記述言語：英語   掲載種別：研究論文（学術雑誌）  

Cardiotoxicity is a growing concern in cancer patients receiving chemotherapy. Renin-angiotensin system (RAS) inhibitors, including angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs), are widely used for cardiovascular protection, but their role in cancer care remains uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effects of RAS inhibitors on cardiotoxicity, dyspnea, and quality of life (QOL) in patients with malignancies. A comprehensive literature search was performed using PubMed, Embase, Web of Science, and the Cochrane Library, from which 15 eligible RCTs were identified. These trials compared RAS inhibitor users and non-users. Group differences were analyzed using mean differences (MDs) or odds ratios (ORs), with heterogeneity assessed by the I² statistic. Pooled results suggested a possible association between RAS inhibitor use and higher left ventricular ejection fraction (LVEF) compared to controls (MD 4.42%, 95% CI -0.02 to 8.85; I² = 96%). Subgroup analysis revealed significant benefit in patients receiving HER2-targeted therapy and those undergoing non-specific chemotherapy, while no advantage was seen in patients treated with anthracyclines and HER2 blockade. RAS inhibitors showed limited benefit in anthracycline regimens. No significant reduction in cardiotoxicity was observed (OR 0.66, 95% CI 0.19-2.30). Additionally, two trials evaluating ACE inhibitors with beta-blockers demonstrated additive effects in preventing LVEF decline in high-risk populations. One trial also reported improved dyspnea with ACE inhibitors in lung cancer. RAS inhibitors may help preserve cardiac function in cancer patients, but current evidence is inconclusive. Confirmation through large-scale RCTs is warranted.

DOI： 10.1038/s41440-025-02402-w

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

As cancer treatments improve, hypertension has become a frequent comorbidity among cancer survivors. While it may result from the cancer itself or its treatment, the impact of hypertension on cancer recurrence remains poorly understood. We conducted a systematic review and meta-analysis to evaluate the association between hypertension and the risk of recurrence of solid cancers in adult survivors. We searched four major databases including PubMed, Embase, Web of Science and the Cochrane Library for relevant studies involving adult cancer survivors who had completed initial treatment for solid tumors. The primary outcome was recurrence risk in hypertensive versus normotensive individuals, assessed using hazard ratios (HRs) pooled through a random-effects model. Heterogeneity across studies was assessed using the I² statistic. Of 1337 records screened, 13 observational studies including 15 cohorts comprising 50,549 participants met the inclusion criteria. In the overall analysis, hypertension was not significantly associated with an increased risk of solid tumor recurrence (HR: 1.09; 95% CI: 0.97-1.22; I² = 49%). Subgroup analyses showed a significant association in colorectal cancer (HR: 1.18; 95% CI: 1.02-1.36; I² = 27%), but not in breast (HR: 1.09; 95% CI: 0.86-1.40; I² = 40%) or prostate cancer (HR: 1.12; 95% CI: 0.91-1.38; I² = 53%). However, no significant difference was found across subgroups (P = 0.18). These findings suggest a potential link between hypertension and recurrence in specific cancers, particularly colorectal cancer. Comprehensive blood pressure control may play a key role in the long-term management of cancer survivors.

DOI： 10.1038/s41440-025-02431-5

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Improvements in cancer survival rates have drawn attention to the long-term cardiovascular health of childhood and adolescent/young adult (AYA) cancer survivors. Hypertension is a key modifiable risk factor contributing to elevated cardiovascular morbidity and mortality in this population. However, its prevalence and persistence remain underexplored. To address this gap, we conducted a systematic review and meta-analysis by searching the PubMed, EMBASE, Cochrane, and Web of Science databases for studies on childhood and AYA cancer survivors who had completed treatment. Hypertension prevalence was pooled using a random-effects model, with subgroup analyses conducted by cancer types and follow-up duration. Meta-regression analysis assessed trends in hypertension prevalence over time. A total of 91 studies involving 86,132 patients met the inclusion criteria. The pooled prevalence of hypertension was 20.35% (95% CI, 17.90-22.80). Subgroup analysis demonstrated a significant time-dependent increase in hypertension prevalence: 16.60% within 10 years, 17.48% at 10-20 years, and 32.12% after 20 years (P = 0.04). Survivors of kidney tumors (24.80%) exhibited a trend toward higher hypertension prevalence compared to other cancer types. Meta-regression analysis confirmed that hypertension prevalence started increasing in the early post-treatment phase and remained significantly elevated over time, emphasizing the progressive and sustained cardiovascular risk in this population. Childhood and AYA cancer survivors face substantial and persistent risks of hypertension, underscoring the need for early detection and long-term management strategies. Enhanced survivorship care tailored to this population is essential to reduce cardiovascular risks and improve life expectancy globally.

DOI： 10.1038/s41440-025-02276-y

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Central venous obstruction following pacemaker implantation is not uncommon and can prove challenging in the case of a system upgrade to a cardiac resynchronization therapy pacemaker (CRT-P). We describe the case of a patient who underwent a successful upgrading procedure of a pacemaker to a CRT-P in the presence of an occluded left subclavian vein and superior vena cava, using collateral veins that drained into right atrium.

DOI： 10.1111/pace.14834

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.2169/internalmedicine.1491-22

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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開催年月日： 2021年2月

会議種別：口頭発表（一般）  

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会議種別：口頭発表（一般）  

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会議種別：口頭発表（一般）  

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会議種別：口頭発表（一般）  

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