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Novel Concept of a Heart-Gut Axis in the Pathophysiology of Heart Failure
Takehiro Kamo,Hiroshi Akazawa,Jun ichi suzuki,Issei Komuro 대한심장학회 2017 Korean Circulation Journal Vol.47 No.5
Patients with heart failure (HF) have structural and functional changes of the gut as a result of microcirculatory disturbances. A disrupted gut epithelial barrier may lead to translocation of microbial products into systemic circulation, possibly aggravating HF by inducing inflammatory responses. Gut microbiota play an essential role in the maintenance of host homeostasis because large quantities of their gene products complement host physiological processes. Emerging evidence has suggested the potential clinical significance of gut microbiota in the pathophysiology of HF. Imbalances of gut microbe-derived metabolites can contribute to cardiac dysfunction and other morbidities in patients with HF. Therapeutic research for HF through targeting microbiota is under way. Thus, the novel concept of a heart-gut axis may lead to breakthroughs in the development of innovative diagnostics and therapeutic approaches for HF.
Cardiac Rehabilitation Increases Exercise Capacity with a Reduction of Oxidative Stress
Taira Fukuda,Miwa Kurano,Kazuya Fukumura,Tomohiro Yasuda,Haruko Iida,Toshihiro Morita,Yumiko Yamamoto,Nami Takano,Issei Komuro,Toshiaki Nakajima 대한심장학회 2013 Korean Circulation Journal Vol.43 No.7
Background and Objectives: Reactive oxygen species (ROS) mediate various signaling pathways that underlie vascular inflammation in atherogenesis and cardiovascular diseases. Cardiac rehabilitation (CR) has a variety of multiple beneficial effects, including anti-inflam -matory effects. The purpose of the present study was to investigate the effects of CR on ROS in patients with cardiovascular diseases. Subjects and Methods: The serum level of derivatives of reactive oxidative metabolites, an index of oxidative stress, was measured in 100 patients with cardiovascular diseases before, and, subsequently, 3 and 6 months after, CR. A biological antioxidant potential (BAP) test was applied to assess the antioxidant power of the serum. Results: The resting reactive oxidative metabolite levels decreased 3-6 months after CR {pre: 351±97 Carratelli unit (CARR U), 3 months:329±77 CARR U, 6 months: 325±63 CARR U, all p<0.01} with the increase of the percentage of the predicted values of V˙O 2 peak and the percentage of the predicted values of V˙O 2 at the anaerobic threshold (V˙O 2 AT ) and the decrease of the B-type natriuretic peptide (BNP). The BAP test and antioxidative/oxidative stress ratio increased 6 months after CR. The % changes of the antioxidative/oxidative stress ratio was positively correlated with the % changes of V˙O 2 AT , and negatively correlated with the % changes of the BNP. Conclusion: These results suggest that intensive supervised CR significantly improved exercise capacity, which may be attributable to an adaptive response involving more efficient oxidative metabolites or the increased capacity of endogenous anti-oxidative systems in pa -tients with cardiovascular diseases.
Effectiveness and Approach of Rehabilitation in Patients With Acute Heart Failure: A Review
Kensuke Ueno,Hidehiro Kaneko,Hidetaka Itoh,Norifumi Takeda,Hiroyuki Morita,Katsuhito Fujiu,Kentaro Kamiya,Issei Komuro 대한심장학회 2022 Korean Circulation Journal Vol.52 No.8
Acute heart failure is associated with high mortality and frequent rehospitalization, resulting in enormous healthcare costs and declining physical function, activities of daily living, and quality of life. Cardiac rehabilitation has been recommended as one of the non-pharmacologic treatments for patients with heart failure. However, much of the evidence for cardiac rehabilitation interventions reported to date has been limited to chronic heart failure. In recent years, the effectiveness of rehabilitation intervention in patients with acute heart failure has been reported, led by the Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial. This review overviews the recent evidence of rehabilitation in patients with acute heart failure.