論文 - 楠瀬　賢也

心拍出量の増加が血流依存性血管拡張反応に及ぼす影響(若年健常者における検討)

西尾 進, 山田 博胤, 楠瀬 賢也, 真鍋 泰毅, 平田 有紀奈, 鳥居 裕太, 天野 里江, 山尾 雅美, 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 )  64回   優秀MS - 4   2016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）

心不全患者に対するAdaptive servo-ventilation装着下6分間歩行における運動耐容能改善効果

八木 秀介, 伊勢 孝之, 西川 幸治, 石井 亜由美, 楠瀬 賢也, 山口 浩司, 松浦 朋美, 飛梅 威, 山田 博胤, 添木 武, 若槻 哲三, 赤池 雅史, 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 )  64回   P - 511   2016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）

下肢陽圧負荷心エコー検査により将来の左房圧上昇を予測できるか

西條 良仁, 楠瀬 賢也, 山田 博胤, 瀬野 弘光, 西尾 進, 伊勢 孝之, 八木 秀介, 山口 浩司, 添木 武, 若槻 哲三, 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 )  64回   優秀D - 2   2016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）

Predictors and Prognostic Significance of Right Ventricular Ejection Fraction in Patients With Ischemic Cardiomyopathy

Marwa A. Sabe, Sharif A. Sabe, Kenya Kusunose, Scott D. Flamm, Brian P. Griffin, Deborah H. Kwon

CIRCULATION ( LIPPINCOTT WILLIAMS & WILKINS )  134 ( 9 ) 656 - 665   2016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: Decreased right ventricular (RV) ejection fraction (RVEF) portends poor prognosis in patients with ischemic cardiomyopathy, and previous studies have suggested an association between mitral regurgitation (MR) and RVEF. We sought to evaluate this association and whether mitral valve repair or replacement affects the relationship between RV function and mortality. METHODS: We included 588 patients (mean age, 63 +/- 11 years; 75% male) with ischemic cardiomyopathy who underwent cardiac magnetic resonance imaging between 2002 and 2008. Baseline characteristics, left ventricular ejection fraction, MR severity, treatment modality, scar burden, and RVEF were assessed. Multivariable linear regression and Cox proportional hazards models were used to assess the association between MR and RVEF and between RVEF and mortality, respectively. RESULTS: After adjustment for age, sex, left ventricular ejection fraction, right bundle-branch block, and RV scar, MR severity was found to be associated independently with RVEF. There were a total of 240 deaths during a median follow-up time of 5.7 years. After multivariable adjustment, every 10% decrease in RVEF was associated with a 17% increased risk of death (P=0.008). Although decreasing RVEF was associated with a poor prognosis in the nonrepair group (hazard ratio, 1.28; 95% confidence interval, 1.12-1.47; P<0.001), it was not associated with death in the mitral valve repair or replacement group (P for interaction=0.046). CONCLUSIONS: MR severity was found to be an independent predictor of RVEF, as were right bundle-branch block, left ventricular ejection fraction, and the presence of RV scar. Decreasing RVEF is associated with increased mortality in patients with ischemic cardiomyopathy; however, this association may be mitigated in patients who undergo mitral valve repair or replacement.

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表在エコー図検査と心エコー図検査のコラボレーションにより感染性心内膜炎が迅速に診断できた僧帽弁逸脱症の1例:Staphylococcus warneriによる自己弁への感染性心内膜炎

山田 博胤, 田中 秀和, 宮原 俊介, 尾形 竜郎, 楠瀬 賢也, 西尾 進, 鳥居 裕太, 平田 有紀奈, 大北 裕, 佐田 政隆

超音波医学 ( 一般社団法人 日本超音波医学会 )  Vol.43 ( No.4 ) 581 - 586   2016年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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症例は，46歳男性，循環器内科医師，主訴は左足関節内果部と上腕の疼痛である．僧帽弁逸脱症による僧帽弁逆流と発作性心房細動の既往がある．足関節の疼痛は蜂窩織炎を疑って，血液検査と表在エコー図検査を行った．疼痛部は皮下浮腫が著明であったが，軟部組織の血流シグナルが乏しく，後脛骨動脈の血管壁を主体とした炎症と，同動脈の閉塞が確認された．一方，左手関節近位の尺骨動脈は逆行性血流を示しており，左尺骨動脈分岐部直後で閉塞していた．これらの所見から多発性血管閉塞性動脈炎と診断し，その原因究明のために直ちに心エコー図検査を施行した．その結果，僧帽弁に可動性を有する棍棒状の異常構造物を認め，僧帽弁逆流は高度に増悪しており，感染性心内膜炎と診断された．頭部MRI検査で異常を認めなかったため，外科的加療(疣腫摘除術，僧帽弁形成術，左房縫縮術，左心耳閉鎖術，Maze手術)が行われた．血液培養は陰性であったが，摘出した疣腫の培養からStaphylococcus warneriが同定された．Staphylococcus warneriは皮膚常在菌であり，本病原体による自己弁の感染性心内膜炎は報告が少ない．術後の経過は良好であり，抗生剤を6週間静脈投与した後に社会復帰した．患者が循環器内科医であり，自身の足関節および上腕の疼痛を契機に，表在エコー図検査と心エコー図検査を用いることで，感染性心内膜炎を迅速に診断した稀有な症例であり，かつ，感染性心内膜炎の起炎菌としては稀なStaphylococcus warneriが同定されたので，文献的な考察を加えて報告する．

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Predictors and Prognostic Impact of Progressive Ischemic Mitral Regurgitation in Patients With Advanced Ischemic Cardiomyopathy A Multimodality Study

Deborah H. Kwon, Kenya Kusunose, Nancy A. Obuchowski, Joao L. Cavalcante, Zoran B. Popovic, James D. Thomas, Milind Y. Desai, Scott D. Flamm, Brian P. Griffin

Circulation-Cardiovascular Imaging ( LIPPINCOTT WILLIAMS & WILKINS )  9 ( 7 )   2016年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Background-Ischemic mitral regurgitation (IMR) is associated with poor outcomes. It is unknown what factors contribute to progression of IMR and how progressive IMR affects outcomes. We sought to determine imaging predictors of IMR progression and to determine if progressive IMR is an independent predictor of survival in patients with advanced ischemic cardiomyopathy. Methods and Results-Consecutive advanced ischemic cardiomyopathy patients who underwent cardiac magnetic resonance and echocardiograms at baseline with echocardiographic follow-up were studied. Cardiac magnetic resonance was used to assess left ventricular volumes, infarct size, and mitral valve geometry. The effective regurgitant orifice area (EROA) was calculated from the proximal isovelocity surface area by echocardiography. Repeated measures mixed effects and Cox proportional hazards regression models were built to identify predictors of IMR progression and survival. We evaluated 336 patients (age, 62 +/- 11 years) over a median follow-up time of 54 months: 154 patients were subsequently revascularized, and 182 patients were medically treated. Ninety-eight patients (29%) demonstrated an increase in EROA values of >= 0.1 cm(2). There were 87 adverse events (death or transplant). On multivariable analysis, infarct size (P<0.001), progression in IMR (P=0.008), age (P=0.003), and baseline EROA (P=0.010) were independently associated with adverse events. Independent predictors of IMR progression were as follows: baseline EROA (P<0.001), left ventricular end-systolic volume index (P=0.014), and total scar (P=0.036). Conclusions-IMR frequently increases in severity, and progression is independently associated with adverse left ventricular remodeling and infarct size, as assessed by cardiac magnetic resonance. Furthermore, IMR progression is a powerful independent predictor of adverse events, even after controlling for the severity of IMR at baseline.

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Association of Abnormal Postoperative Left Ventricular Global Longitudinal Strain With Outcomes in Severe Aortic Stenosis Following Aortic Valve Replacement

Rami Kafa, Kenya Kusunose, Andrew L. Goodman, Lars G. Svensson, Joseph F. Sabik, Brian P. Griffin, Milind Y. Desai

JAMA CARDIOLOGY ( AMER MEDICAL ASSOC )  1 ( 4 ) 494 - 496   2016年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Noninvasive Vascular Function Tests - Long Journey for Predicting Cardiovascular Events

Kenya Kusunose, Hirotsugu Yamada

CIRCULATION JOURNAL ( JAPANESE CIRCULATION SOC )  80 ( 6 ) 1321 - 1322   2016年06月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Left Ventricular Global Strain for Estimating Relaxation and Filling Pressure - A Multicenter Study -

Taichi Hayashi, Satoshi Yamada, Hiroyuki Iwano, Masahiro Nakabachi, Mamoru Sakakibara, Kazunori Okada, Daisuke Murai, Hisao Nishino, Kenya Kusunose, Kiyotaka Watanabe, Tomoko Ishizu, Kazuaki Wakami, Hirotsugu Yamada, Kaoru Dohi, Yoshihiro Seo, Nobuyuki Ohte, Taisei Mikami, Hiroyuki Tsutsui

CIRCULATION JOURNAL ( JAPANESE CIRCULATION SOC )  80 ( 5 ) 1163 - 1170   2016年05月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Background: Speckle-tracking echocardiography (STE)-derived parameters may have better correlation with left ventricular (LV) relaxation and filling pressure than tissue Doppler-derived parameters. However, it has not been elucidated which parameter - strain or strain rate - and which direction of myocardial deformation - longitudinal or circumferential - is the most useful marker of LV relaxation and filling pressure. Methods and Results: We conducted a prospective multicenter study and compared the correlation of tissue Doppler-and STE-derived parameters with the time constant of LV pressure decay (tau) and LV mean diastolic pressure (MDP) in 77 patients. The correlation of early-diastolic mitral annular velocity (e') with t was weak (r=-0.32, P<0.01), and that of peak longitudinal strain (LS) was the strongest (r=-0.45, P<0.001) among the STE-derived parameters. There was a modest correlation between LVMDP and the ratio of early-diastolic inflow velocity (E) to e' (E/e') (r=0.50, P<0.001). In contrast, the ratio of E to LS (E/LS) correlated strongly with LVMDP (r=0.70, P<0.001). The correlation of E/LS with LVMDP was significantly better than that for E/e' (P<0.01). Receiver-operating characteristic analysis showed that E/LS had the largest area under the curve for distinguishing elevated LVMDP (E/LS 0.86, E/e' 0.74, E/A 0.67). Conclusions: STE-derived longitudinal parameters correlated well with LV relaxation and filling pressure. In particular, E/LS could be more accurate than E/e' for estimating LV filling pressure.

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Prognostic implication of relative regional strain ratio in cardiac amyloidosis

Alpana Senapati, Brett W. Sperry, Justin L. Grodin, Kenya Kusunose, Paaladinesh Thavendiranathan, Wael Jaber, Patrick Collier, Mazen Hanna, Zoran B. Popovic, Dermot Phelan

HEART ( BMJ PUBLISHING GROUP )  102 ( 10 ) 748 - 754   2016年05月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Objective Cardiac amyloidosis (CA) is a rapidly progressive disease that portends poor prognosis. Our objective was to evaluate the prognostic impact of relative regional strain ratio (RRSR, a measure of the relative apical sparing of longitudinal strain (LS)) in CA. Methods This is a retrospective study evaluating 97 patients with CA from 2004 to 2013. Patients were included if they met criteria for CA based on endomyocardial biopsy or advanced imaging criteria coupled with either extracardiac biopsy or genetic analysis. Baseline clinical and imaging data were collected and compared between light-chain amyloidosis (AL) (n=59) and transthyretin amyloidosis (ATTR) (n=38) subtypes. RRSR was defined as the average apical LS divided by the sum of the average mid and basal LS values. A Cox proportional hazards model was used to assess the effects of clinical and echocardiographic characteristics, including RRSR, on the outcome of time to death or heart transplantation. Results Despite younger age, the AL subtype had a statistically significant association with the composite outcome as compared with ATTR (p=0.022). Log-transformed RRSR was independently associated with the composite outcome at 5 years (HR 2.45 (1.36 to 4.40), p=0.003). Patients with low ejection fraction and high RRSR had the worst prognosis. In multivariable analysis, RRSR remained predictive of the primary outcome (p=0.018). Addition of covariates related to systolic function (global LS and ejection fraction) to the model attenuated this effect. Conclusions High RRSR is adversely prognostic in patients with cardiac amyloid. This novel tool is both diagnostic and prognostic and may have implications in management and suitability for treatment.

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Noninvasive Quantitative Tissue Characterization of Carotid Plaques Using Color-Coded Mapping Based on Ultrasound Integrated Backscatter.

Bando M, Yamada H, Kusunose K, Fukuda D, Amano R, Tamai R, Torii Y, Hirata Y, Nishio S, Satomi J, Nagahiro S, Sata M

JACC. Cardiovascular imaging ( ELSEVIER SCIENCE INC )  9 ( 5 ) 625 - 627   2016年05月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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COMPARISON OF RIGHT VENTRICULAR GLOBAL LONGITUDINAL STRAIN BETWEEN VENDER-DEPENDENT AND VENDER-INDEPENDENT TWO-DIMENSIONAL SPECKLE TRACKING SOFTWARE

Seno Hiromitsu, Kusunose Kenya, Yamada Hirotsugu, Saijo Yoshihito, Nishio Susumu, Hirata Yukina, Ise Takayuki, Yamaguchi Koji, Yagi Shusuke, Soeki Takeshi, Wakatsuki Tetsuzo, Masataka Sata

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   67 ( 13 ) 1781   2016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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Effects of Transthoracic Echocardiographic Simulator Training on Performance and Satisfaction in Medical Students

Kenya Kusunose, Hirotsugu Yamada, Rino Suzukawa, Yukina Hirata, Masami Yamao, Takayuki Ise, Shusuke Yagi, Masashi Akaike, Masataka Sata

JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY ( MOSBY-ELSEVIER )  29 ( 4 ) 375 - 377   2016年04月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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m Prognostic Implications of Non-Invasive Vascular Function Tests in High-Risk Atherosclerosis Patients

Kenya Kusunose, Mitsuyo Sato, Hirotsugu Yamada, Yoshihito Saijo, Mika Bando, Yukina Hirata, Susumu Nishio, Shuji Hayashi, Masataka Sata

CIRCULATION JOURNAL ( JAPANESE CIRCULATION SOC )  80 ( 4 ) 1034 - 1040   2016年04月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Background: The aim of this study was to assess the role of clinically available vascular function tests as predictors of cardiovascular events and decline in kidney function. Methods and Results: One hundred and fourteen patients who had at least 2 cardiovascular risk factors were recruited for vascular function assessment including ankle-brachial blood pressure index (ABI), brachial-ankle pulse wave velocity (baPWV), cardio-ankle vascular index (CAVI) and flow-mediated vasodilatation (%FMD). During a median period of 51 months, 35 patients reached the primary endpoint (29 cardiovascular events and 6 cardiac deaths), and 30 patients reached the secondary endpoint (decline in kidney function: defined as a 5% per year decline of estimated glomerular filtration rate). In sequential Cox models, a model on the basis of the Framingham risk score, hemoglobin, and high-sensitivity C-reactive protein (chi-squared, 16.6) was improved by the ABI (chisquared: 21.5; P=0.047). The baPWV (hazard ratio: 1.42 per 1 SD increase; P=0.025) and the CAVI (hazard ratio: 1.52 per 1 SD increase; P=0.040) were associated with the secondary endpoint. The %FMD was only slightly associated with the primary and secondary endpoints. Conclusions: Both ABI and baPWV are significantly associated with future cardiovascular events in high-risk patients with cardiovascular disease. The predictive capabilities of these parameters are greater than that of other parameters in this cohort.

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Erratum: Relationship between right ventricular longitudinal strain, invasive hemodynamics, and functional assessment in pulmonary arterial hypertension (Korean Circulation Journal (2015) 45 (398-407) DOI: 10.4070/kcj.2015.45.5.398)

Jae-Hyeong Park, Kenya Kusunose, Deborah H. Kwon, Margaret M. Park, James D. Thomas, Richard A. Grimm, Brian P. Griffin, Thomas H. Marwick, Zoran B. Popovic

Korean Circulation Journal ( Korean Society of Circulation )  46 ( 2 ) 273   2016年03月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Rest and exercise echocardiography for early detection of pulmonary hypertension

Kenya Kusunose, Hirotsugu Yamada

Journal of Echocardiography ( Springer Tokyo )  14 ( 1 ) 2 - 12   2016年03月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Early detection of pulmonary hypertension (PH) is essential to ensure that patients receive timely and appropriate treatment for this progressive disease. Rest and exercise echocardiography has been used to screen patients in an attempt to identify early stage PH. However, current PH guidelines recommend against exercise tests because of the lack of evidence. We reviewed previous studies to discuss the current standpoint concerning rest and exercise echocardiography in PH. Around 20 exercise echocardiography studies were included to assess the cutoff value for exercise-induced pulmonary hypertension (EIPH). Approximately 40 exercise echocardiography studies were also included to evaluate the pulmonary artery pressure-flow relationship as assessed by the slope of the mean pulmonary artery pressure and cardiac output (ΔmPAP/ΔQ). There were several EIPH and ΔmPAP/ΔQ reference values in individuals with pulmonary vascular disease. We believed that assessing the ΔmPAP/ΔQ makes sense from a physiological standpoint, and the clinical value should be confirmed in future studies. Exercise echocardiography is an appealing alternative in PH. Further studies are needed to assess the prognostic value of the pulmonary artery pressure-flow relationship in high-risk subjects.

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Relationship between Right Ventricular Longitudinal Strain, Invasive Hemodynamics, and Functional Assessment in Pulmonary Arterial Hypertension (vol 45, pg 398, 2015)

Jae-Hyeong Park, Kenya Kusunose, Deborah H. Kwon, Margaret M. Park, James D. Thomas, Richard A. Grimm, Brian P. Griffin, Thomas H. Marwick, Zoran B. Popovic

KOREAN CIRCULATION JOURNAL ( KOREAN SOC CARDIOLOGY )  46 ( 2 ) 273 - 273   2016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）

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Vegetation in the coronary sinus that concealed the presence of a coronary arteriovenous fistula in a patient with infectious endocarditis

Akira Takashima, Shusuke Yagi, Koji Yamaguchi, Eri Takagi, Tamotsu Kanbara, Hirohisa Ogawa, Takayuki Ise, Kenya Kusunose, Takeshi Tobiume, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Tetsuya Kitagawa, Masataka Sata

INTERNATIONAL JOURNAL OF CARDIOLOGY ( ELSEVIER IRELAND LTD )  207   266 - 268   2016年03月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Effects of the Addition of Eicosapentaenoic Acid to Strong Statin Therapy on Inflammatory Cytokines and Coronary Plaque Components Assessed by Integrated Backscatter Intravascular Ultrasound

Toshiyuki Niki, Tetsuzo Wakatsuki, Koji Yamaguchi, Yoshio Taketani, Hiroyasu Oeduka, Kenya Kusunose, Takayuki Ise, Takashi Iwase, Hirotsugu Yamada, Takeshi Soeki, Masataka Sata

CIRCULATION JOURNAL ( JAPANESE CIRCULATION SOC )  80 ( 2 ) 450 - 460   2016年02月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Background: The effects of eicosapentaenoic acid (EPA) on coronary artery disease have been previously reported; however, those of the addition of EPA to strong statins on coronary plaque components and local inflammatory cytokines are not known. Methods and Results: A total of 95 patients who had been treated with strong statin for at least 6 months were randomized into 2 groups: an EPA group (additional treatment with EPA at 1,800 mg/day, n=48) or a control group (no additional treatment, n=47), for 6 months. The tissue characteristics of target coronary plaque in each patient were analyzed using IB-IVUS before and after treatment. We also measured plasma levels of inflammatory cytokines sampled in the coronary sinus (CS) and peripheral vein. A significant reduction in lipid volume (18.5+/-1.3 to 15.0+/-1.5 mm(3), P=0.007) and a significant increase in fibrous volume (22.9+/-0.8 to 25.6+/-1.1 mm(3), P=0.01) were observed in IB-IVUS image analyses in the EPA group, but no significant changes in the plaque components in the control group. CS levels of pentraxin 3 and monocyte chemoattractant protein-1 were lower after than before treatment with EPA (3.3+/-2.1 to 2.6+/-1.2 ng/ml, 120.4+/-26.2 to 110.2+/-26.8 pg/ml, P=0.015 and P=0.008, respectively); however, there were no significant changes in those inflammatory cytokines between pre-and post-treatment in the control group. Conclusions: The addition of EPA was associated with reduced lipid volume in coronary plaques and decreased inflammatory cytokines.

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Left Ventricular Lipomatous Hamartoma Mimicking a Calcified Amorphous Tumor

Yuta Torii, Hirotsugu Yamada, Susumu Matsukuma, Susumu Nishio, Kenya Kusunose, Miho Abe, Masataka Sata

CIRCULATION ( LIPPINCOTT WILLIAMS & WILKINS )  133 ( 8 ) E408 - E410   2016年02月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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