Clinical Profile of Thromboembolic Events in Patients With Hypertrophic Cardiomyopathy in a Regional Japanese Cohort ― Results From Kochi RYOMA Study
Background:There is limited information about the clinical profiles of patients with hypertrophic cardiomyopathy (HCM) and thromboembolic events in a community-based Japanese patient cohort.Methods and Results:In 2004, we established a cardiomyopathy registration network in Kochi Prefecture that com...
Gespeichert in:
| Veröffentlicht in: | Circulation Journal 2019/07/25, Vol.83(8), pp.1747-1754 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1754 |
|---|---|
| container_issue | 8 |
| container_start_page | 1747 |
| container_title | Circulation Journal |
| container_volume | 83 |
| creator | Hirota, Takayoshi Kubo, Toru Baba, Yuichi Ochi, Yuri Takahashi, Asa Yamasaki, Naohito Hamashige, Naohisa Yamamoto, Katsuhito Kondo, Fumiaki Bando, Kanji Yamada, Eisuke Furuno, Takashi Yabe, Toshikazu Doi, Yoshinori L. Kitaoka, Hiroaki |
| description | Background:There is limited information about the clinical profiles of patients with hypertrophic cardiomyopathy (HCM) and thromboembolic events in a community-based Japanese patient cohort.Methods and Results:In 2004, we established a cardiomyopathy registration network in Kochi Prefecture that comprised 9 hospitals, and finally 293 patients with HCM were followed. The mean age at registration was 63±14 years, and 197 patients (67%) were men. At registration, 86 patients (29%) had documented atrial fibrillation (AF). During a mean follow-up period of 6.1±3.2 years, thromboembolic events, including 3 embolic stroke deaths, occurred in 23 patients. The 5-year embolic event rate was 5.5%. During the follow-up period, an additional 31 patients (11%) had documentation of AF and finally a total of 117 patients (40%) developed AF. The 5-year embolic event rate in those 117 patients with AF was 12.3%. Of the 23 patients with embolic events, 12 had AF prior to the embolic complications and another 6 had documented AF after thromboembolism. AF was not detected in the remaining 5 patients. The CHADS2score did not correlate with the embolic outcome in HCM patients.Conclusions:In this community-based registry, thromboembolic events were not rare in patients with HCM. All patients with HCM in whom AF develops should be given anticoagulation therapy regardless of their CHADS2score. |
| doi_str_mv | 10.1253/circj.CJ-19-0186 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2250625679</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2250625679</sourcerecordid><originalsourceid>FETCH-LOGICAL-c494t-ad486d2c4df6ce2ddc104e9a2a0cd3eeeb3215f8b92cadf25a4a5c4e7b46d6e63</originalsourceid><addsrcrecordid>eNpFkc1u1DAYRSMEoqWwZ4W8ZJPiv2SSZRV1KENRq1KEWFmO_aXxKIlT20HKbl6ii74evAieH9qF7U_yuceWbpK8J_iU0Ix9Usap9Wm1SkmZYlLkL5Jjwvgi5QXFL3dznpYFZ0fJG-_XGNMSZ-Xr5IjF9IIRdpw8Vp0ZjJIduna2MR0g26Db1tm-thBXZxQ6_w1D8MgM6FoGs5t_mtCii3kEF5wd2whV0mlj-9mOMrTzFpboBu6MHaJ7JUc5gAdU2da68Hez-bN5iNd-6qJsGV9DX61qDbr5dfXtDH0Pk57fJq8a2Xl4dzhPkh_L89vqIr28-vylOrtMFS95SKXmRa6p4rrJFVCtFcEcSkklVpoBQM0oyZqiLqmSuqGZ5DJTHBY1z3UOOTtJPu69o7P3E_ggeuMVdF38sZ28oDTDOc3yRRlRvEeVs947aMToTC_dLAgW20LErhBRrQQpxbaQGPlwsE91D_op8L-BCCz3wNoHeQdPgHTBqA4OxoKJYrs9m5-BVjoBA_sHRxemmQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2250625679</pqid></control><display><type>article</type><title>Clinical Profile of Thromboembolic Events in Patients With Hypertrophic Cardiomyopathy in a Regional Japanese Cohort ― Results From Kochi RYOMA Study</title><source>J-STAGE Free</source><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Hirota, Takayoshi ; Kubo, Toru ; Baba, Yuichi ; Ochi, Yuri ; Takahashi, Asa ; Yamasaki, Naohito ; Hamashige, Naohisa ; Yamamoto, Katsuhito ; Kondo, Fumiaki ; Bando, Kanji ; Yamada, Eisuke ; Furuno, Takashi ; Yabe, Toshikazu ; Doi, Yoshinori L. ; Kitaoka, Hiroaki</creator><creatorcontrib>Hirota, Takayoshi ; Kubo, Toru ; Baba, Yuichi ; Ochi, Yuri ; Takahashi, Asa ; Yamasaki, Naohito ; Hamashige, Naohisa ; Yamamoto, Katsuhito ; Kondo, Fumiaki ; Bando, Kanji ; Yamada, Eisuke ; Furuno, Takashi ; Yabe, Toshikazu ; Doi, Yoshinori L. ; Kitaoka, Hiroaki</creatorcontrib><description>Background:There is limited information about the clinical profiles of patients with hypertrophic cardiomyopathy (HCM) and thromboembolic events in a community-based Japanese patient cohort.Methods and Results:In 2004, we established a cardiomyopathy registration network in Kochi Prefecture that comprised 9 hospitals, and finally 293 patients with HCM were followed. The mean age at registration was 63±14 years, and 197 patients (67%) were men. At registration, 86 patients (29%) had documented atrial fibrillation (AF). During a mean follow-up period of 6.1±3.2 years, thromboembolic events, including 3 embolic stroke deaths, occurred in 23 patients. The 5-year embolic event rate was 5.5%. During the follow-up period, an additional 31 patients (11%) had documentation of AF and finally a total of 117 patients (40%) developed AF. The 5-year embolic event rate in those 117 patients with AF was 12.3%. Of the 23 patients with embolic events, 12 had AF prior to the embolic complications and another 6 had documented AF after thromboembolism. AF was not detected in the remaining 5 patients. The CHADS2score did not correlate with the embolic outcome in HCM patients.Conclusions:In this community-based registry, thromboembolic events were not rare in patients with HCM. All patients with HCM in whom AF develops should be given anticoagulation therapy regardless of their CHADS2score.</description><identifier>ISSN: 1346-9843</identifier><identifier>ISSN: 1347-4820</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-19-0186</identifier><identifier>PMID: 31257313</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anticoagulants - therapeutic use ; Atrial fibrillation ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - drug therapy ; Atrial Fibrillation - epidemiology ; Atrial Fibrillation - mortality ; Cardiomyopathy, Hypertrophic - diagnosis ; Cardiomyopathy, Hypertrophic - drug therapy ; Cardiomyopathy, Hypertrophic - epidemiology ; Cardiomyopathy, Hypertrophic - mortality ; CHADS2 score ; Child ; Female ; Humans ; Hypertrophic cardiomyopathy ; Incidence ; Japan - epidemiology ; Longitudinal Studies ; Male ; Middle Aged ; Prevalence ; Prognosis ; Registries ; Risk Assessment ; Risk Factors ; Thromboembolic events ; Thromboembolism - diagnosis ; Thromboembolism - epidemiology ; Thromboembolism - mortality ; Thromboembolism - prevention & control ; Time Factors ; Young Adult</subject><ispartof>Circulation Journal, 2019/07/25, Vol.83(8), pp.1747-1754</ispartof><rights>2019 THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c494t-ad486d2c4df6ce2ddc104e9a2a0cd3eeeb3215f8b92cadf25a4a5c4e7b46d6e63</citedby><cites>FETCH-LOGICAL-c494t-ad486d2c4df6ce2ddc104e9a2a0cd3eeeb3215f8b92cadf25a4a5c4e7b46d6e63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,1877,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31257313$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hirota, Takayoshi</creatorcontrib><creatorcontrib>Kubo, Toru</creatorcontrib><creatorcontrib>Baba, Yuichi</creatorcontrib><creatorcontrib>Ochi, Yuri</creatorcontrib><creatorcontrib>Takahashi, Asa</creatorcontrib><creatorcontrib>Yamasaki, Naohito</creatorcontrib><creatorcontrib>Hamashige, Naohisa</creatorcontrib><creatorcontrib>Yamamoto, Katsuhito</creatorcontrib><creatorcontrib>Kondo, Fumiaki</creatorcontrib><creatorcontrib>Bando, Kanji</creatorcontrib><creatorcontrib>Yamada, Eisuke</creatorcontrib><creatorcontrib>Furuno, Takashi</creatorcontrib><creatorcontrib>Yabe, Toshikazu</creatorcontrib><creatorcontrib>Doi, Yoshinori L.</creatorcontrib><creatorcontrib>Kitaoka, Hiroaki</creatorcontrib><title>Clinical Profile of Thromboembolic Events in Patients With Hypertrophic Cardiomyopathy in a Regional Japanese Cohort ― Results From Kochi RYOMA Study</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>Background:There is limited information about the clinical profiles of patients with hypertrophic cardiomyopathy (HCM) and thromboembolic events in a community-based Japanese patient cohort.Methods and Results:In 2004, we established a cardiomyopathy registration network in Kochi Prefecture that comprised 9 hospitals, and finally 293 patients with HCM were followed. The mean age at registration was 63±14 years, and 197 patients (67%) were men. At registration, 86 patients (29%) had documented atrial fibrillation (AF). During a mean follow-up period of 6.1±3.2 years, thromboembolic events, including 3 embolic stroke deaths, occurred in 23 patients. The 5-year embolic event rate was 5.5%. During the follow-up period, an additional 31 patients (11%) had documentation of AF and finally a total of 117 patients (40%) developed AF. The 5-year embolic event rate in those 117 patients with AF was 12.3%. Of the 23 patients with embolic events, 12 had AF prior to the embolic complications and another 6 had documented AF after thromboembolism. AF was not detected in the remaining 5 patients. The CHADS2score did not correlate with the embolic outcome in HCM patients.Conclusions:In this community-based registry, thromboembolic events were not rare in patients with HCM. All patients with HCM in whom AF develops should be given anticoagulation therapy regardless of their CHADS2score.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anticoagulants - therapeutic use</subject><subject>Atrial fibrillation</subject><subject>Atrial Fibrillation - diagnosis</subject><subject>Atrial Fibrillation - drug therapy</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Atrial Fibrillation - mortality</subject><subject>Cardiomyopathy, Hypertrophic - diagnosis</subject><subject>Cardiomyopathy, Hypertrophic - drug therapy</subject><subject>Cardiomyopathy, Hypertrophic - epidemiology</subject><subject>Cardiomyopathy, Hypertrophic - mortality</subject><subject>CHADS2 score</subject><subject>Child</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertrophic cardiomyopathy</subject><subject>Incidence</subject><subject>Japan - epidemiology</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Registries</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Thromboembolic events</subject><subject>Thromboembolism - diagnosis</subject><subject>Thromboembolism - epidemiology</subject><subject>Thromboembolism - mortality</subject><subject>Thromboembolism - prevention & control</subject><subject>Time Factors</subject><subject>Young Adult</subject><issn>1346-9843</issn><issn>1347-4820</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkc1u1DAYRSMEoqWwZ4W8ZJPiv2SSZRV1KENRq1KEWFmO_aXxKIlT20HKbl6ii74evAieH9qF7U_yuceWbpK8J_iU0Ix9Usap9Wm1SkmZYlLkL5Jjwvgi5QXFL3dznpYFZ0fJG-_XGNMSZ-Xr5IjF9IIRdpw8Vp0ZjJIduna2MR0g26Db1tm-thBXZxQ6_w1D8MgM6FoGs5t_mtCii3kEF5wd2whV0mlj-9mOMrTzFpboBu6MHaJ7JUc5gAdU2da68Hez-bN5iNd-6qJsGV9DX61qDbr5dfXtDH0Pk57fJq8a2Xl4dzhPkh_L89vqIr28-vylOrtMFS95SKXmRa6p4rrJFVCtFcEcSkklVpoBQM0oyZqiLqmSuqGZ5DJTHBY1z3UOOTtJPu69o7P3E_ggeuMVdF38sZ28oDTDOc3yRRlRvEeVs947aMToTC_dLAgW20LErhBRrQQpxbaQGPlwsE91D_op8L-BCCz3wNoHeQdPgHTBqA4OxoKJYrs9m5-BVjoBA_sHRxemmQ</recordid><startdate>20190725</startdate><enddate>20190725</enddate><creator>Hirota, Takayoshi</creator><creator>Kubo, Toru</creator><creator>Baba, Yuichi</creator><creator>Ochi, Yuri</creator><creator>Takahashi, Asa</creator><creator>Yamasaki, Naohito</creator><creator>Hamashige, Naohisa</creator><creator>Yamamoto, Katsuhito</creator><creator>Kondo, Fumiaki</creator><creator>Bando, Kanji</creator><creator>Yamada, Eisuke</creator><creator>Furuno, Takashi</creator><creator>Yabe, Toshikazu</creator><creator>Doi, Yoshinori L.</creator><creator>Kitaoka, Hiroaki</creator><general>The Japanese Circulation Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20190725</creationdate><title>Clinical Profile of Thromboembolic Events in Patients With Hypertrophic Cardiomyopathy in a Regional Japanese Cohort ― Results From Kochi RYOMA Study</title><author>Hirota, Takayoshi ; Kubo, Toru ; Baba, Yuichi ; Ochi, Yuri ; Takahashi, Asa ; Yamasaki, Naohito ; Hamashige, Naohisa ; Yamamoto, Katsuhito ; Kondo, Fumiaki ; Bando, Kanji ; Yamada, Eisuke ; Furuno, Takashi ; Yabe, Toshikazu ; Doi, Yoshinori L. ; Kitaoka, Hiroaki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c494t-ad486d2c4df6ce2ddc104e9a2a0cd3eeeb3215f8b92cadf25a4a5c4e7b46d6e63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anticoagulants - therapeutic use</topic><topic>Atrial fibrillation</topic><topic>Atrial Fibrillation - diagnosis</topic><topic>Atrial Fibrillation - drug therapy</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Atrial Fibrillation - mortality</topic><topic>Cardiomyopathy, Hypertrophic - diagnosis</topic><topic>Cardiomyopathy, Hypertrophic - drug therapy</topic><topic>Cardiomyopathy, Hypertrophic - epidemiology</topic><topic>Cardiomyopathy, Hypertrophic - mortality</topic><topic>CHADS2 score</topic><topic>Child</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertrophic cardiomyopathy</topic><topic>Incidence</topic><topic>Japan - epidemiology</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prevalence</topic><topic>Prognosis</topic><topic>Registries</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Thromboembolic events</topic><topic>Thromboembolism - diagnosis</topic><topic>Thromboembolism - epidemiology</topic><topic>Thromboembolism - mortality</topic><topic>Thromboembolism - prevention & control</topic><topic>Time Factors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hirota, Takayoshi</creatorcontrib><creatorcontrib>Kubo, Toru</creatorcontrib><creatorcontrib>Baba, Yuichi</creatorcontrib><creatorcontrib>Ochi, Yuri</creatorcontrib><creatorcontrib>Takahashi, Asa</creatorcontrib><creatorcontrib>Yamasaki, Naohito</creatorcontrib><creatorcontrib>Hamashige, Naohisa</creatorcontrib><creatorcontrib>Yamamoto, Katsuhito</creatorcontrib><creatorcontrib>Kondo, Fumiaki</creatorcontrib><creatorcontrib>Bando, Kanji</creatorcontrib><creatorcontrib>Yamada, Eisuke</creatorcontrib><creatorcontrib>Furuno, Takashi</creatorcontrib><creatorcontrib>Yabe, Toshikazu</creatorcontrib><creatorcontrib>Doi, Yoshinori L.</creatorcontrib><creatorcontrib>Kitaoka, Hiroaki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hirota, Takayoshi</au><au>Kubo, Toru</au><au>Baba, Yuichi</au><au>Ochi, Yuri</au><au>Takahashi, Asa</au><au>Yamasaki, Naohito</au><au>Hamashige, Naohisa</au><au>Yamamoto, Katsuhito</au><au>Kondo, Fumiaki</au><au>Bando, Kanji</au><au>Yamada, Eisuke</au><au>Furuno, Takashi</au><au>Yabe, Toshikazu</au><au>Doi, Yoshinori L.</au><au>Kitaoka, Hiroaki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical Profile of Thromboembolic Events in Patients With Hypertrophic Cardiomyopathy in a Regional Japanese Cohort ― Results From Kochi RYOMA Study</atitle><jtitle>Circulation Journal</jtitle><addtitle>Circ J</addtitle><date>2019-07-25</date><risdate>2019</risdate><volume>83</volume><issue>8</issue><spage>1747</spage><epage>1754</epage><pages>1747-1754</pages><issn>1346-9843</issn><issn>1347-4820</issn><eissn>1347-4820</eissn><abstract>Background:There is limited information about the clinical profiles of patients with hypertrophic cardiomyopathy (HCM) and thromboembolic events in a community-based Japanese patient cohort.Methods and Results:In 2004, we established a cardiomyopathy registration network in Kochi Prefecture that comprised 9 hospitals, and finally 293 patients with HCM were followed. The mean age at registration was 63±14 years, and 197 patients (67%) were men. At registration, 86 patients (29%) had documented atrial fibrillation (AF). During a mean follow-up period of 6.1±3.2 years, thromboembolic events, including 3 embolic stroke deaths, occurred in 23 patients. The 5-year embolic event rate was 5.5%. During the follow-up period, an additional 31 patients (11%) had documentation of AF and finally a total of 117 patients (40%) developed AF. The 5-year embolic event rate in those 117 patients with AF was 12.3%. Of the 23 patients with embolic events, 12 had AF prior to the embolic complications and another 6 had documented AF after thromboembolism. AF was not detected in the remaining 5 patients. The CHADS2score did not correlate with the embolic outcome in HCM patients.Conclusions:In this community-based registry, thromboembolic events were not rare in patients with HCM. All patients with HCM in whom AF develops should be given anticoagulation therapy regardless of their CHADS2score.</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>31257313</pmid><doi>10.1253/circj.CJ-19-0186</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1346-9843 |
| ispartof | Circulation Journal, 2019/07/25, Vol.83(8), pp.1747-1754 |
| issn | 1346-9843 1347-4820 1347-4820 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2250625679 |
| source | J-STAGE Free; MEDLINE; EZB-FREE-00999 freely available EZB journals |
| subjects | Adolescent Adult Aged Aged, 80 and over Anticoagulants - therapeutic use Atrial fibrillation Atrial Fibrillation - diagnosis Atrial Fibrillation - drug therapy Atrial Fibrillation - epidemiology Atrial Fibrillation - mortality Cardiomyopathy, Hypertrophic - diagnosis Cardiomyopathy, Hypertrophic - drug therapy Cardiomyopathy, Hypertrophic - epidemiology Cardiomyopathy, Hypertrophic - mortality CHADS2 score Child Female Humans Hypertrophic cardiomyopathy Incidence Japan - epidemiology Longitudinal Studies Male Middle Aged Prevalence Prognosis Registries Risk Assessment Risk Factors Thromboembolic events Thromboembolism - diagnosis Thromboembolism - epidemiology Thromboembolism - mortality Thromboembolism - prevention & control Time Factors Young Adult |
| title | Clinical Profile of Thromboembolic Events in Patients With Hypertrophic Cardiomyopathy in a Regional Japanese Cohort ― Results From Kochi RYOMA Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-20T12%3A56%3A04IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Clinical%20Profile%20of%20Thromboembolic%20Events%20in%20Patients%20With%20Hypertrophic%20Cardiomyopathy%20in%20a%20Regional%20Japanese%20Cohort%E3%80%80%E2%80%95%20Results%20From%20Kochi%20RYOMA%20Study&rft.jtitle=Circulation%20Journal&rft.au=Hirota,%20Takayoshi&rft.date=2019-07-25&rft.volume=83&rft.issue=8&rft.spage=1747&rft.epage=1754&rft.pages=1747-1754&rft.issn=1346-9843&rft.eissn=1347-4820&rft_id=info:doi/10.1253/circj.CJ-19-0186&rft_dat=%3Cproquest_cross%3E2250625679%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2250625679&rft_id=info:pmid/31257313&rfr_iscdi=true |