名古屋大学 · 医学
Toru Kondo教授の研究室は、心不全、特に射出分率低くない心不全(HFrEF)における治療戦略と予後予測の高度化を目的としています。特に、虚弱度や筋肉機能が運動耐容量や生存に与える影響、ならびにSGLT2阻害薬やRAAS阻害薬などの薬剤療法の効果が左室射出分率に応じてどのように変化するかを、大規模な登録研究や臨床試験を活用して解明しています。また、心房細動のない患者においても脳卒中リスクが同等である可能性がある群の同定や、抗凝固療法の妥当性の検証にも注力しています。
Figures are computed from collected data and may differ slightly.
gov; Unique identifiers: NCT00634309, NCT00634400, NCT00634712, NCT00095238, NCT01035255, NCT00094302, NCT00853658, and NCT01920711.
In a Japanese national registry of patients with CS, different causes of CS were associated with different types of MCS and differences in survival.
Interaction between the effect of: (A) the sodium–glucose co-transporter 2 (SGLT2) empagliflozin; from Butler et al.;6 and of (B) the angiotensin receptor blocker (ARB) candesartan; (C) the angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril valsartan; (D) the mineralocorticoid receptor antagonists (MRAs) spironolactone and eplerenone; and (E) the digitalis glycoside digoxin according to baseline LVEF in the trials reported by Dewan et al.2 and the Digitalis Investigation Group12. The an
It is possible to identify a subset of HFrEF patients without AF with a stroke-risk equivalent to that of patients with AF who are not anticoagulated. In these patients, the risk-to-benefit balance might justify the use of prophylactic anticoagulation, but this hypothesis needs to be tested prospectively.
BACKGROUND Guideline-recommended therapies that improve prognosis remain underused in clinical practice. Physical frailty may lead to underprescription of life-saving therapy. We aimed to investigate the association between physical frailty and the use of evidence-based pharmacological therapy for heart failure with reduced ejection fraction and the impact of this on prognosis. METHODS AND RESULTS The FLAGSHIP (Multicentre Prospective Cohort Study to Develop Frailty-Based Prognostic Criteria for
Lower leg skeletal muscle function may contribute to exercise capacity through an indirect mechanism on cardiac function in HF.
Abstract Aims In acute heart failure (AHF), immobilization is caused because of unstable haemodynamics and dyspnoea, leading to protein wasting. Neuromuscular electrical stimulation (NMES) has been reported to preserve muscle mass and improve functional outcomes in chronic disease. NMES may be effective against protein wasting frequently manifested in patients with AHF; however, whether NMES can be implemented safely without any adverse effect on haemodynamics has remained unknown. This study ai
CI at rest and hemoglobin level are associated with poor exercise capacity in patients with LVAD.
New guidelines have emphasized the primacy of starting the four key life-saving therapies for patients with heart failure and reduced ejection fraction as quickly as possible, with titration to 'target dose' of these, as secondary consideration. In this article, we examine the reasons for this change in emphasis and revisit the evidence regarding the dosing of pharmacological therapy in heart failure. We demonstrate the early benefits obtained with even low doses of most of the foundational ther
Almost one-quarter of patients with HF with mildly reduced/preserved ejection fraction had a low NT-proBNP level. Although these patients have a favorable prognosis, compared to those with a high NT-proBNP level, they have similarly impaired health status which should be a target for treatment. (Irbesartan in Heart Failure With Preserved Systolic Function [I- PRESERVE]; NCT00095238).
The efficacy and safety of dapagliflozin were consistent across global regions despite geographic differences in patient characteristics, background treatment, and event rates.
BACKGROUND: The primary end point in most heart failure (HF) trials is a composite of time to a first worsening HF event or cardiovascular death. Prevention of recurrent events and improvements in symptoms/quality of life are also important for patients but are usually analyzed separately. Win statistics can integrate all these outcomes into a single composite end point, which is analyzed in hierarchical order, reflecting the clinical importance of each component. METHODS: The Dapagliflozin and
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