論文 - 楠瀬　賢也

Regression of left ventricular hypertrophy after tafamidis therapy in a patient with transthyretin amyloidosis variant.

Shusuke Yagi, Hiromu Yamazaki, Kenya Kusunose, Yusuke Osaki, Takayuki Ise, Muneyuki Kadota, Munkhtsetseg Tserensonom, Yutaka Kawabata, Tomoya Hara, Rie Ueno, Yoshihito Saijo, Tomomi Matsuura, Koji Yamaguchi, Hirotsugu Yamada, Daiju Fukuda, Takeshi Soeki, Tetsuzo Wakatsuki, Masataka Sata

The journal of medical investigation : JMI   69 ( 3.4 ) 320 - 322   2022年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

Transthyretin amyloidosis (ATTR) variant is a life-threatening hereditary disease predominantly affecting the peripheral nervous system and heart. Tafamidis, which prevents the deposition of amyloid by stabilizing transthyretin, is available for the treatment of neuropathy and cardiomyopathy of ATTR. However, whether tafamidis could eliminate established amyloid deposits and improve cardiac function remains unknown. We reported a case of regression of left ventricular hypertrophy after tafamidis therapy in a patient with an ATTR variant. J. Med. Invest. 69 : 320-322, August, 2022.

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Comparison of Direct Oral Anticoagulants for Acute Hospital Mortality in Venous Thromboembolism.

Yuichiro Okushi, Kenya Kusunose, Michikazu Nakai, Yoko Sumita, Takayuki Ise, Koji Yamaguchi, Shusuke Yagi, Daiju Fukuda, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Masataka Sata

American journal of cardiovascular drugs : drugs, devices, and other interventions   22 ( 4 ) 407 - 416   2021年12月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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BACKGROUND: The choice of direct oral anticoagulants (DOACs) for venous thromboembolism (VTE) is at the physician's discretion; however, it is useful to know the differences in the clinical data of DOACs to help physicians choose. OBJECTIVE: We aimed to compare the mortality associated with the use of rivaroxaban, edoxaban, and apixaban in clinical practice. METHODS: We identified 38,245 patients with first hospitalization for VTE from the Diagnosis Procedure Combination database in the Japanese Registry of All Cardiac and Vascular Datasets (JROAD-DPC). We classified patients into three groups by DOAC (rivaroxaban and edoxaban group, rivaroxaban and apixaban group, and edoxaban and apixaban group) and compared the in-hospital mortality and bleeding risk by propensity score (PS) matching in each group. RESULTS: After PS matching, patients with rivaroxaban use had significantly lower total in-hospital mortality (1.2% vs. 2.1%; odds ratio [OR] 0.55, p = 0.012) and in-hospital mortality within 21 days (0.4% vs. 1.0%; OR 0.41, p = 0.020) and 28 days (0.7% vs. 1.3%; OR 0.53, p = 0.042) than patients with apixaban use. In the subanalysis, significant differences were only observed in patients younger than 80 years of age, patients with pulmonary embolism, and patients without heart failure. There was no significant difference in in-hospital mortality in the other groups and in the rate of bleeding events among the three groups. CONCLUSION: On PS-matched analysis, there was a difference in in-hospital mortality, especially in the rivaroxaban and apixaban group. Identifying the clinical characteristics of patients associated with each DOAC, as well as prognosis, will be useful in determining treatment strategies for VTE.

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Pre-clinical medical student cardiac point-of-care ultrasound curriculum based on the American Society of Echocardiography recommendations: a pilot and feasibility study

Satoshi Jujo, Jannet J. Lee-Jayaram, Brandan I. Sakka, Atsushi Nakahira, Akihisa Kataoka, Masaki Izumo, Kenya Kusunose, Natsinee Athinartrattanapong, Sayaka Oikawa, Benjamin W. Berg

Pilot and Feasibility Studies ( Springer Science and Business Media LLC )  7 ( 1 ) 175   2021年12月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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<title>Abstract</title><sec> <title>Background</title> Cardiac point-of-care ultrasound (POCUS) training has been integrated into medical school curricula. However, there is no standardized cardiac POCUS training method for medical students. To address this issue, the American Society of Echocardiography (ASE) proposed a framework for medical student cardiac POCUS training. The objective of this pilot study was to develop a medical student cardiac POCUS curriculum with test scoring systems and test the curriculum feasibility for a future definitive study. </sec><sec> <title>Methods</title> Based on the ASE-recommended framework, we developed a cardiac POCUS curriculum consisting of a pre-training online module and hands-on training with a hand-held ultrasound (Butterfly iQ, Butterfly Network Inc., Guilford, CT, USA). The curriculum learning effects were assessed with a 10-point maximum skill test and a 40-point maximum knowledge test at pre-, immediate post-, and 8-week post-training. To determine the curriculum feasibility, we planned to recruit 6 pre-clinical medical students. We semi-quantitatively evaluated the curriculum feasibility in terms of recruitment rate, follow-up rate 8 weeks after training, instructional design of the curriculum, the effect size (ES) of the test score improvements, and participant satisfaction. To gather validity evidence of the skill test, interrater and test-retest reliability of 3 blinded raters were assessed. </sec><sec> <title>Results</title> Six pre-clinical medical students participated in the curriculum. The recruitment rate was 100% (6/6 students) and the follow-up rate 8 weeks after training was 100% (6/6). ESs of skill and knowledge test score differences between pre- and immediate post-, and between pre- and 8-week post-training were large. The students reported high satisfaction with the curriculum. Both interrater and test-retest reliability of the skill test were excellent. </sec><sec> <title>Conclusions</title> This pilot study confirmed the curriculum design as feasible with instructional design modifications including the hands-on training group size, content of the cardiac POCUS lecture, hands-on teaching instructions, and hand-held ultrasound usage. Based on the pilot study findings, we plan to conduct the definitive study with the primary outcome of long-term skill retention 8 weeks after initial training. The definitive study has been registered in <ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://clinicaltrials.gov">ClinicalTrials.gov</ext-link> (Identifier: NCT04083924). </sec>

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ペースメーカー植込み後に発覚した側頭葉てんかんによる発作性心静止の一例

吉田 知哉, 瀬野 弘光, 松本 和久, 松浦 朋美, 西條 良仁, 門田 宗之, 川端 豊, 楠瀬 賢也, 伊勢 孝之, 添木 武, 山口 浩司, 八木 秀介, 山田 博胤, 若槻 哲三, 多田 恵曜, 佐田 政隆

四国医学雑誌 ( 徳島医学会 )  77 ( 5-6 ) 297 - 297   2021年12月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

生活習慣病を克服して、健康寿命を延伸するために カテーテル大動脈弁置換術(TAVI)によって激変した大動脈弁狭窄症治療

伊勢 孝之, 門田 宗之, 川端 豊, 楠瀬 賢也, 山口 浩司, 八木 秀介, 福田 大受, 山田 博胤, 添木 武, 若槻 哲三, 佐田 政隆, 佐村 高明, 藤本 鋭貴, 秦 広樹

四国医学雑誌 ( 徳島医学会 )  77 ( 5-6 ) 288 - 288   2021年12月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

動脈硬化性疾患の高リスク患者において大動脈弁の石灰化と血清リポ蛋白との関連

Munkhtsetseg Tserrensonom, 八木 秀介, 伊勢 孝之, 門田 宗之, 川端 豊, 西條 良仁, 松浦 朋美, 楠瀬 賢也, 山口 浩司, 福田 大受, 山田 博胤, 添木 武, 若槻 哲三, 佐田 政隆

四国医学雑誌 ( 徳島医学会 )  77 ( 5-6 ) 296 - 297   2021年12月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

Impact of cancer on short-term in-hospital mortality after primary acute myocardial infarction

Robert Zheng, Kenya Kusunose, Yuichiro Okushi, Yoshihiro Okayama, Michikazu Nakai, Yoko Sumita, Takayuki Ise, Koji Yamaguchi, Shusuke Yagi, Daiju Fukuda, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Masataka Sata

OPEN HEART ( BMJ PUBLISHING GROUP )  8 ( 2 )   2021年11月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Background Cardiovascular diseases are the second most common cause of mortality among cancer survivors, after death from cancer. We sought to assess the impact of cancer on the short-term outcomes of acute myocardial infarction (AMI), by analysing data obtained from a large-scale database.Methods This study was based on the Diagnosis Procedure Combination database in the Japanese Registry of All Cardiac and Vascular Diseases and the Diagnosis Procedure Combination. We identified patients who were hospitalised for primary AMI between April 2012 and March 2017. Propensity Score (PS) was estimated with logistic regression model, with cancer as the dependent variable and 21 clinically relevant covariates. The main outcome was in-hospital mortality.Results We split 1 52 208 patients into two groups with or without cancer. Patients with cancer tended to be older (cancer group 73 +/- 11 years vs non-cancer group 68 +/- 13 years) and had smaller body mass index (cancer group 22.8 +/- 3.6vs non-cancer 23.9 +/- 4.3). More patients in the non-cancer group had hypertension or dyslipidaemia than their cancer group counterparts. The non-cancer group also had a higher rate of percutaneous coronary intervention (cancer 92.6% vs non-cancer 95.2%). Patients with cancer had a higher 30-day mortality (cancer 6.0% vs non-cancer 5.3%) and total mortality (cancer 8.1% vs non-cancer 6.1%) rate, but this was statistically insignificant after PS matching.Conclusion Cancer did not significantly impact short-term in hospital mortality rates after hospitalisation for primary AMI.

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Impact of cancer on short-term in-hospital mortality after primary acute myocardial infarction.

Robert Zheng, Kenya Kusunose, Yuichiro Okushi, Yoshihiro Okayama, Michikazu Nakai, Yoko Sumita, Takayuki Ise, Koji Yamaguchi, Shusuke Yagi, Daiju Fukuda, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Masataka Sata

Open heart   8 ( 2 )   2021年11月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

BACKGROUND: Cardiovascular diseases are the second most common cause of mortality among cancer survivors, after death from cancer. We sought to assess the impact of cancer on the short-term outcomes of acute myocardial infarction (AMI), by analysing data obtained from a large-scale database. METHODS: This study was based on the Diagnosis Procedure Combination database in the Japanese Registry of All Cardiac and Vascular Diseases and the Diagnosis Procedure Combination. We identified patients who were hospitalised for primary AMI between April 2012 and March 2017. Propensity Score (PS) was estimated with logistic regression model, with cancer as the dependent variable and 21 clinically relevant covariates. The main outcome was in-hospital mortality. RESULTS: We split 1 52 208 patients into two groups with or without cancer. Patients with cancer tended to be older (cancer group 73±11 years vs non-cancer group 68±13 years) and had smaller body mass index (cancer group 22.8±3.6 vs non-cancer 23.9±4.3). More patients in the non-cancer group had hypertension or dyslipidaemia than their cancer group counterparts. The non-cancer group also had a higher rate of percutaneous coronary intervention (cancer 92.6% vs non-cancer 95.2%). Patients with cancer had a higher 30-day mortality (cancer 6.0% vs non-cancer 5.3%) and total mortality (cancer 8.1% vs non-cancer 6.1%) rate, but this was statistically insignificant after PS matching. CONCLUSION: Cancer did not significantly impact short-term in-hospital mortality rates after hospitalisation for primary AMI.

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ハイエンド汎用超音波診断装置(LOGIQ E10)と循環器専用超音波診断装置(Vvid E95)におけるglobal longitudinal strainの装置間差に関する検討

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

超音波検査技術 ( (一社)日本超音波検査学会 )  46 ( 5 ) 463 - 470   2021年10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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目的:近年、global longitudinal strain(GLS)は、左室駆出率と異なる左室収縮能の指標として注目されているが、計測値装置間差が大きいことが以前から問題となっていた。2018年にリリースされたGE Healthcare社製LOGIQ E10は汎用超音波診断装置として多くの施設に導入されている。主に腹部領域や乳腺領域において使用されるが、心臓領域にも利用され、GLSの計測も可能である。本研究の目的は、汎用超音波診断装置LOGIQ E10と、循環器専用超音波診断装置Vivid E95における、GLSの装置間差を検討することである。対象と方法:対象は、徳島大学病院超音波センターで心エコー図検査を受けた患者44例である。平均年齢65±15歳、男性20例、使用装置は上記の2種類である。それぞれの装置でストレイン解析を行い、GLSを測定した。両装置のGLSの相関係数を求め、ばらつきと誤差はBland-Altman解析で評価した。結果と考察:全例で解析可能な画像が取得できた。GLSの相関係数はr=0.957(p<0.01)と、両者には良好な相関関係を認めた。Bland-Altman解析においては、bias 0.0%、一致限界は-2.4%から2.5%と、計測誤差、ばらつきともに小であった。結語:両装置で計測したGLSには良好な相関関係があり、装置間差も小であった。汎用超音波診断装置LOGIQ E10は、循環器専用超音波診断装置Vivid E95と同等の精度でGLSを評価できた。(著者抄録)

無症候性高尿酸血症患者の左室拡張機能に対するフェブキソスタットの効果 PRIZE試験のサブ解析

楠瀬 賢也, 吉田 寿子, 田中 敦史, 寺川 宏樹, 赤崎 雄一, 福本 義弘, 江口 和男, 神谷 春雄, 苅尾 七臣, 山田 博胤, 佐田 政隆, 野出 孝一

日本高血圧学会総会プログラム・抄録集 ( (NPO)日本高血圧学会 )  43回   241 - 241   2021年10月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

循環器領域のAI開発 Radiomics in Echocardiography

楠瀬 賢也, 山田 博胤, 佐田 政隆

日本超音波医学会関西地方会学術集会 ( (公社)日本超音波医学会-関西地方会 )  48回   41 - 41   2021年10月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

Use of Echocardiography and Heart Failure In-Hospital Mortality from Registry Data in Japan.

Kenya Kusunose, Yuichiro Okushi, Yoshihiro Okayama, Robert Zheng, Michikazu Nakai, Yoko Sumita, Takayuki Ise, Koji Yamaguchi, Shusuke Yagi, Daiju Fukuda, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Masataka Sata

Journal of cardiovascular development and disease   8 ( 10 )   2021年09月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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BACKGROUND: Echocardiography requires a high degree of skill on the part of the examiner, and the skill may be more improved in larger volume centers. This study investigated trends and outcomes associated with the use and volume of echocardiographic exams from a real-world registry database of heart failure (HF) hospitalizations. METHODS: This study was based on the Diagnosis Procedure Combination database in the Japanese Registry of All Cardiac and Vascular Datasets (JROAD-DPC). A first analysis was performed to assess the trend of echocardiographic examinations between 2012 and 2016. A secondary analysis was performed to assess whether echocardiographic use was associated with in-hospital mortality in 2015. RESULTS: During this period, the use of echocardiography grew at an average annual rate of 6%. Patients with echocardiography had declining rates of hospital mortality, and these trends were associated with high hospitalization costs. In the 2015 sample, a total of 52,832 echocardiograms were examined, corresponding to 65.6% of all HF hospital admissions for that year. We found that the use and volume of echocardiography exams were associated with significantly lower odds of all-cause hospital mortality in heart failure (adjusted odds ratio (OR): 0.48 for use of echocardiography and 0.78 for the third tertile; both p < 0.001). CONCLUSIONS: The use of echocardiography was associated with decreased odds of hospital mortality in HF. The volumes of echocardiographic examinations were also associated with hospital mortality.

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Effects of canagliflozin on NT-proBNP stratified by left ventricular diastolic function in patients with type 2 diabetes and chronic heart failure: a sub analysis of the CANDLE trial.

Kenya Kusunose, Takumi Imai, Atsushi Tanaka, Kaoru Dohi, Kazuki Shiina, Takahisa Yamada, Keisuke Kida, Kazuo Eguchi, Hiroki Teragawa, Yasuchika Takeishi, Nobuyuki Ohte, Hirotsugu Yamada, Masataka Sata, Koichi Node

Cardiovascular diabetology   20 ( 1 ) 186 - 186   2021年09月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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BACKGROUND: Identification of the effective subtypes of treatment for heart failure (HF) is an essential topic for optimizing treatment of the disorder. We hypothesized that the beneficial effect of SGLT2 inhibitors (SGLT2i) on the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) might depend on baseline diastolic function. To elucidate the effects of SGLT2i in type 2 diabetes mellitus (T2DM) and chronic HF we investigated, as a post-hoc sub-study of the CANDLE trial, the effects of canagliflozin on NT-proBNP levels from baseline to 24 weeks, with the data stratified by left ventricular (LV) diastolic function at baseline. METHODS: Patients (n = 233) in the CANDLE trial were assigned randomly to either an add-on canagliflozin (n = 113) or glimepiride treatment groups (n = 120). The primary endpoint was a comparison between the two groups of the changes from baseline to 24 weeks in NT-pro BNP levels, stratified according to baseline ventricular diastolic function. RESULTS: The change in the geometric mean of NT-proBNP level from baseline to 24 weeks was 0.98 (95% CI 0.89-1.08) in the canagliflozin group and 1.07 (95% CI 0.97-1.18) in the glimepiride group. The ratio of change with canagliflozin/glimepiride was 0.93 (95% CI 0.82-1.05). Responder analyses were used to investigate the response of an improvement in NT-proBNP levels. Although the subgroup analyses for septal annular velocity (SEP-e') showed no marked heterogeneity in treatment effect, the subgroup with an SEP-e' < 4.7 cm/s indicated there was an association with lower NT-proBNP levels in the canagliflozin group compared with that in the glimepiride group (ratio of change with canagliflozin/glimepiride (0.83, 95% CI 0.66-1.04). CONCLUSIONS: In the subgroup with a lower LV diastolic function, canagliflozin showed a trend of reduced NT-pro BNP levels compared to that observed with glimepiride. This study suggests that the beneficial effects of canagliflozin treatment may be different in subgroups classified by the severity of LV diastolic dysfunction.

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長寿社会における腫瘍循環器医療 静脈血栓塞栓症における癌および経口抗凝固薬の予後に対する影響

楠瀬 賢也, 大櫛 祐一郎, 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 )  69回   S3 - 1   2021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）

Left Atrial Strain Associated with Functional Recovery in Patients Receiving Optimal Treatment for Heart Failure.

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

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography   34 ( 9 ) 966 - 975   2021年09月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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BACKGROUND: Heart failure with recovered ejection fraction (HFrecEF) has been reported in several previous studies to have a better prognosis than heart failure with reduced ejection fraction (HFrEF). However, the factors associated with HFrecEF have not been identified. The aim of this study was to test the hypothesis that left atrial (LA) strain could help identify patients with recovered ejection fraction (EF) among those with heart failure (HF) with low EF on admission. METHODS: One hundred consecutive patients hospitalized for the first time for new-onset HF were enrolled. Patients were clinically diagnosed with HFrEF on admission (left ventricular EF < 40%) and received optimal treatment for HF. Twenty-eight patients improved to HFrecEF during 6 months of follow-up. RESULTS: Regarding clinical background, there were significantly more women and a lower rate of atrial fibrillation in the HFrecEF group than in the HFrEF group. In a multivariate logistic regression analysis, LA strain was an independent predictor of HFrecEF, even after adjustment for gender and left ventricular EF (odds ratio: 4.06; 95% CI: 2.04-8.07; P < .001). A cutoff value of 10.8% for LA strain showed high sensitivity (96%) and specificity (82%) in identifying HFrecEF in patients with HF presenting with low EF on admission. During a follow-up period of 24 ± 13 months, 31 patients (31%) had cardiovascular death or readmission for HF. Patients with reduced LA strain (<10.8%) had significantly shorter event-free survival than those with preserved LA strain (P = .02). CONCLUSIONS: LA strain is a useful indicator for predicting HFrecEF and should be considered as a routine measurement in patients with HFrEF on admission.

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冠動脈塞栓症を発症した2症例の臨床的検討

川端 豊, 若槻 哲三, 山口 浩司, 門田 宗之, 伊勢 孝之, 楠瀬 賢也, 松浦 朋美, 八木 秀介, 福田 大受, 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 )  69回   O - 114   2021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）

人工知能(AI)による心エコー診断の進歩

楠瀬 賢也, 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 )  69回   EL7 - EL7   2021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）

Deep Learning for Detection of Elevated Pulmonary Artery Wedge Pressure Using Standard Chest X-Ray.

Yukina Hirata, Kenya Kusunose, Takumasa Tsuji, Kohei Fujimori, Jun'ichi Kotoku, Masataka Sata

The Canadian journal of cardiology   37 ( 8 ) 1198 - 1206   2021年08月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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BACKGROUND: To accurately diagnose and control heart failure (HF), it is important to carry out a simple assessment of elevated pulmonary arterial wedge pressure (PAWP). The aim of this study was to develop and validate an objective method for detecting elevated PAWP by applying deep learning (DL) to a chest x-ray (CXR). METHODS: We enrolled 1013 consecutive patients with a right-heart catheter between October 2009 and February 2020. We developed a convolutional neural network to identify patients with elevated PAWP (> 18 mm Hg) as the actual value of PAWP to be used in the dataset for training. In the prospective validation dataset used to detect elevated PAWP, the area under the receiver operating characteristic curve (AUC) was calculated using the DL model that evaluated the CXR. RESULTS: In the prospective validation dataset, the AUC of the DL model with CXR was not significantly different from the AUC produced by brain natriuretic peptide (BNP) and the echocardiographic left-ventricular diastolic dysfunction (DD) algorithm (DL model: 0.77 vs BNP: 0.77 vs DD algorithm: 0.70; respectively; P = NS for all comparisons); it was, however, significantly higher than the AUC of the cardiothoracic ratio (DL model vs cardiothoracic ratio [CTR]: 0.66, P = 0.044). The model based on 3 parameters (BNP, DD algorithm, and CTR) was improved by adding the DL model (AUC: from 0.80 to 0.86; P = 0.041). CONCLUSIONS: Applying the DL model based on a CXR (a classical, universal, and low-cost test) is useful for screening for elevated PAWP.

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How to standardize the measurement of left ventricular ejection fraction.

Kenya Kusunose, Robert Zheng, Hirotsugu Yamada, Masataka Sata

Journal of medical ultrasonics (2001)   49 ( 1 ) 35 - 43   2021年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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Despite recent advances in imaging for myocardial deformation, left ventricular ejection fraction (LVEF) is still the most important index for systolic function in daily practice. Its role in multiple fields (e.g., valvular heart disease, myocardial infarction, cancer therapy-related cardiac dysfunction) has been a mainstay in guidelines. In addition, assessment of LVEF is vital to clinical decision-making in patients with heart failure. However, notable limitations to LVEF include poor inter-observer reproducibility dependent on observer skill, poor acoustic windows, and variations in measurement techniques. To solve these problems, methods for standardization of LVEF by sharing reference images among observers and artificial intelligence for accurate measurements have been developed. In this review, we focus on the standardization of LVEF using reference images and automated LVEF using artificial intelligence.

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Activated Factor X Signaling Pathway via Protease-Activated Receptor 2 Is a Novel Therapeutic Target for Preventing Atrial Fibrillation.

Tomomi Matsuura, Takeshi Soeki, Daiju Fukuda, Etsuko Uematsu, Takeshi Tobiume, Tomoya Hara, Kenya Kusunose, Takayuki Ise, Koji Yamaguchi, Shusuke Yagi, Hirotsugu Yamada, Tetsuzo Wakatsuki, Masataka Sata

Circulation journal : official journal of the Japanese Circulation Society   85 ( 8 ) 1383 - 1391   2021年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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BACKGROUND: Activated factor X (FXa), which contributes to chronic inflammation via protease-activated receptor 2 (PAR2), might play an important role in atrial fibrillation (AF) arrhythmogenesis. This study aimed to assess whether PAR2 signaling contributes to AF arrhythmogenesis and whether rivaroxaban ameliorates atrial inflammation and prevents AF.Methods and Results:In Study 1, PAR2 deficient (PAR2-/-) and wild-type mice were infused with angiotensin II (Ang II) or a vehicle via an osmotic minipump for 2 weeks. In Study 2, spontaneously hypertensive rats (SHRs) were treated with rivaroxaban, warfarin, or vehicle for 2 weeks after 8 h of right atrial rapid pacing. The AF inducibility and atrial remodeling in both studies were examined. Ang II-treated PAR2-/- mice had a lower incidence of AF and less mRNA expression of collagen1 and collagen3 in the atrium compared to wild-type mice treated with Ang II. Rivaroxaban significantly reduced AF inducibility compared with warfarin or vehicle. In SHRs treated with a vehicle, rapid atrial pacing promoted gene expression of inflammatory and fibrosis-related biomarkers in the atrium. Rivaroxaban, but not warfarin, significantly reduced expression levels of these genes. CONCLUSIONS: The FXa-PAR2 signaling pathway might contribute to AF arrhythmogenesis associated with atrial inflammation. A direct FXa inhibitor, rivaroxaban, could prevent atrial inflammation and reduce AF inducibility, probably by inhibiting the pro-inflammatory activation.

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