論文 - 楠瀬　賢也

第三世代薬剤溶出性ステント留置後における局所凝固反応と総ステント長の関連性

山口 浩司, 若槻 哲三, 西條 良仁, 上野 理絵, 川端 豊, 坂東 美佳, 伊藤 浩敬, 轟 貴史, 松浦 朋美, 伊勢 孝之, 楠瀬 賢也, 飛梅 威, 八木 秀介, 山田 博胤, 添木 武, 佐田 政隆

日本心臓病学会学術集会抄録 ( (一社)日本心臓病学会 )  66回   EP - 001   2018年09月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

深部静脈血栓症に対する各種DOACsの治療成績 下肢静脈エコー検査を用いた検討

鳥居 裕太, 楠瀬 賢也, 西尾 進, 松本 力三, 平田 有紀奈, 天野 里江, 西條 良仁, 坂東 美佳, 山田 博胤, 佐田 政隆

日本心臓病学会学術集会抄録 ( (一社)日本心臓病学会 )  66回   EP - 187   2018年09月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

活性型血液凝固第X因子が冠動脈硬化に与える影響

福田 大受, 山口 浩司, 楠瀬 賢也, 八木 秀介, 山田 博胤, 若槻 哲三, 添木 武, 佐田 政隆

日本心臓病学会学術集会抄録 ( (一社)日本心臓病学会 )  66回   O - 044   2018年09月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

未固定遺体における冠動脈壁微小管腔構造と局所心臓周囲脂肪内炎症との関連

伊藤 浩敬, 若槻 哲三, 山口 浩司, 福田 大受, 川端 豊, 伊勢 孝之, 楠瀬 賢也, 松浦 朋美, 轟 貴史, 飛梅 威, 八木 秀介, 山田 博胤, 添木 武, 佐田 政隆

日本心臓病学会学術集会抄録 ( (一社)日本心臓病学会 )  66回   P - 016   2018年09月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

未固定遺体において光干渉断層法で観察される冠動脈壁微小管腔構造と局所周囲脂肪炎症との関連

川端 豊, 若槻 哲三, 山口 浩司, 伊藤 浩敬, 福田 大受, 伊勢 孝之, 楠瀬 賢也, 松浦 朋美, 轟 貴文, 飛梅 威, 八木 秀介, 山田 博胤, 添木 武, 佐田 政隆

日本心臓病学会学術集会抄録 ( (一社)日本心臓病学会 )  66回   P - 017   2018年09月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

Association of Decreased Docosahexaenoic Acid Level After Statin Therapy and Low Eicosapentaenoic Acid Level with In-Stent Restenosis in Patients with Acute Coronary Syndrome

八木 秀介, D Kondo, 伊勢 孝之, 福田 大受, 山口 浩司, 若槻 哲三, 川端 豊, 伊藤 浩敬, 西條 良仁, 瀬野 弘光, 數藤 久美子, 上野 理絵, 轟 貴史, 楠瀬 賢也, 松浦 朋美, 飛梅 威, 山田 博胤, 添木 武, 島袋 充生, KI Aihara, 赤池 雅史, 佐田 政隆

Journal of Atherosclerosis and Thrombosis   26 ( 3 ) 272 - 281   2018年08月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

AIM: It is speculated that statin therapy modulates the synthesis of polyunsaturated fatty acids (PUFA), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). However, the data available on the effects of statin therapy on the serum levels of PUFA and the subsequent impact on in-stent restenosis (ISR) in patients with acute coronary syndrome (ACS) are limited. METHODS: A total of 120 ACS patients who received emergent coronary stent implantation, follow-up coronary angiography to evaluate ISR, and new statin therapy were enrolled. We measured the serum levels of the PUFA and lipids at the onset of ACS and at the follow-up coronary angiography. RESULTS: The follow-up coronary angiography revealed 38 ISR cases. New statin therapy significantly reduced the serum levels of DHA and low-density lipoprotein cholesterol (LDL-C), while it did not affect EPA level. Single regression analysis revealed that a decreased serum level of LDL-C was associated with decreased DHA level. The multiple logistic regression analysis revealed that the decreased DHA level after statin therapy and low serum level of EPA on admission were determinants of prevalence of ISR. CONCLUSION: Statin therapy decreased the serum level of DHA with a parallel reduction in LDL-C level in patients with ACS. Decreased DHA level after statin therapy and low EPA level on admission are risk factors for ISR, indicating that in patients with ACS, decreased serum levels of DHA may be a residual target for the prevention of ISR.

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Clinical, Electrocardiographic, and Echocardiographic Parameter Combination Predicts the Onset of Atrial Fibrillation.

Soeki T, Matsuura T, Tobiume T, Bando S, Matsumoto K, Nagano H, Uematsu E, Kusunose K, Ise T, Yamaguchi K, Yagi S, Fukuda D, Yamada H, Wakatsuki T, Shimabukuro M, Sata M

Circulation journal : official journal of the Japanese Circulation Society   82 ( 9 ) 2253 - 2258   2018年08月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

BACKGROUND: The ability to identify risk markers for new-onset atrial fibrillation (AF) is critical to the development of preventive strategies, but it remains unknown whether a combination of clinical, electrocardiographic, and echocardiographic parameters predicts the onset of AF. In the present study, we evaluated the predictive value of a combined score that includes these parameters. Methods and Results: We retrospectively studied 1,040 patients without AF who underwent both echocardiography and 24-h Holter electrocardiography between May 2005 and December 2010. During a median follow-up period of 68.4 months (IQR, 49.9-93.3 months), we investigated the incidence of new-onset AF. Of the 1,040 patients, 103 (9.9%) developed AF. Patients who developed AF were older than patients who did not. Total heart beats, premature atrial contraction (PAC) count, maximum RR interval, and frequency of sinus pause quantified on 24-h electrocardiography were associated with new-onset AF. LA diameter (LAD) on echocardiography was also associated with the development of AF. On multivariate Cox analysis, age ≥58 years, PAC count ≥80 beats/day, maximum RR interval ≥1.64 s, and LAD ≥4.5 cm were independently associated with the development of AF. The incidence rate of new-onset AF significantly increased as the combined score (i.e., the sum of the risk score determined using hazard ratios) increased. CONCLUSIONS: A combined score that includes age, PAC count, maximum RR interval, and LAD could help characterize the risk of new-onset AF.

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A clinical application of preload stress echocardiography for predicting future hemodynamic worsening in patients with early-stage heart failure.

西條 良仁, 山田 博胤, 楠瀬 賢也, 坂東 美佳, 西尾 進, 鳥居 裕太, 平田 有紀奈, 瀬野 弘光, 松浦 朋美, 伊勢 孝之, 飛梅 威, 山口 浩司, 八木 秀介, 添木 武, 若槻 哲三, 佐田 政隆

Echocardiography   35 ( 10 ) 1587 - 1595   2018年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

AIM: To improve the prognosis of patients with heart failure, risk stratification in their early stage is important. We assessed whether the change in transmitral flow (TMF) velocity pattern during preload augmentation can predict future hemodynamic worsening in early-stage heart failure patients with impaired relaxation TMF pattern. METHODS: We designed a prospective cohort study that included 155 consecutive patients with impaired relaxation (IR) pattern at rest. Preload stress echocardiography was achieved using leg-positive pressure (LPP), and changes in TMF pattern during the LPP was observed during baseline echocardiographic examination. The patients whose TMF pattern developed to pseudonormal (PN) pattern throughout the study period were classified into the change to PN group, and patients whose TMF pattern stayed in IR pattern were classified into the stay in IR group. RESULTS: The median follow-up period was 17 months. The average age was 68 ± 11 years old, and 97 patients (63%) were male. Among 155 patients, 27 were classified into the change to PN group. A Cox proportional hazard analysis confirmed that the change in the peak atrial systolic TMF velocity during the LPP (ΔA, hazard ratio = 0.58 per 1SD; 95% CI = 0.39-0.88, P = 0.010) was the powerful independent predictor of change into PN pattern. Kaplan-Meier analysis revealed that the patients with ΔA ≤ -7 cm/s had more likely to develop into PN pattern than patients with ΔA > -7 cm/s (P = 0.001). CONCLUSIONS: Evaluation of a response in TMF during the LPP might provide an incremental diagnostic value to detect future overt heart failure in patients with early-stage heart failure.

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Novel Echocardiographic Parameters in Patients With Aortic Stenosis and Preserved Left Ventricular Systolic Function Undergoing Surgical Aortic Valve Replacement.

Huded CP, Kusunose K, Shahid F, Goodman AL, Alashi A, Grimm RA, Gillinov AM, Johnston DR, Rodriguez LL, Popovic ZB, Sato, Kimi, Svensson LG, Griffin BP, Desai MY

Am J Cardiol.     2018年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Reduced variability of visual left ventricular ejection fraction assessment with reference images: The Japanese Association of Young Echocardiography Fellows multicenter study.

Kenya Kusunose, Kentaro Shibayama, Hiroyuki Iwano, Masaki Izumo, Nobuyuki Kagiyama, Koji Kurosawa, Hirotsugu Mihara, Hiroki Oe, Tetsuari Onishi, Toshinari Onishi, Mitsuhiko Ota, Shunsuke Sasaki, Yumi Shiina, Hikaru Tsuruta, Hidekazu Tanaka

Journal of cardiology   72 ( 1 ) 74 - 80   2018年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

BACKGROUND: Visual estimation of left ventricular ejection fraction (LVEF) is widely applied to confirm quantitative EF. However, visual assessment is subjective, and variability may be influenced by observer experience. We hypothesized that a learning session might reduce the misclassification rate. METHODS: Protocol 1: Visual LVEFs for 30 cases were measured by 79 readers from 13 cardiovascular tertiary care centers. Readers were divided into 3 groups by their experience: limited (1-5 years, n=28), intermediate (6-11 years, n=26), and highly experienced (12-years, n=25). Protocol 2: All readers were randomized to assess the effect of a learning session with reference images only or feedback plus reference images. After the session, 20 new cases were shown to all readers following the same methodology. To assess the concordance and accuracy pre- and post-intervention, each visual LVEF measurement was compared to overall average values as a reference. RESULTS: Experience affected the concordance in visual EF values among the readers. Groups with intermediate and high experience showed significantly better mean difference (MD), standard deviation (SD), and coefficient of variation (CV) than those with limited experience at baseline. The learning session with reference image reduced the MD, SD, and CV in readers with limited experience. The learning session with reference images plus feedback also reduced proportional bias. Importantly, the misclassification rate for mid-range EF cases was reduced regardless of experience. CONCLUSION: This large multicenter study suggested that a simple learning session with reference images can successfully reduce the misclassification rate for LVEF assessment.

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Prognostic Value of Frailty and Diastolic Dysfunction in Elderly Patients.

Kusunose K, Okushi Y, Yamada H, Nishio S, Torii Y, Hirata Y, Saijo Y, Ise T, Yamaguchi K, Yagi S, Soeki T, Wakatsuki T, Sata M

Circulation journal : official journal of the Japanese Circulation Society   82 ( 8 ) 2103 - 2110   2018年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

BACKGROUND: High prevalence of frailty and of diastolic dysfunction (DD) in heart failure and high mortality in frail adults have been noted. We characterized frailty by quantifying differences on echocardiography, and assessed the added prognostic utility of frailty and DD grade in an elderly population. METHODS AND RESULTS: One hundred and ninety-one patients ≥65 years who had at least 1 cardiovascular risk factor were prospectively recruited for clinically indicated echocardiography at the present institute. Weight loss, exhaustion, and deficits in physical activity, gait speed, and handgrip strength were used to categorize patients as frail (≥3 features), intermediately frail (1 or 2 features), or non-frail (0 features). DD grade ≥2 was defined as severe. Frailty was associated with larger left atrial volume, smaller stroke volume, and worse DD grade after adjustment for age. In a period of 14 months, 29 patients (15%) had cardiovascular events. The addition of frailty score and severe DD significantly improved the prognostic power of a model containing male gender (model 1, male gender, χ2=6.4; model 2, model 1 plus frailty score, χ2=16.7, P=0.004; model 3, model 2 plus severe DD, χ2=25.5, P=0.015). CONCLUSIONS: Both frailty and DD grade were significantly associated with future cardiovascular events in an elderly population with preserved ejection fraction and ≥1 risk factor of cardiovascular disease.

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Clinical, Electrocardiographic, and Echocardiographic Parameter Combination Predicts the Onset of Atrial Fibrillation.

添木 武, 松浦 朋美, 飛梅 威, 坂東 佐知子, 松本 和久, H Nagano, E Uematsu, 楠瀬 賢也, 伊勢 孝之, 山口 浩司, 八木 秀介, 福田 大受, 山田 博胤, 若槻 哲三, 島袋 充生, 佐田 政隆

Circulation Journal   82 ( 9 ) 2253 - 2258   2018年05月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

The ability to identify risk markers for new-onset atrial fibrillation (AF) is critical to the development of preventive strategies, but it remains unknown whether a combination of clinical, electrocardiographic, and echocardiographic parameters predicts the onset of AF. In the present study, we evaluated the predictive value of a combined score that includes these parameters.Methods and Results:We retrospectively studied 1,040 patients without AF who underwent both echocardiography and 24-h Holter electrocardiography between May 2005 and December 2010. During a median follow-up period of 68.4 months (IQR, 49.9-93.3 months), we investigated the incidence of new-onset AF. Of the 1,040 patients, 103 (9.9%) developed AF. Patients who developed AF were older than patients who did not. Total heart beats, premature atrial contraction (PAC) count, maximum RR interval, and frequency of sinus pause quantified on 24-h electrocardiography were associated with new-onset AF. LA diameter (LAD) on echocardiography was also associated with the development of AF. On multivariate Cox analysis, age ?58 years, PAC count ?80 beats/day, maximum RR interval ?1.64 s, and LAD ?4.5 cm were independently associated with the development of AF. The incidence rate of new-onset AF significantly increased as the combined score (i.e., the sum of the risk score determined using hazard ratios) increased. A combined score that includes age, PAC count, maximum RR interval, and LAD could help characterize the risk of new-onset AF.

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Noninvasive Assessment of Preload Reserve Enhances Risk Stratification of Patients With Heart Failure With Reduced Ejection Fraction.

Kensuke Matsumoto, Akira Onishi, Hirotsugu Yamada, Kenya Kusunose, Makiko Suto, Yutaka Hatani, Hiroki Matsuzoe, Kazuhiro Tatsumi, Hidekazu Tanaka, Ken-Ichi Hirata

Circulation. Cardiovascular imaging   11 ( 5 ) e007160 - e007160   2018年05月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

BACKGROUND: The leg-positive pressure maneuver can safely and noninvasively apply preload stress without increase in total body fluid volume. The purpose of this study was to determine whether preload stress could be useful for risk stratification of patients with heart failure with reduced ejection fraction. METHODS AND RESULTS: For this study, 120 consecutive patients with heart failure with reduced ejection fraction were prospectively recruited. The stroke work index was estimated as product of stroke volume index and mean blood pressure, and the E/e' ratio was calculated to estimate ventricular filling pressure. The echocardiographic parameters were obtained both at rest and during leg-positive pressure stress. During the median follow-up period of 20 months, 30 patients developed adverse cardiovascular events. During preload stress, stroke work index increased significantly (from 3280±1371 to 3857±1581 mm Hg·mL/m2; P<0.001) along with minimal changes in ventricular filling pressure (E/e', from 16±10 to 17±9; P<0.05) in patients without cardiovascular events. However, patients with cardiovascular events showed impairment of Frank-Starling mechanism (stroke work index, from 2863±969 to 2903±1084 mm Hg·mL/m2; P=0.70) and a serious increase in E/e' ratio (from 19±11 to 25±14; P<0.001). Both the patients without contractile reserve and those without diastolic reserve exhibited worse event-free survival than the others (P<0.001). In a Cox proportional-hazards analysis, the changes in stroke work index (hazard ratio: 0.44 per 500 mm Hg·mL/m2 increase; P=0.001) and in E/e' (hazard ratio: 2.58 per 5-U increase; P<0.001) were predictors of cardiovascular events. CONCLUSION: Contractile reserve and diastolic reserve during leg-positive pressure stress are important determinants of cardiovascular outcomes for patients with heart failure with reduced ejection fraction.

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Prognostic Value of Frailty and Diastolic Dysfunction in Elderly Patients.

楠瀬 賢也, Y Okushi, 山田 博胤, 西尾 進, 鳥居 裕太, 平田 有紀奈, 西條 良仁, 伊勢 孝之, 山口 浩司, 八木 秀介, 添木 武, 若槻 哲三, 佐田 政隆

Circulation Journal   82 ( 8 ) 2103 - 2110   2018年04月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

High prevalence of frailty and of diastolic dysfunction (DD) in heart failure and high mortality in frail adults have been noted. We characterized frailty by quantifying differences on echocardiography, and assessed the added prognostic utility of frailty and DD grade in an elderly population. One hundred and ninety-one patients ?65 years who had at least 1 cardiovascular risk factor were prospectively recruited for clinically indicated echocardiography at the present institute. Weight loss, exhaustion, and deficits in physical activity, gait speed, and handgrip strength were used to categorize patients as frail (?3 features), intermediately frail (1 or 2 features), or non-frail (0 features). DD grade ?2 was defined as severe. Frailty was associated with larger left atrial volume, smaller stroke volume, and worse DD grade after adjustment for age. In a period of 14 months, 29 patients (15%) had cardiovascular events. The addition of frailty score and severe DD significantly improved the prognostic power of a model containing male gender (model 1, male gender, χ=6.4; model 2, model 1 plus frailty score, χ=16.7, P=0.004; model 3, model 2 plus severe DD, χ=25.5, P=0.015). Both frailty and DD grade were significantly associated with future cardiovascular events in an elderly population with preserved ejection fraction and ?1 risk factor of cardiovascular disease.

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Calcified Amorphous Tumorに対し腫瘍摘出術を行った一例

清水 郁子, 瀬野 弘光, 山口 浩司, 楠瀬 賢也, 山田 博胤, 若槻 哲三, 添木 武, 佐田 政隆, 岩瀬 俊, 黒部 裕嗣, 北川 哲也

四国医学雑誌 ( 徳島医学会 )  74 ( 1-2 ) 84 - 84   2018年04月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Local Thickness of Epicardial Adipose Tissue Surrounding the Left Anterior Descending Artery Is a Simple Predictor of Coronary Artery Disease - New Prediction Model in Combination With Framingham Risk Score.

Maimaituxun G, Shimabukuro M, Fukuda D, Yagi S, Hirata Y, Iwase T, Takao S, Matsuura T, Ise T, Kusunose K, Tobiume T, Yamaguchi K, Yamada H, Soeki T, Wakatsuki T, Harada M, Sata M

Circulation journal : official journal of the Japanese Circulation Society   82 ( 5 ) 1369 - 1378   2018年04月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

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Paclitaxel投与を併用した冠動脈形成術後の局所凝固療法への反応の差(Differential Response of Local Coagulation after Coronary Angioplasty with Paclitaxel)

山口 浩司, 若槻 哲三, 川端 豊, 伊藤 浩敬, 轟 貴史, 松浦 朋美, 伊勢 孝之, 楠瀬 賢也, 飛梅 威, 八木 秀介, 山田 博胤, 添木 武, 佐田 政隆

日本循環器学会学術集会抄録集 ( (一社)日本循環器学会 )  82回   PJ022 - 1   2018年03月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

心血管系イベント予測のための上腕収縮期血圧左右差の至適カットオフ値の設定および検証(Development and Validation of Optimal Cut-off Value in inter-armsystolic Blood Pressure Difference for Prediction of Cardiovascular Events)

廣野 明, 楠瀬 賢也, 蔭山 徳人, 藤永 裕之, 佐田 政隆

日本循環器学会学術集会抄録集 ( (一社)日本循環器学会 )  82回   PJ033 - 2   2018年03月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

栄養血管の増殖は新鮮遺体において冠動脈プラーク周囲の局所炎症と関連する(Growth of Vasa Vasorum is Associated with Local Inflammation around Coronary Plaque in Fresh Cadavers)

伊藤 浩敬, 若槻 哲三, 山口 浩司, 福田 大受, 川端 豊, 轟 貴史, 松浦 朋美, 伊勢 孝之, 楠瀬 賢也, 飛梅 威, 八木 秀介, 山田 博胤, 添木 武, 佐田 政隆

日本循環器学会学術集会抄録集 ( (一社)日本循環器学会 )  82回   PJ007 - 3   2018年03月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

高血圧患者におけるL/N型カルシウム拮抗薬が蛋白尿およびangiotensin II-reninフィードバックに及ぼす効果(Effects of L-/N-type Calcium Channel Blocker on Proteinuria and Angiotensin II-renin Feedback in Hypertensive Patients)

川端 豊, 添木 武, 伊勢 孝之, 松浦 朋美, 楠瀬 賢也, 飛梅 威, 八木 秀介, 山口 浩司, 山田 博胤, 若槻 哲三, 佐田 政隆

日本循環器学会学術集会抄録集 ( (一社)日本循環器学会 )  82回   PJ067 - 4   2018年03月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）