担当区分：筆頭著者   記述言語：英語  

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掲載種別：研究論文（学術雑誌）  

© 2020 The Author(s). Background: Protection from lethal ventricular arrhythmias leading to sudden cardiac death (SCD) is a crucial challenge after acute myocardial infarction (AMI). Cardiac sympathetic and parasympathetic activity can be noninvasively assessed using heart rate variability (HRV) and heart rate turbulence (HRT). The EMBODY trial was designed to determine whether the Sodium-glucose cotransporter 2 (SGLT2) inhibitor improves cardiac nerve activity. Methods: This prospective, multicenter, randomized, double-blind, placebo-controlled trial included patients with AMI and type 2 diabetes mellitus (T2DM) in Japan; 105 patients were randomized (1:1) to receive once-daily 10-mg empagliflozin or placebo. The primary endpoints were changes in HRV, e.g., the standard deviation of all 5-min mean normal RR intervals (SDANN) and the low-frequency-to-high-frequency (LF/HF) ratio from baseline to 24 weeks. Secondary endpoints were changes in other sudden cardiac death (SCD) surrogate markers such as HRT. Results: Overall, 96 patients were included (46, empagliflozin group; 50, placebo group). The changes in SDANN were + 11.6 and + 9.1 ms in the empagliflozin (P = 0.02) and placebo groups (P = 0.06), respectively. Change in LF/HF ratio was - 0.57 and - 0.17 in the empagliflozin (P = 0.01) and placebo groups (P = 0.43), respectively. Significant improvement was noted in HRT only in the empagliflozin group (P = 0.01). Whereas intergroup comparison on HRV and HRT showed no significant difference between the empagliflozin and placebo groups. Compared with the placebo group, the empagliflozin group showed significant decreases in body weight, systolic blood pressure, and uric acid. In the empagliflozin group, no adverse events were observed. Conclusions: This is the first randomized clinical data to evaluate the effect of empagliflozin on cardiac sympathetic and parasympathetic activity in patients with T2DM and AMI. Early SGLT2 inhibitor administration in AMI patients with T2DM might be effective in improving cardiac nerve activity without any adverse events. Trial Registration: The EMBODY trial was registered by the UMIN in November 2017 (ID: 000030158). UMIN000030158; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000034442.

DOI： 10.1186/s12933-020-01127-z

Scopus

PubMed

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記述言語：英語  

Perforation of a peptic ulcer into the ventricle is uncommon, and the definitive diagnosis is difficult in living patients. We herein report a case of perforation of a peptic ulcer in a hiatal hernia into the left ventricle with systemic air and food embolism. This is the first case report of the perforation diagnosed by computed tomography and confirmed by autopsy. Computed tomography was useful for the diagnosis of perforation into the ventricle.

DOI： 10.1097/RCT.0000000000000747

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Blood pressure variability (BPV), especially visit-to-visit BPV, has been reported to be a risk factor for cardiovascular disease. The impact of BPV on coronary plaque vulnerability remains uncertain. The aim of this study was to investigate the relationship between BPV and coronary plaque vulnerability.From August 2013 to May 2014, 36 patients with both hypertension and stable angina pectoris who underwent a percutaneous coronary intervention guided by frequency-domain optical coherence tomography were investigated retrospectively. The size of the lipid cores and the thickness of the fibrous cap covering the lipid core were measured by frequency-domain optical coherence tomography, and we calculated the blood pressure coefficient of variation (CV) and SD as intraindividual visit-to-visit BPV.Both SD and CV of systolic blood pressure (SBP) correlated positively with lipid arc (SBP-SD: r=0.68, P<0.01; SBP-CV: r=0.64, P<0.01) as well as average SBP (r=0.48, P<0.01). Fibrous cap thickness did not correlate with blood pressure variables or BPV.BPV is related to coronary plaque volume, but not to coronary plaque vulnerability. In addition to conventional coronary risk factors, BPV may b

DOI： 10.1097/MCA.0000000000000462

PubMed

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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  

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記述言語：日本語  

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：(株)総合医学社  

＜Point＞▼急性心膜炎の診断基準4項目の把握。▼治療におけるコルヒチン併用の有用性。(著者抄録)

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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  

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J00679&link_issn=&doc_id=20170720210029&doc_link_id=10.11281%2Fshinzo.49.754&url=https%3A%2F%2Fdoi.org%2F10.11281%2Fshinzo.49.754&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：(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)日本集中治療医学会  

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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45歳男性。心筋梗塞に対する経カテーテルインターベンション施行6日後に同一波形の心室期外収縮(PVC)を契機として心室細動(VF)によるelectrical stormを生じ、緊急高周波カテーテルアブレーション(RFCA)を施行した。PVC(PVC-1)は右脚ブロック+下方軸型で、左脚前枝領域にPVC時のQRSに40ms先行するPurkinje potential(PP)が記録された。同部位を焼灼するとPVC-1は消失しVFも一時的に抑制された。術後、波形の異なるPVC-2(右脚ブロック+水平軸型)に続くVF stormが再発し、再度RFCAを施行。PVC-2は左室中隔領域が最早期興奮部位であり、PVC時にQRSに45ms先行するPPが記録された。同部位での焼灼でPVC-2は消失しESは抑制されたが、その後さらに波形の異なるPVC-3から再度VF stormとなったため3回目のRFCAを施行。PVC-3は僧帽弁輪0時方向の左心室基部近傍が最早期興奮部位であった。同部位を焼灼した結果PVC-3は消失し、以後VFは抑制され独歩退院した。複数のPurkinje起源PVCに対しRFCAを行うことでVF stormを抑制し得た心筋梗塞の1例を報告する。(著者抄録)

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記述言語：英語  

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記述言語：日本語  

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記述言語：日本語   会議種別：口頭発表（一般）  

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記述言語：日本語  

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記述言語：英語  

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