論文 - 楠瀬　賢也

Factors associated with carotid intima-media thickness progression in patients with asymptomatic hyperuricemia: insights from the PRIZE study

Saito Y.

Scientific Reports ( Scientific Reports )  13 ( 1 )   2023年12月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Effectiveness of surveillance by echocardiography for cancer therapeutics-related cardiac dysfunction of patients with breast cancer

Okushi, Y; Saijo, Y; Yamada, H; Toba, H; Zheng, RB; Seno, H; Takahashi, T; Ise, T; Yamaguchi, K; Yagi, S; Soeki, T; Wakatsuki, T; Sata, M; Kusunose, K

JOURNAL OF CARDIOLOGY ( Journal of Cardiology )  82 ( 6 ) 467 - 472   2023年12月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

BACKGROUND: Cancer therapeutics-related cardiac dysfunction (CTRCD) affect the prognosis of patients with breast cancer. Echocardiographic surveillance of patients treated with anti-human epidermal growth factor receptor type 2 (HER2) antibodies has been recommended, but few reports have provided evidence on patients with breast cancer only. We aimed to evaluate the effectiveness of echocardiographic surveillance for breast cancer patients. METHODS: We identified 250 patients with breast cancer who were treated with anti-HER2 antibodies from July 2007 to September 2021. We divided 48 patients with echocardiographic surveillance every 3 months into the surveillance group and 202 patients without echocardiographic surveillance into the non-surveillance group. In the surveillance group, patients with a considerable reduction in global longitudinal strain of 15 % were considered for the initiation of cardioprotective drugs. The composite outcome of CTRCD and acute heart failure was the study endpoint. RESULTS: The mean age was 59 ± 12 years. During the follow-up period of 15 months (12-17 months), 12 patients reached the endpoint. The surveillance group had significantly lower incidence of the composite outcome (2.1 % vs. 5.5 %, adjusted odds ratio: 0.28, 95 % confidential intervals: 0.09-0.94; p = 0.039) and higher rates of prescriptions of cardioprotective drugs than the non-surveillance group. CONCLUSIONS: The incidence of cardiac complications was significantly lower in the surveillance group than the non-surveillance group, which supports the effectiveness of echocardiographic surveillance in patients with breast cancer.

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The Clinical Utility of Noninvasive Forrester Classification in Acute Heart Failure from PREDICT Study

Takahashi, T; Iwano, H; Shibayama, K; Kitai, T; Tanaka, H; Yamada, H; Sata, M; Kusunose, K

AMERICAN JOURNAL OF CARDIOLOGY ( American Journal of Cardiology )  207   75 - 81   2023年11月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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The Forrester classification plays a crucial role in comprehending the underlying pathophysiology of heart failure (HF) and is employed to categorize the severity and predict the outcomes of patients with acute HF. Our objective was to assess the predictive value of the Forrester classification, based on noninvasive hemodynamic measurements obtained through Doppler echocardiography at admission, in forecasting the short-term prognosis posthospitalization of patients with acute HF. Patients were recruited for the Prospect trial to elucidate the utility of EchocarDIography-based Cardiac ouTput in acute heart failure (PREDICT) study, a multicenter, prospective study conducted in Japan. Participants were stratified into 4 profiles using cardiac index (CI) and early mitral filling velocity (E)/early-diastolic mitral annular velocity (e') ratio obtained from Doppler echocardiography upon admission (profile I: CI >2.2, E/e' ≤15, profile II: CI >2.2, E/e' >15, profile III: CI ≤2.2, E/e' ≤15, profile IV: CI ≤2.2, E/e' >15). The primary composite outcome of the study was all-cause mortality or worsening HF during the 14 days of hospitalization. Cox proportional hazards model analysis was employed to identify prognostic factors during the observation period. A total of 270 subjects, with a mean age of 74 ± 14 years and a male proportion of 60%, were enrolled in the study. During the 14-day period of hospitalization, 58 participants (22%) had a composite outcome. Patients with low CI (i.e., profiles III and IV) demonstrated an elevated risk of composite outcome after adjusting for confounding variables, as evidenced by the adjusted hazard ratios of 5.85 (95% confidence interval 1.17 to 29.09, p <0.01, vs profile III) and 6.50 (95% confidence interval 1.53 to 27.68, p <0.01, vs profile IV) in comparison with profile I, respectively. In conclusion, the Forrester classification, derived from noninvasive Doppler echocardiography at admission, may predict early deterioration in patients hospitalized with acute HF.

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Innate Immune System Regulated by Stimulator of Interferon Genes, a Cytosolic DNA Sensor, Regulates Endothelial Function.

Pham PT, Bavuu O, Kim-Kaneyama JR, Lei XF, Yamamoto T, Otsuka K, Suto K, Kusunose K, Yagi S, Yamada H, Soeki T, Shimabukuro M, Barber GN, Sata M, Fukuda D

Journal of the American Heart Association ( Journal of the American Heart Association )  12 ( 22 ) e030084   2023年11月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Value and challenges of lung ultrasound in stratifying ST-elevation myocardial infarction risk

Kusunose, K; Toma, Y

HEART ( Heart )  109 ( 21 ) 1580 - 1581   2023年11月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Correlation between energy loss index and B-type natriuretic peptide: a vector flow mapping study

Morita, S; Hirata, Y; Nishio, S; Takahashi, T; Saijo, Y; Yamada, H; Sata, M; Kusunose, K

JOURNAL OF ECHOCARDIOGRAPHY ( Journal of Echocardiography )    2023年09月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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BACKGROUND: Vector Flow Mapping (VFM) and Energy Loss (EL) evaluation are emerging echocardiographic techniques that offer detailed insights into cardiac function. This study aimed to explore the relationship between EL parameters and B-type natriuretic peptide (BNP) levels, a well-established marker of heart failure severity. METHODS: Our study prospectively enrolled 62 patients experiencing shortness of breath and suspected heart failure, who underwent echocardiography and had BNP levels measured between January 2018 and August 2020. Patients were stratified based on BNP levels, and their clinical and echocardiographic characteristics were evaluated. Univariate and multivariate regression analyses were performed to assess the correlation between BNP levels and various echocardiographic variables, including VFM parameters. RESULTS: Patients were stratified into two groups based on their BNP levels: BNP < 200 pg/ml (n = 53) and BNP ≥ 200 pg/ml (n = 9). Patients with BNP ≥ 200 pg/ml presented significantly different clinical and echocardiographic characteristics, such as older age, larger left ventricular mass and volume indices, higher pulmonary artery systolic pressure, higher E/e' ratio, and larger EL parameters. Multivariate regression analysis demonstrated the E/e' ratio and ELA (EL during Atrial contraction phase/A wave ratio as significant determinants of logBNP. Receiver operating characteristic curve analysis showed ELA/A > 36.0 J/m2 as a significant predictor of high BNP with 89% sensitivity and 85% specificity. ELA/A demonstrated an incremental diagnostic value over elevated left atrial pressure for predicting high BNP (C statistic = 0.98 vs 0.74, P = 0.006). CONCLUSION: This study provides novel insights into the potential utility of EL parameters as auxiliary indicators of cardiac load, thereby enhancing our understanding of heart failure.

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Revolution of echocardiographic reporting: the new era of artificial intelligence and natural language processing

Kusunose, K

JOURNAL OF ECHOCARDIOGRAPHY ( Journal of Echocardiography )  21 ( 3 ) 99 - 104   2023年09月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Prognostic implications of pulmonary vascular resistance in transcatheter aortic valve implantation

Kusunose, K; Ikemiyagi, H

HEART ( Heart )  110 ( 1 ) 5 - 6   2023年08月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Olive mill wastewater and hydroxytyrosol inhibits atherogenesis in apolipoprotein E-deficient mice.

Tomoya Hara, Daiju Fukuda, Byambasuren Ganbaatar, Phuong Tran Pham, Kunduziayi Aini, Arief Rahadian, Kumiko Suto, Shusuke Yagi, Kenya Kusunose, Hirotsugu Yamada, Takeshi Soeki, Masataka Sata

Heart and vessels   38 ( 11 ) 1386 - 1394   2023年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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The Mediterranean diet, which is characterized by high consumption of olive oil, prevents cardiovascular disease. Meanwhile, olive mill wastewater (OMWW), which is obtained as a byproduct during olive oil production, contains various promising bioactive components such as water-soluble polyphenols. Hydroxytyrosol (HT), the major polyphenol in OMWW, has anti-oxidative and anti-inflammatory properties; however, the atheroprotective effects of OMWW and HT remain to be fully understood. Here, we investigated the effect of OMWW and HT on atherogenesis. Male 8-week-old apolipoprotein E-deficient mice were fed a western-type diet supplemented with OMWW (0.30%w/w) or HT (0.02%w/w) for 20 weeks. The control group was fed a non-supplemented diet. OMWW and HT attenuated the development of atherosclerosis in the aortic arch as determined by Sudan IV staining (P < 0.01, respectively) without alteration of body weight, plasma lipid levels, and blood pressure. OMWW and HT also decreased the production of oxidative stress (P < 0.01, respectively) and the expression of NADPH oxidase subunits (e.g., NOX2 and p22phox) and inflammatory molecules (e.g. IL-1β and MCP-1) in the aorta. The results of in vitro experiments demonstrated that HT inhibited the expression of these molecules that were stimulated with LPS in RAW264.7 cells, murine macrophage-like cells. OMWW and HT similarly attenuated atherogenesis. HT is a major component of water-soluble polyphenols in OMWW, and it inhibited inflammatory activation of macrophages. Therefore, our results suggest that the atheroprotective effects of OMWW are at least partially attributable to the anti-inflammatory effects of HT.

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Artificial intelligence-assisted interpretation of systolic function by echocardiogram

Yamaguchi, N; Kosaka, Y; Haga, A; Sata, M; Kusunose, K

OPEN HEART ( Open Heart )  10 ( 2 )   2023年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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OBJECTIVE: Precise and reliable echocardiographic assessment of left ventricular ejection fraction (LVEF) is needed for clinical decision-making. Recently, artificial intelligence (AI) models have been developed to estimate LVEF accurately. The aim of this study was to evaluate whether an AI model could estimate an expert read of LVEF and reduce the interinstitutional variability of level 1 readers with the AI-LVEF displayed on the echocardiographic screen. METHODS: This prospective, multicentre echocardiographic study was conducted by five cardiologists of level 1 echocardiographic skill (minimum level of competency to interpret images) from different hospitals. Protocol 1: Visual LVEFs for the 48 cases were measured without input from the AI-LVEF. Protocol 2: the 48 cases were again shown to all readers with inclusion of AI-LVEF data. To assess the concordance and accuracy with or without AI-LVEF, each visual LVEF measurement was compared with an average of the estimates by five expert readers as a reference. RESULTS: A good correlation was found between AI-LVEF and reference LVEF (r=0.90, p<0.001) from the expert readers. For the classification LVEF, the area under the curve was 0.95 on heart failure with preserved EF and 0.96 on heart failure reduced EF. For the precision, the SD was reduced from 6.1±2.3 to 2.5±0.9 (p<0.001) with AI-LVEF. For the accuracy, the root-mean squared error was improved from 7.5±3.1 to 5.6±3.2 (p=0.004) with AI-LVEF. CONCLUSIONS: AI can assist with the interpretation of systolic function on an echocardiogram for level 1 readers from different institutions.

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【Update on Reference Values for Echocardiography】左室駆出率計測の標準化に向けた展望

楠瀬 賢也, Zheng Robert, 山田 博胤, 佐田 政隆

超音波医学 ( (公社)日本超音波医学会 )  50 ( 4 ) 233 - 240   2023年07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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循環器画像診断は日々進歩しているが,左室駆出率(left ventricular ejection fraction:LVEF)は現在でも日常の診療における収縮機能の指標として最も重要である.LVEFは複数の分野(心臓弁膜症,心筋梗塞,がん治療に伴う心機能障害など)におけるガイドラインで中心的な位置を占めており,心不全患者における臨床的な方針決定にも不可欠である.しかし,LVEFの注目すべき限界として,不明瞭な音響窓や測定法のばらつきなどによる検査者間の再現性の低さが挙げられる.この問題を解決するために,検査者間で基準画像を共有することでLVEFの計測を標準化する方法や,人の手によらない計測を行うための人工知能が開発されてきた.本総説では,基準画像を用いたLVEFの標準化と,人工知能を用いたLVEF測定の自動化に焦点を当てる.(著者抄録)

Evaluation of the Accuracy of ChatGPT in Answering Clinical Questions on the Japanese Society of Hypertension Guidelines

Kusunose, K; Kashima, S; Sata, M

CIRCULATION JOURNAL ( 一般社団法人 日本循環器学会 )  87 ( 7 ) 1030 - 1033   2023年06月

掲載種別: 研究論文（学術雑誌）

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<p><b><i>Background:</i></b> To assist healthcare providers in interpreting guidelines, clinical questions (CQ) are often included, but not always, which can make interpretation difficult for non-expert clinicians. We evaluated the ability of ChatGPT to accurately answer CQs on the Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019).</p><p><b><i>Methods and Results:</i></b> We conducted an observational study using data from JSH 2019. The accuracy rate for CQs and limited evidence-based questions of the guidelines (Qs) were evaluated. ChatGPT demonstrated a higher accuracy rate for CQs than for Qs (80% vs. 36%, P value: 0.005).</p><p><b><i>Conclusions:</i></b> ChatGPT has the potential to be a valuable tool for clinicians in the management of hypertension.</p>

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Intimal Sarcoma of the Pulmonary Artery as an Embolic Cause of Sudden Death.

Shusuke Yagi, Tomoya Hara, Hirotsugu Yamada, Kenya Kusunose, Takayuki Ise, Masataka Sata

Circulation journal : official journal of the Japanese Circulation Society   87 ( 7 ) 1036 - 1036   2023年06月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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術前の画像検査で肝細胞癌と診断された肝炎症性偽腫瘍の1例

松本 力三, 西尾 進, 森田 沙瑛, 湯浅 麻美, 平田 有紀奈, 山尾 雅美, 齋藤 裕, 楠瀬 賢也, 山田 博胤, 島田 光生, 佐田 政隆

超音波検査技術 ( (一社)日本超音波検査学会 )  48 ( 3 ) 334 - 334   2023年06月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

術前の画像検査で肝細胞癌と診断された肝炎症性偽腫瘍の1例

松本 力三, 西尾 進, 森田 沙瑛, 湯浅 麻美, 平田 有紀奈, 山尾 雅美, 齋藤 裕, 楠瀬 賢也, 山田 博胤, 島田 光生, 佐田 政隆

超音波検査技術 ( (一社)日本超音波検査学会 )  48 ( 3 ) 334 - 334   2023年06月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

Deep learning approach for analyzing chest x-rays to predict cardiac events in heart failure

Kenya Kusunose, Yukina Hirata, Natsumi Yamaguchi, Yoshitaka Kosaka, Takumasa Tsuji, Jun’ichi Kotoku, Masataka Sata

Frontiers in Cardiovascular Medicine ( Frontiers Media SA )  10   2023年05月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Background A deep learning (DL) model based on a chest x-ray was reported to predict elevated pulmonary artery wedge pressure (PAWP) as heart failure (HF). Objectives The aim of this study was to (1) investigate the role of probability of elevated PAWP for the prediction of clinical outcomes in association with other parameters, and (2) to evaluate whether probability of elevated PAWP based on DL added prognostic information to other conventional clinical prognostic factors in HF. Methods We evaluated 192 patients hospitalized with HF. We used a previously developed AI model to predict HF and calculated probability of elevated PAWP. Readmission following HF and cardiac mortality were the primary endpoints. Results Probability of elevated PAWP was associated with diastolic function by echocardiography. During a median follow-up period of 58 months, 57 individuals either died or were readmitted. Probability of elevated PAWP appeared to be associated with worse clinical outcomes. After adjustment for readmission score and laboratory data in a Cox proportional-hazards model, probability of elevated PAWP at pre-discharge was associated with event free survival, independent of elevated left atrial pressure (LAP) based on echocardiographic guidelines (p &amp;lt; 0.001). In sequential Cox models, a model based on clinical data was improved by elevated LAP (p = 0.005), and increased further by probability of elevated PAWP (p &amp;lt; 0.001). In contrast, the addition of pulmonary congestion interpreted by a doctor did not statistically improve the ability of a model containing clinical variables (compared p = 0.086). Conclusions This study showed the potential of using a DL model on a chest x-ray to predict PAWP and its ability to add prognostic information to other conventional clinical prognostic factors in HF. The results may help to enhance the accuracy of prediction models used to evaluate the risk of clinical outcomes in HF, potentially resulting in more informed clinical decision-making and better care for patients.

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Point-of-Careの心臓超音波検査(FoCUS)の普及に向けて 当院における技師による簡易エコー(POCUS)の取り組み

平田 有紀奈, 山田 博胤, 山口 夏美, 森田 沙瑛, 湯浅 麻美, 松本 力三, 山尾 雅美, 西尾 進, 楠瀬 賢也, 佐田 政隆

超音波医学 ( (公社)日本超音波医学会 )  50 ( Suppl. ) S280 - S280   2023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）

心臓の希少疾患を学ぶ:心エコー図と他の画像診断の比較 心サルコイドーシスとの鑑別に苦慮した巨細胞性心筋炎の1例

山口 夏美, 山田 博胤, 門田 宗之, 森田 沙瑛, 平田 有紀奈, 西尾 進, 高橋 智紀, 西條 良仁, 楠瀬 賢也, 佐田 政隆

超音波医学 ( (公社)日本超音波医学会 )  50 ( Suppl. ) S291 - S291   2023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）

卒前・卒後の超音波研修:医師の超音波離れをどうするか 徳島大学病院の卒後研修プログラムにおける超音波研修

山田 博胤, 楠瀬 賢也, 西尾 進, 佐田 政隆

超音波医学 ( (公社)日本超音波医学会 )  50 ( Suppl. ) S536 - S536   2023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）

アスリート心臓の心エコー最新知見 マラソンと左房機能 スポーツ後のCardiac fatigueとは

平田 有紀奈, 山田 博胤, 山口 夏美, 森田 沙瑛, 西尾 進, 高橋 智紀, 西條 良仁, 楠瀬 賢也, 添木 武, 佐田 政隆

超音波医学 ( (公社)日本超音波医学会 )  50 ( Suppl. ) S255 - S255   2023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）