type: misc

label: url

en: 心臓サルコイドーシス再燃に対してメトトレキサートの併用が有効であった1例

ja: 心臓サルコイドーシス再燃に対してメトトレキサートの併用が有効であった1例

en: 心臓サルコイドーシスの標準的治療はステロイドであるが，ステロイドを投与中であっても再燃を認めることも多く，またステロイドの多岐にわたる副作用も問題となることが多い．症例は70歳代，女性．心臓サルコイドーシスの診断でプレドニンを維持量5 mg/日で加療されていた．定期検査で施行した心電図で陰性T波，前壁心尖部に新規の左室壁運動異常を認めた．FDG-PET，Gaシンチグラフィーで壁運動異常部位に一致して集積を認め，心臓サルコイドーシスの再燃と判断した．本症例では，ステロイドの副作用として糖尿病，肥満，白内障などを認めており，ステロイド増量が躊躇され，メトトレキサートの併用を開始した．メトトレキサート開始後，特に副作用を認めず，心電図ならびに左室壁運動異常の改善が認められた．ステロイド投与で再燃を認める心臓サルコイドーシス症例にはメトトレキサート併用も考慮すべきであると考えられた．

en: The Journal of the Japanese Society of Internal Medicine

ja: 日本内科学会雑誌


en: Efficacy of percutaneous transluminal renal angioplasty for renovascular hypertension complicated with heart failure

ja: 心不全を合併した腎血管性高血圧に対する経皮的腎動脈形成術の有効性(第11回若手奨励賞受賞論文)

en: 【Background】 Percutaneous transluminal renal angioplasty (PTRA) is recommended for patients with heart failure due to renovascular hypertension ; however, the clinical characteristics of the patients and the effects of PTRA on heart failure and cardiorenal function have not been elucidated. 【Methods】 We retrospectively analyzed data for 4 PTRA-treated patients (male/female, 1/3 ; mean age, 70.0±10 years ; mean left ventricular ejection fraction, 51.5±15.2%) with heart failure due to renovascular hypertension and evaluated the effects of PTRA on heart failure and cardiorenal function 6 months after treatment. 【Results】 All patients had pro-arteriosclerotic diseases including diabetes mellitus, essential thrombocythemia, heparin cofactor II deficency, metabolic syndrome, and familial hypercholesterolemia, and 3 patients had ischemic heart disease. No abdominal bruit was heard and mean plasma renin activity was 4.5±3.6 ng/ml/hr, which was not elevated, contrary to expectation. All contralateral kidneys of PTRA were nonfunctioning, suggesting bilateral kidneys were disturbed in all patients. In all patients, PTRA was successfully performed and resolved heart failure. PTRA resulted in decreases in systolic blood pressure from 157±18 to 124±8.6 mmHg, mean serum creatinine from 3.2±2.6 to 2.7±2.2 mg/dl, and mean BNP from 919±998 to 243±291 pg/ml at 6 months after treatment. PTRA did not change left ventricular ejection fraction, a parameter of systolic fraction evaluated by an echocardiogram ; however, PTRA improved E/e', a parameter of left ventricular diastolic fraction, from 16.1±5.2 to 9.7±3.7. None of the patients were hospitalized due to heart failure during the 6-month period after PTRA. 【Conclusions】 Patients with heart failure with cardiovascular risk factors should be screened for renovascular hypertension regardless of abdominal bruit or plasma renin activity. PTRA is effective for resolving heart failure and for improving renal and cardiac diastolic functions in patients with renovascular hypertension complicated with heart failure.

en: Shikoku Acta Medica

ja: 四国医学雑誌


en: Ghrelin and its receptor: the role of the ghrelin signaling system in regulating cardiac function.

en: Regulatory Peptides

ja: Regulatory Peptides


en: 高血圧の炎症・免疫バイオマーカー

ja: 高血圧の炎症・免疫バイオマーカー

en: 血圧

ja: 血圧


en: RAS研究 -ラボの最前線- 徳島大学大学院ヘルスバイオサイエンス研究部 循環器内科学・心臓血管病態医学

en: Angiotensin Research

ja: Angiotensin Research


en: 循環器専門医が考えるCa拮抗薬の選択ポイント(動脈硬化)

ja: 循環器専門医が考えるCa拮抗薬の選択ポイント(動脈硬化)

en: 循環Plus

ja: 循環Plus


en: Atrial fibrillation and thromboembolic stroke: when and how can it be treated

ja: 循環器病診療における最新の診かた，考え方 心房細動と塞栓症-何時，どのような治療を始めるか?-

en: Atrial fibrillation(AF)is a common arrhythmia and the prevalence of this arrhythmia is increasing as aging. Secondary AF is defined as AF with organic heart disease and lone AF as AF without it. The AF is divided into paroxysmal, persistent and chronic by its onset and persistence. It is clinically important that any type AF causes thromboembolic stroke. The preventive Qumadin therapy should be applied to patients with AF. Transesophageal echocardiography has been utilized for the diagnosis of left atrial thrombus and for the prediction of stroke. CHADS2 score is a clinical prediction rule for estimating the risk of stroke in patients with non-rheumatic AF. Patients with CHADS2 score_1should be treated with Qumadin. Rhythm control and rate control are two different strategies for the treatment of AF. There is no evidence that indicate better choice between rhythm control and rate control. Recently, inhibitors of the renin-angiotensin system have a potential to prevent new onset of AF in patients who has risk factors.


en: 虚血性心疾患患者の心血管事故発生の予測因子

ja: 虚血性心疾患患者の心血管事故発生の予測因子

en: The Japanese journal of clinical and experimental medicine

ja: 臨床と研究


en: 心血管疾患各論 1)弁膜症 (2)大動脈弁膜症

ja: 心血管疾患各論 1)弁膜症 (2)大動脈弁膜症

en: Journal of Medical Technology

ja: 臨床検査


en: 虚血性心疾患の危険因子としての線溶系

ja: 虚血性心疾患の危険因子としての線溶系

en: Japanese Journal of National Medical Services

ja: 医療