論文 - 楠瀬　賢也

Relationship between regional left ventricular dysfunction and cancer-therapy-related cardiac dysfunction.

Yoshihito Saijo, Kenya Kusunose, Yuichiro Okushi, Hirotsugu Yamada, Hiroaki Toba, Masataka Sata

Heart (British Cardiac Society)   106 ( 22 ) 1752 - 1758   2020年11月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

OBJECTIVE: The aim of our study was to assess the association between risk of cancer-therapy-related cardiac dysfunction (CTRCD) after first follow-up and the difference in echocardiographic measures from baseline to follow-up. METHODS: We retrospectively enrolled 87 consecutive patients (58±14 years, 55 women) who received anthracycline and underwent echocardiographic examinations both before (baseline) and after initial anthracycline administration (first follow-up). We measured absolute values of global longitudinal strain (GLS), apical longitudinal strain (LS), mid-LS and basal-LS at baseline and first follow-up, and per cent changes (Δ) of these parameters were calculated. Among 61 patients who underwent further echocardiographic examinations (second follow-up, third follow-up, etc), we assessed the association between regional left ventricular (LV) systolic dysfunction from baseline to follow-up and development of CTRCD, defined as LV ejection fraction (LVEF) under 53% and more absolute decrease of 10% from baseline, after first follow-up. RESULTS: LVEF (65%±4% vs 63±4%, p=0.004), GLS (23.2%±2.6% vs 22.2±2.4%, p=0.005) and basal-LS (21.9%±2.5% vs 19.9±2.4%, p<0.001) at first follow-up significantly decreased compared with baseline. Among the 61 patients who had further follow-up echocardiographic examinations, 13% developed CTRCD. In the Cox-hazard model, worse Δbasal-LS was significantly associated with CTRCD. By Kaplan-Meier analysis, patients with Δbasal-LS decrease of more than the median value (-9.7%) had significantly worse event-free survival than those with a smaller decrease (p=0.015). CONCLUSIONS: Basal-LS significantly decreased prior to development of CTRCD, and worse basal-LS was associated with development of CTRCD in patients receiving anthracycline chemotherapy.

• この論文にアクセスする

  DOI
• 関連情報を調べる
  PubMed

加速する循環器画像領域におけるAI研究の現在と未来

楠瀬 賢也, 芳賀 昭弘, 山田 博胤, 西尾 進, 平田 有紀奈, 佐田 政隆

超音波医学 ( (公社)日本超音波医学会 )  47 ( Suppl. ) S546 - S546   2020年11月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

下大静脈原発平滑筋肉腫の1例

西尾 進, 森根 裕二, 湯浅 麻美, 松本 力三, 平田 有紀奈, 山尾 雅美, 楠瀬 賢也, 山田 博胤, 島田 光生, 佐田 政隆

超音波医学 ( (公社)日本超音波医学会 )  47 ( Suppl. ) S336 - S336   2020年11月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

最新の心エコー図診断装置および装置非依存性ストレイン解析ソフトウェアを用いたGlobal Longitudinal Strain計測の装置間差に関する検討

平田 有紀奈, 西尾 進, 楠瀬 賢也, 藤田 幸那, 荒瀬 美晴, 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 )  45 ( 4 ) 405 - 413   2020年08月 [ 査読有り ]

掲載種別: 研究論文（その他学術会議資料等）

　概要を見る

目的:左室長軸方向ストレイン(GLS)は、正確で再現性の良い左室機能評価の指標とされているが、超音波診断装置間でのばらつきは未だ議論がある。本研究では、最新の超音波診断装置を用いることにより、GLSの装置間差が軽減しているという仮説を検証することを目的とした。対象と方法:34名の健康なボランティアの測定を行った。心尖部の画像は、徳島大学病院超音波センターに導入された最新の超音波装置を使用して取得した。GLSの測定はそれぞれの装置に搭載されているソフトウェアおよび、装置非依存性ストレイン解析ソフトウェアであるEchoInsightを用いて測定し、比較した。結果と考察:各装置間でGLSに良好な相関が得られた(GE vs.Philips[r=0.678、p<0.001、Bias 1.1%、2SD±2.9%]、GE vs.Canon[r=0.690、p<0.001、Bias 0.4%、2SD±2.5%]、Philips vs.Canon[r=0.551、p<0.001、Bias 1.5%、2SD±3.2%])。EchoInsightを用いた場合、各装置で計測したGLSよりも相関関係は良好であった。結語:GLSの装置間差は過去の報告と比較して改善していた。さらにEchoInsightを用いて計測したGLSは、良好な相関関係を認めた。(著者抄録)

Association between Sarcopenia/Lower Muscle Mass and Short-Term Regression of Deep Vein Thrombosis Using Direct Oral Anticoagulants.

Yuta Torii, Kenya Kusunose, Robert Zheng, Hirotsugu Yamada, Rie Amano, Rikizo Matsumoto, Yukina Hirata, Susumu Nishio, Nao Yamada, Takayuki Ise, Koji Yamaguchi, Takeshi Tobiume, Daiju Fukuda, Shusuke Yagi, Takeshi Soeki, Tetsuzo Wakatsuki, Yoshihiro Okayama, Masataka Sata

International heart journal   61 ( 4 ) 787 - 794   2020年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

Advanced age, obesity, and muscle weakness are independent factors in the onset of deep vein thrombosis (DVT). Recently, an association between sarcopenia and DVT has been reported. We hypothesized that sarcopenia related factors, observed by ultrasonography, are associated with the regression effect on the thrombus following anticoagulation therapy. The present study focused on gastrocnemius muscle (GCM) thickness and the GCM's internal echogenic brightness. We examined the association with DVT regression following direct oral anticoagulants (DOACs) treatment.The prospective cohort study period was between October 2017 and August 2018. We enrolled 46 patients diagnosed with DVT by ultrasonography, who were aged >60 years old and treated with DOACs. Sarcopenia was evaluated using the Asian Working Group for Sarcopenia flowchart. The average DOACs treatment period was 94 days, and 29 patients exhibited thrombus regression. On univariate logistic regression analysis, sarcopenia, average GCM diameter index, and gastrocnemius integrated backscatter index were significantly associated with thrombus regression. In a multivariate model, only the average GCM diameter index correlated with thrombus regression.The average GCM diameter index is associated with DVT regression treated with DOACs. Considering the GCM diameter during DVT treatment can be a marker to make a decision for the treatment of DVT.

• この論文にアクセスする

  DOI
• 関連情報を調べる
  PubMed

循環器疾患のAI画像診断 心エコー検査における人工知能の現状と将来展望(Prospects for the Present and Future of Artificial Intelligence in Echocardiography)

楠瀬 賢也, 山田 博胤, 中谷 敏, 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 )  84回   シンポジウム22 - 6   2020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）

薬剤溶出性ステント留置後の慢性的局所的な血液凝固反応に対しストラット厚の薄さとポリマー吸収の速さが及ぼす影響(The Effect of Lower Strut Thickness and Faster Polymer Resorption on Chronic Local Coagulative Response after Drug Eluting 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, 上野 理絵, 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 )  84回   PJ26 - 1   2020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）

薬剤溶出性ステント留置後の慢性的局所的な血液凝固反応に対しストラット厚の薄さとポリマー吸収の速さが及ぼす影響(The Effect of Lower Strut Thickness and Faster Polymer Resorption on Chronic Local Coagulative Response after Drug Eluting 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, 上野 理絵, 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 )  84回   PJ26 - 1   2020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）

循環器疾患のAI画像診断 心エコー検査における人工知能の現状と将来展望(Prospects for the Present and Future of Artificial Intelligence in Echocardiography)

楠瀬 賢也, 山田 博胤, 中谷 敏, 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 )  84回   シンポジウム22 - 6   2020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）

心筋梗塞発症後に真性心室瘤と仮性心室瘤を認めた1例

平田 有紀奈, 西尾 進, 山口 夏美, 森田 沙瑛, 山尾 雅美, 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 )  45 ( 3 ) 331 - 331   2020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）

肝芽腫の1例

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

超音波検査技術 ( (一社)日本超音波検査学会 )  45 ( 3 ) 330 - 330   2020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）

Empagliflozin ameliorates endothelial dysfunction and suppresses atherogenesis in diabetic apolipoprotein E-deficient mice.

Byambasuren Ganbaatar, Daiju Fukuda, Masakazu Shinohara, Shusuke Yagi, Kenya Kusunose, Hirotsugu Yamada, Takeshi Soeki, Ken-Ichi Hirata, Masataka Sata

European journal of pharmacology   875   173040 - 173040   2020年05月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

Recent studies reported cardioprotective effects of sodium glucose co-transporter 2 (SGLT2) inhibitors; however, the underlying mechanisms are still obscure. Here, we investigated whether empagliflozin attenuates atherogenesis and endothelial dysfunction in diabetic apolipoprotein E-deficient (ApoE-/-) mice. Male streptozotocin (STZ) - induced diabetic ApoE-/- mice were treated with empagliflozin for 12 or 8 weeks. Empagliflozin lowered blood glucose (P < 0.001) and lipid levels in diabetic ApoE-/- mice. Empagliflozin treatment for 12 weeks significantly decreased atherosclerotic lesion size in the aortic arch (P < 0.01) along with reduction of lipid deposition (P < 0.05), macrophage accumulation (P < 0.001), and inflammatory molecule expression in plaques compared with the untreated group. Empagliflozin treatment for 8 weeks significantly ameliorated diabetes-induced endothelial dysfunction as determined by the vascular response to acetylcholine (P < 0.001). Empagliflozin reduced RNA expression of a macrophage marker, CD68, and inflammatory molecules such as MCP-1 (P < 0.05) and NADPH oxidase subunits in the aorta compared with the untreated group. Empagliflozin also reduced plasma levels of vasoconstrictive eicosanoids, prostaglandin E2 and thromboxane B2 (P < 0.001), which were elevated in diabetic condition. Furthermore, empagliflozin attenuated RNA expression of inflammatory molecules in perivascular adipose tissue (PVAT), suggesting the reduction of inflammation in PVAT. In in vitro studies, methylglyoxal (MGO), a precursor of AGEs, significantly increased the expression of inflammatory molecules such as MCP-1 and TNF-α in a murine macrophage cell line, RAW264.7. Our results indicated that empagliflozin attenuated endothelial dysfunction and atherogenesis in diabetic ApoE-/- mice. Reduction of vasoconstrictive eicosanoids and inflammation in the vasculature and PVAT may have a role as underlying mechanisms at least partially.

• この論文にアクセスする

  DOI
• 関連情報を調べる
  PubMed

Deep Learning for Assessment of Left Ventricular Ejection Fraction from Echocardiographic Images.

Kenya Kusunose, Akihiro Haga, Natsumi Yamaguchi, Takashi Abe, Daiju Fukuda, Hirotsugu Yamada, Masafumi Harada, Masataka Sata

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography   33 ( 5 ) 632 - 635   2020年05月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

• この論文にアクセスする

  DOI
• 関連情報を調べる
  PubMed

Clinically Feasible and Accurate View Classification of Echocardiographic Images Using Deep Learning.

Kenya Kusunose, Akihiro Haga, Mizuki Inoue, Daiju Fukuda, Hirotsugu Yamada, Masataka Sata

Biomolecules   10 ( 5 )   2020年04月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

A proper echocardiographic study requires several video clips recorded from different acquisition angles for observation of the complex cardiac anatomy. However, these video clips are not necessarily labeled in a database. Identification of the acquired view becomes the first step of analyzing an echocardiogram. Currently, there is no consensus whether the mislabeled samples can be used to create a feasible clinical prediction model of ejection fraction (EF). The aim of this study was to test two types of input methods for the classification of images, and to test the accuracy of the prediction model for EF in a learning database containing mislabeled images that were not checked by observers. We enrolled 340 patients with five standard views (long axis, short axis, 3-chamber view, 4-chamber view and 2-chamber view) and 10 images in a cycle, used for training a convolutional neural network to classify views (total 17,000 labeled images). All DICOM images were rigidly registered and rescaled into a reference image to fit the size of echocardiographic images. We employed 5-fold cross validation to examine model performance. We tested models trained by two types of data, averaged images and 10 selected images. Our best model (from 10 selected images) classified video views with 98.1% overall test accuracy in the independent cohort. In our view classification model, 1.9% of the images were mislabeled. To determine if this 98.1% accuracy was acceptable for creating the clinical prediction model using echocardiographic data, we tested the prediction model for EF using learning data with a 1.9% error rate. The accuracy of the prediction model for EF was warranted, even with training data containing 1.9% mislabeled images. The CNN algorithm can classify images into five standard views in a clinical setting. Our results suggest that this approach may provide a clinically feasible accuracy level of view classification for the analysis of echocardiographic data.

• この論文にアクセスする

  DOI
• 関連情報を調べる
  PubMed

Atherosclerotic Coronary Plaque Is Associated With Adventitial Vasa Vasorum and Local Inflammation in Adjacent Epicardial Adipose Tissue in Fresh Cadavers.

Hiroyuki Ito, Tetsuzo Wakatsuki, Koji Yamaguchi, Daiju Fukuda, Yutaka Kawabata, Tomomi Matsuura, Kenya Kusunose, Takayuki Ise, Takeshi Tobiume, Shusuke Yagi, Hirotsugu Yamada, Takeshi Soeki, Yoshihiro Tsuruo, Masataka Sata

Circulation journal : official journal of the Japanese Circulation Society   84 ( 5 ) 769 - 775   2020年04月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

BACKGROUND: The coronary adventitia has recently attracted attention as a source of inflammation because it harbors nutrient blood vessels, termed the vasa vasorum (VV). This study assessed the link between local inflammation in adjacent epicardial adipose tissue (EAT) and coronary arterial atherosclerosis in fresh cadavers.Methods and Results:Lesion characteristics in the left anterior descending coronary artery of 10 fresh cadaveric hearts were evaluated using integrated backscatter intravascular ultrasound (IB-IVUS), and the density of the VV and levels of inflammatory molecules from the adjacent EAT were measured for each of the assessed lesions. The lesions were divided into lipid-rich, lipid-moderate, and lipid-poor groups according to percentage lipid volume assessed by IB-IVUS. Higher expression of inflammatory molecules (i.e., vascular endothelial growth factor A [VEGFA] andVEGFB) was observed in adjacent EAT of lipid-rich (n=11) than in lipid-poor (n=11) lesions (7.99±3.37 vs. 0.45±0.85 arbitrary units [AU], respectively, forVEGFA; 0.27±0.15 vs. 0.11±0.07 AU, respectively, forVEGFB; P<0.05). The density of adventitial VV was greater in lipid-rich than lipid-poor lesions (1.50±0.58% vs. 0.88±0.23%; P<0.05). CONCLUSIONS: Lipid-rich coronary plaques are associated with adventitial VV and local inflammation in adjacent EAT in fresh cadavers. This study suggests that local inflammation of EAT is associated with coronary plaque progression via the VV.

• この論文にアクセスする

  DOI
• 関連情報を調べる
  PubMed

Study protocol for prospect trial to elucidate the utility of echocardiography-based cardiac output in acute heart failure (PREDICT).

Hiroyuki Iwano, Kentaro Shibayama, Takeshi Kitai, Kenya Kusunose, Tetsuari Onishi, Hidekazu Tanaka, Toshihisa Anzai

Journal of echocardiography   18 ( 4 ) 235 - 239   2020年04月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

　概要を見る

BACKGROUND: Early worsening heart failure (WHF), defined as worsening of symptoms and signs of heart failure requiring intensification of medical or mechanical therapy during an admission for acute decompensated heart failure (ADHF), has recently been recognized as a risk of morbidity or mortality after the discharge. Although echocardiographic parameters of left ventricular (LV) output has been shown to be associated with long-term outcome in heart failure patients, its predictive value for early WHF has not been elucidated. METHODS: Prospect trial to Elucidate the utility of EchocarDiography-based Cardiac output in acute heart failure (PREDICT) is a multicenter, nonrandomized, prospective observational study to test the predictive value of echocardiographic LV output parameters for early WHF in ADHF patients. We will enroll patients admitted to 16 participating hospitals due to ADHF who did not receive positive inotropic agents as an initial therapy. Primary outcome will be set at early WHF defined as need for initiation of positive inotropic agents within 7 days after the admission. Predictive accuracy will be compared between Doppler echocardiographic LV output (stroke distance, stroke volume index, and cardiac index) and low perfusion findings assessed by physical examination. RESULTS: N/A. CONCLUSIONS: The PREDICT is expected to provide large data set to test the predictive value of echocardiographic LV output for early WHF in ADHF patients.

• この論文にアクセスする

  DOI
• 関連情報を調べる
  PubMed

ジルチアゼム大量服薬による循環不全に対し経皮的心肺補助装置を導入し救命し得た1例

田中 真波, 高橋 智紀, 高橋 智子, 谷 彰浩, 藤本 裕太, 大櫛 祐一郎, 數藤 久美子, 松本 和久, 上野 理絵, 門田 宗之, 川端 豊, 山田 なお, 松浦 朋美, 伊勢 孝之, 楠瀬 賢也, 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

四国医学雑誌 ( 徳島医学会 )  76 ( 1-2 ) 128 - 129   2020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）

ペーシングによる速伝導路と遅伝導路のマッピングが治療に有用であった通常型房室結節リエントリー性頻拍の1例

堀 祥昌, 飛梅 威, 松本 和久, 松浦 朋美, 添木 武, 志村 拓哉, 高橋 智子, 谷 彰浩, 藤本 裕太, 大櫛 祐一郎, 數藤 久美子, 高橋 智紀, 上野 理絵, 門田 宗之, 川端 豊, 坂東 美佳, 山田 なお, 伊藤 浩敬, 伊勢 孝之, 楠瀬 賢也, 山口 浩司, 八木 秀介, 福田 大受, 山田 博胤, 若槻 哲三, 佐田 政隆

四国医学雑誌 ( 徳島医学会 )  76 ( 1-2 ) 127 - 128   2020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）

Diastolic Mitral Regurgitation on Color M-Mode Echocardiography in a Patient With Complete Atrioventricular Block.

Akihiro Tani, Kenya Kusunose, Kazuhisa Matsumoto, Hirotsugu Yamada, Masataka Sata

Circulation reports   2 ( 3 ) 207 - 208   2020年02月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

• この論文にアクセスする

  DOI
• 関連情報を調べる
  PubMed

冠動脈疾患の予測における心外膜下脂肪厚計測の有用性について 多施設共同研究

平田 有紀奈, 西尾 進, 原田 修, 宮里 尚美, 原國 督, 楠瀬 賢也, 伊藤 敦彦, 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 )  45 ( 1 ) 11 - 20   2020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）

　概要を見る

目的:心外膜下脂肪(Epicardial adipose tissue:EAT)は心臓周囲に付着した異所性内臓脂肪であり、冠動脈疾患(Coronary artery disease:CAD)進展と密接な関連がある。我々は過去に、リニア型探触子を使用して前室間溝(Anterior Interventricular Groove:AIG)でEAT厚を測定する手法(EAT-AIG厚)を考案した。また、EAT-AIG厚のカットオフ値を7.1mmと設定した場合、最も感度・特異度高くCADの有無を判別できることを単施設で報告した。そこで本研究では、EAT-AIG厚のカットオフ値7.1mmを用いた場合のCAD予測の有用性について、多施設における新たなコホートを対象として検証することを目的とした。対象と方法:多施設前向き研究として、2017年4月1日〜2018年3月31日までに心臓カテーテル検査が施行された216例(平均年齢67±12歳、男性134例)を対象とした。EAT-AIG厚は、心臓カテーテル検査を施行する前に、リニア型探触子を用いて計測した。EAT-AIG厚のカットオフ値7.1mmに基づいて2群に分類した。結果と考察:CADを有した症例は97例(45%)であった。EAT-AIG厚>7.1mmの患者では、EAT-AIG厚≦7.1mmと比較して有意にCADの罹患率が大であった(66% vs.23%、p<0.001)、EAT-AIG厚>7.1mmは、感度75%、特異度68%でCADの有無を予測できた。陽性的中率、陰性的中率および正診率はそれぞれ66%、77%、71%であった。EAT-AIG厚>7.1mmは、従来の冠危険因子(年齢、性別、Body mass index、高血圧、脂質異常症、糖尿病、喫煙歴)に加えてCADを予測する指標である。結語:EAT-AIG厚のカットオフ値7.1mmは、CADの予測に有用であることを多施設共同研究でも確認できた。(著者抄録)