論文 - 楠瀬　賢也

A Selective Mineralocorticoid Receptor Blocker, Esaxerenone, Attenuates Vascular Dysfunction in Diabetic C57BL/6 Mice.

Uugantsetseg Munkhjargal, Daiju Fukuda, Byambasuren Ganbaatar, Kumiko Suto, Tomomi Matsuura, Takayuki Ise, Kenya Kusunose, Koji Yamaguchi, Shusuke Yagi, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Masataka Sata

Journal of atherosclerosis and thrombosis   30 ( 4 ) 326 - 334   2022年06月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

AIMS: Pharmacological blockade of mineralocorticoid receptors (MRs) is a potential therapeutic approach to reduce cardiovascular complications since MRs play a crucial role in cardiovascular regulation. Recent studies suggest that MR antagonists affect several extrarenal tissues, including vessel function. We investigated the effect of a novel nonsteroidal selective MR blocker, esaxerenone, on diabetes-induced vascular dysfunction. METHODS: Diabetes was induced by a single dose of streptozotocin in 8-week-old male C57BL/6 mice. Esaxerenone (3 mg/kg/day) or a vehicle was administered by gavage to diabetic mice for 3 weeks. Metabolic parameters, plasma aldosterone levels, and parameters related to renal function were measured. Endothelium-dependent or -independent vascular responses of the aortic segments were analyzed with acetylcholine or sodium nitroprusside, respectively. Human umbilical vein endothelial cells (HUVECs) were used for the in vitro study. RESULTS: Induction of diabetes elevated plasma aldosterone level (P＜0.05) and impaired endothelium-dependent vascular relaxation (P＜0.05). The administration of esaxerenone ameliorated the endothelial dysfunction (P＜0.01) without the alteration of metabolic parameters, blood pressure, and renal function. Esaxerenone improved the eNOSSer1177 phosphorylation in the aorta obtained from diabetic mice (P＜0.05) compared with that in the vehicle-treated group. Furthermore, a major MR agonist, aldosterone, decreased eNOSSer1177 phosphorylation and increased eNOSThr495 phosphorylation in HUVECs, which recovered with esaxerenone. Esaxerenone ameliorated the endothelium-dependent vascular relaxation caused by aldosterone in the aortic segments obtained from C57BL/6 mice (P＜0.001). CONCLUSION: Esaxerenone attenuates the development of diabetes-induced endothelial dysfunction in mice. These results suggest that esaxerenone has potential vascular protective effects in individuals with diabetes.

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Association between cardiovascular risk factors and left ventricular strain distribution in patients without previous cardiovascular disease.

Tomonori Takahashi, Kenya Kusunose, Robert Zheng, Natsumi Yamaguchi, Yukina Hirata, Susumu Nishio, Yoshihito Saijo, Takayuki Ise, Koji Yamaguchi, Shusuke Yagi, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Masataka Sata

Journal of echocardiography   20 ( 4 ) 208 - 215   2022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: Some cardiovascular (CV) risk factors, such as hypertension and diabetes mellitus, have been reported to reduce left ventricular (LV) longitudinal strain (LS) even in patients with preserved LV ejection fraction. We hypothesized that multiple CV risk factors might cause changes in myocardial strain. Our study aimed to assess the association between multiple CV risk factors and strain in patients without previous CV disease (CVD). METHODS: We retrospectively evaluated 137 patients without CVD, who underwent echocardiography at our institution between May 2017 and February 2020. They were divided into four groups based on the number of risk factors (group 0: no risk factor, group 1: one risk factor, group 2: two risk factors, and groups 3: three or four risk factors). Risk factors were hypertension, dyslipidemia, diabetes mellitus, and chronic kidney disease. Absolute values of global LS (GLS) and relative apical LS ratio (RALSR) defined using the equation: average apical LS/(average basal LS + average mid LS) and was used as a marker of strain distribution. RESULTS: Out of 137 patients, group 0 had 35 patients, group 1 had 35 patients, group 2 had 32 patients, and group 3 had 35 patients. GLS was 22.4 ± 2.0%, 21.7 ± 2.1%, 21.3 ± 1.8%, 20.7 ± 2.2%, and RALSR was 0.64 ± 0.06, 0.66 ± 0.06, 0.68 ± 0.08, 0.69 ± 0.07 in groups 0-3, respectively. The one-way ANOVA detected significant differences between groups in GLS (p = 0.005) and RALSR (p = 0.037), respectively. Group 3 had a significantly lower GLS and higher RALSR than group 0 (p < 0.05). CONCLUSION: In patients without previous CVD, LS decreased especially from the basal segment as the number of cardiovascular risks increased. The segmental LS may be markers of occult LV dysfunction in patients with CV risk factors.

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Effects of Radiofrequency Catheter Ablation on Cardiac Reserve Using Preload Stress Echocardiography in Paroxysmal and Persistent Atrial Fibrillation.

Nao Ishii, Kenya Kusunose, Ayu Shono, Kensuke Matsumoto, Susumu Nishio, Natsumi Yamaguchi, Yukina Hirata, Tomomi Matsuura, Takayuki Ise, Koji Yamaguchi, Shusuke Yagi, Daiju Fukuda, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Masataka Sata

The American journal of cardiology   168   71 - 77   2022年04月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

The effects of catheter ablation on exercise tolerance and quality of life in patients with atrial fibrillation (AF) have been reported. We assessed cardiac function in more detail using the leg positive pressure (LPP) technique and found that contractile reserve is particularly important in relation to exercise tolerance and prognosis. In this study, we used the LPP technique to examine changes in contractile reserve immediately after ablation and 6 months later. We prospectively enrolled patients who underwent catheter ablation for AF at 2 institutes. We performed LPP stress echocardiography 2 to 3 days after (FU-1) and 6 months after (FU-2) ablation to examine changes in cardiac function indexes. The primary end point was improvement in contractile reserve. Ultimately, 109 patients (mean age 67.4 ± 9.6 years; 70% men) underwent 2 sessions of LPP stress echocardiography. The median CHA2DS2-VASC score was 2 (interquartile range 13). From FU-1 to FU-2, the change in the stroke volume index after the LPP maneuver increased in patients with paroxysmal and persistent AF with low CHA2DS2-VASC scores (both p <0.05). Regardless of AF subtype, contractile reserve at FU-2 improved in patients with low CHA2DS2-VASC scores compared with that at FU-1. In contrast, patients with high CHA2DS2-VASC scores had no change. In conclusion, patients with AF with a low CHA2DS2-VASC score had improved contractile reserve after ablation, whereas patients with high scores did not show any improvement. Aggressive interventions in patients with high scores may lead to better management after catheter ablation.

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ガイドライン/日循超音波ガイドライン 心毒性を有する薬物投与時の心機能評価

楠瀬 賢也, 山田 博胤, 佐田 政隆

超音波医学 ( (公社)日本超音波医学会 )  49 ( Suppl. ) S302 - S302   2022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）

腫瘍循環器学/心臓、血栓 心エコー図検査を用いたがん治療関連心機能障害サーベイランス

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

超音波医学 ( (公社)日本超音波医学会 )  49 ( Suppl. ) S273 - S273   2022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）

腫瘍循環器学/心臓、血栓 心エコー図検査を用いたがん治療関連心機能障害サーベイランス

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

超音波医学 ( (公社)日本超音波医学会 )  49 ( Suppl. ) S273 - S273   2022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）

外科的治療が血行動態改善に有用であった滲出性収縮性心膜炎の1例

折野 逸人, 門田 宗之, 折野 逸人, 西條 良仁, 吉田 知哉, 手束 一貴, 志村 拓哉, 瀬野 弘光, 高橋 智紀, 松本 和久, 數藤 久美子, 川端 豊, 松浦 朋美, 伊勢 孝之, 楠瀬 賢也, 山口 浩司, 八木 秀介, 山田 博胤, 添木 武, 若槻 哲三, 佐田 政隆, 佐村 高明, 秦 広樹, 高橋 智子

四国医学雑誌 ( 徳島医学会 )  78 ( 1-2 ) 91 - 91   2022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）

外科的治療が血行動態改善に有用であった滲出性収縮性心膜炎の1例

折野 逸人, 門田 宗之, 折野 逸人, 西條 良仁, 吉田 知哉, 手束 一貴, 志村 拓哉, 瀬野 弘光, 高橋 智紀, 松本 和久, 數藤 久美子, 川端 豊, 松浦 朋美, 伊勢 孝之, 楠瀬 賢也, 山口 浩司, 八木 秀介, 山田 博胤, 添木 武, 若槻 哲三, 佐田 政隆, 佐村 高明, 秦 広樹, 高橋 智子

四国医学雑誌 ( 徳島医学会 )  78 ( 1-2 ) 91 - 91   2022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）

人工知能による左室駆出率予測モデルの施設間差についての検討

高坂 佳孝, 楠瀬 賢也, 芳賀 昭宏, 山口 夏美, 竹田 泰治, 田中 秀和, 三宅 誠, 森内 健史, 山田 博胤, 佐田 政隆

超音波医学 ( (公社)日本超音波医学会 )  49 ( Suppl. ) S697 - S697   2022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）

人工知能による左室駆出率予測モデルの施設間差についての検討

高坂 佳孝, 楠瀬 賢也, 芳賀 昭宏, 山口 夏美, 竹田 泰治, 田中 秀和, 三宅 誠, 森内 健史, 山田 博胤, 佐田 政隆

超音波医学 ( (公社)日本超音波医学会 )  49 ( Suppl. ) S697 - S697   2022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）

ガイドライン/日循超音波ガイドライン 心毒性を有する薬物投与時の心機能評価

楠瀬 賢也, 山田 博胤, 佐田 政隆

超音波医学 ( (公社)日本超音波医学会 )  49 ( Suppl. ) S302 - S302   2022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）

Results of PRospect trial to Elucidate the utility of EchocarDiography-based Cardiac ouTput in acute heart failure (PREDICT).

Hiroyuki Iwano, Hiroto Utsunomiya, Kentaro Shibayama, Hidekazu Tanaka, Akihiro Isotani, Toshinari Onishi, Masaru Obokata, Masaki Izumo, Kenya Kusunose, Atsuko Furukawa, Masahiro Yamada, Takeshi Kitai, Tetsuari Onishi, Masayoshi Yamamoto, Shunsuke Sasaki, Kotaro Nochioka, Yoichi M Ito, Toshihisa Anzai

Journal of cardiology   80 ( 3 ) 218 - 225   2022年03月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

BACKGROUND: The predictive value of echocardiographic parameters for early worsening heart failure (WHF), worsening of symptoms of heart failure requiring intensification of therapy during an admission for acute decompensated heart failure (ADHF), has not been elucidated. METHODS: Sixteen centers in Japan prospectively enrolled 303 ADHF hospitalized patients who did not receive positive inotropic agents as an initial therapy. Physical and Doppler echocardiographic examinations were performed before the initial therapy and the association of low output findings and occurrence of early WHF were tested. RESULTS: Early WHF occurred in 63 patients with a median duration of 6 (IQR: 2-23) hours from the administration of the initial therapy. In patients with left ventricular (LV) ejection fraction <40% (N = 153), echocardiographic stroke volume index, and cardiac index showed greater c-index [95% confidence interval, 0.71 (0.61-0.79) and 0.72 (0.63-0.80), respectively] compared to single low perfusion finding (symptomatic hypotension, reduced pulse pressure, and impaired mentation) other than cool extremities. When physical findings were combined (low perfusion score), the predictive ability improved to the similar levels of echocardiographic LV output parameters [c-index: 0.69 (0.60-0.76)]. However, addition of cardiac index significantly improved the prognostic ability when added to low perfusion score [0.82 (0.74-0.87), p < 0.001]. In contrast, in patients with LV ejection fraction ≥40% (N = 150), low perfusion score, rather than LV output parameters, was predictive of early WHF [c-index: 0.73 (0.56-0.85)]. CONCLUSIONS: We demonstrated the predictive value of echocardiographic LV output indices for early WHF in ADHF patients with LV systolic dysfunction. These data support the motivation for routine use of echocardiography for initial assessment of ADHF.

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近赤外分光法-血管内超音波法による冠動脈プラークの脆弱性と脂質コア負荷の初評価(First Assessment of Coronary Plaque Vulnerability and Lipid Core Burden Assessed by Near-Infrared Spectroscopy-Intravascular Ultrasound in a Fresh Cadaver)

川端 豊, 若槻 哲三, 山口 浩司, 福田 大受, 西條 良仁, 門田 宗之, 松浦 朋美, 伊勢 孝之, 楠瀬 賢也, 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 )  86回   CRDP4 - 1   2022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）

肺高血圧症における負荷心電図の臨床的有用性(Clinical Utility of Stress Echocardiography in Pulmonary Hypertension)

楠瀬 賢也, 山田 博胤, 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 )  86回   TP20 - 5   2022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）

肺高血圧症の診断と治療における放射線診療の役割 胸部X線画像に人工知能を組み合わせた肺高血圧の検出 今後の展望と課題点について

平田 有紀奈, 楠瀬 賢也, 辻 拓将, 古徳 純一, 西尾 進, 山田 博胤, 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 )  86回   CS1 - 6   2022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）

肺高血圧症の診断と治療における放射線診療の役割 胸部X線画像に人工知能を組み合わせた肺高血圧の検出 今後の展望と課題点について

平田 有紀奈, 楠瀬 賢也, 辻 拓将, 古徳 純一, 西尾 進, 山田 博胤, 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 )  86回   CS1 - 6   2022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）

Preload Stress Echocardiography for the Assessment of Heart Failure With Preserved Ejection Fraction.

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

JACC. Cardiovascular imaging   15 ( 2 ) 375 - 378   2022年02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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Clinical clerkship students' preferences and satisfaction regarding online lectures during the COVID-19 pandemic.

Shusuke Yagi, Daiju Fukuda, Takayuki Ise, Koji Yamaguchi, Kenya Kusunose, Muneyuki Kadota, Yutaka Kawabata, Tomomi Matsuura, Tomohiro Soga, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Shinji Kawahito, Masataka Sata

BMC medical education   22 ( 1 ) 43 - 43   2022年01月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

BACKGROUND: The COVID-19 pandemic has caused an unprecedented disruption in medical education. Students and lecturers had to adapt to online education. The current study aimed to investigate the level of satisfaction and future preference for online lectures among clinical clerkship students and elucidated the factors that affect these outcomes. METHODS: We selected a sample of 114 medical students undergoing clinical clerkship during the COVID-19 pandemic. We conducted onsite lectures before the pandemic and online lectures after the outbreak. A survey was conducted, and the sample included students and 17 lecturers. The average scores of total satisfaction and future preference related to online lectures were computed. RESULTS: Students' scores on total satisfaction with online lectures and their future preference were higher than those for onsite lectures. Scores on the ease of debating dimension were low and those on accessibility of lectures in online lectures were higher than those in onsite lectures. There was no difference between the two groups in the scores on the comprehensibility and ease of asking questions dimensions. Results of the multiple regression analysis revealed that accessibility determined total satisfaction, and future preference was determined by comprehensibility as well as accessibility. Contrary to students' future preferences, lecturers favored onsite lectures to online ones. CONCLUSION: Online lectures are an acceptable mode of teaching during the COVID-19 pandemic for students undergoing clinical clerkship. Online lectures are expected to become more pervasive to avoid the spread of COVID-19.

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Effect of febuxostat on left ventricular diastolic function in patients with asymptomatic hyperuricemia: a sub analysis of the PRIZE Study

Kusunose K.

Hypertension Research ( Hypertension Research )  45 ( 1 ) 106 - 115   2022年01月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Hyperuricemia is related to an increased risk of cardiovascular events from a meta-analysis and antihyperuricemia agents may influence to cardiac function. We evaluated the effect of febuxostat on echocardiographic parameters of diastolic function in patients with asymptomatic hyperuricemia as a prespecified endpoint in the subanalysis of the PRIZE study. Patients in the PRIZE study were assigned randomly to either add-on febuxostat treatment group or control group with only appropriate lifestyle modification. Of the 514 patients in the overall study, 65 patients (31 in the febuxostat group and 34 in the control group) who had complete follow-up echocardiographic data of the ratio of peak early diastolic transmitral flow velocity (E) to peak early diastolic mitral annular velocity (e') at baseline and after 12 and 24 months were included. The primary endpoint was a comparison of the changes in the E/e' between the two groups from baseline to 24 months. Interestingly, e' was slightly decreased in the control group compared with in the febuxostat group (treatment p = 0.068, time, p = 0.337, treatment × Time, p = 0.217). As a result, there were significant increases in E/e' (treatment p = 0.045, time, p = 0.177, treatment × time, p = 0.137) after 24 months in the control group compared with the febuxostat group. There was no significant difference in the serum levels of N-terminal-pro brain natriuretic peptide and high-sensitive troponin I between the two groups during the study period. In conclusions, additional febuxostat treatment in patients with asymptomatic hyperuricemia for 24 months might have a potential of preventable effects on the impaired diastolic dysfunction.

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Deep Learning for Detection of Exercise-Induced Pulmonary Hypertension Using Chest X-Ray Images.

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

Frontiers in cardiovascular medicine   9   891703 - 891703   2022年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

Background: Stress echocardiography is an emerging tool used to detect exercise-induced pulmonary hypertension (EIPH). However, facilities that can perform stress echocardiography are limited by issues such as cost and equipment. Objective: We evaluated the usefulness of a deep learning (DL) approach based on a chest X-ray (CXR) to predict EIPH in 6-min walk stress echocardiography. Methods: The study enrolled 142 patients with scleroderma or mixed connective tissue disease with scleroderma features who performed a 6-min walk stress echocardiographic test. EIPH was defined by abnormal cardiac output (CO) responses that involved an increase in mean pulmonary artery pressure (mPAP). We used the previously developed AI model to predict PH and calculated PH probability in this cohort. Results: EIPH defined as ΔmPAP/ΔCO >3.3 and exercise mPAP >25 mmHg was observed in 52 patients, while non-EIPH was observed in 90 patients. The patients with EIPH had a higher mPAP at rest than those without EIPH. The probability of PH based on the DL model was significantly higher in patients with EIPH than in those without EIPH. Multivariate analysis showed that gender, mean PAP at rest, and the probability of PH based on the DL model were independent predictors of EIPH. A model based on baseline parameters (age, gender, and mPAP at rest) was improved by adding the probability of PH predicted by the DL model (AUC: from 0.65 to 0.74; p = 0.046). Conclusion: Applying the DL model based on a CXR may have a potential for detection of EIPH in the clinical setting.

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