-7.0 mmol/L), 3 subjects developed IFG plus IGT, and 53 subjects developed isolated elevated glycated hemoglobin levels (HbA1c; level of 41-47 mmol/mol). The multivariate analysis revealed that, relative to the lowest quartile, the highest serum C-reactive protein quartile was independently associated with an increased risk of developing isolated elevated HbA1c levels (odds ratio: 2.95, 95% confidence interval: 1.16-7.51, P=0.024) and marginally associated with an increased risk of developing impaired glucose tolerance plus diabetes. However, C-reactive protein levels were not associated with an increased risk of developing IFG. CONCLUSIONS: Elevated serum C-reactive protein levels independently predicted elevated HbA1c levels, but not IFG.

DOI： 10.1055/a-0869-7584

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: Prediabetes is a precursor of diabetes and increases the risk for cardiovascular disease. A high C-reactive protein (CRP) level is a risk factor for diabetes, and individuals with prediabetes have higher CRP levels than those with normal glucose tolerance. In addition, systemic inflammation may play a role in the early-phase deterioration of glucose metabolism. We examined the association between serum CRP levels and prediabetes. METHODS: Overall, 4,101 subjects without diabetes underwent oral glucose tolerance tests. Levels of serum CRP were divided into quartiles; the lowest quartile was used as the reference when calculating odds ratios (ORs) and confidence intervals. Isolated fasting glucose, isolated glucose tolerance and elevated glycated hemoglobin levels (i.e. between 42 and 47 mmol/mol [6.0% to 6.4%]) were indicative of prediabetes. RESULTS: In the multiple logistic regression analysis, the ORs (95% confidence intervals) for impaired glucose tolerance, impaired fasting glucose and elevated glycated hemoglobin levels corresponding to the highest quartile of CRP levels were 1.67 (1.31 to 2.14); 1.62 (1.15 to 2.28); and 1.47 (1.14 to 1.90), respectively. In the stratified analysis, the ORs for impaired glucose tolerance were consistently higher in the uppermost quartile than in the reference quartile in both the presence and absence of hypertension or dyslipidemia. In contrast, the ORs for impaired fasting glucose in the uppermost quartile were higher only in the presence of hypertension and dyslipidemia, and the OR for elevated glycated hemoglobin levels in the uppermost quartile was higher only in the presence of hypertension. CONCLUSIONS: Elevated serum CRP levels are associated with prediabetes, particularly impaired glucose tolerance.

DOI： 10.1016/j.jcjd.2018.03.007

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Objective- Although postprandial hypertriglyceridemia can be a risk factor for coronary artery disease, the extent of its significance remains unknown. This study aimed to investigate the correlation between the postprandial lipid profiles rigorously estimated with the meal tolerance test and the presence of lipid-rich plaque, such as thin-cap fibroatheroma (TCFA), in the nonculprit lesion. Approach and Results- A total of 30 patients with stable coronary artery disease who underwent a multivessel examination using optical coherence tomography during catheter intervention for the culprit lesion were enrolled. Patients were divided into 2 groups: patients with TCFA (fibrous cap thickness ≤65 µm) in the nonculprit lesion and those without TCFA. Serum remnant-like particle-cholesterol and ApoB-48 (apolipoprotein B-48) levels were measured during the meal tolerance test. The value of remnant-like particle-cholesterol was significantly greater in the TCFA group than in the non-TCFA group ( P=0.045). Although the baseline ApoB-48 level was similar, the increase in the ApoB-48 level was significantly higher in the TCFA group than in the non-TCFA group ( P=0.028). In addition, the baseline apolipoprotein C-III levels was significantly greater in the TCFA group ( P=0.003). These indexes were independent predictors of the presence of TCFA (ΔApoB-48: odds ratio, 1.608; 95% confidence interval, 1.040-2.486; P=0.032; apolipoprotein C-III: odds ratio, 2.581; 95% confidence interval, 1.177-5.661; P=0.018). Conclusions- Postprandial hyperchylomicronemia correlates with the presence of TCFA in the nonculprit lesion and may be a residual risk factor for coronary artery disease.

DOI： 10.1161/ATVBAHA.118.311245

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

INTRODUCTION: Although reduction in the incidence of nocturnal hypoglycemia, as estimated by symptom or self-monitored plasma glucose, was shown to be more pronounced with 300 units/mL insulin glargine (Gla-300) than with 100 units/mL insulin glargine (Gla-100) in type 2 diabetes patients, the exact frequency of nocturnal hypoglycemia estimated with continuous glucose monitoring (CGM) has not been reported. METHODS: Forty patients with type 2 diabetes who were admitted for glycemic control with basal-bolus insulin therapy (BBT) were randomized into the Gla-100 and Gla-300 groups. Insulin doses were adjusted to maintain blood glucose levels within 100-120 mg/dL at each meal. Plasma glucose and C-peptide profiles were estimated serially after admission and before discharge. Daily CGM was also performed before discharge. RESULTS: In the Gla-100 and Gla-300 groups, the mean duration of hospitalization was 15 ± 2 and 15 ± 1 days, respectively, and the mean basal insulin dose before discharge was 13 ± 7 and 15 ± 10 units, respectively. The dose of meal-time insulin was not different between the two groups. Compared with the Gla-300 group, the Gla-100 group had significantly lower nocturnal profiles of plasma glucose and C-peptide, but significantly higher frequency of CGM-estimated nocturnal hypoglycemia (10.7% ± 18.4% versus 1.2% ± 3.6%, P = 0.033). CONCLUSION: In type 2 diabetic patients, reduction in the incidence of CGM-estimated nocturnal hypoglycemia by BBT under tightly controlled diet therapy was higher with Gla-300 than with Gla-100. TRIAL REGISTRATION: UMIN clinical trials registry (UMIN000023360).

DOI： 10.1007/s13300-018-0419-z

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記述言語：英語   出版者・発行元：(一社)日本動脈硬化学会  

2型糖尿病患者を対象に、血糖値(PG)とカイロミクロン(CM)の食後代謝の関係を評価した。血糖コントロールのため入院した2型糖尿病患者32例を、インスリン療法単独群(Ins群)16例またはインスリン療法+ビルダグリプチン100mg群(InsV群)16例に無作為に割り付けた。インスリン量は正常血糖値を維持できるように調整した。その結果、血清トリグリセリド(TG)およびレムナントリポ蛋白質コレステロール(RemL-C)の日中プロファイルは入院時と比較して退院前に有意な減少を示した。しかし、両群とも血清アポリポ蛋白質B48(ApoB48)値の有意な変化は観察されなかった。退院時の日中血糖値変動プロファイル、また空腹時からピーク時迄の血清ApoB48値の日中プロファイル変化は、InsV群がIns群よりも有意に小さかった。Ins群において、血清ApoB48値の増分は持続的血糖値モニタリング(CGM)データを用いて算出した平均血糖変動幅と有意に相関した(R2=0.5242,P<0.001)。短期血糖コントロールは血清TGおよびRemL-C値を減少させたが、ApoB48値は減少しなかった。また、PGおよびCMの食後代謝はGLP-1作用以外の同じメカニズムにより制御される可能性が示唆された。

DOI： 10.5551/jat.32409

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J04692&link_issn=&doc_id=20170321310007&doc_link_id=130005306527&url=http%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130005306527&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：John Wiley and Sons Inc.  

BACKGROUND: Left ventricular (LV) diastolic dysfunction depends on an impaired relaxation and stiffness. Abnormal LV relaxation contributes to the development of atrial fibrillation (AF), but the role of LV stiffness in AF remains unclear. HYPOTHESIS: Diastolic wall strain (DWS), a load-independent, noninvasive direct measure of LV stiffness, correlates with prevalent AF. METHODS: This study included 328 consecutive subjects with structurally normal hearts: 164 paroxysmal AF patients and 164 age- and sex-matched (1:1) controls. We calculated the DWS from the M-mode echocardiographic measurements of the LV posterior wall thickness at end-systole and end-diastole during sinus rhythm. RESULTS: The DWS was lower in the AF patients (0.35 ± 0.07) than in the controls (0.41 ± 0.06; P < 0.001). After adjusting for the risk factors of AF using a conditional logistic regression analysis, a history of hypertension, plasma brain-type natriuretic peptide level, and DWS were independently associated with AF prevalence, whereas body mass index, LV mass index, left atrial volume, and any conventional indices of the diastolic function were not. A low DWS (<0.380) was the strongest indicator of AF (odds ratio: 6.22, 95% confidence interval: 3.08-14.2, P < 0.001). CONCLUSIONS: Increased LV stiffness estimated by DWS was a strong determinant of the prevalence of AF. LV stiffness may play a role in the pathogenesis of paroxysmal AF in structurally normal hearts.

DOI： 10.1002/clc.22595

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記述言語：英語   出版者・発行元：Blackwell Publishing  

Contrast media are considered to cause acute kidney injury by activating various factors that induce renal vasoconstriction. We analysed the renal microvascular haemodynamic response using the Doppler flow wire method. Then changes in urinary liver-type fatty acid-binding protein levels following contrast medium administration were compared between groups with or without a micro-injury of the kidney. In the group without renal micro-injury, the average peak velocity (APV) decreased significantly, whereas the renal artery resistance index (RI) increased significantly following contrast medium administration. In contrast, there was no significant change in either the APV or RI in the group with a renal micro-injury. A blunted microvascular response was found in the micro-injury group, whereas microvascular resistance increased in the non-micro-injury group.

DOI： 10.1111/1440-1681.12653

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC  

Although an association has been reported between the microvascular complications of diabetic patients and their poor prognosis after cardiovascular events related to advanced atherosclerosis, it is not clear whether there is a relation between diabetic retinopathy (DR) and the severity of plaque vulnerability. Fifty-seven diabetic patients with coronary artery disease, classified as non-DR (n = 42) or DR (n = 15), underwent angioscopic observation of at least 1 entire coronary artery. The number of yellow plaques (NYP) through the observed coronary artery was counted and their color grades, defined as 1 (light yellow), 2 (yellow), or 3 (intense yellow), were evaluated. The NYP per vessel and the maximum yellow grade were determined. The association between the presence of DR and incidences of acute coronary syndrome (ACS) was analyzed during the follow-up period (mean 7.1 ± 3.3 years; range, 0.83 to 11.75 years). Mean NYP per vessel and maximum yellow grade were significantly greater in DR than in non-DR patients (2.08 ± 1.01 vs 1.26 ± 0.77, p = 0.002, and 2.40 ± 0.74 vs 1.90 ± 0.82, p = 0.044, respectively). The cumulative incidences of ACS were higher in the DR group (p = 0.004), and the age-adjusted hazard ratio for ACS was 6.943 (95% CI 1.267 to 38.054; p = 0.026) for DR compared with non-DR patients. Our findings indicate that coronary atherosclerosis and plaque vulnerability are more severe in patients with DR. DR as a microvascular complication may be directly linked with macrovascular plaque vulnerability and fatal cardiovascular events such as ACS.

DOI： 10.1016/j.amjcard.2016.06.060

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記述言語：英語   出版者・発行元：(一社)日本動脈硬化学会  

2008年に日本の精密機器企業で定期健診を受けた社員20909名のうち、日本動脈硬化学会ガイドライン2012に基づいて低リスク群に分類された17023名(男性14352名、平均37.8±8.6歳)の血清non-HDLコレステロール(non-HDLC)を解析し、最適な管理目標値を提案した。解析の結果、LDLコレステロール(LDLC)値とnon-HDLC値の間に強い相関が認められた(r=0.95、p<0.001)。線形回帰分析の結果、non-HDLCを算出するための回帰式は、non-HDLC(mg/dL)=1.09×LDLC(mg/dL)+7.79で表すことができ、この回帰式によると、LDLC値(160mg/dL)と対応するnon-HDLC値の最適な管理目標値は180mg/dLであった。多重ロジスティック回帰分析により、年齢、肥満、習慣的アルコール摂取、現在の喫煙はnon-HDLC≧180mg/dLと有意に関連していることが明らかになった。低リスク日本人労働者におけるnon-HDLCの管理目標値は、LDLC値よりも20mg/dL高い値(即ち180mg/dL)に設定することが推奨される。

DOI： 10.5551/jat.33068

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J04692&link_issn=&doc_id=20160610300009&doc_link_id=10.5551%2Fjat.33068&url=https%3A%2F%2Fdoi.org%2F10.5551%2Fjat.33068&type=Crossref&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00002_2.gif

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

BACKGROUND: Hypertension is one of the main comorbidities associated with dyslipidemia. This study aimed to examine the extent to which dyslipidemia increases the risk of developing hypertension in a Japanese working-age male population. METHODS AND RESULTS: We analyzed data from 14 215 nonhypertensive male workers (age 38±9 years) who underwent annual medical checkups. Subjects were followed up for a median of 4 years to determine new-onset hypertension, defined as blood pressure (BP) ≥140/90 mm Hg or use of antihypertensive medication. The associations between serum lipid levels and development of hypertension were examined. During the follow-up period, 1483 subjects developed hypertension. After adjusting for age, body mass index, impaired fasting glucose/diabetes, baseline BP category, alcohol intake, smoking, exercise, and parental history of hypertension, subjects with a total cholesterol (TC) level ≥222 mg/dL were at a significantly increased risk of developing hypertension (hazard ratio: 1.28; 95% CI: 1.06-1.56) compared to subjects with a TC level ≤167 mg/dL. Similar results were observed for subjects with high low-density lipoprotein cholesterol (LDLC) and non-high-density lipoprotein cholesterol (HDLC) levels. A U-shaped relationship was found between HDLC level and risk of hypertension; compared to the third quintile, the multiadjusted hazard ratio was 1.22 (95% CI: 1.03-1.43) in the lowest quintile and 1.34 (95% CI: 1.12-1.60) in the highest quintile. CONCLUSIONS: Elevated serum levels of TC, LDLC, and non-HDLC were associated with an increased risk of hypertension in working-age Japanese men. For HDLC, risk of hypertension was increased at both low and high levels.

DOI： 10.1161/JAHA.115.003053

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DOI： 10.1016/j.amjcard.2015.07.004

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Nature Publishing Group  

労働年齢の日本人男性における高血圧発症に関する簡便かつ実用的なリスク予測モデルの開発を試みた。会社で定期健診を受けた日本人男性労働者15025名(平均38.8±8.9歳)に対して、中央値4.0年間のフォローアップを実施した。参加者をderivation cohort(12020名)とvalidation cohort(3005名)に分けた。derivation cohortでは、多変量コックス比例ハザード分析により、年齢、BMI、収縮期/拡張期血圧、喫煙状態、過度の飲酒、高血圧の家族歴が高血圧発症の独立予測因子であることが示された。これらの変数を用いて、高血圧発症の4年リスクを推定するリスク予測モデルを構築した。validation cohortでは、本リスク予測モデルのC統計量は0.861、modified Hosmer-Lemeshow χ2統計量は15.2であり、高い識別能と許容可能な較正を示した。約4年間の高血圧発生率を簡単に算出できるリスクスコアシートを作成した。

DOI： 10.1038/hr.2014.159

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J04682&link_issn=&doc_id=20150608230009&doc_link_id=10.1038%2Fhr.2014.159&url=https%3A%2F%2Fdoi.org%2F10.1038%2Fhr.2014.159&type=Crossref&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00002_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier Ireland Ltd  

Background: We aimed to examine whether serum levels of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase, and C-reactive protein (CRP) are associated with the risk of developing metabolic syndrome in middle-aged men. Methods: In this longitudinal study, serum ADMA and CRP levels were measured in Japanese men without metabolic syndrome, which was diagnosed according to the currently accepted unified criteria. The subjects were followed-up for a maximum of four years to determine new-onset metabolic syndrome. A Cox proportional hazards model with adjusting for potential confounders was applied to determine the hazard ratio (HR) for developing metabolic syndrome according to serum levels of ADMA and CRP, considered either alone or in combination. Results: Of the 848 subjects (mean age, 43. ±. 6. years), 100 subjects developed metabolic syndrome. High ADMA levels (≥. 0.45. μmol/L) alone did not show a significant HR for developing metabolic syndrome, while high CRP levels (≥. 0.3. mg/L) did (HR 1.75, 95% CI 1.12-2.74). The combination of high levels of both CRP and ADMA had a high HR (2.09, 95% CI 1.12-3.76) as compared to low levels of both markers. In contrast, the HR was not significant in the combination of high CRP and low ADMA levels, as well as low CRP and high ADMA levels. Conclusions: Serum CRP, but not ADMA, levels were associated with the risk of metabolic syndrome. Nevertheless, the risk of metabolic syndrome could be predicted more reliably by considering these two markers together rather than CRP alone.

DOI： 10.1016/j.ijcme.2014.10.001

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記述言語：英語   出版者・発行元：(一社)日本内科学会  

スタチン治療歴がなく平均左室駆出率26.0±6.0%の慢性心不全(CHF)患者95名について検討した。単球のTNF-αおよびIL-6の産生は血清LDL-コレステロール値と有意な負相関を示した。中央値66.0ヵ月の追跡期間中に49名が心イベントを発症した(心臓死21名、CHF悪化による再入院28名)。多変量Coxハザード解析にて、末梢血単核細胞(PBMC)10^6個あたり単球TNF-α値≧4.9pg/mLおよびLDL-コレステロール値<120mg/dLが心イベント発生と独立して関係していた。

DOI： 10.2169/internalmedicine.53.2672

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J04675&link_issn=&doc_id=20150119380002&doc_link_id=130004704951&url=http%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130004704951&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：OXFORD UNIV PRESS  

BACKGROUND: The aim of this study was to examine the predictive value of serum cystatin C (CysC) and that of creatinine-based estimated glomerular filtration rate (eGFRCreat) for the risk of incident hypertension in a middle-aged male population. METHODS: Serum CysC levels were measured in 904 nonhypertensive, Japanese male subjects (mean age = 44±6 years) who received an annual general health examination in a company. Serum creatinine levels were simultaneously measured, and eGFRCreat was calculated. Subjects were followed-up for a maximum period of 4 years, and annual blood pressure measurements were recorded. RESULTS: During the follow-up period, 124 subjects developed hypertension, defined as systolic/diastolic blood pressure ≥140/90 mmHg or use of antihypertensive medications. In the Kaplan-Meier analysis, both the third quintile of CysC and that of eGFRCreat showed the lowest 4-year cumulative incident rate of hypertension. The multiadjusted hazard ratio for incident hypertension was significantly increased in the highest quintile of CysC compared with the third quintile (2.60; 95% confidence interval (CI) = 1.41-4.77; P = 0.002), as well as compared with the lowest 4 quintiles combined (1.89; 95% CI = 1.26-2.84; P = 0.002). However, eGFRCreat did not show significant hazard ratios for incident hypertension in any of the adjusted models. CONCLUSIONS: Elevated serum CysC levels could predict the risk of incident hypertension in this study population with a maximum follow-up period of 4 years. In contrast, eGFRCreat did not show predictive value for the risk of incident hypertension.

DOI： 10.1093/ajh/hpt164

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

AimsElevated post-load plasma glucose levels may increase the risk of cardiovascular disease, even when they are within the normoglycaemic range. We examined the association of carotid artery intima-media thickness, a marker of early atherosclerosis, with glycaemic variables, including post-load plasma glucose levels, in Japanese subjects with normal glucose tolerance.
MethodsThe study participants were 663 Japanese subjects with normal glucose tolerance (565 men, mean age 479years) who underwent both a 75-g oral glucose tolerance test and carotid artery intima-media thickness measurement by B-mode ultrasonography during a health examination. Associations between maximal common carotid artery intima-media thickness and fasting plasma glucose, 1-h and 2-h plasma glucose during an oral glucose tolerance test, and HbA(1c) were examined.
ResultsThe carotid artery intima-media thickness gradually increased across the tertiles of 1-h plasma glucose, 2-h plasma glucose and HbA(1c). In multiple linear regression analysis, 2-h plasma glucose (=0.09, P=0.012), as well as age, male gender, hypertension, dyslipidaemia, and current smoking were independent determinants of carotid artery intima-media thickness. In contrast, other glycaemic variables were not independent determinants of carotid artery intima-media thickness. The carotid artery intima-media thickness in hypertensive subjects with the highest tertile of 2-h plasma glucose [0.70 (95%CI 0.64-0.76) mm] was significantly greater than in normotensive subjects, with the lowest tertile of 2-h plasma glucose [0.60 (95%CI 0.58-0.63) mm, P=0.037], even after adjusting for the multiple potential confounders.
ConclusionsThe 2-h plasma glucose during an oral glucose tolerance test was positively and independently associated with carotid artery intima-media thickness in Japanese subjects with normal glucose tolerance. In particular, the combination of elevated 2-h plasma glucose and hypertension may contribute to an increased carotid artery intima-media thickness.

DOI： 10.1111/dme.12288

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掲載種別：研究論文（学術雑誌）  

Background: Excess salt intake increases blood pressure (BP). Identifying individuals with excess salt intake is, therefore, important for the prevention of hypertension. Aim: To examine the predictive value of subjective evaluation of salty foods intake for the risk of incident hypertension in a middle-aged population. Methods: A total of 970 non-hypertensive workers (mean age, 44 ± 6 years) was followed for a maximum period of 4 years, and their BP was measured annually. At baseline, all participants were asked about their subjective frequency of salty foods intake (seldom, sometimes or always), and they were divided into three groups according to their answers. Hypertension was defined as systolic/diastolic BP ≥ 140/90mmHg or use of antihypertensive medications. Results: There were no significant differences in the 4-year cumulative incident rate of hypertension among the 'seldom', 'sometimes' and 'always' groups (15.8%, 14.3% and 10.3%, respectively, log-rank test P = 0.44). In a multivariate Cox proportional hazards model, age, body mass index and the baseline BP category were independent predictors for developing hypertension, whereas the frequency of salty foods intake was not a predictor (adjusted hazard ratio (95% confidence interval), 0.99 (0.64-1.54) in the 'sometimes' group and 0.64 (0.33-1.28) in the 'always' group as compared with the 'seldom' group). Conclusion: The subjective evaluation of salty foods intake did not predict the 4-year risk of incident hypertension in this study population. Further investigations with a longer follow-up period are needed to clarify whether the present insignificant results are maintained for more than 4 years. © 2013 Royal Australasian College of Physicians.

DOI： 10.1111/imj.12259

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記述言語：英語   出版者・発行元：Nature Publishing Group  

心血管疾患の既往のない中年男性387例(平均38±9歳)を対象に、健康診断中に振動測定法を用いて上腕動脈の絶対的体積変化を評価し、拡張末期の上腕動脈の推定面積(eA)を算出した。同様の方法で、血管硬化度の指標として、上腕動脈容積弾性率(VE)と上腕-足関節脈波伝播速度(baPWV)を評価し、eAと心血管リスク因子(年齢、肥満、高血圧、脂質異常症、空腹時血糖異常/糖尿病、高尿酸血症、喫煙、関連する連続変数)、VE、baPWVの関連を評価した。平均eAは12.9±2.9mm2で、肥満、高血圧、空腹時血糖異常/糖尿病では、eAが有意に高値であった。多重回帰分析において、BMI、年齢、収縮期血圧、脈拍数は、eAの独立した決定因子であったが、VEまたはbaPWVはeAの決定因子ではなかった。以上から、上腕動脈横断面積の拡大は、年齢、BMI、収縮期血圧などの心血管リスク因子と有意に相関するが、血管硬化度の増進とは関連しないことが示された。

DOI： 10.1038/hr.2013.56

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J04682&link_issn=&doc_id=20140617160014&doc_link_id=10.1038%2Fhr.2013.56&url=https%3A%2F%2Fdoi.org%2F10.1038%2Fhr.2013.56&type=Crossref&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00002_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

DOI： 10.1016/j.jacc.2013.01.097

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記述言語：英語   出版者・発行元：(一社)日本衛生学会  

塩辛い食品の摂取頻度に関する主観評価と、尿中ナトリウム排泄および血圧(BP)の両方との関連性について検討した。2011年に、健康診断中の被験者419例(平均年齢37歳、男性385名、女性34名)について、スポット検体における尿中ナトリウム濃度およびクレアチニン濃度と上腕BPを測定した。スポット検体におけるナトリウム濃度およびクレアチニン濃度から、24時間尿中ナトリウム排泄を推定した。主観評価に基づき回答を「めったに」「時々」「いつも」から選択する自記式質問票で、塩辛い食品の摂取頻度について質問を受けた。24時間尿中ナトリウム排泄は1日食塩摂取量へと変換された。2010年の全国健康・栄養調査による日本人の1日平均食塩摂取量よりも多いと定義した高度食塩摂取の比率は、「めったに」(10.3%)、「時々」(13.4%)、「いつも」(24.0%)となった。各群における24時間ナトリウム排泄もまた、異なる傾向を示したが、その差は統計学的に有意な水準には達しなかった。各群において収縮期および拡張期BPはいずれも同等であった。

DOI： 10.1007/s12199-012-0323-5

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J04710&link_issn=&doc_id=20130726320009&doc_link_id=10.1007%2Fs12199-012-0323-5&url=https%3A%2F%2Fdoi.org%2F10.1007%2Fs12199-012-0323-5&type=Crossref&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00002_2.gif

掲載種別：研究論文（学術雑誌）  

Background : The present study examined the reproducibility and accuracy of the measurement of brachial artery cross-sectional area based on a newly developed oscillometric method in two distinct studies. Methods : The Study 1 and Study 2 consisted of 9 healthy subjects (mean age 32±7 years, 7 males) and 29 patients with definitive or suspected coronary heart disease (mean age 64±10 years, 19 males), respectively. In both studies, brachial artery diameter was firstly measured with ultrasonography and then estimated area(eA) of the brachial artery was measured with the new oscillometric device, Health Chronos TM-2771 prototype (A&D Company, Tokyo, Japan). The reproducibility of the 2 consecutive measurements of eA was examined in the Study 1. The correlation between eA and brachial artery diameter by ultrasonography was examined in both studies. Results : In the Study 1, the mean coefficient of variation of eA was 3.6%. A close correlation was found between eA and brachial artery diameter by ultrasonography (r = 0.93, p < 0.001). The regression equation between eA-based brachial artery diameter (X) and brachial artery diameter by ultrasonography (Y) was expressed as Y = 1.05X-0.46. In the Study 2, the correlation coefficient between eA and brachial artery diameter by ultrasonography was 0.75 (p < 0.001). Conclusions : An acceptable reproducibility and accuracy of the oscillometric measurement of eA was observed in healthy subjects. In contrast, the correlation between eA and brachial artery diameter by ultrasonography appeared to be reduced in patients with definitive or suspected coronary heart disease.

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記述言語：英語   出版者・発行元：(一社)日本循環器学会  

血管攣縮性狭心症患者における長期硝酸薬治療投与による影響について調べた。血管攣縮性狭心症患者(すべてアセチルコリン誘発試験陽性)で抗狭心薬を服用してない231例を対象とし、全例にCa拮抗薬投与を開始してから硝酸薬投与群(n=86)、硝酸薬非投与群(n=145)の2群に分けて追跡した(中央値70.5月)。追跡中に心事故が29例(突然死7例、急性冠症候群による入院22例)あった。心事故の頻度は硝酸薬投与群で19.8%、非投与群で8.3%であり(P=0.015)、多変量解析では硝酸薬長期投与は心事故の独立余地因子であった(ハザード比5.18、95%信頼区間1.69-15.89)。すなわち、Ca拮抗物に硝酸薬を併用してもVSA患者の心事故は減少しなかった。

DOI： 10.1253/circj.CJ-11-0056

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2011&ichushi_jid=J04756&link_issn=&doc_id=20110907090028&doc_link_id=10029339744&url=http%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F10029339744&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

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記述言語：日本語   出版者・発行元：(NPO)日本高血圧学会  

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記述言語：英語  

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：OXFORD UNIV PRESS  

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

J-GLOBAL

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記述言語：英語   出版者・発行元：(一社)日本循環器学会  

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記述言語：英語  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本衛生学会  

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記述言語：日本語   出版者・発行元：日本成人病(生活習慣病)学会  

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記述言語：日本語   出版者・発行元：(一社)日本神経学会  

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記述言語：日本語   出版者・発行元：(NPO)日本高血圧学会  

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記述言語：日本語   出版者・発行元：(一社)日本衛生学会  

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記述言語：英語  

J-GLOBAL

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記述言語：英語   出版者・発行元：(一社)日本循環器学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：日本臨床生理学会  

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記述言語：日本語   出版者・発行元：(NPO)日本高血圧学会  

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記述言語：日本語   出版者・発行元：日本公衆衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本循環器病予防学会  

【背景】医療費に占める割合を傷病分類別にみた場合、循環器系疾患が占める割合は他疾患と比較して最も高い。したがって、循環器系疾患の危険因子が集積した病態であるメタボリックシンドローム(MetS)を予防することにより医療費の適正化も期待できると考えられる。本研究では、労働年齢集団におけるMetSの保有や各因子の集積状況がその後の高額医療費、入院発生へ与える影響について検討した。【方法】某精密機器製造企業で平成22年度の定期健康診断を受診し、同社の健康保険組合に継続加入していた社員14,019人(男性12,065人、平均年齢41.1±7.4歳)を対象とし、計5年間の追跡を行なった。健診結果から対象者を非MetS群とMetS群に分類し、多重ロジスティック回帰分析により高額医療費並びに入院発生リスクの検討を行なった。高額医療費の定義は、5年間の1人当たり合計医療費が600,000円以上、対象集団の上位10%以内、上位5%以内の3通りを設定した。更に、MetSの診断基準に基づき対象者を肥満(腹部肥満)の有無とその他の診断基準項目の個数(0個、1個、2個以上)により層別化して分類し同様のリスク分析を行なった。加えて、集団寄与危険割合に準拠して、危険因子が寄与している過剰医療費の推定を行なった。【結果】非MetS群とMetS群を比較すると、MetS群において5年間の1人当たり合計医療費が600,000円以上となるリスクは有意に上昇し(オッズ比[OR]1.91、95%信頼区間[CI]1.55-2.35)、同様に上位10%以内、上位5%以内となるリスクも有意に上昇した。一方、入院発生リスクは有意な上昇を認めなかった(OR1.20、95%CI0.93-1.56)。また、いずれの定義においても高額医療費発生リスクは肥満の有無に関わらずMetS診断基準項目数の増加とともに上昇したが、そのリスクは肥満がある群でより高かった。入院発生リスクに関しては、肥満がある場合のみ有意な上昇を認めた。総医療費に占める過剰医療費の割合については、高額医療費発生リスクが最大となる「肥満/診断基準項目2個以上」の群(1.2%)よりも、より低リスクの群が占める割合が高かった(非肥満/診断基準1個、1.5%;肥満/診断基準1個、2.5%)。【結語】比較的若年の労働者集団において、MetSの保有は高額医療費発生のリスクを上昇させた。また、MetSの診断基準となる代謝異常の集積は高額医療発生リスクを段階的に上昇させた。一方、過剰医療費割合の分析結果から、医療費の適正化に際しては高リスク群への介入のみならずより低リスクの群に対しても肥満や代謝異常への介入を行なっていくことの重要性が示唆された。(著者抄録)

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記述言語：英語  

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記述言語：英語   出版者・発行元：日本心臓血管内視鏡学会  

症例は85歳女性で、脂質異常症、高血圧症、慢性腎臓病に罹患しており、労作時胸痛を訴え当院に入院となった。患者は2年前に安定狭心症のためステント植込み術を行っており、左前下行枝中部の責任病変をコバルトクロムエベロリムス溶出ステントで治療していた。冠状動脈造影でステント遠位部にステント内再狭窄が認められた。冠動脈内視鏡検査では、再狭窄病変の黄色プラークがステントを完全に覆っているのが確認された。そのため、non-slip element balloonによる治療を行い、stent-in-stentを避けるため薬剤被覆バルーンによる補助的血管形成術を施行した。胸痛は完全に消失し、臨床経過は良好であった。

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J06603&link_issn=&doc_id=20170619250005&doc_link_id=10.15791%2Fangioscopy.cr.16.0009&url=https%3A%2F%2Fdoi.org%2F10.15791%2Fangioscopy.cr.16.0009&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：英語   出版者・発行元：日本心臓血管内視鏡学会  

複数血管の血管内視鏡検査により、BMIと冠動脈硬化度との関連性について検討した。2000年9月〜2007年7月に複数血管の血管内視鏡検査を施行した冠動脈疾患患者89例を、BMIに基づいて過小体重(<20kg/m2)群7例、正常体重(20〜25kg/m2)群40例、過体重(25〜28kg/m2)群27例、肥満(≧28kg/m2)群15例に分けた。観察した冠動脈で認められた黄色プラーク数(NYP)を数え、各プラークの色をグレード1(淡黄色)、グレード2(黄色)、グレード3(濃い黄色)と定義した。1血管あたりのNYPと最大黄色グレード(MYG)を4群間で比較した。その結果、冠動脈硬化度の重症度(NYP、MYG)は有意に異なっていた。多変量回帰分析により、BMIは1血管あたりのNYPと独立して相関していることが明らかになった。過小体重患者の冠動脈硬化は正常および過体重患者よりも進行しており、低BMIは進行性冠動脈硬化と独立して関連していることが示された。

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J06603&link_issn=&doc_id=20170619250004&doc_link_id=10.15791%2Fangioscopy.oa.16.0010&url=https%3A%2F%2Fdoi.org%2F10.15791%2Fangioscopy.oa.16.0010&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：英語   掲載種別：速報，短報，研究ノート等（学術雑誌）   出版者・発行元：WILEY-BLACKWELL  

DOI： 10.1111/1440-1681.12653

Web of Science

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記述言語：日本語   出版者・発行元：日本心臓血管内視鏡学会  

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記述言語：英語   出版者・発行元：(一社)日本心血管インターベンション治療学会  

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記述言語：日本語   出版者・発行元：(一社)日本循環器病予防学会  

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記述言語：英語   出版者・発行元：(一社)日本循環器学会  

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記述言語：英語   出版者・発行元：(一社)日本循環器学会  

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記述言語：英語   出版者・発行元：(一社)日本循環器学会  

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記述言語：日本語   出版者・発行元：(NPO)日本高血圧学会  

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記述言語：英語   出版者・発行元：(NPO)日本高血圧学会  

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記述言語：日本語   出版者・発行元：(一社)日本循環器病予防学会  

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記述言語：英語   出版者・発行元：NATURE PUBLISHING GROUP  

DOI： 10.1038/hr.2015.41

Web of Science

PubMed

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記述言語：日本語   出版者・発行元：(NPO)日本高血圧学会  

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記述言語：日本語   出版者・発行元：(一社)日本糖尿病学会  

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記述言語：日本語   出版者・発行元：日本臨床生理学会  

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J-GLOBAL

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記述言語：日本語   出版者・発行元：日本臨床生理学会  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：EUROPEAN RESPIRATORY SOC JOURNALS LTD  

Web of Science

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記述言語：日本語   出版者・発行元：(一社)日本衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本衛生学会  

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記述言語：日本語   出版者・発行元：(一社)日本糖尿病学会  

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記述言語：日本語   出版者・発行元：(NPO)日本高血圧学会  

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記述言語：日本語   出版者・発行元：(NPO)日本高血圧学会  

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記述言語：日本語   出版者・発行元：(一社)日本循環器病予防学会  

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記述言語：日本語   出版者・発行元：(一社)日本循環器病予防学会  

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記述言語：日本語   出版者・発行元：(一社)日本糖尿病学会  

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記述言語：英語   出版者・発行元：(一社)日本循環器学会  

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記述言語：日本語   出版者・発行元：ライフサイエンス出版(株)  

オシロメトリック法血圧脈波検査装置を用いて、上腕動脈推定内腔断面積(A)を測定した。まず、Study 1として健常成人ボランティア9例を対象に、Aの再現性と超音波法で測定した上腕動脈径とAとの関連性を検討し、更に上腕動脈容積弾性率(V)の測定も行い再現性を検討した。次いで、Study 2として冠動脈疾患の疑い、またはその疑いのある29例を対象に、超音波法で測定した上腕動脈径とAとの関連性を検討した。その結果、Study 1では、Aの連続2回測定値における変動係数は18測定中17測定が10%未満で、全18測定における変動係数の平均は3.6%であった。Bland-Altmanプロットでは、全連続測定において誤差の許容範囲内であった。一方で、VについてはBland-Altmanプロットでは誤差は許容範囲内であったが、連続測定では変動係数の平均は8.3%であった。本機器により算出した上腕動脈面積の正確性を検討するため、超音波法における上腕動脈径とAおよびAから算出した上腕動脈径との相関関係を検討した結果、Study 1では超音波法における上腕動脈径とA、およびAから算出した上腕動脈径との間に高い相関関係を認めたが、Study 2ではその相関係数は低下していた。

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J01759&link_issn=&doc_id=20121206110015&doc_link_id=issn%3D0289-8020%26volume%3D33%26issue%3D11%26spage%3D1701&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0289-8020%26volume%3D33%26issue%3D11%26spage%3D1701&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

記述言語：日本語   出版者・発行元：(公財)日本心臓財団  

症例は、42歳、男性。2010年7月ごろより胸痛を自覚。近医にて肥大型心筋症を疑われβ遮断薬を処方されたが、その後、症状が増悪したため精査加療目的で当科紹介受診。来院時に胸痛を自覚しており、心電図にてV1〜4誘導の陰性T波を認めたため急性冠症候群を疑い緊急冠動脈造影施行。右冠動脈から右室枝を介する左前下行枝への側副血行路を認め、また右冠動脈近位部に90%狭窄を認めたが、硝酸薬の冠動脈内注入により側副血行路、狭窄は消失。左右冠動脈ともに器質的狭窄を認めないことから冠攣縮性狭心症と診断した。本例は、以前より胸痛を自覚していたことから、冠攣縮による慢性心筋虚血により器質的狭窄がないにもかかわらず側副血行路が発達し、かつ発作時に緊急冠動脈造影を施行したことによりその存在が同定されたものと推察された。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2012&ichushi_jid=J00679&link_issn=&doc_id=20121015170018&doc_link_id=10.11281%2Fshinzo.44.1296&url=https%3A%2F%2Fdoi.org%2F10.11281%2Fshinzo.44.1296&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   出版者・発行元：(NPO)日本高血圧学会  

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記述言語：日本語   出版者・発行元：(株)東京医学社  

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記述言語：日本語   出版者・発行元：(一社)日本循環器病予防学会  

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記述言語：日本語   出版者・発行元：(一社)日本糖尿病学会  

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記述言語：英語   出版者・発行元：(一社)日本循環器学会  

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記述言語：英語   出版者・発行元：(一社)日本循環器学会  

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記述言語：日本語   出版者・発行元：日本成人病(生活習慣病)学会  

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記述言語：日本語   出版者・発行元：(公財)日本心臓財団  

症例は53歳、男性。フィットネスジムでジョギング中に心肺停止となり、インストラクターによるバイスタンダー心肺蘇生法(CPR)、自動体外式除細動器(AED)にて蘇生され、当院救命救急センターに搬送された。AEDの解析結果では、心室細動(VF)に対して除細動が作動した後、完全房室ブロックを経て洞調律に復帰した記録を認めた。冠動脈に有意狭窄なく、アセチルコリン(ACh)負荷試験にて左前下行枝起始部に攣縮を認め冠攣縮性狭心症と診断した。本例は、突然死の家族歴があり、心臓MRIにおいてガドリニウム(Gd)遅延造影効果を認めたため冠攣縮以外の不整脈原性基質の存在を否定し得ず、植込み型除細動器(ICD)の植込みを行った。VFを契機に発症した冠攣縮性狭心症では、VFの原因が冠攣縮によるものとは限らず、ICDの適応に関しては、冠拡張薬の有効性に加え、心筋症などの冠攣縮以外の不整脈原性基質を考慮することも重要である。当院で経験した類似症例7例の臨床経過を含め、冠攣縮性狭心症を有するがそのほかの不整脈原性基質が否定できない症例に対するICDの適応に関して考察した。(著者抄録)

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記述言語：英語   出版者・発行元：(一社)日本循環器学会  

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記述言語：英語   出版者・発行元：(一社)日本循環器学会  

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記述言語：英語   出版者・発行元：(一社)日本循環器学会  

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

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記述言語：英語   出版者・発行元：(一社)日本心血管インターベンション治療学会  

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記述言語：英語   出版者・発行元：(一社)日本循環器学会  

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

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記述言語：日本語   出版者・発行元：(一社)日本糖尿病学会  

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

CiNii Books

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記述言語：英語   出版者・発行元：(一社)日本循環器学会  

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記述言語：日本語   出版者・発行元：(一社)日本内科学会  

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記述言語：日本語   出版者・発行元：同愛記念病院学術雑誌部  

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記述言語：日本語   出版者・発行元：同愛記念病院学術雑誌部  

糖尿病診察におけるBNP測定の意義を検討した。平成19年5月〜6月の糖尿病患者中、心血管疾患を疑いBNPを測定した114例(男73例、女41例、平均年齢65.5歳)を対象に年齢、HbA1c、高血圧症、高脂血症の有無、BMI25以上の肥満症の有無につき臨床像を検討した。対象を、BNP異常群(18.4pg/ml以上)とBNP正常群(18.4pg/ml以下)に群分けした。正常群は61例(54%)であった。正常群に比べ、異常群は高齢者に多く平均年齢も有意に高く女性が多かった。また、異常群ではHbA1cは比較的低い例が多く、高血圧症の合併が多かった。高脂血症の合併症は両群に差はなかった。BMI25以上の肥満症合併は異常群が有意に少なかった。以上より糖尿病患者のBNP測定は心疾患検出に有用であるが、肥満症の合併によってBNPが低値を示す可能性があるため注意を要すると考えた。

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記述言語：日本語   出版者・発行元：(一社)日本糖尿病学会  

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記述言語：日本語   出版者・発行元：(一社)日本内科学会  

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記述言語：日本語   出版者・発行元：日本内科学会-関東地方会  

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記述言語：日本語   出版者・発行元：(一社)日本内科学会  

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記述言語：英語   出版者・発行元：社団法人日本循環器学会  

CiNii Books

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記述言語：英語   出版者・発行元：(一社)日本循環器学会  

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

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記述言語：日本語   出版者・発行元：日本臨床生理学会  

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

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記述言語：日本語   出版者・発行元：(一社)日本循環器学会  

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記述言語：日本語   出版者・発行元：(一社)日本循環器学会  

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記述言語：日本語   出版者・発行元：(一社)日本循環器学会  

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記述言語：日本語   出版者・発行元：(一社)日本不整脈心電学会  

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記述言語：日本語   出版者・発行元：(NPO)日本冠疾患学会  

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記述言語：日本語   出版者・発行元：日本内科学会-関東地方会  

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記述言語：日本語   出版者・発行元：日本医科大学医学会  

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