論文 - 楠瀬　賢也

癌が静脈血栓塞栓症の予後へ及ぼす影響 循環器疾患診療実態調査から(Prognostic Impact of Cancer on Venous Thromboembolism from Japanese Registry of All Cardiac and Vascular Datasets)

大櫛 祐一郎, 楠瀬 賢也, 岡山 佳弘, 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 )  85回   PL01 - 3   2021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）

生体吸収性ポリマー薬剤溶出性ステント留置後の初期および慢性期の局所凝固反応(Early and Chronic Phased Local Coagulative Responses Following Bioresorbable-polymer Drugeluting Stent Implantation)

山口 浩司, 若槻 哲三, 大櫛 祐一郎, 數藤 久美子, 松本 和久, 高橋 智紀, 門田 宗之, 川端 豊, 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 )  85回   OJ38 - 3   2021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）

慢性心不全患者におけるアンジオテンシン受容体-ネプリライシン阻害剤の急性ホルモン作用(Acute Hormonal Effect of the Angiotensin Receptor-Neprilysin Inhibitor in Patients with Chronic Heart Failure)

門田 宗之, 八木 秀介, 伊勢 孝之, 川端 豊, 松浦 朋美, 楠瀬 賢也, 飛梅 威, 山口 浩司, 山田 博胤, 添木 武, 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 )  85回   OJ64 - 7   2021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）

心不全死亡率に対するビタミンD補充の効果 循環器疾患診療実態調査より(Effects of Vitamin D Supplementation on Heart Failure Mortality from Japanese Registry of All Cardiac and Vascular Datasets)

阿部 美保, 楠瀬 賢也, 大櫛 祐一郎, Zheng Robert, 伊勢 孝之, 飛梅 威, 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

日本循環器学会学術集会抄録集 ( (一社)日本循環器学会 )  85回   OJ63 - 3   2021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）

冠動脈内微小管腔構造と心外膜脂肪組織およびプラーク形成との関連 新鮮遺体を用いた研究(Relationship between Coronary Intraplaque Microluminal Structure and Epicardial Adipose Tissue and Plaque Formation: A Fresh Cadaveric Study)

川端 豊, 若槻 哲三, 山口 浩司, 福田 大受, 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 )  85回   OJ17 - 3   2021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）

リアルワールドでの人工知能を活用した心エコー図検査およびX線検査(Utilization of Artificial Intelligence for Echocardiography and X-ray in the Real World)

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 )  85回   MIRAI3 - 1   2021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）

【糖尿病専門医に必要な心不全の知識update】SGLT2阻害薬と心不全

八木 秀介, 福田 大受, 平田 有紀奈, Byambasuren Ganbaatar, Arief Rahadian, 伊勢 孝之, 楠瀬 賢也, 山田 博胤, 山口 浩司, 松浦 朋美, 飛梅 威, 曽我 朋宏, 添木 武, 若槻 哲三, 川人 伸次, 佐田 政隆

糖尿病・内分泌代謝科 ( (有)科学評論社 )  52 ( 3 ) 257 - 264   2021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）

Utilization of Artificial Intelligence for Echocardiography and X-ray in the Real World(和訳中)

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 )  85回   MIRAI3 - 1   2021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）

Relationship between Coronary Intraplaque Microluminal Structure and Epicardial Adipose Tissue and Plaque Formation: A Fresh Cadaveric Study(和訳中)

川端 豊, 若槻 哲三, 山口 浩司, 福田 大受, 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 )  85回   OJ17 - 3   2021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）

Antegrade slow pathway mapping of typical atrioventricular nodal reentrant tachycardia based on direct slow pathway capture.

Takeshi Tobiume, Ritsushi Kato, Tomomi Matsuura, Kazuhisa Matsumoto, Motoki Hara, Nobuyuki Takamori, Yoshio Taketani, Keisuke Okawa, Takayuki Ise, Kenya Kusunose, Koji Yamaguchi, Shusuke Yagi, Daijyu Fukuda, Hirotsugu Yamada, Tetsuzo Wakatsuki, Takeshi Soeki, Masataka Sata, Kazuo Matsumoto

Journal of arrhythmia   37 ( 1 ) 128 - 139   2021年02月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

Background: Radiofrequency (RF) ablation of typical atrioventricular nodal reentrant tachycardia (tAVNRT) is performed without revealing out the location of antegrade slow pathway (ASp). In this study, we studied a new electrophysiological method of identifying the site of ASp. Methods: This study included 19 patients. Repeated series of very high-output single extrastimulations (VhoSESts) were delivered at the anatomical slow pathway region during tAVNRT. Tachycardia cycle length (TCL), coupling interval (CI), and return cycle (RC) were measured and the prematurity of VhoSESts [ΔPM (= TCL - CI)] and the prolongation of RCs [ΔPL (= RC - TCL)] were calculated. Pacing sites were classified into two categories: (i) ASp capture sites [DSPC(+) sites], where two different RCs were shown, and ASp non-capture sites [DSPC(-) sites], where only one RC was shown. RF ablation was performed at DSPC(+) sites and/or sites with catheter-induced mechanical trauma (CIMT) to ASp. Results: DSPC(+) sites were shown in 13 patients (68%). RF ablation was successful in all patients without any degree of atrioventricular block nor recurrence. Total number of RF applications was 1.8 ± 1.1. Minimal distance between successful ablation sites and DSPC(+)/CIMT sites and His bundle (HB) electrogram recording sites was 1.9 ± 0.8 mm and 19.8 ± 6.1 mm, respectively. ΔPL of more than 92.5 ms, ΔPL/TCL of more than 0.286, and ΔPL/ΔPM of more than 1.565 could identify ASp with sensitivity of 100%, 91.1%, and 88.9% and specificity of 92.9%, 97.0%, and 97.6%, respectively. Conclusions: Sites with ASp capture and CIMT were close to successful ablation sites and could be useful indicators of tAVNRT ablation.

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Cardiac reserve by 6-minute walk stress echocardiography in systemic sclerosis.

Miharu Arase, Kenya Kusunose, Sae Morita, Natsumi Yamaguchi, Yukina Hirata, Susumu Nishio, Yuichiro Okushi, Takayuki Ise, Takeshi Tobiume, Koji Yamaguchi, Daiju Fukuda, Shusuke Yagi, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Masataka Sata

Open heart   8 ( 1 )   2021年02月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

OBJECTIVES: There is a high prevalence of left ventricular diastolic dysfunction (LVDD) in systemic sclerosis (SSc) which is associated with high mortality. Thus, early detection of LVDD could be important in management of SSc. We hypothesised that exercise echocardiography in SSc patients with normal resting haemodynamics may expose early phase LVDD, which could affect its prognosis, defined as cardiovascular death and unplanned hospitalisation for heart failure. METHODS: Between January 2014 and December 2018, we prospectively enrolled 140 patients with SSc who underwent 6-minute walk (6MW) stress echocardiographic studies with normal range of estimated mean pulmonary arterial pressure (mPAP) (<25 mm Hg) and mean pulmonary artery wedge pressure (mPAWP) (<15 mm Hg) at rest. We used ΔmPAP/Δcardiac output (CO) to assess pulmonary vascular reserve and ΔmPAWP/ΔCO to assess LV cardiac reserve between resting and post-6MW. RESULTS: During a median period of 3.6 years (IQR 2.0-5.1 years), 25 patients (18%) reached the composite outcome. Both ΔmPAP/ΔCO and ΔmPAWP/ΔCO in patients with events were significantly greater than in those without events (8.9±3.8 mm Hg/L/min vs 3.0±1.7 mm Hg/L/min; p=0.002, and 2.2±0.9 mm Hg/L/min vs 0.9±0.5 mm Hg/L/min; p<0.001, respectively). Patients with both impaired LV cardiac reserve (ΔmPAWP/ΔCO>1.4 mm Hg/L/min) and impaired pulmonary vascular reserve (ΔmPAP/ΔCO>3.0 mm Hg/L/min) had worse outcomes compared with those without these abnormalities (p<0.001). CONCLUSION: The 6MW stress echocardiography revealed impaired LV cardiac reserve in SSc patients with normal resting haemodynamics. Furthermore, LV cardiac reserve independently associates with clinical worsening in SSc, providing incremental prognostic utility, in addition to pulmonary vascular parameters.

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Association between Vitamin D and Heart Failure Mortality in 10,974 Hospitalized Individuals.

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

Nutrients   13 ( 2 )   2021年01月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

A broad range of chronic conditions, including heart failure (HF), have been associated with vitamin D deficiency. Existing clinical trials involving vitamin D supplementation in chronic HF patients have been inconclusive. We sought to evaluate the outcomes of patients with vitamin D supplementation, compared with a matched cohort using real-world big data of HF hospitalization. This study was based on the Diagnosis Procedure Combination database in the Japanese Registry of All Cardiac and Vascular Datasets (JROAD-DPC). After exclusion criteria, we identified 93,692 patients who were first hospitalized with HF between April 2012 and March 2017 (mean age was 79 ± 12 years, and 52.2% were male). Propensity score (PS) was estimated with logistic regression model, with vitamin D supplementation as the dependent variable and clinically relevant covariates. On PS-matched analysis with 10,974 patients, patients with vitamin D supplementation had lower total in-hospital mortality (6.5 vs. 9.4%, odds ratio: 0.67, p < 0.001) and in-hospital mortality within 7 days and 30 days (0.9 vs. 2.5%, OR, 0.34, and 3.8 vs. 6.5%, OR: 0.56, both p < 0.001). In the sub-group analysis, mortalities in patients with age < 75, diabetes, dyslipidemia, atrial arrhythmia, cancer, renin-angiotensin system blocker, and β-blocker were not affected by vitamin D supplementation. Patients with vitamin D supplementation had a lower in-hospital mortality for HF than patients without vitamin D supplementation in the propensity matched cohort. The identification of specific clinical characteristics in patients benefitting from vitamin D may be useful for determining targets of future randomized control trials.

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Deleterious Effects of Epicardial Adipose Tissue Volume on Global Longitudinal Strain in Patients With Preserved Left Ventricular Ejection Fraction

Maimaituxun, G; Kusunose, K; Yamada, H; Fukuda, D; Yagi, S; Torii, Y; Yamada, N; Soeki, T; Masuzaki, H; Sata, M; Shimabukuro, M

FRONTIERS IN CARDIOVASCULAR MEDICINE ( Frontiers in Cardiovascular Medicine )  7   607825 - 607825   2021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: It is known that epicardial adipose tissue (EAT) volume is linked to cardiac dysfunction. However, it is unclear whether EAT volume (EATV) is closely linked to abnormal LV strain. We examined the relationship between EATV and global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) in patients with preserved LV function. Methods: Notably, 180 consecutive subjects (68 ± 12 years; 53% men) underwent 320-slice multi-detector computed tomography coronary angiography and were segregated into coronary artery disease (CAD) (≥1 coronary artery branch stenosis ≥50%) and non-CAD groups. GLS, GCS, and GRS were evaluated by 2-dimensional speckle tracking in patients with preserved left ventricular (LV) ejection fraction (LVEF) ≥50%. Results: First, GLS, but not GRS and GCS, was lower in the high EATV group though the LVEF was comparable to the low EATV group. Frequency of GLS ≤18 was higher in the high EATV group. Second, multiple regression model showed that EATV, age, male sex, and CAD, were determinants of GLS. Third, the cutoff points of EATV were comparable (~116-117 mL) in both groups. The cutoff of EATV ≥116 showed a significant correlation with GLS ≤18 in overall subjects. Conclusions: Increasing EATV was independently associated with global longitudinal strain despite the preserved LVEF and lacking obstructive CAD. Our findings suggest an additional role of EAT on myocardial systolic function by impaired LV longitudinal strain.

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Congenital Hypogonadotropic Hypogonadism with Early-Onset Coronary Artery Disease.

Akira Takashima, Shusuke Yagi, Koji Yamaguchi, Kiyoe Kurahashi, Yuko Kojima, Robert Zheng, Takayuki Ise, Kenya Kusunose, Sumiko Yoshida, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Ken-Ichi Aihara, Masashi Akaike, Masataka Sata

The journal of medical investigation : JMI   68 ( 1.2 ) 189 - 191   2021年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

The patient with congenital hypogonadotropic hypogonadism (HH) shows low serum levels of androgen, which is a group of sex hormones including testosterone, caused by the decreased gonadotropin release in the hypothalamus. Recent reports showed androgens exert protective effects against insulin resistance or atherosclerotic diseases, such as diabetes mellitus or coronary artery disease. However, whether the juvenile hypogonadism affects the diabetes or cardiovascular disease is unclear. We report a case of a middle-aged man with congenital HH who had severe coronary artery disease complicated with metabolic disorders. J. Med. Invest. 68 : 189-191, February, 2021.

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Deep Learning Analysis of Echocardiographic Images to Predict Positive Genotype in Patients With Hypertrophic Cardiomyopathy.

Sae X Morita, Kenya Kusunose, Akihiro Haga, Masataka Sata, Kohei Hasegawa, Yoshihiko Raita, Muredach P Reilly, Michael A Fifer, Mathew S Maurer, Yuichi J Shimada

Frontiers in cardiovascular medicine   8   669860 - 669860   2021年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

Genetic testing provides valuable insights into family screening strategies, diagnosis, and prognosis in patients with hypertrophic cardiomyopathy (HCM). On the other hand, genetic testing carries socio-economical and psychological burdens. It is therefore important to identify patients with HCM who are more likely to have positive genotype. However, conventional prediction models based on clinical and echocardiographic parameters offer only modest accuracy and are subject to intra- and inter-observer variability. We therefore hypothesized that deep convolutional neural network (DCNN, a type of deep learning) analysis of echocardiographic images improves the predictive accuracy of positive genotype in patients with HCM. In each case, we obtained parasternal short- and long-axis as well as apical 2-, 3-, 4-, and 5-chamber views. We employed DCNN algorithm to predict positive genotype based on the input echocardiographic images. We performed 5-fold cross-validations. We used 2 reference models-the Mayo HCM Genotype Predictor score (Mayo score) and the Toronto HCM Genotype score (Toronto score). We compared the area under the receiver-operating-characteristic curve (AUC) between a combined model using the reference model plus DCNN-derived probability and the reference model. We calculated the p-value by performing 1,000 bootstrapping. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). In addition, we examined the net reclassification improvement. We included 99 adults with HCM who underwent genetic testing. Overall, 45 patients (45%) had positive genotype. The new model combining Mayo score and DCNN-derived probability significantly outperformed Mayo score (AUC 0.86 [95% CI 0.79-0.93] vs. 0.72 [0.61-0.82]; p < 0.001). Similarly, the new model combining Toronto score and DCNN-derived probability exhibited a higher AUC compared to Toronto score alone (AUC 0.84 [0.76-0.92] vs. 0.75 [0.65-0.85]; p = 0.03). An improvement in the sensitivity, specificity, PPV, and NPV was also achieved, along with significant net reclassification improvement. In conclusion, compared to the conventional models, our new model combining the conventional and DCNN-derived models demonstrated superior accuracy to predict positive genotype in patients with HCM.

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Deep learning to predict elevated pulmonary artery pressure in patients with suspected pulmonary hypertension using standard chest X ray

Kenya Kusunose, Yukina Hirata, Takumasa Tsuji, Jun’ichi Kotoku, Masataka Sata

Scientific Reports ( Springer Science and Business Media LLC )  10 ( 1 )   2020年12月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

<title>Abstract</title>Accurate diagnosis of pulmonary hypertension (PH) is crucial to ensure that patients receive timely treatment. We hypothesized that application of artificial intelligence (AI) to the chest X-ray (CXR) could identify elevated pulmonary artery pressure (PAP) and stratify the risk of heart failure hospitalization with PH. We retrospectively enrolled a total of 900 consecutive patients with suspected PH. We trained a convolutional neural network to identify patients with elevated PAP (&gt; 20 mmHg) as the actual value of PAP. The endpoints in this study were admission or occurrence of heart failure with elevated PAP. In an independent evaluation set for detection of elevated PAP, the area under curve (AUC) by the AI algorithm was significantly higher than the AUC by measurements of CXR images and human observers (0.71 vs. 0.60 and vs. 0.63, all p &lt; 0.05). In patients with AI predicted PH had 2-times the risk of heart failure with PH compared with those without AI predicted PH. This preliminary work suggests that applying AI to the CXR in high risk groups has limited performance when used alone in identifying elevated PAP. We believe that this report can serve as an impetus for a future large study.

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Identifying the extent of oral fluid droplets on echocardiographic machine consoles in COVID-19 era.

Kenya Kusunose, Kosuke Matsunaga, Hirotsugu Yamada, Masataka Sata

Journal of echocardiography   18 ( 4 ) 268 - 270   2020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）

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イバブラジンの導入により心機能の改善を認めた虚血性心筋症の1例

阿部 拓馬, 門田 宗之, 八木 秀介, 谷 彰浩, 大櫛 祐一郎, 瀬野 弘光, 松本 和久, 高橋 智紀, 數藤 久美子, 川端 豊, 松浦 朋美, 伊勢 孝之, 楠瀬 賢也, 飛梅 威, 山口 浩司, 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 )  76 ( 5-6 ) 354 - 354   2020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）

膝窩動脈捕捉症候群と診断した若年女性の1例

根岸 佑典, 門田 宗之, 八木 秀介, 谷 彰浩, 大櫛 祐一郎, 瀬野 弘光, 松本 和久, 高橋 智紀, 數藤 久美子, 川端 豊, 松浦 朋美, 伊勢 孝之, 楠瀬 賢也, 飛梅 威, 山口 浩司, 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 )  76 ( 5-6 ) 353 - 354   2020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）

Canagliflozin Prevents Diabetes-Induced Vascular Dysfunction in ApoE-Deficient Mice.

Arief Rahadian, Daiju Fukuda, Hotimah Masdan Salim, Shusuke Yagi, Kenya Kusunose, Hirotsugu Yamada, Takeshi Soeki, Masataka Sata

Journal of atherosclerosis and thrombosis   27 ( 11 ) 1141 - 1151   2020年11月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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AIM: Recent studies have demonstrated that selective sodium-glucose cotransporter 2 inhibitors (SGLT2is) reduce cardiovascular events, although their mechanism remains obscure. We examined the effect of canagliflozin, an SGLT2i, on atherogenesis and investigated its underlying mechanism. METHOD: Canagliflozin (30 mg/kg/day) was administered by gavage to streptozotocin-induced diabetic apolipoprotein E-deficient (ApoE－/－) mice. Sudan IV staining was performed at the aortic arch. Immunostaining, quantitative RT-PCR, and vascular reactivity assay were performed using the aorta. In vitro experiments using human umbilical vein endothelial cells (HUVECs) were also performed. RESULT: Canagliflozin decreased blood glucose (P＜0.001) and total cholesterol (P＜0.05) levels. Sudan IV staining showed that 12-week canagliflozin treatment decreased atherosclerotic lesions (P＜0.05). Further, 8-week canagliflozin treatment ameliorated endothelial dysfunction, as determined by acetylcholine-induced vasodilation (P＜0.05), and significantly reduced the expressions of inflammatory molecules such as ICAM-1 and VCAM-1 in the aorta at the RNA and protein levels. Canagliflozin also reduced the expressions of NADPH oxidase subunits such as NOX2 and p22phox in the aorta and reduced urinary excretion of 8-OHdG, suggesting a reduction in oxidative stress. Methylglyoxal, a precursor of advanced glycation end products, increased the expressions of ICAM-1 and p22phox in HUVECs (P＜0.05, both). Methylglyoxal also decreased the phosphorylation of eNOSSer1177 and Akt but increased the phosphorylation of eNOSThr495 and p38 MAPK in HUVECs. CONCLUSION: Canagliflozin prevents endothelial dysfunction and atherogenesis in diabetic ApoE－/－ mice. Anti-inflammatory and antioxidative potential due to reduced glucose toxicity to endothelial cells might be its underlying mechanisms.

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