chocardiography is now recognized as an integral diagnostic tool that enables noninvasive quantification of cardiac chamber size, ventricular mass, and function in the clinical setting. Furthermore, technological advancement in Doppler echocardiography enables quantitative assessment of ventricular diastolic function as well as systolic function. Thus, echocardiography has become an important cardiac imaging technique in a number of clinical trials evaluating the efficacy of drug treatments or new therapeutic strategies.A guideline for quantifying cardiac chamber size and function using echocardiography, and references values for Circulation Journal Vol.72, November 2008 these echocardiographic measurements, were provided by the American Society of Echocardiography in conjunction with the European Association of Echocardiography. 1 Likewise, Doppler echocardiographic criteria for assessing left ventricular (LV) diastolic function were provided by the Canadian Consensus, 2 European 3 and American Medical Association guidelines, 4 and diastolic function parameters were reported to decline gradually with age. 5 However, most of these data are derived from American and European populations and because physical 6,7 and racial 8-10 differences can influence cardiac chamber size and function, it is important to evaluate the echocardiographic parameters in other populations. Reference values based on a large Asian population have not been previously reported, although some investigators have reported these values in a small population. 11 In addition, most studies that have investigated the relationship between age and cardiac chamber size and function have focused on a few parameters and have not assessed all of them in a large population.Accordingly, we designed and conducted a multicenter study, the Japanese Normal Values for Echocardiographic Measurements Project (JAMP) study, to determine the normal values for echocardiographic measurements and evaluate the relationship between these parameters and age in a large, healthy Japanese population. J 2008; 72: 1859 -1866 (Received February 27, 2008 revised manuscript received June 11, 2008; accepted June 26, 2008; released online September 29, 2008) Circ
The long-term outcome of asymptomatic patients with severe AS was dismal when managed conservatively in this real-world analysis and might be substantially improved by an initial AVR strategy. (Contemporary Outcomes After Surgery and Medical Treatment in Patients With Severe Aortic Stenosis Registry; UMIN000012140).
Detection of post-ischemic regional LV delayed relaxation or diastolic stunning after treadmill exercise using SI is a sensitive and reliable method for the detection of coronary artery disease.
Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp ender-based differences in the management and outcomes of cardiovascular disease have been studied extensively. 1-4 In women, heart failure (HF) is associated more with left ventricular (LV) diastolic dysfunction than in men, whereas LV systolic dysfunction is the predominant cause of HF in men. 5-8 In particular, elderly women frequently have HF associated with a normal LV ejection fraction. 2 Recent studies have also emphasized the importance of gender differences in the management of cardiovascular disease. 1,8,9 Thus, recognition of gender difference in LV geometry and function has important implications for the optimal diagnosis and management of cardiovascular disease. Background: The purpose of the present study was to investigate gender differences in age-related changes of left ventricular (LV) and right ventricular (RV) geometries and functions throughout the entire adult age range using the Japanese Normal Values for Echocardiographic Measurements Project (JAMP) study database.
Long-term safety and efficacy of drug-eluting stents remains controversial. The CREDO-Kyoto registry cohort-2 is a physician-initiated non-company sponsored multi-center registry enrolling consecutive patients undergoing first coronary revascularization in 26 centers in Japan. We compared 3-year outcome between patients treated with sirolimus-eluting stent (SES) only (5092 patients) and bare-metal stent (BMS) only (5405 patients). SES-use as compared with BMS-use was associated with significantly lower adjusted risk for all-cause death [hazard ratio (HR) [95% confidence interval (CI)] 0.72 (0.59-0.87), P = 0.0007], which was mainly driven by the reduction in non-cardiac death [HR (95% CI) 0.64 (0.48-0.85), P = 0.002]. The risk of cardiac death [HR (95% CI) 0.82 (0.63-1.07), P = 0.15], myocardial infarction [HR (95% CI) 0.73 (0.51-1.03), P = 0.07] and definite stent thrombosis [HR (95% CI) 0.62 (0.35-1.09), P = 0.1] was not different between the two groups. Despite longer duration of thienopyridine administration, SES-use was associated with significantly lower risk for bleeding [HR (95% CI) 0.75 (0.6-0.95), P = 0.02] and similar risk for stroke [HR (95% CI) 1.0 (0.75-1.34), P = 1.0]. The risk for target-lesion revascularization (TLR) was markedly lower in the SES group [HR (95% CI) 0.42 (0.36-0.48), P < 0.0001]. The direction and magnitude of the effect of SES relative to BMS in patients presenting acute myocardial infarction (AMI) were similar to those in patients presenting otherwise. In conclusion, SES-use as compared with BMS-use was associated with marked reduction of TLR without any increases in death, myocardial infarction, stent thrombosis, stroke and bleeding in real world clinical practice regardless of clinical presentation including AMI.
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