{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1390282679679802624.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.4326/jjcvs.38.91"}},{"identifier":{"@type":"NAID","@value":"130004886927"}},{"identifier":{"@type":"URI","@value":"https://search.jamas.or.jp/link/ui/2009143063"}}],"dc:title":[{"@language":"en","@value":"A Novel Strategy with Fasudil, a Rho-kinase Inhibitor for Intractable Perioperative Myocardial Ischemia with Coronary Spasm"},{"@language":"ja","@value":"冠動脈スパズムを含む周術期難治性心筋虚血に対する塩酸ファスジルの有用性"}],"dc:language":"ja","description":[{"type":"abstract","notation":[{"@language":"en","@value":"We experienced 6 cases of intractable perioperative myocardial ischemia with coronary spasm that was successfully treated with fasudil, a Rho-kinase inhibitor. Three of the patients (aged 49-81 years) showed ST elevation on electrocardiograms and abrupt circulatory collapse after off-pump coronary artery bypass grafting. Emergeny coronary angiogram revealed severe spasm of their own coronary arteries and/or bypass grafts. Since intracoronary and/or intragraft injection of isosorbide dinitrate (ISDN) was ineffective, we administered fasudil into the spastic vessels, and that completely resolved the spasm. The other 3 patients (aged 55-77 years) suffered myocardial ischemia during the operation, though intravenous vasodilators including ISDN, diltiazem and nicorandil had been administered continuously. Their ischemia occurred when the aorta was declamped, the pericardium opened, or the bypass graft was anastomosed, respectively. We decided to use fasudil in these cases since ISDN was ineffective, or severe spasm was found on intraoperative inspection. Administration of fasudil successfully relieved the ischemia, and subsequently all 3 patients could be weaned from the cardiopulmonary bypass during the operation. Fasudil completely resolved the myocardial ischemia in all 6 patients. In conclusion, fasudil, a Rho-kinase inhibitor, is a useful agent for perioperative myocardial ischemia including coronary spasm that is resistant to intensive conventional vasodilator therapy. We should administer fasudil and relieve spasms as early as possible to rescue patients with intractable ischemia."},{"@language":"ja","@value":"開心術周術期に治療抵抗性の難治性心筋虚血（冠動脈スパズムを含む）を発症した6例に対し，Rho-kinase阻害剤である塩酸ファスジルを使用した．術後急性期に発症した3例は年齢49～81歳，男性2例，女性1例であった．術直後～手術3時間後にST上昇を伴う循環虚脱を来たした．緊急冠動脈造影を行ったところ，冠動脈あるいはバイパスグラフトのスパズムを認めた．硝酸イソソルビド（ISDN）の冠動脈内投与を行うも軽快が得られなかったため，塩酸ファスジルをスパズム発症血管に対し選択的に投与したところ，3例ともに解除に成功した．術中に発症した3例は年齢57～77歳，いずれも男性であった．大動脈遮断解除後，心膜切開直後，バイパスグラフト吻合中に心筋虚血を発症した．ISDN無効あるいはスパズム疑診例であったため塩酸ファスジルを投与したところ，血行動態の安定化が得られ3例とも術中に体外循環を離脱し得た．スパズムと確定診断された症例はもとより，他剤無効例，スパズム疑診例に対しても塩酸ファスジルは有効であった．Rho-kinaseを標的とした治療戦略は，冠動脈スパズムを含む周術期難治性心筋虚血に対する新たな治療手段となり得る．"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410853647298931329","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000283455384"}],"foaf:name":[{"@language":"en","@value":"Maeda Taketoshi"},{"@language":"ja","@value":"前田 武俊"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Cardiovascular Surgery, Kyushu University Graduate School of Medical Sciences"},{"@language":"ja","@value":"九州大学大学院医学研究院循環器外科学"}]},{"@id":"https://cir.nii.ac.jp/crid/1030003658513966338","@type":"Researcher","personIdentifier":[{"@type":"KAKEN_RESEARCHERS","@value":"40372742"},{"@type":"NRID","@value":"1000040372742"},{"@type":"NRID","@value":"9000003869129"},{"@type":"NRID","@value":"9000003897382"}],"foaf:name":[{"@language":"en","@value":"Tanoue Yoshihisa"},{"@language":"ja","@value":"田ノ上 禎久"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Cardiovascular Surgery, Kyushu University Graduate School of Medical Sciences"},{"@language":"ja","@value":"九州大学大学院医学研究院循環器外科学"}]},{"@id":"https://cir.nii.ac.jp/crid/1410853647298931330","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000283455386"}],"foaf:name":[{"@language":"en","@value":"Nagasaki Etsuko"},{"@language":"ja","@value":"長嵜 悦子"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Cardiovascular Surgery, Kyushu University Graduate School of Medical Sciences"},{"@language":"ja","@value":"九州大学大学院医学研究院循環器外科学"}]},{"@id":"https://cir.nii.ac.jp/crid/1030003658539996033","@type":"Researcher","personIdentifier":[{"@type":"KAKEN_RESEARCHERS","@value":"20419526"},{"@type":"NRID","@value":"1000020419526"},{"@type":"NRID","@value":"9000003920634"},{"@type":"NRID","@value":"9000283455387"},{"@type":"NRID","@value":"9000240035066"},{"@type":"NRID","@value":"9000257997539"}],"foaf:name":[{"@language":"en","@value":"Eto Masataka"},{"@language":"ja","@value":"江藤 政尚"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Cardiovascular Surgery, Kyushu University Graduate School of Medical 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Yuichi"},{"@language":"ja","@value":"塩川 祐一"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"九州大学大学院医学研究院循環器外科学"},{"@language":"en","@value":"Department of Cardiovascular Surgery, Kyushu University Graduate School of Medical Sciences"}]},{"@id":"https://cir.nii.ac.jp/crid/1410853647298931334","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000283455391"}],"foaf:name":[{"@language":"en","@value":"Tomita Yukihiro"},{"@language":"ja","@value":"富田 幸裕"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Cardiovascular Surgery, Kyushu University Graduate School of Medical Sciences"},{"@language":"ja","@value":"九州大学大学院医学研究院循環器外科学"}]},{"@id":"https://cir.nii.ac.jp/crid/1410853647298931328","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000283455392"}],"foaf:name":[{"@language":"en","@value":"Tominaga Ryuji"},{"@language":"ja","@value":"富永 隆治"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Cardiovascular Surgery, Kyushu University Graduate School of Medical Sciences"},{"@language":"ja","@value":"九州大学大学院医学研究院循環器外科学"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"02851474"},{"@type":"EISSN","@value":"18834108"}],"prism:publicationName":[{"@language":"en","@value":"Japanese Journal of Cardiovascular Surgery"},{"@language":"ja","@value":"日本心臓血管外科学会雑誌"},{"@language":"en","@value":"Nihon Shinzo Kekkan Geka Gakkai zasshi"},{"@language":"en","@value":"Japanese Journal of Cardiovascular Surgery Official Publication of the Japanese Society for Cardiovascular Surgery"},{"@language":"en","@value":"J. J. C. V. S."},{"@language":"ja","@value":"日心外会誌"},{"@language":"en","@value":"J.J.C.V.S"}],"dc:publisher":[{"@language":"en","@value":"The Japanese Society for Cardiovascular Surgery"},{"@language":"ja","@value":"特定非営利活動法人 日本心臓血管外科学会"}],"prism:publicationDate":"2009","prism:volume":"38","prism:number":"2","prism:startingPage":"91","prism:endingPage":"95"},"reviewed":"false","url":[{"@id":"https://search.jamas.or.jp/link/ui/2009143063"}],"availableAt":"2009","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=%E5%86%A0%E5%8B%95%E8%84%88%E3%82%B9%E3%83%91%E3%82%BA%E3%83%A0","dc:title":"冠動脈スパズム"},{"@id":"https://cir.nii.ac.jp/all?q=%E9%9B%A3%E6%B2%BB%E6%80%A7%E5%BF%83%E7%AD%8B%E8%99%9A%E8%A1%80","dc:title":"難治性心筋虚血"},{"@id":"https://cir.nii.ac.jp/all?q=Rho-kinase","dc:title":"Rho-kinase"},{"@id":"https://cir.nii.ac.jp/all?q=%E5%A1%A9%E9%85%B8%E3%83%95%E3%82%A1%E3%82%B9%E3%82%B8%E3%83%AB","dc:title":"塩酸ファスジル"},{"@id":"https://cir.nii.ac.jp/all?q=Rho-kinase","dc:title":"Rho-kinase"}],"relatedProduct":[{"@id":"https://cir.nii.ac.jp/crid/1360292621572012928","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Rho-kinase-mediated pathway induces enhanced myosin light chain phosphorylations in a swine model of coronary artery spasm"}]},{"@id":"https://cir.nii.ac.jp/crid/1360855569435460096","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Suppression of Coronary Artery Spasm by the Rho-Kinase Inhibitor Fasudil in Patients With Vasospastic Angina"}]},{"@id":"https://cir.nii.ac.jp/crid/1361137043975377536","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"A postmarketing surveillance study of fasudil treatment after aneurysmal subarachnoid hemorrhage"}]},{"@id":"https://cir.nii.ac.jp/crid/1361981471104001152","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Signal transduction by G‐proteins, Rho‐kinase and protein phosphatase to smooth muscle and non‐muscle myosin II"}]},{"@id":"https://cir.nii.ac.jp/crid/1363388845604252032","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Rho-kinase as a Novel Therapeutic Target in Treatment of Cardiovascular Diseases"}]},{"@id":"https://cir.nii.ac.jp/crid/1363670318362813696","@type":"Article","relationType":["references"],"jpcoar:relatedTitle":[{"@value":"Perioperative coronary arterial spasm: Long-term follow-up"}]}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:0032846554"},{"@type":"CROSSREF","@value":"10.4326/jjcvs.38.91"},{"@type":"CIA","@value":"130004886927"}]}