研究者詳細 - 楠瀬　賢也

論文 - 楠瀬　賢也

分割表示 >> ／全件表示415 件中 1 - 415 件目

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）

この論文にアクセスする

DOI

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

【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）

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）

Background: 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).Methods and Results: 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).Conclusions: ChatGPT has the potential to be a valuable tool for clinicians in the management of hypertension.

この論文にアクセスする

DOI
関連情報を調べる

PubMed CiNii Research

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）

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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 &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 &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.

この論文にアクセスする

DOI

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）

The Impact of Coronary Plaque Progression Stage on Coronary Neovascularization Structures in Fresh Cadavers(タイトル和訳中)

川端豊, 若槻哲三, 山口浩司, 坂東遼, 西條良仁, 上野理絵, 門田宗之, 原知也, 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 ) 87回 PJ005 - 1 2023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）

薬物治療可能な心筋症の非侵襲的画像診断:早期診断のための活用法(Utility of Periodic Echocardiographic Surveillance for Early Detection of Cardiac Dysfunction from Chemotherapy in Breast Cancer Patients)

西條良仁, 大櫛祐一郎, 楠瀬賢也, 山田博胤, ゼングロバート, 高橋智紀, 瀬野弘光, 西尾進, 上野理絵, 門田宗之, 原知也, 川端豊, 松浦朋美, 伊勢孝之, 山口浩司, 八木秀介, 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 ) 87回 SY11 - 3 2023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）

未来の医療機器・デバイスのために(Novel Home-based Cardiac Telerehabilitation System Using a Wearable Device and a Web Application)

伊勢孝之, 八木秀介, 上野理絵, 門田宗之, 大谷啓太, 根岸佑典, 宮本亮太, 坂東遼, ゼングロバート, 瀬野弘光, 高橋智紀, 川端豊, 西條良仁, 松浦朋美, 楠瀬賢也, 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 ) 87回 SY03 - 4 2023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）

マルチモダリティによる心筋ストレイン評価心エコー図検査における2Dストレイン計測の現状と課題

西尾進, 楠瀬賢也, 平田有紀奈, 山口夏美, Zheng Robert, 高橋智紀, 瀬野弘光, 西條良仁, 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 ) 87回 CS5 - 2 2023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）

Two-year Outcomes of Drug-coated Balloon-only Strategy for De Novo Lesions in Large Coronary Vessels(タイトル和訳中)

坂東遼, 若槻哲三, 山口浩司, 川端豊, 宮本亮太, ゼングロバート, 高橋智紀, 西條良仁, 上野理絵, 門田宗之, 原知也, 松浦朋美, 伊勢孝之, 楠瀬賢也, 八木秀介, 山田博胤, 添木武, 赤池雅史, 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 ) 87回 OJ32 - 1 2023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）

Canagliflozin independently reduced plasma volume from conventional diuretics in patients with type 2 diabetes and chronic heart failure: a subanalysis of the CANDLE trial

Shiina K.

Hypertension Research ( Hypertension Research ) 46 ( 2 ) 495 - 506 2023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

Benefits of guideline-directed medical therapy to loop diuretics in management of heart failure.

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

The journal of medical investigation : JMI 70 ( 1.2 ) 41 - 53 2023年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

BACKGROUND: We sought to compare the outcomes of patients receiving combination therapy of diuretics and neurohormonal blockers, with a matched cohort with monotherapy of loop diuretics, using real-world big data. METHODS: 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 78,685 patients who were first hospitalized with heart failure (HF) between April 2015 and March 2017. Propensity score (PS) was estimated with logistic regression model, with neurohormonal blockers (angiotensin-converting enzyme inhibitor : ACEi or angiotensin receptor blocker : ARB, ?-blockers and mineralocorticoid receptor antagonists : MRA) as the dependent variable and 24 clinically relevant covariates to compare the in-hospital mortality between monotherapy of loop diuretics and combination therapies. RESULTS: On PS-matched analysis, patients with ACEi?/?ARB, ?-blockers, and MRA had lower total in-hospital mortality and in-hospital mortality within 7 days, 14 days and 30 days. In the sub-group analysis, regardless of clinical characteristics including elderly people and cancer, patients treated with a combination of loop diuretics and neurohormonal blockers had significantly lower in-hospital mortality than matched patients. CONCLUSIONS: Our data indicate the benefits of guideline-directed medical therapy to loop diuretics in the management of HF. J. Med. Invest. 70 : 41-53, February, 2023.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

パンデミック下の臨床実習におけるオンライン医学教育の実際と問題点

八木秀介, 伊勢孝之, 門田宗之, 川端豊, 原知也, 上野理絵, 西條良仁, 松浦朋美, 楠瀬賢也, 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 ) 78 ( 5-6 ) 254 - 254 2022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）

腎動脈拡張術により心不全の著明な改善を認めたCardiac Disturbance syndromeの1例

根岸佑典, 門田宗之, 山口浩司, 山田博胤, 折野逸人, 大谷啓太, 吉田知哉, 宮本亮太, 坂東遼, Zheng Robert, 瀬野弘光, 高橋智紀, 西條良仁, 上野理絵, 原知也, 川端豊, 松浦朋美, 伊勢孝之, 楠瀬賢也, 八木秀介, 添木武, 若槻哲三, 佐田政隆, 田蒔昌憲

四国医学雑誌 ( 徳島医学会 ) 78 ( 5-6 ) 252 - 252 2022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）

肺動脈弁位感染性心内膜炎の1例

山口夏美, 西尾進, 門田宗之, 森田沙瑛, 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, 佐田政隆

超音波検査技術 ( (一社)日本超音波検査学会 ) 47 ( 6 ) 590 - 596 2022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）

症例は,60代女性.幼少期に心雑音を指摘され,21歳時に当院で膜様部型心室中隔欠損症と診断されていたが,その後は医療機関を受診していなかった.今回,発熱および咳嗽を主訴に近医を受診し,血液検査で細菌感染が疑われ,抗生剤が処方された.心拡大とNT-proBNPが高値であったことから精査のため前医を紹介受診したところ,経胸壁心エコー図検査で肺動脈弁に長径30mm程度の可動性を有する心筋と等輝度の異常構造物を認め,重症の肺動脈弁逆流を呈していた.感染性心内膜炎の診断で同日に前医に入院し,抗生剤が開始された.その後,外科的治療検討のため当院へ紹介となった.同日施行された経胸壁心エコー図検査では肺動脈弁に付着する巨大な疣腫と重症の肺動脈弁逆流を認めた.また,心室中隔膜様部に既知の心室中隔欠損を認めた.さらに右室内に異常筋束を認め,右室二腔症と診断された.前医の血液培養からStaphylococcus warneriが検出された.血行動態は安定しており,明らかな塞栓症は起こしていなかったため抗生剤による加療が優先された.その後,待機的に肺動脈弁置換術,心室中隔欠損閉鎖術,右室流出路心筋切除術が施行された.右心系の感染性心内膜炎の割合は感染性心内膜炎全体の5～10%程度とされており,左心系に比べ少ない.今回,先天性心疾患に合併した肺動脈弁位感染性心内膜炎の1例を経験したので報告する.(著者抄録)

急性A型大動脈解離をきたしたMarfan症候群の一例

松崎慶仁, 西條良仁, 伊勢孝之, 大谷啓太, 折野逸人, 吉田知哉, 根岸佑典, 宮本亮太, 坂東遼, Zheng Robert, 瀬野弘光, 高橋智紀, 上野理絵, 門田宗之, 原知也, 川端豊, 松浦朋美, 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

四国医学雑誌 ( 徳島医学会 ) 78 ( 5-6 ) 257 - 257 2022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）

Isoproterenol loading transesophageal echocardiography in atrial fibrillation.

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

The international journal of cardiovascular imaging 39 ( 3 ) 511 - 518 2022年11月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

In patients with sludge or severe spontaneous echo contrast (SEC) in the left atrial appendage (LAA), cases with isoproterenol loading transesophageal echocardiography (ISP-TEE) have been reported to identify the presence of thrombus in the LAA. This study aimed to assess the validity and hemodynamic changes of ISP-TEE in the LAA. We prospectively enrolled patients with atrial fibrillation (AF) who underwent ISP-TEE. The degree of sludge/SEC was categorized as being either absent (grade 0), mild SEC (grade 1), moderate SEC (grade 2), severe SEC or sludge (grade 3). The hemodynamic evaluation was performed by measuring LAA flow velocity, LAA tissue Doppler imaging (LAA-TDI) velocity, and pulmonary vein systolic forward flow velocity (PVS). In total, 35 patients (mean age 71 ± 7 years; 71% male) underwent ISP-TEE. Among 35 patients, 30 patients had grade 3 or 2 SEC, 5 patients had grade 1 SEC. After ISP loading, 23 patients (66% of all patients) showed improved sludge/SEC and one patient was diagnosed with thrombus in the LAA. There were 25 patients with grade 1 SEC, or no SEC (classified as Group1), 10 patients had residual sludge or grade 2 to 3 SEC (classified as Group2) after ISP administration. LAA flow, LAA-TDI, and PVS velocities were significantly higher in group 1 than in group 2 after ISP administration. There was no complication during the examination and after 24 h and 3 months. ISP infusion may be a potential tool to recognize LAA thrombus under the sludge/SEC during TEE in AF.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Association of Microluminal Structures Assessed by Optical Coherence Tomography With Local Inflammation in Adjacent Epicardial Adipose Tissue and Coronary Plaque Characteristics in Fresh Cadavers.

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

Circulation journal : official journal of the Japanese Circulation Society 87 ( 2 ) 329 - 335 2022年10月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

BACKGROUND: Coronary intraplaque microluminal structures (MS) are associated with plaque vulnerability, and the inward progression of vascular inflammation from the adventitia towards the media and intima has also been demonstrated. Therefore, in the present study we investigated the relationships among MS, local inflammation in adjacent epicardial adipose tissue (EAT), and coronary plaque characteristics.Methods and Results: Optical coherence tomography (OCT) revealed MS in the left anterior descending coronary artery in 10 fresh cadaveric hearts. We sampled 30 lesions and subdivided them based on the presence of MS: MS (+) group (n=19) and MS (-) group (n=11). We measured inflammatory molecule levels in the adjacent EAT and percentage lipid volume assessed by integrated backscatter intravascular ultrasound in each lesion. The expression levels of vascular endothelial growth factor B and C-C motif chemokine ligand 2 were significantly higher in the MS (+) group than in the MS (-) group (0.9±0.7 vs. 0.2±0.2 arbitrary units (AU), P=0.04 and 1.5±0.5 vs. 0.6±0.7 AU, P=0.02, respectively). Percentage lipid volume was significantly higher in the MS (+) group than in the MS (-) group (38.7±16.5 vs. 23.7±10.9%, P=0.03). CONCLUSIONS: Intraplaque MS observed on OCT were associated with lipid-rich plaques and local inflammation in the adjacent EAT. Collectively, these results suggest that local inflammation in the EAT is associated with coronary plaque vulnerability via MS.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Esaxerenone, a selective mineralocorticoid receptor blocker, improves insulin sensitivity in mice consuming high-fat diet.

Oyunbileg Bavuu, Daiju Fukuda, Byambasuren Ganbaatar, Tomomi Matsuura, Takayuki Ise, Kenya Kusunose, Koji Yamaguchi, Shusuke Yagi, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Masataka Sata

European journal of pharmacology 931 175190 - 175190 2022年09月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

BACKGROUND: Esaxerenone is a novel, non-steroidal selective mineralocorticoid receptor (MR) blocker. MR activation plays a crucial role in the development of cardiovascular and metabolic diseases. In this study, we investigated the effects of esaxerenone on various metabolic parameters in mice. MATERIALS AND METHODS: Esaxerenone (3 mg/kg/day) was orally administered to high-fat diet (HFD)-fed male C57BL/6 mice. Mice fed a normal diet (ND) served as controls. Glucose and insulin tolerance, plasma lipid levels, and transaminase levels were assessed as metabolic parameters. Macrophage accumulation in the adipose tissue was evaluated using histological analysis. 3T3-L1 adipocytes, HepG2 cells, and C2C12 myotubes were used for in vitro experiments. Gene expression and insulin signaling were examined using quantitative RT-PCR and western blotting, respectively. RESULTS: HFD successfully induced insulin resistance compared with that in ND. Esaxerenone ameliorated insulin resistance (P < 0.05) without altering other metabolic parameters, such as the lipid profile. Esaxerenone administration tended to decrease plasma transaminase levels compared with those in the non-treated group. In the adipose tissue, esaxerenone decreased macrophage accumulation (P < 0.05) and increased the expression levels of adiponectin and PPARγ. Aldosterone significantly decreased the expression levels of PPARγ and adiponectin in 3T3-L1 adipocytes. Furthermore, aldosterone attenuated insulin-induced Akt phosphorylation in 3T3-L1 adipocytes, HepG2 cells, and C2C12 myotubes in a dose-dependent manner (P < 0.01). These effects were ameliorated by pretreatment with esaxerenone. CONCLUSION: Esaxerenone ameliorated insulin resistance in HFD-fed mice. Reduction of inflammation and improvement in insulin signaling may underlie the beneficial effects of esaxerenone.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

冠動脈入口部および鎖骨下動脈に特徴的な血管内超音波所見を認めた高安動脈炎の2例

吉田知哉, 若槻哲三, 山口浩司, 西條良仁, 川端豊, 伊勢孝之, 楠瀬賢也, 八木秀介, 山田博胤, 添木武, 佐田政隆

日本心臓病学会学術集会抄録 ( (一社)日本心臓病学会 ) 70回 C - 4 2022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）

冠動脈入口部および鎖骨下動脈に特徴的な血管内超音波所見を認めた高安動脈炎の2例

吉田知哉, 若槻哲三, 山口浩司, 西條良仁, 川端豊, 伊勢孝之, 楠瀬賢也, 八木秀介, 山田博胤, 添木武, 佐田政隆

日本心臓病学会学術集会抄録 ( (一社)日本心臓病学会 ) 70回 C - 4 2022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）

Clinical course and decision-making in heart failure by preload stress echocardiography: a preliminary study.

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

ESC heart failure 9 ( 6 ) 4020 - 4029 2022年08月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

AIMS: Abnormal left ventricular diastolic response to preload stress can be an early marker of heart failure (HF). The aim of this study was to assess clinical course in patients with HF with preserved ejection fraction (HFpEF) who underwent preload stress echocardiography. In the subgroup analysis, we assessed the prognosis of patients with unstable signs during preload stress classified by treatment strategies. METHODS AND RESULTS: We prospectively conducted preload stress echocardiographic studies between January 2006 and December 2013 in 211 patients with HFpEF. Fifty-eight patients had abnormal diastolic reserve during preload stress (unstable impaired relaxation: unstable IR). Of 58 patients with unstable IR, 19 patients were assigned to additional therapy by increased or additional therapy and 39 patients were assigned to standard therapy. Composite outcomes were prespecified as the primary endpoint of death and hospitalization for deteriorating HF. During a median period of 6.9 years, 19 patients (33%) reached the composite outcome. Unstable group with standard therapy had significantly shorter event-free survival than stable group. Patients with uptitration of therapy had longer event-free survival than those with standard therapy group after adjustment of laboratory data (hazard ratio, 0.20, 95% confidence interval, 0.05-0.90; P = 0.036); the 10 year event-free survival in patients with and without uptitration of therapy was 93% and 51%, respectively (P = 0.023). CONCLUSIONS: Patients with unstable sign had significantly shorter event-free survival than patients with stable sign. After additional therapy, the prognosis of patients with unstable signs improved. This technique may impact decision-making for improving their prognosis.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Drug-coated balloon angioplasty for severe pulmonary vein stenosis resulting from cryoballoon ablation for atrial fibrillation.

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

Journal of cardiology cases 26 ( 1 ) 35 - 38 2022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）

We performed a drug-coated balloon (DCB) angioplasty for severe pulmonary vein (PV) stenosis resulting from cryoballoon ablation for atrial fibrillation. Three and fourteen months after the angioplasty, follow-up multidetector computed tomography did not show restenosis. Lesion regression was observed at 14-month follow-up. Two years after PV angioplasty with DCB, the patient was well without any symptoms. DCB angioplasty may become an alternative effective procedure for PV stenosis. Learning objective: The usefulness and safety of drug-coated balloon angioplasty for severe pulmonary vein stenosis resulting from cryoballoon ablation for atrial fibrillation was observed at 14-month follow-up.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

無症候で発見された頸動脈プラーク潰瘍形成と以後の神経学的症状出現との関連

湯浅麻美, 西尾進, 平田有紀奈, 大櫛祐一郎, 荒瀬美晴, 楠瀬賢也, 山田博胤, 佐田政隆

医学検査 ( (一社)日本臨床衛生検査技師会 ) 71 ( 3 ) 404 - 411 2022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）

目的:潰瘍形成を伴うプラークは、要注意プラークとして脳梗塞発症のリスクを有するとされている。また、頸動脈エコー検査時に偶然発見される無症候性の潰瘍形成を伴うプラークは少なくない。本研究の目的は、頸動脈エコー検査において無症候で発見された潰瘍形成を伴うプラークが、同様のリスクを有する潰瘍形成のないプラークと比べ、経過観察中に脳梗塞を疑うような神経学的症状(以下、神経学的症状)出現が多いか否かを検討することである。方法:2014年1月から2018年12月までの間に、初回超音波検査で潰瘍形成を認めた87例を潰瘍形成群、初回検査で潰瘍形成を伴うプラークを指摘されなかった1,526例から、propensity scoreを用いてリスクファクターをマッチさせた87例を抽出し非潰瘍形成群とした。両群の神経学的症状出現の有無について後ろ向きに調査し、比較検討した。成績:検査後の経過観察中に神経学的症状の出現を認めたのは、潰瘍形成群87例中2例(ともに一過性脳虚血発作)であり、非潰瘍形成群では神経学的症状の出現を認めなかった。2群間の神経学的症状出現の有無について統計学的有意差を認めなかった。結論:無症候で発見された潰瘍形成を伴うプラークは、経過観察中の神経学的症状出現と有意な関連を認めなかった。(著者抄録)

無症候で発見された頸動脈プラーク潰瘍形成と以後の神経学的症状出現との関連

湯浅麻美, 西尾進, 平田有紀奈, 大櫛祐一郎, 荒瀬美晴, 楠瀬賢也, 山田博胤, 佐田政隆

医学検査 ( (一社)日本臨床衛生検査技師会 ) 71 ( 3 ) 404 - 411 2022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）

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

<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>

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI

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

Open heart 8 ( 2 ) 2021年11月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Evaluation of the input site and characteristics of the antegrade fast pathway based on three-dimensional bi-atrial stimulus-ventricle mapping.

Kazuhisa Matsumoto, Takeshi Tobiume, Tomomi Matsuura, Takayuki Ise, Kenya Kusunose, Koji Yamaguchi, Shusuke Yagi, Daijyu Fukuda, Tetsuzo Wakatsuki, Hirotsugu Yamada, Takeshi Soeki, Masataka Sata

Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 63 ( 2 ) 417 - 424 2021年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

PURPOSE: Previous studies examined the right atrial (RA) input site of the antegrade fast pathway (AFp) (AFpI). However, the left atrial (LA) input to the atrioventricular (AV) node has not been extensively evaluated. In this study, we created three-dimensional (3-D) bi-atrial stimulus-ventricle (St-V) maps and analyzed the input site and characteristics of the AFp in both the RA and LA. METHODS: Forty-four patients diagnosed with atrial fibrillation or WPW syndrome were included in this study. Three-dimensional bi-atrial St-V mapping was performed using an electroanatomical mapping system. Sites exhibiting the minimal St-V interval (MinSt-V) were defined as AFpIs and were classified into seven segments, four in the RA (F, S, M, and I) and three in the LA (M1, M2, and M3). By combining the MinSt-V in the RA and LA, the AFpIs were classified into three types: RA, LA, and bi-atrial (BA) types. The clinical and electrophysiological characteristics were compared. RESULTS: AFpIs were most frequently observed at site S in the RA (34%) and M2 in the LA (50%), and the BA type was the most common (57%). AFpIs in the LA were recognized in 75% of the patients. There were no clinical or electrophysiological indicators for predicting AFpI sites. CONCLUSIONS: Three-dimensional bi-atrial St-V maps could classify AFpIs in both the RA and LA. AFpIs in the LA were frequently recognized. There were no significant clinical or electrophysiological indicators for predicting AFpI sites, and 3-D bi-atrial St-V mapping was the only method to reveal the precise AFp input site.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

STING, a cytosolic DNA sensor, plays a critical role in atherogenesis: a link between innate immunity and chronic inflammation caused by lifestyle-related diseases.

Phuong Tran Pham, Daiju Fukuda, Sachiko Nishimoto, Joo-Ri Kim-Kaneyama, Xiao-Feng Lei, Yutaka Takahashi, Tomohito Sato, Kimie Tanaka, Kumiko Suto, Yutaka Kawabata, Koji Yamaguchi, Shusuke Yagi, Kenya Kusunose, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Kenji Shimada, Yasuhisa Kanematsu, Yasushi Takagi, Michio Shimabukuro, Mitsutoshi Setou, Glen N Barber, Masataka Sata

European heart journal 42 ( 42 ) 4336 - 4348 2021年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

AIMS : Lifestyle-related diseases promote atherosclerosis, a chronic inflammatory disease; however, the molecular mechanism remains largely unknown. Endogenous DNA fragments released under over-nutrient condition provoke sterile inflammation through the recognition by DNA sensors. Here, we investigated the role of stimulator of interferon genes (STING), a cytosolic DNA sensor, in atherogenesis. METHODS AND RESULTS : Apolipoprotein E-deficient (Apoe-/-) mice fed a western-type diet (WTD), a hypercholesterolaemic mouse model, showed higher STING expression and markers for DNA damage such as γH2AX, p53, and single-stranded DNA (ssDNA) accumulation in macrophages in the aorta compared with wild-type (WT) mice. The level of cGAMP, a STING agonist, in the aorta was higher in Apoe-/- mice. Genetic deletion of Sting in Apoe-/- mice reduced atherosclerotic lesions in the aortic arch, lipid, and macrophage accumulation in plaques, and inflammatory molecule expression in the aorta compared with the control. Pharmacological blockade of STING using a specific inhibitor, C-176, ameliorated atherogenesis in Apoe-/- mice. In contrast, bone marrow-specific STING expression in Apoe-/- mice stimulated atherogenesis. Expression or deletion of STING did not affect metabolic parameters and blood pressure. In vitro studies revealed that STING activation by cGAMP or mitochondrial DNA accelerated inflammatory molecule expression (e.g. TNF-α or IFN-β) in mouse and human macrophages. Activation of nuclear factor-κB and TANK binding kinase 1 was involved in STING-associated vascular inflammation and macrophage activation. Furthermore, human atherosclerotic lesions in the carotid arteries expressed STING and cGAMP. CONCLUSION : Stimulator of interferon genes stimulates pro-inflammatory activation of macrophages, leading to the development of atherosclerosis. Stimulator of interferon genes signalling may serve as a potential therapeutic target for atherosclerosis.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Clinical Utility of Overlap Time for Incomplete Relaxation to Predict Cardiac Events in Heart Failure.

Kenya Kusunose, Miharu Arase, Robert Zheng, Yukina Hirata, Susumu Nishio, Takayuki Ise, Koji Yamaguchi, Daiju Fukuda, Shusuke Yagi, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Masataka Sata

Journal of cardiac failure 27 ( 11 ) 1222 - 1230 2021年06月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

BACKGROUND: The overlap time of transmitral flow can be a novel marker of subclinical left ventricular dysfunction for predicting adverse events in heart failure (HF). We aimed to (1) investigate the role of overlap time of the E-A wave in association with clinical parameters and (2) evaluate whether the overlap time could add prognostic information with respect to other conventional clinical prognosticators in HF. METHODS: We prospectively evaluated 153 patients hospitalized with HF (mean age 68 ± 15 years; 63% male). The primary endpoint was readmission following HF or cardiac death. RESULTS: During a median period of 25 months, 43 patients were readmitted or died. Overlap time appeared to be associated with worse outcomes. After adjustment for readmission scores and ratios of diastolic filling period and cardiac cycle length in a Cox proportional-hazards model, overlap time was associated with event-free survival, independent of elevated left atrial pressure based on guidelines. When overlap time was added to the model based on clinical variables and elevated left atrial pressure, the C-statistic significantly improved from 0.70 (95% CI: 0.63-0.77) to 0.77 (95% CI: 0.69-0.83, compared) (P = 0.035). CONCLUSION: This preliminary study suggested that prolonged overlap time may have potential for predicting readmission and cardiac mortality risk assessment in patients with HF.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Predictive value of left atrial function for latent paroxysmal atrial fibrillation as the cause of embolic stroke of undetermined source.

Kenya Kusunose, Hironori Takahashi, Susumu Nishio, Yukina Hirata, Robert Zheng, Takayuki Ise, Koji Yamaguchi, Shusuke Yagi, Daiju Fukuda, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Kenji Shimada, Yasuhisa Kanematsu, Yasushi Takagi, Masataka Sata

Journal of cardiology 78 ( 5 ) 355 - 361 2021年06月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

BACKGROUND: In patients with embolic stroke of undetermined source (ESUS), paroxysmal atrial fibrillation (AF) is often diagnosed, however, the risk of paroxysmal AF in ESUS has not been well described. Several studies have suggested a linkage between left atrial (LA) functional parameters and risk of AF in stroke patients. The aim of this study was to assess the role of LA functional parameters as predictors of latent paroxysmal AF in ESUS on admission. METHODS: Between January 2015 and December 2019, consecutive stroke patients with suspected ESUS at admission were prospectively included in this study. They were under hospital electrocardiographic monitoring for detection of new-onset AF. Various echocardiographic parameters including left atrial strain were assessed for association with new-onset AF. RESULTS: We gathered 1082 consecutive patients with ischemic stroke. After exclusions, 121 patients with suspected ESUS at admission formed the study cohort. New-onset AF was detected in 46 (38%) patients during hospital electrocardiographic monitoring (median follow-up: 18 days). LA pump and reservoir strains were significantly and independently associated with new-onset AF. Receiver operating characteristic analysis for the association with new-onset AF showed that the areas under the curve (AUCs) of clinical parameters plus one of each strain (LA pump strain: AUC: 0.86±0.04 and LA reservoir strain: AUC: 0.76±0.05) models were significantly better than plus LA volume index (AUC: 0.68±0.04, compared p-values <0.05). CONCLUSIONS: LA strain was significantly associated with new development of AF. Patients with impaired LA function at admission should be carefully monitored to find AF.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Inhibition of S1P Receptor 2 Attenuates Endothelial Dysfunction and Inhibits Atherogenesis in Apolipoprotein E-Deficient Mice.

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

Journal of atherosclerosis and thrombosis 28 ( 6 ) 630 - 642 2021年06月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

AIM: The bioactive lipid, sphingosine-1-phosphate (S1P), has various roles in the physiology and pathophysiology of many diseases. There are five S1P receptors; however, the role of each S1P receptor in atherogenesis is still obscure. Here we investigated the contribution of S1P receptor 2 (S1P2) to atherogenesis by using a specific S1P2 antagonist, ONO-5430514, in apolipoprotein E-deficient (Apoe-/- ) mice. METHODS: Apoe-/- mice fed with a western-type diet (WTD) received ONO-5430514 (30 mg/kg/day) or vehicle. To examine the effect on atherogenesis, Sudan IV staining, histological analysis, qPCR, and vascular reactivity assay was performed. Human umbilical vein endothelial cells (HUVEC) were used for in vitro experiments. RESULTS: WTD-fed Apoe-/- mice had significantly higher S1P2 expression in the aorta compared with wild-type mice. S1P2 antagonist treatment for 20 weeks reduced atherosclerotic lesion development (p＜0.05). S1P2 antagonist treatment for 8 weeks ameliorated endothelial dysfunction (p＜0.05) accompanied with significant reduction of lipid deposition, macrophage accumulation, and inflammatory molecule expression in the aorta compared with vehicle. S1P2 antagonist attenuated the phosphorylation of JNK in the abdominal aorta compared with vehicle (p＜0.05). In HUVEC, S1P promoted inflammatory molecule expression such as MCP-1 and VCAM-1 (p＜0.001), which was attenuated by S1P2 antagonist or a JNK inhibitor (p＜0.01). S1P2 antagonist also inhibited S1P-induced JNK phosphorylation in HUVEC (p＜0.05). CONCLUSIONS: Our results suggested that an S1P2 antagonist attenuates endothelial dysfunction and prevents atherogenesis. S1P2, which promotes inflammatory activation of endothelial cells, might be a therapeutic target for atherosclerosis.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Acute Hospital Mortality of Venous Thromboembolism in Patients With Cancer From Registry Data.

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

Journal of the American Heart Association 10 ( 11 ) e019373 2021年06月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Background The prognosis of patients with cancer-venous thromboembolism (VTE) is not well known because of a lack of registry data. Moreover, there is also no knowledge on how specific types are related to prognosis. We sought to evaluate the clinical characteristics and outcomes of patients with cancer-associated VTE, compared with a matched cohort without cancer using real-world registry data of VTE. Methods and Results This study was based on the Diagnosis Procedure Combination database in the JROAD-DPC (Japanese Registry of All Cardiac and Vascular Diseases and the Diagnosis Procedure Combination). Of 5 106 151 total patients included in JROAD-DPC, we identified 49 580 patients who were first hospitalized with VTE from April 2012 to March 2017. Propensity score was estimated with a logistic regression model, with cancer as the dependent variable and 18 clinically relevant covariates. After propensity matching, there were 25 148 patients with VTE with or without cancer. On propensity score-matched analysis with 25 148 patients with VTE, patients with cancer had higher total in-hospital mortality within 7 days (1.3% versus 1.1%, odds ratio [OR], 1.66; 95% CI, 1.31-2.11; P<0.0001), 14 days (2.5% versus 1.5%, OR, 2.07; 95% CI, 1.72-2.49; P<0.0001), and 30 days (4.8% versus 2.0%, OR, 2.85; 95% CI, 2.45-3.31; P<0.0001). On analysis for each type of cancer, in-hospital mortality in 11 types of cancer was significantly high, especially pancreas (OR, 12.96; 95% CI, 6.41-26.20), biliary tract (OR, 8.67; 95% CI, 3.00-25.03), and liver (OR, 7.31; 95% CI, 3.05-17.50). Conclusions Patients with cancer had a higher in-hospital acute mortality for VTE than those without cancer, especially in pancreatic, biliary tract, and liver cancers.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Infective Endocarditis from Furuncle with Meningitis Complication Caused by Methicillin-resistant Staphylococcus aureus.

Shusuke Yagi, Tomoko Takahashi, Keiji Murakami, Momoyo Azuma, Mikio Sugano, Ryosuke Miyamoto, Mariko Niki, Hirotsugu Yamada, Yutaka Kawabata, Akihiro Tani, Daiju Fukuda, Muneyuki Kadota, Takayuki Ise, Kenya Kusunose, Takeshi Tobiume, Tomomi Matsuura, Koji Yamaguchi, Takeshi Soeki, Tetsuzo Wakatsuki, Hiroki Hata, Masataka Sata

Internal medicine (Tokyo, Japan) 60 ( 20 ) 3251 - 3255 2021年04月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Infective endocarditis (IE) may be acquired in the community as community-acquired (CA) IE or in the healthcare setting. In Japan, cases of CA-methicillin-resistant Staphylococcus aureus (MRSA) infection as skin infection have been increasing. CA-MRSA strains, including the USA300 clone, have higher pathogenicity and are more destructive to tissue than healthcare-associated MRSA strains because of the toxins they produce, including arginine-catabolic mobile element (ACME) and Panton-Valentine leukocidin (PVL). However, only a few IE cases induced by USA300 have been reported. We herein report a 64-year-old man who developed CA-IE from a furuncle caused by USA300 MRSA producing PVL and ACME, which resulted in complications of meningitis.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

負荷心エコー図検査の現状と未来強皮症における6分間歩行負荷により評価した左室拡張能の臨床的意義

楠瀬賢也, 荒瀬美晴, 平田有紀奈, 西尾進, 山尾雅美, 山田博胤, 阿部美保, 添木武, 佐田政隆

超音波医学 ( (公社)日本超音波医学会 ) 48 ( Suppl. ) S214 - S214 2021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）

Clinical usefulness of the HFA-PEFF diagnostic scoring system in identifying late elderly heart failure with preserved ejection fraction patients

Yoshihiro Seo, Tomoko Ishizu, Masaki Ieda, Nobuyuki Ohte, Masako Asakawa, Chikage Oshita, Masanori Takada, Mitsufumi Furuya, Fumiko Sakamaki, Hitomi Hashimoto, Takako Minami, Harutoshi Tamura, Akiko Okunaga, Yuichi Oshima, Yoshie Omori, Takuma Aoyama, Takako Iino, Makoto Saito, Tetsuya Kasuga, Taro Minagawa, Satoshi Kibira, Hidekazu Tanaka, Yoshihisa Horizoe, Hiroyoshi Yamamoto, Shintaro Beppu, Misun Pak, Miyako Nagumo, Masaki Izumo, Atsushi Kobayashi, Shohei Kikuchi, Noriaki Iwahashi, Kotaro Numaguchi, Toshinari Onishi, Yuki Izumi, Hirotsugu Yamada, Kenya Kusunose, Hideo Kawakami, Hiroyuki Iwano

Circulation Journal 85 ( 5 ) 604 - 611 2021年04月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Background: Diagnosis of heart failure with preserved ejection fraction (HFpEF) remains challenging in elderly. This study investigated the diagnostic ability of the HFA-PEFF scoring system in elderly patients (>75 years of age). Methods and Results: This study enrolled 286 subjects aged >75 years (130 men; mean [± SD] age 81.5±5.1 years): 95 healthy controls, 98 with hypertension (HT), and 93 with HFpEF. The HFA-PEFF score was calculated as a sum of points in functional, morphological, and biomarker domains. In the HFpEF group, 84%, 84%, and 70% of subjects met the major functional, morphological, and biomarker criteria for HFpEF, respectively. Thus, 73 subjects with HFpEF (78%) were diagnosed as having HFpEF using the HFA-PEFF scoring system. In contrast, among the healthy controls and subjects with HT, 52% and 72%, respectively, met the major functional criteria for HFpEF, 28% and 53%, respectively, met the morphological criteria, and 0% and 24%, respectively, met the biomarker criteria. As such, 32 subjects with HT (33%) were diagnosed with HFpEF. Even in the healthy control group, 72% were classified as having an intermediate probability of HFpEF, and 3 were diagnosed with HFpEF. Conclusions: In the late elderly, the HFA-PEFF scoring system diagnosed subjects with HFpEF precisely. In addition, this scoring system may be able to detect early stage HFpEF in the subclinical population.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

今後の心エコー室の在り方を考える徳島大学病院超音波センターの教育プログラム

西尾進, 山田博胤, 楠瀬賢也, 阿部美保, 林修司, 平田有紀奈, 山尾雅美, 添木武, 佐田政隆

超音波医学 ( (公社)日本超音波医学会 ) 48 ( Suppl. ) S230 - S230 2021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）

当院におけるイバブラジンの使用経験

ムーギー, 八木秀介, 門田宗之, 川端豊, 松本和久, 楠瀬賢也, 山口浩司, 飛梅威, 松浦朋美, 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 ( 1-2 ) 114 - 114 2021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）

大動脈四尖弁に対してTAVIを施行した一症例

山田拓也, 谷彰浩, 門田宗之, 伊勢孝之, 川端豊, 松浦朋美, 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 ) 77 ( 1-2 ) 120 - 121 2021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）

Pemafibrate, A Novel Selective Peroxisome Proliferator-Activated Receptor α Modulator, Reduces Plasma Eicosanoid Levels and Ameliorates Endothelial Dysfunction in Diabetic Mice.

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

Journal of atherosclerosis and thrombosis 28 ( 12 ) 1349 - 1360 2021年03月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

AIMS: Various pathological processes related to diabetes cause endothelial dysfunction. Eicosanoids derived from arachidonic acid (AA) have roles in vascular regulation. Fibrates have recently been shown to attenuate vascular complications in diabetics. Here we examined the effects of pemafibrate, a selective peroxisome proliferator-activated receptor α modulator, on plasma eicosanoid levels and endothelial function in diabetic mice. METHODS: Diabetes was induced in 7-week-old male wild-type mice by a single injection of streptozotocin (150 mg/kg). Pemafibrate (0.3 mg/kg/day) was administered orally for 3 weeks. Untreated mice received vehicle. Circulating levels of eicosanoids and free fatty acids were measured using both gas and liquid chromatography-mass spectrometry. Endothelium-dependent and endothelium-independent vascular responses to acetylcholine and sodium nitroprusside, respectively, were analyzed. RESULTS: Pemafibrate reduced both triglyceride and non-high-density lipoprotein -cholesterol levels (P＜0.01), without affecting body weight. It also decreased circulating levels of AA (P＜0.001), thromboxane B2 (P＜0.001), prostaglandin E2, leukotriene B4 (P＜0.05), and 5-hydroxyeicosatetraenoic acid (P＜0.001), all of which were elevated by the induction of diabetes. In contrast, the plasma levels of 15-deoxy-Δ12,14-prostaglandin J2, which declined following diabetes induction, remained unaffected by pemafibrate treatment. In diabetic mice, pemafibrate decreased palmitic acid (PA) and stearic acid concentrations (P＜0.05). Diabetes induction impaired endothelial function, whereas pemafibrate ameliorated it (P＜0.001). The results of ex vivo experiments indicated that eicosanoids or PA impaired endothelial function. CONCLUSION: Pemafibrate diminished the levels of vasoconstrictive eicosanoids and free fatty acids accompanied by a reduction of triglyceride. These effects may be associated with the improvement of endothelial function by pemafibrate in diabetic mice.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Acute Hormonal Effect of the Angiotensin Receptor-Neprilysin Inhibitor in Patients with Chronic Heart Failure(和訳中)

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）

ESUSにおける新規発症心房細動と心エコー図指標との関連

高橋寛典, 楠瀬賢也, 西尾進, 平田有紀奈, 山口夏美, 佐田政隆, 山田博胤, 高橋智紀, 瀬野弘光, 大櫛祐一郎

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 CO2 - 4 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）

ESUSにおける新規発症心房細動と心エコー図指標との関連

高橋寛典, 楠瀬賢也, 西尾進, 平田有紀奈, 山口夏美, 佐田政隆, 山田博胤, 高橋智紀, 瀬野弘光, 大櫛祐一郎

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 CO2 - 4 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）

Effects of Vitamin D Supplementation on Heart Failure Mortality from Japanese Registry of All Cardiac and Vascular Datasets(和訳中)

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）

Early and Chronic Phased Local Coagulative Responses Following Bioresorbable-polymer Drugeluting Stent Implantation(和訳中)

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）

Deep Learning for Detection of Elevated Pulmonary Artery Wedge Pressure Using Standard Chest X-Ray(和訳中)

平田有紀奈, 楠瀬賢也, 辻拓将, 藤森康平, 山口夏美, 森田沙瑛, 西尾進, 大櫛祐一郎, 瀬野弘光, 高橋智紀, 伊勢孝之, 飛梅威, 山口浩司, 福田大受, 八木秀介, 山田博胤, 添木武, 若槻哲三, 古徳純一, 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 SS23 - 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）

Prognostic Impact of Cancer on Venous Thromboembolism from Japanese Registry of All Cardiac and Vascular Datasets(和訳中)

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）

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)

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

<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 (> 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 < 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.

この論文にアクセスする

DOI

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）

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

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）

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）

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）

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）

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）

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）

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）

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）

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）

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）

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)

Association of Local Epicardial Adipose Tissue Depots and Left Ventricular Diastolic Performance in Patients With Preserved Left Ventricular Ejection Fraction

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

CIRCULATION JOURNAL ( 一般社団法人日本循環器学会 ) 84 ( 2 ) 203 - 216 2020年01月

掲載種別: 研究論文（学術雑誌）

Background:Although full-volume quantification of epicardial adipose tissue (EAT) is a predictor of LV diastolic dysfunction (LVDD), how localized EAT depots are linked to LVDD remains unclear. We evaluated the effect of local EAT depots on LV diastolic function parameters in patients with preserved LV ejection fraction (LVEF).Methods and Results:From 423 consecutive patients who underwent cardiac CT angiography, we recruited 252 with sinus rhythm and normal LVEF. The EAT volume index (EATV/body surface area) and the localized EAT thickness around the right coronary artery (EATRCA), left anterior descending artery (EATLAD), left circumflex artery (EATLCX), right ventricle (EATRV), left ventricle (EATLV), right atrium (EATRA), and left atrium (EATLA) were measured using cardiac CT. In the LVDD group (n=71), the EATV index (75±30 vs. 64±28 mL/m2, P=0.010), EATLCX(10.7±3.8 vs. 9.4±3.4 mm, P=0.008), and EATLV(2.6±1.6 vs. 2.1±1.4 mm, P=0.024) were greater than in the non-LVDD group (n=181). In contrast, EATLCXand EATLVwere markedly associated with decreased lateral e’ and increased lateral E/e’. Multiple regression analysis indicated that EATLCXand EATLVwere strongly associated with LV diastolic function parameters.Conclusions:Localized EAT depots are linked to altered mitral annular motion. Further study is warranted to clarify whether localized EAT depots are functionally linked to the clinical manifestations of LVDD.

この論文にアクセスする

DOI
関連情報を調べる

PubMed CiNii Research

Elderly Japanese Standard Data of Echocardiography; From J-LONG study

Journal of Echocardiography 18 ( 3 ) 175 - 182 2020年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

© 2020, Japanese Society of Echocardiography. Background: Age-related changes in cardiac morphology and function have not been unknown in the elderly. The Japanese eLderly data Of Normal echocardioGraphy (J-LONG) study is a prospective multicenter cohort study and aimed to investigate the echocardiographic data in the healthy Japanese elderly. Methods: Thirty domestic facilities participated in this study, and 130 healthy subjects (57 men, 73 women, 79.6 ± 4.7 years, range 75–98 years, interquartile range 76–82 years) were enrolled in this cohort. Echocardiographic and clinical data sets were obtained in each facility, and total analyses were performed in the University of Tsukuba. Results: Almost all cardiac morphological data were significantly larger in men than those in women. However, corrected data by body surface area (BSA) were similar or closer between genders. As a gender difference, the negative correlation between BSA and age was observed in women only (r = − 0.46, p < 0.001), showing the independent determinant of women’s left ventricular end-diastolic volume (LVEDV) was age (β = − 0.29, p = 0.01), but not BSA. In men, LVEDV was significantly correlated with BSA (β = 0.42, p = 0.001), but not with age (p = 0.10). Also, women had higher LV ejection fraction (70 ± 7.1 vs. 68 ± 4.9%, p = 0.02), lower E/A (0.67 ± 0.16 vs. 0.75 ± 0.21, p = 0.02), and higher E/eʹ (10 ± 2.7 vs. 8.9 ± 2.5, p = 0.03) as compared to men. Conclusions: The J-LONG study suggested that correction by the physique was needed to interpret echocardiographic data of the elderly. Also, gender differences and age-related changes in cardiac morphology and function were observed, and further studies are needed to confirm the clinical significance.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Effects of L-/N-Type Calcium Channel Blockers on Angiotensin II-Renin Feedback in Hypertensive Patients.

Yutaka Kawabata, Takeshi Soeki, Hiroyuki Ito, Tomomi Matsuura, Kenya Kusunose, Takayuki Ise, Koji Yamaguchi, Takeshi Tobiume, Shusuke Yagi, Daiju Fukuda, Hirotsugu Yamada, Tetsuzo Wakatsuki, Mitsuhiro Kitani, Kazuhiro Kawano, Yoshio Taketani, Masataka Sata

International journal of hypertension 2020 6653851 - 6653851 2020年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Objectives: Cilnidipine, an L-/N-type calcium channel blocker (CCB), has unique organ-protective properties due to suppression of hyperactivity in the sympathetic nervous system and renin-angiotensin system (RAS). In this study, we hypothesized that cilnidipine might exert a renoprotective effect by suppressing the RAS. Methods: A total of 25 hypertensive patients receiving a RAS inhibitor were randomly assigned to a cilnidipine (n = 12) or amlodipine (n = 13) group. The effects of cilnidipine on proteinuria and angiotensin II-renin feedback were assessed. Results: After 6 months of treatment, both systolic and diastolic blood pressures were significantly reduced to a similar extent in both groups. The urine albumin-to-creatinine ratio was significantly lower in the cilnidipine group (p < 0.05) than in the amlodipine group. Amlodipine increased plasma angiotensin I and angiotensin II levels (p < 0.05), whereas cilnidipine did not. Interestingly, the cilnidipine group had a higher ratio of angiotensin-(1-7) (Ang-(1-7)) to angiotensin II in plasma than the amlodipine group (p < 0.05). Conclusions: The L-/N-type CCB cilnidipine, but not amlodipine, decreased urinary albumin excretion in hypertensive patients. Cilnidipine also increased the ratio of Ang-(1-7) to angiotensin II in plasma, which might be one factor underlying its beneficial effects.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Improvement of global longitudinal strain following high-dose chemotherapy and autologous peripheral blood stem cell transplantation in patients with amyloid light-chain cardiac amyloidosis: a case report

Yukina Hirata, Kenya Kusunose, Hirokazu Miki, Hirotsugu Yamada

European Heart Journal - Case Reports ( Oxford University Press (OUP) ) 3 ( 4 ) 1 - 6 2019年12月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

<title>Abstract</title> <sec> <title>Background</title> Cardiac amyloidosis (CA) is a secondary form of cardiomyopathy where abnormal accumulation of amyloid protein in the myocardial interstitium causes cardiac hypertrophy and myocardial fibrosis. If primary CA advances to heart failure, most patients do not survive for very long after the diagnosis. </sec> <sec> <title>Case summary</title> A 40-year-old man was admitted to our hospital for dyspnoea, progressive anaemia, and decreased appetite. He has diagnosed with amyloid light-chain (AL) amyloidosis. Although BD treatment (bortezomib + dexamethasone) and medical treatment were started, there was no sign of improvement. Then, high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (auto-PBSCT) was initiated. Pretreatment echocardiography revealed typical findings of CA, such as ventricular wall thickening, valvular thickening, diastolic dysfunction, and pericardial effusion. Global longitudinal strain (GLS) was significantly reduced, and bull's-eye mapping showed typical apical sparing. After auto-PBSCT, GLS gradually improved and was almost normal after 2 years. Other echocardiographic parameters, functional status, and laboratory data also showed that there was significant regression of CA. </sec> <sec> <title>Discussion</title> Although the prognosis in primary CA is extremely poor, we achieved long-term survival in a patient with effective high-dose chemotherapy and auto-PBSCT. Global longitudinal strain may be a useful marker of prognosis, regression, and recovery. </sec>

この論文にアクセスする

DOI

Noninvasive assessment of left-ventricular diastolic electromechanical coupling in hypertensive heart disease.

Saito Y, Yamada H, Kusunose K, Saito K, Sata M

Journal of echocardiography 17 ( 4 ) 206 - 212 2019年12月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

BACKGROUND: There is a need to stratify patients who may develop heart failure because of the current "heart failure pandemic". We hypothesized that noninvasive assessment of diastolic electromechanical coupling by electrocardiography and Doppler echocardiography may be clinically useful for risk stratification of hypertensive patients who may develop heart failure. METHODS: We measured the time from the peak to end of the T wave (TpTe) as an electrophysiological parameter, and peak early diastolic mitral flow (E) and lateral annular (e') velocities as mechanical parameters in 109 patients with hypertension. Relationships between these parameters and their association with the prognosis were evaluated. RESULTS: The e' was inversely correlated with TpTe (p < 0.001) and QTc (p < 0.014), whereas E/e' was positively correlated with TpTe (p < 0.001) and QTc (p < 0.001). The TpTe predicted patients with E/e' > 12. There were 24 cardiovascular events during follow-up (57 ± 20 months), and Kaplan-Meier analysis showed that outcome was worse (p = 0.003) in patients with higher E/e' than lower E/e'; however, there was no difference between patients with longer TpTe (≧72 ms) and shorter TpTe (< 72 ms). CONCLUSION: The correlation of TpTe with e' and E/e' in hypertensive patients suggests that these parameters reflect diastolic ventricular electromechanical coupling. The E/e' predicted outcome, and an elevated E/e' should be suspected when TpTe is prolonged (> 72 ms). Noninvasive evaluation of diastolic electromechanical coupling is clinically useful in patients with hypertension for predicting their outcome.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Pulmonary Artery Hypertension-Specific Therapy Improves Exercise Tolerance and Outcomes in Exercise-Induced Pulmonary Hypertension.

Kusunose K, Yamada H, Nishio S, Hirata Y, Saijo Y, Torii Y, Yamada N, Ise T, Yamaguchi K, Fukuda D, Yagi S, Soeki T, Wakatsuki T, Sata M

JACC. Cardiovascular imaging 12 ( 12 ) 2576 - 2579 2019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）

この論文にアクセスする

DOI
関連情報を調べる

PubMed

房室ブロックの予防に順行性速伝導路と順行性遅伝導路のマッピングが有用であった順行性速伝導路の下方偏位を伴う遅速型房室結節リエントリー性頻拍の1例

井口裕貴, 飛梅威, 松本和久, 坂東左知子, 松浦朋美, 添木武, 志村拓哉, 高橋智子, 谷彰浩, 藤本裕, 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 ) 75 ( 5-6 ) 259 - 259 2019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）

骨髄増殖性疾患に続発した慢性血栓塞栓性肺高血圧症の1例

志村拓哉, 西條良仁, 八木秀介, 楠瀬賢也, 山田博胤, 藤本裕太, 松本和久, 上野理絵, 川端豊, 山田なお, 伊勢孝之, 飛梅威, 山口浩司, 添木武, 若槻哲三, 佐田政隆

四国医学雑誌 ( 徳島医学会 ) 75 ( 5-6 ) 227 - 232 2019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）

症例は60歳代、女性。200X年3月に労作時息切れを自覚し近医を受診。造影CT検査で肺動脈および下肢静脈内に造影欠損像を認め、肺動脈塞栓症および深部静脈血栓症の診断で抗凝固療法が開始された。その際に、血小板の異常増加(74万/μl)を指摘され、原発性骨髄線維症(JAK2変異+)と診断されたが、低リスク群のためステロイド内服で加療を行う方針となった。しかし、その後も症状が持続するため当院を紹介受診。肺動脈内に血栓の残存および肺動脈圧の上昇を認め、慢性血栓塞栓性肺高血圧(CTEPH:chronic thromboembolic pulmonary hypertension)の診断に至り、リオシグアトによる薬物治療を開始した。CTEPHは、急性肺塞栓後の血栓が器質化し発生するといった報告もあるが、詳細な機序は不明である。本症例は、原発性骨髄線維症を合併しており、CTEPHの発生機序として原発性骨髄線維症による血小板機能低下を始めとした血球障害による肺血管床の減少および内皮増殖因子や平滑筋増殖因子増加による肺血管リモデリングが肺動脈圧上昇に寄与していると考えられた。(著者抄録)

房室ブロックの進行に伴い明らかになり、恒久的ペースメーカー植込み術後のファーフィールドR波センシングへの関与が疑われた束枝心室間副伝導路の1例

木田貴弘, 飛梅威, 松本和久, 坂東左知子, 松浦朋美, 添木武, 志村拓哉, 高橋智子, 谷彰浩, 藤本裕, 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 ) 75 ( 5-6 ) 259 - 259 2019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）

Association of Echocardiography Before Major Elective Non-Cardiac Surgery With Improved Postoperative Outcomes - Possible Implications for Patient Care.

Kusunose K, Torii Y, Yamada H, Nishio S, Hirata Y, Saijo Y, Ise T, Yamaguchi K, Fukuda D, Yagi S, Soeki T, Wakatsuki T, Sata M

Circulation journal : official journal of the Japanese Circulation Society 83 ( 12 ) 2512 - 2519 2019年11月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

BACKGROUND: Whether preoperative echocardiography improves postoperative outcomes is not well established, so we examined the value of echocardiographic assessment on the onset of postoperative heart failure (HF), and determining which patients benefitted most from undergoing echocardiography prior to major elective non-cardiac surgery.Methods and Results:We identified all patients aged 50 years and older who had major elective non-cardiac surgery, and excluded patients with previously identified severe cardiovascular disease. The primary endpoint was the onset of HF during hospitalization. A total of 806 patients were included in the analysis. During hospitalization, 49 patients (6%) reached the primary endpoint. Within the matched cohort, preoperative echocardiography was associated with a statistically significant decrease in postoperative HF (hazard ratio: 0.46, P=0.01). In subgroup analyses, age, sex, body surface area, hypertension, diabetes mellitus, prior HF, surgical type, chronic kidney disease, pulmonary disease, and malignancy influenced the association of echocardiography with postoperative HF. CONCLUSIONS: The use of echocardiography in elderly patients with certain risk factors was associated with improved postoperative outcomes. The basis for this finding remains to be determined; particularly whether echocardiography is simply a marker of a population with better outcomes or whether it leads to better management that improves outcomes.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Vildagliptin, a DPP-4 Inhibitor, Attenuates Endothelial Dysfunction and Atherogenesis in Nondiabetic Apolipoprotein E-Deficient Mice.

Aini K, Fukuda D, Tanaka K, Higashikuni Y, Hirata Y, Yagi S, Kusunose K, Yamada H, Soeki T, Sata M

International heart journal 60 ( 6 ) 1421 - 1429 2019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）

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Thrombin inhibition by dabigatran attenuates endothelial dysfunction in diabetic mice.

Rahadian A, Fukuda D, Salim HM, Yagi S, Kusunose K, Yamada H, Soeki T, Shimabukuro M, Sata M

Vascular pharmacology 124 106632 - 106632 2019年11月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Diabetic patients have coagulation abnormalities, in which thrombin plays a key role. Whereas accumulating evidence suggests that it also contributes to the development of vascular dysfunction through the activation of protease-activated receptors (PARs). Here we investigated whether the blockade of thrombin attenuates endothelial dysfunction in diabetic mice. Induction of diabetes by streptozotocin (STZ) increased the expression of PAR1, PAR3, and PAR4 in the aorta. STZ-induced diabetic mice showed impairment of endothelial function, while the administration of dabigatran etexilate, a direct thrombin inhibitor, significantly attenuated endothelial dysfunction in diabetic mice with no alteration of metabolic parameters including blood glucose level. Dabigatran did not affect endothelium-independent vasodilation. Dabigatran decreased the expression of inflammatory molecules (e.g., MCP-1 and ICAM-1) in the aorta of diabetic mice. Thrombin increased the expression of these inflammatory molecules and the phosphorylation of IκBα, and decreased the phosphorylation of eNOSSer1177 in human umbilical endothelial cells (HUVEC). Thrombin significantly impaired the endothelium-dependent vascular response of aortic rings obtained from wild-type mice. Inhibition of NF-κB attenuated thrombin-induced inflammatory molecule expression in HUVEC and ameliorated thrombin-induced endothelial dysfunction in aortic rings. Dabigatran attenuated the development of diabetes-induced endothelial dysfunction. Thrombin signaling may serve as a potential therapeutic target in diabetic condition.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Updated Left Ventricular Diastolic Function Recommendations and Cardiovascular Events in Patients with Heart Failure Hospitalization.

Torii Y, Kusunose K, Yamada H, Nishio S, Hirata Y, Amano R, Yamao M, Zheng R, Saijo Y, Yamada N, Ise T, Yamaguchi K, Yagi S, Soeki T, Wakatsuki T, Sata M

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 32 ( 10 ) 1286 - 1297.e2 2019年10月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

BACKGROUND: Evaluation of diastolic dysfunction is crucial in determining elevated left atrial pressure. However, a validation of the long-term prognostic value of the newly proposed algorithm updated in 2016 has not been performed. The aim of the present study was to investigate the relative value of the updated 2016 diastolic dysfunction grading system for the incidence of readmission in patients with heart failure (HF) with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). METHODS: Two hundred thirty-two patients hospitalized with HF were retrospectively evaluated. Subjects were divided into two subgroups: those with HFrEF (n = 127) and those with HFpEF (n = 105). Readmission risk scores were calculated using the Yale Center for Outcomes Research and Evaluation HF, LACE index, and HOSPITAL scores. The primary end point was readmission following HF and cardiac death. RESULTS: Over a period of 24 months, 86 patients were either readmitted or died. Multivariate Cox analysis was performed on both the HFrEF and HFpEF groups. In the HFrEF group, both the 2009 and 2016 algorithms had superior incremental value for the association of the primary end point to several readmission risk scores. In the HFpEF group, only the 2016 algorithm led to significant improvement in association with the primary end point. The 2016 algorithm had incremental value over several readmission risk scores alone. CONCLUSIONS: The recommendations of the 2016 algorithm can be useful for readmission and cardiac mortality risk assessment in patients with HFrEF and HFpEF. The use of echocardiography to estimate elevated left atrial pressure appears to identify a higher risk group and may allow a more tailored approach to therapy.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Association Between Right Ventricular Contractile Function and Cardiac Events in Isolated Postcapillary and Combined Pre- and Postcapillary Pulmonary Hypertension.

Kusunose K, Yamada N, Yamada H, Nishio S, Saijo Y, Hirata Y, Torii Y, Ise T, Yamaguchi K, Fukuda D, Yagi S, Soeki T, Wakatsuki T, Sata M

Journal of cardiac failure 26 ( 1 ) 43 - 51 2019年09月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

BACKGROUND: Recent studies have shown that patients with combined pre- and postcapillary pulmonary hypertension (CpcPH) had worse outcomes than those with isolated postcapillary pulmonary hypertension (IpcPH). However, the prognostic factors including right ventricular (RV) function have not been well documented. The aim of this study was to assess the differentiation of PH phenotypes, using echocardiography, and the association between RV longitudinal strain and cardiac events. METHODS AND RESULTS: We prospectively recruited consecutive patients who had undergone right heart catheterization. The primary endpoint was cardiovascular death or readmission due to heart failure. We included 137 patients with Group 2 PH. A RV longitudinal strain of 17% was sensitive (85%) and specific (70%) to determine the CpcPH. During a median period of 31 months, 43 patients experienced the primary endpoint during follow-up. In a multivariate analysis, RV longitudinal strain was associated with the primary endpoint in both CpcPH and IpcPH (HR: 0.84, P = 0.003; HR: 0.86, P = 0.001). CONCLUSIONS: Lower RV longitudinal strain was independently associated with worse outcomes in CpcPH and IpcPH. RV longitudinal strain may play a prognostic role in PH phenotypes.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

心外膜下脂肪厚と性差および年齢との関連

平田有紀奈, 楠瀬賢也, 山口夏美, 森田沙瑛, 鳥居裕太, 西尾進, 山田なお, 阿部美保, 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 ) 67回優秀3 - 1 2019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）

Optical Coherence Tomographyにより器質化血栓の存在が疑われた肺癌術後急性冠症候群の1例

山口浩司, 若槻哲三, 川端豊, 山田なお, 楠瀬賢也, 伊勢孝之, 八木秀介, 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 ) 67回 O - 266 2019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）

Deterioration of biventricular strain is an early marker of cardiac involvement in confirmed sarcoidosis.

Kusunose K, Fujiwara M, Yamada H, Nishio S, Saijo Y, Yamada N, Hirata Y, Torii Y, Ise T, Yamaguchi K, Fukuda D, Yagi S, Soeki T, Wakatsuki T, Sata M

European heart journal cardiovascular Imaging 21 ( 7 ) 796 - 804 2019年09月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

AIMS: Risk assessment of developing cardiac involvement in systemic sarcoidosis can be challenging because of limited data. Recently, attention has been given to left ventricular and right ventricular (LV and RV) involvement in cardiac sarcoidosis (CS) and its prevalence, relevance, and prognostic value. The aim of this study was to assess the role of biventricular strain to predict prognosis in confirmed sarcoidosis patients. METHODS AND RESULTS: LV and RV longitudinal strains (LSs) were evaluated by 2D speckle tracking in 139 consecutive confirmed sarcoidosis patients without other pre-existing structural heart diseases, and 52 age- and gender-matched control subjects. The primary endpoint was CS-related events (cardiac death or development of cardiac involvement). Sarcoidosis without cardiac involvement had significantly lower LV and RV free wall LS compared with control subjects. Basal LS had a higher area under the curve for differentiation of sarcoidosis in patients without cardiac involvement compared to control (cut-off value: -18% with 89% sensitivity and 69% specificity). During a median period of 50 months, the occurrence of CS-related events was observed in 20 patients. In a multivariate analysis, basal LV LS and RV free wall LS were associated with the events [hazard ratio (HR) 0.72, P < 0.001 and HR: 0.83, P = 0.006, respectively]. Patients with impaired biventricular function had significantly shorter event-free survival than those with preserved biventricular function (P < 0.001). CONCLUSION: Deterioration of biventricular strain was associated with CS-related events. This information might be useful for clinical evaluation and follow-up in sarcoidosis.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

日常臨床に活かす心筋ストレイン解析診断に活かす局所心筋ストレイン解析

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 ) 67回 SS - 3 2019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）

高血圧心疾患における左室拡張期電気機械的カップリングの非侵襲的評価

山田なお, 小島友子, 山田博胤, 楠瀬賢也, 大櫛祐一郎, 高橋智紀, 西尾進, 林修司, 藤原美佳, 西條良仁, 平田有紀奈, 鳥居裕太, 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 ) 67回 O - 052 2019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）

負荷心エコーの展望運動誘発性肺高血圧の臨床的意義と未来

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 ) 67回 S14 - 2 2019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）

Rivaroxaban, a specific FXa inhibitor, improved endothelium-dependent relaxation of aortic segments in diabetic mice.

Pham PT, Fukuda D, Yagi S, Kusunose K, Yamada H, Soeki T, Shimabukuro M, Sata M

Scientific reports 9 ( 1 ) 11206 - 11206 2019年08月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Activated factor X (FXa) plays a central role in the coagulation cascade, while it also mediates vascular function through activation of protease-activated receptors (PARs). Here, we examined whether inhibition of FXa by rivaroxaban, a direct FXa inhibitor, attenuates endothelial dysfunction in streptozotocin (STZ)-induced diabetic mice. Induction of diabetes increased the expression of a major FXa receptor, PAR2, in the aorta (P < 0.05). Administration of rivaroxaban (10 mg/kg/day) to diabetic wild-type (WT) mice for 3 weeks attenuated endothelial dysfunction as determined by acetylcholine-dependent vasodilation compared with the control (P < 0.001), without alteration of blood glucose level. Rivaroxaban promoted eNOSSer1177 phosphorylation in the aorta (P < 0.001). Induction of diabetes to PAR2-deficient (PAR2-/-) mice did not affect endothelial function and eNOSSer1177 phosphorylation in the aorta compared with non-diabetic PAR2-/- mice. FXa or a PAR2 agonist significantly impaired endothelial function in aortic rings obtained from WT mice, but not in those from PAR2-/- mice. FXa promoted JNK phosphorylation (P < 0.01) and reduced eNOSSer1177 phosphorylation (P < 0.05) in human coronary artery endothelial cells (HCAEC). FXa-induced endothelial dysfunction in aortic rings (P < 0.001) and eNOSSer1177 phosphorylation (P < 0.05) in HCAEC were partially ameliorated by a JNK inhibitor. Rivaroxaban ameliorated diabetes-induced endothelial dysfunction. Our results suggest that FXa or PAR2 is a potential therapeutic target.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

SGLT2阻害薬canagliflozinは糖尿病発症性ApoE-/-マウスにおいて内皮機能障害とアテローム性動脈硬化症を軽減する(SGLT2 inhibitor, Canagliflozin, Ameliorate Endothelial Dysfunction and Atherosclerosis in Diabetic ApoE-/- Mice)

Arief Rahadian, 福田大受, Hotima Salim, 八木秀介, 楠瀬賢也, 山田博胤, 添木武, 佐田政隆

日本性機能学会雑誌 ( (一社)日本性機能学会 ) 34 ( 2 ) 190 - 190 2019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）

糖尿病性腎症の各病期における超音波指標の比較

松本力三, 西尾進, 平田有紀奈, 湯浅麻美, 鳥居裕太, 天野里江, 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 ) 44 ( 4 ) 447 - 455 2019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）

目的:糖尿病性腎症の各病期における超音波像を比較し、病期を最も反映する腎臓の超音波検査指標を検討すること。対象と方法:対象は臨床的に2型糖尿病と診断され、当院で腹部超音波検査を施行した57例(男性39例、女性18例、平均年齢60歳(16〜86歳))。糖尿病性腎症の病期分類は2013年12月に改訂された糖尿病性腎症病期分類を用いた。1期が23例、2期が16例、3期が8例、4期が10例であった。使用装置はGE社製Logiq7で、検討した超音波検査指標は、腎サイズ、腎末梢血管抵抗、腎皮質輝度であった。腎皮質輝度は当院で開発したiPlaqueを用いて定量的に評価した。結果と考察:腎サイズはいずれの群間においても有意差を認めなかった。腎末梢血管抵抗は1期と3期、4期および2期と4期において有意差を認め(p<0.05)、病期と腎末梢血管抵抗の間には、弱い相関を認めた(ρ=0.472、p<0.05)。腎皮質輝度はいずれの群間においても有意差を認め(p<0.05)、病期と腎皮質輝度の間にも、有意な相関を認めた(ρ=0.736、p<0.05)。尿アルブミンは、腎末梢血管抵抗および腎臓の皮質輝度と有意な相関を認め、最も相関の高い超音波検査指標は、腎皮質輝度であった(r=0.57、p<0.001)。eGFRは、腎臓のサイズ、腎末梢血管抵抗および皮質輝度のいずれとも有意な相関を認めたが、腎皮質輝度が最も高い相関を示した(r=-0.59、p<0.001)。腎皮質輝度は糖尿病性腎症において、病初期から上昇し、病期の進行に応じて上昇傾向を示すため、病期の評価に有用と考えた。結論:糖尿病性腎症において、病期を最も反映する腎臓の超音波検査指標は、腎皮質輝度であった。(著者抄録)

非糖尿病アポリポタンパク質E欠損マウスにおいてDPP-4阻害薬vildagliptinは内皮機能障害を予防する(Vildagliptin, a DPP-4 Inhibitor, prevents endothelial dysfunction in non-diabetic apolipoprotein E-deficient mice)

アイニ・クンドゥズアイ, 福田大受, 八木秀介, 楠瀬賢也, 山田博胤, 添木武, 佐田政隆

日本性機能学会雑誌 ( (一社)日本性機能学会 ) 34 ( 2 ) 189 - 189 2019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）

野生型マウスにおいてFXaの直接阻害薬であるrivaroxabanは糖尿病誘発性内皮機能障害を抑制する(Rivaroxaban, a direct inhibitor of FXa, attenuated diabetes-induced endothelial dysfunction in wild-type mice)

Pham Tran Phuong, 福田大受, 八木秀介, 楠瀬賢也, 山田博胤, 添木武, 島袋充生, 佐田政隆

日本性機能学会雑誌 ( (一社)日本性機能学会 ) 34 ( 2 ) 191 - 191 2019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）

超音波検査を用いた心外膜下脂肪厚の検査者間誤差の検討

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 ) 44 ( 4 ) 456 - 463 2019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）

目的:心外膜下脂肪(EAT)は主に冠動脈周囲に付着する異所性内臓脂肪である。我々は、過去にリニアプローブを用いて前室間溝で計測したEAT厚(EAT-AIG)が、冠動脈疾患との有用な指標となることを報告した。しかし、これらは単施設での報告であったため、多施設で用いることができるかについての検証はできていない。そこで、本研究は、同一被験者におけるEAT-AIG厚の検査者間誤差について多施設で検討することを目的とした。対象と方法:各施設の3名の技師がボランティア12名(平均年齢61±22歳、男性8例)のEAT-AIG厚を測定し、検査者間誤差を検討した。使用装置はVivid E9の高周波リニアプローブを用いた。EAT-AIG厚は、心尖部よりも一肋間上の位置で、収縮期の時相で心膜から心筋に垂直に測定した。各検査者は、被験者情報および他の検査者の計測値がブラインドされた状態でEAT-AIG厚を記録した。検査者間誤差の評価には、Bland-Altman解析、級内相関係数(ICC)を用いた。結果と考察:全検査者におけるEAT-AIG厚の計測値は良好な相関であった。ICCは0.91(95%信頼区間:0.78-0.97、p<0.01)であり、高い再現性を示した。しかし、1例EAT-AIG厚が平均よりも過大評価されていた。その計測位置は、心尖部よりも一肋間上の位置ではなく、心尖部断面であった。結語:全検査者におけるEAT-AIG厚の計測値は、高い再現性を示した。EAT-AIG厚の測定法は、計測位置に留意していれば計測誤差も比較的少ない優れた測定法であることが証明できた。(著者抄録)

Utilization of Artificial Intelligence in Echocardiography.

Kenya Kusunose, Akihiro Haga, Takashi Abe, Masataka Sata

Circulation journal : official journal of the Japanese Circulation Society 83 ( 8 ) 1623 - 1629 2019年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Echocardiography has a central role in the diagnosis and management of cardiovascular disease. Precise and reliable echocardiographic assessment is required for clinical decision-making. Even if the development of new technologies (3-dimentional echocardiography, speckle-tracking, semi-automated analysis, etc.), the final decision on analysis is strongly dependent on operator experience. Diagnostic errors are a major unresolved problem. Moreover, not only can cardiologists differ from one another in image interpretation, but also the same observer may come to different findings when a reading is repeated. Daily high workloads in clinical practice may lead to this error, and all cardiologists require precise perception in this field. Artificial intelligence (AI) has the potential to improve analysis and interpretation of medical images to a new stage compared with previous algorithms. From our comprehensive review, we believe AI has the potential to improve accuracy of diagnosis, clinical management, and patient care. Although there are several concerns about the required large dataset and "black box" algorithm, AI can provide satisfactory results in this field. In the future, it will be necessary for cardiologists to adapt their daily practice to incorporate AI in this new stage of echocardiography.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

冠動脈疾患に対する心外膜脂肪組織肥厚度の性別特異的影響(Gender specific impact of epicardial adipose tissue thickness on coronary artery disease)

マイマイチュクン・グリヌ, 福田大受, 八木秀介, 平田有紀奈, 岩瀬俊, 松浦朋美, 伊勢孝之, 楠瀬賢也, 山口浩司, 山田博胤, 添木武, 若槻哲三, 佐田政隆, 島袋充生

日本抗加齢医学会総会プログラム・抄録集 ( (一社)日本抗加齢医学会 ) 19回 254 - 254 2019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）

A Deep Learning Approach for Assessment of Regional Wall Motion Abnormality From Echocardiographic Images.

Kusunose K, Abe T, Haga A, Fukuda D, Yamada H, Harada M, Sata M

JACC. Cardiovascular imaging 13 ( 2 Pt 1 ) 374 - 381 2019年05月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

OBJECTIVES: This study investigated whether a deep convolutional neural network (DCNN) could provide improved detection of regional wall motion abnormalities (RWMAs) and differentiate among groups of coronary infarction territories from conventional 2-dimensional echocardiographic images compared with that of cardiologists, sonographers, and resident readers. BACKGROUND: An effective intervention for reduction of misreading of RWMAs is needed. The hypothesis was that a DCNN trained using echocardiographic images would provide improved detection of RWMAs in the clinical setting. METHODS: A total of 300 patients with a history of myocardial infarction were enrolled. From this cohort, 3 groups of 100 patients each had infarctions of the left anterior descending (LAD) artery, the left circumflex (LCX) branch, and the right coronary artery (RCA). A total of 100 age-matched control patients with normal wall motion were selected from a database. Each case contained cardiac ultrasonographs from short-axis views at end-diastolic, mid-systolic, and end-systolic phases. After the DCNN underwent 100 steps of training, diagnostic accuracies were calculated from the test set. Independently, 10 versions of the same model were trained, and ensemble predictions were performed using those versions. RESULTS: For detection of the presence of WMAs, the area under the receiver-operating characteristic curve (AUC) produced by the deep learning algorithm was similar to that produced by the cardiologists and sonographer readers (0.99 vs. 0.98, respectively; p = 0.15) and significantly higher than the AUC result of the resident readers (0.99 vs. 0.90, respectively; p = 0.002). For detection of territories of WMAs, the AUC by the deep learning algorithm was similar to the AUC by the cardiologist and sonographer readers (0.97 vs. 0.95, respectively; p = 0.61) and significantly higher than the AUC by resident readers (0.97 vs. 0.83, respectively; p = 0.003). From a validation group at an independent site (n = 40), the AUC by the deep learning algorithm was 0.90. CONCLUSIONS: The present results support the possibility of using DCNN for automated diagnosis of RWMAs in the field of echocardiography.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Toll-Like Receptor 9 Plays a Pivotal Role in Angiotensin II-Induced Atherosclerosis.

Fukuda D, Nishimoto S, Aini K, Tanaka A, Nishiguchi T, Kim-Kaneyama JR, Lei XF, Masuda K, Naruto T, Tanaka K, Higashikuni Y, Hirata Y, Yagi S, Kusunose K, Yamada H, Soeki T, Imoto I, Akasaka T, Shimabukuro M, Sata M

Journal of the American Heart Association 8 ( 7 ) e010860 2019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）

この論文にアクセスする

DOI
関連情報を調べる

PubMed

心臓血管領域におけるSTC/TGCの調整

山田博胤, 楠瀬賢也, 西條良仁, 山田なお, 鳥居裕太, 平田有紀奈, 山尾雅美, 西尾進, 添木武, 佐田政隆

超音波医学 ( (公社)日本超音波医学会 ) 46 ( Suppl. ) S506 - S506 2019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）

心外膜下脂肪厚とBody mass indexとの関連

平田有紀奈, 西尾進, 山口夏美, 森田沙瑛, 鳥居裕太, 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 ) 44 ( Suppl. ) S165 - S165 2019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）

心エコーの精度をいかに保つか(自動計測vsマニュアル計測など含め) 右心機能評価

西尾進, 楠瀬賢也, 平田有紀奈, 西條良仁, 山田なお, 鳥居裕太, 山尾雅美, 添木武, 山田博胤, 佐田政隆

超音波医学 ( (公社)日本超音波医学会 ) 46 ( Suppl. ) S274 - S274 2019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）

Oncocardiologyにおける心エコーの役割「がん治療関連心筋障害(CTRCD)」の診療における心エコー図検査の有用性

山田博胤, 西條良仁, 楠瀬賢也, 山田なお, 鳥居裕太, 平田有紀奈, 山尾雅美, 西尾進, 添木武, 佐田政隆

超音波医学 ( (公社)日本超音波医学会 ) 46 ( Suppl. ) S252 - S252 2019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）

日常臨床における心血管エコー計測項目の選択と計測方法:ガイドラインの使い方 ASE/EACVIの心腔計測ガイドライン2015の概要

山田博胤, 楠瀬賢也, 西條良仁, 山田なお, 鳥居裕太, 平田有紀奈, 山尾雅美, 西尾進, 添木武, 佐田政隆

超音波医学 ( (公社)日本超音波医学会 ) 46 ( Suppl. ) S268 - S268 2019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）

骨髄増殖性疾患に続発した慢性血栓塞栓性肺高血圧症の一例

志村拓哉, 西條良仁, 楠瀬賢也, Zheng Robert, 藤本裕太, 原田貴文, 松本和久, 上野理絵, 川端豊, 山田なお, 伊藤浩敬, 轟貴史, 伊勢孝之, 飛梅威, 山口浩司, 八木秀介, 添木武, 若槻哲三, 佐田政隆, 山田博胤

四国医学雑誌 ( 徳島医学会 ) 75 ( 1-2 ) 90 - 91 2019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）

血清IgG4値と心エコー図検査指標との関連性

阿部美保, 楠瀬賢也, 山田博胤, 山田なお, Zheng Robert, 西條良仁, 西尾進, 平田有紀奈, 鳥居裕太, 佐田政隆

超音波医学 ( (公社)日本超音波医学会 ) 46 ( Suppl. ) S586 - S586 2019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）

治療に活かす静脈エコー:深部静脈血栓症、静脈瘤直接作用型経口抗凝固薬による深部静脈血栓症の退縮効果に及ぼす因子の検討

鳥居裕太, 楠瀬賢也, 松本力三, 天野里江, 西尾進, 西條良仁, 山田博胤, 佐田政隆

超音波医学 ( (公社)日本超音波医学会 ) 46 ( Suppl. ) S447 - S447 2019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）

早期に診断し得た心臓原発悪性腫瘍の一例

中村昌史, 川端豊, 伊勢孝之, 藤本裕太, 原田貴文, 松本和久, 西條良仁, 上野理絵, 山田なお, 伊藤浩敬, 轟貴史, 楠瀬賢也, 飛梅威, 山口浩司, 福田大受, 八木秀介, 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 ) 75 ( 1-2 ) 91 - 91 2019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）

マラソン完走後の左房リザーバーストレインの反応を予測する指標の検討

平田有紀奈, 楠瀬賢也, 山田博胤, 森田沙瑛, 鳥居裕太, 西尾進, ゼング・ロバート, 西條良仁, 八木秀介, 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 ) 83回 CP05 - 3 2019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）

強皮症における6分間歩行距離の規定因子心エコー図法を用いた検討

森田沙瑛, 楠瀬賢也, 山田博胤, 西尾進, 平田有紀奈, 鳥居裕太, 西條良仁, 阿部美保, 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 ) 83回 CP07 - 6 2019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）

冠動脈プラーク内微小管腔構造は心外膜の脂肪組織の質と量に関連する新鮮遺体を用いた研究(Coronary Intraplaque Microluminal Structure are Associated with the Quality and Quantity of Epicardial Adipose Tissue: A Fresh Cadaveric Study)

川端豊, 若槻哲三, 山口浩司, 伊藤浩敬, 福田大受, 轟貴史, 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 ) 83回 PJ057 - 2 2019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）

冠動脈プラークと脈管の血管の微小管腔構造は冠動脈の炎症に影響を与える未固定遺体による研究(Microluminal Structures of Coronary Plaque and Vasa Vasorums Affect Coronary Inflammation: A Fresh Cadaveric Study)

伊藤浩敬, 若槻哲三, 山口浩司, 福田大受, 川端豊, 轟貴史, 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 ) 83回 PJ106 - 5 2019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）

Sequential speckle tracking imaging to detect early stage of cancer therapeutics-related cardiac dysfunction in a patient with breast cancer.

Saijo Y, Kusunose K, Yamada N, Yamada H, Nishio S, Hirata Y, Sata M

Journal of echocardiography 18 ( 2 ) 134 - 135 2019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

Adult onset of Immunoglobulin A vasculitis - A case report.

Yagi S, Endo I, Murakami T, Hida T, Yamamoto Y, Soga T, Ise T, Kusunose K, Yamaguchi K, Fukuda D, Yamada H, Soeki T, Wakatsuki T, Kawahito S, Sata M

The journal of medical investigation : JMI 66 ( 3.4 ) 344 - 346 2019年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Immunoglobulin A vasculitis (IgAV), formerly known as Henoch-Schönlein purpura, primarily occurs during childhood between the ages of 3 and 15 years and is the most common form of systemic vasculitis in children ; its occurrence in adults has been rarely reported. Such low incidence could be attributable to either under-diagnosis or misdiagnosis. Thus, not only pediatricians but also physicians should be able to diagnose IgAV accurately to manage the patients appropriately and avoid its associated complications. In addition, treatment of adult onset IgAV with renal involvement has not been fully established yet. We describe here a case of adult onset IgAV complicated by proteinuria and pharyngitis, which was cured by no specific treatment. J. Med. Invest. 66 : 344-346, August, 2019.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Osteolytic primary bone lymphoma in the multiple bones.

Shusuke Yagi, Robert Zheng, Seiichi Nishiyama, Yutaka Kawabata, Takayuki Ise, Kosuke Sugiura, Haruhiko Yoshinari, Toshihiko Nishisho, Yoshimi Bando, Kumiko Kagawa, Daiju Fukuda, Tomohiro Soga, Yoshihito Saijo, Kenya Kusunose, Koji Yamaguchi, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Shinji Kawahito, Masashi Akaike, Masataka Sata

The journal of medical investigation : JMI 66 ( 3.4 ) 347 - 350 2019年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Primary non-Hodgkin bone lymphoma (PBL) can involve solitary or multiple destructive bone lesions such as those of the femur or pelvis humerus, and some cases have osteolytic lesions. PBL is a rare disease in adults. Thus, PBL is rarely considered a differential diagnosis of the osteolytic tumor. In addition, PBL can be underdiagnosed because patients do not experience symptoms or show objective abnormalities in the early stage. Here, we reported an elderly patient with PBL in multiple bones, including the cranial and femoral bones that were fractured due to falling. J. Med. Invest. 66 : 347-350, August, 2019.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Lambda-like J wave due to acute myocardial infarction of the diagonal branch.

Yagi S, Ueno R, Sutou K, Wakatsuki T, Yamaguchi K, Saijo Y, Hara T, Ise T, Kusunose K, Bando M, Matsuura T, Tobiume T, Yamada H, Fukuda D, Soeki T, Akaike M, Sata M

The journal of medical investigation : JMI 66 ( 1.2 ) 185 - 187 2019年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

The culprit lesion of acute myocardial infarction could be predicted by electrocardiogram findings. However, we experienced some cases with coronary angiographic finding in the area of ST-T elevation that was different from that predicted. The lambda-like J wave could be caused by ischemia although the mechanism has not been fully elucidated. We report a case of acute myocardial infarction that showed discrepancy between ST-T elevation with lambda-like ischemic J wave in a broad area and coronary angiographical finding of diagonal branch occlusion. J. Med. Invest. 66 : 185-187, February, 2019.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Provocation of clinically significant left ventricular outflow tract obstruction by postural change in patients with sigmoid septum.

Hirata Y, Yamada H, Kusunose K, Nishio S, Torii Y, Horike Y, Sata M

Journal of echocardiography 16 ( 4 ) 173 - 174 2018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）

この論文にアクセスする

DOI
関連情報を調べる

PubMed

大動脈弁直下のHis束電位記録部位に副伝導路が存在し治療を断念したA型WPW症候群の1例

土山洋介, 飛梅威, 松本和久, 松浦朋美, 添木武, 藤本裕太, 原田貴文, Zheng Robert, 數藤久美子, 西條良仁, 上野理絵, 川端豊, 坂東美佳, 山田なお, 伊藤浩敬, 轟貴史, 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 ) 74 ( 5-6 ) 223 - 223 2018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）

大動脈弁人工弁(機械弁)置換術後遠隔期に生じたOMI-VT stormに対し経心房中隔的に施行したカテーテルアブレーションが著効した1例

高橋未奈, 飛梅威, 松本和久, 松浦朋美, 添木武, 藤本裕太, 原田貴文, Zheng Robert, 數藤久美子, 西條良仁, 上野理絵, 川端豊, 坂東美佳, 山田なお, 伊藤浩敬, 轟貴史, 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 ) 74 ( 5-6 ) 201 - 208 2018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）

68歳女性。植込み型除細動器(ICD)植込み術を行い、Amiodarone、MgSO4の処方で外来にて経過観察されていたが、術後5ヵ月より心室頻拍(VT)によるICD頻回作動を繰り返した。Lidocain、Pilsicainide、Sotalolは無効であったため、カテーテルアブレーションを行った。経心房中隔的に左室にアプローチし、1回目はactivation mapping、2回目はsubstrate mappingに基づいて、左室心尖部瘤内の残存心筋に対して治療した。その後、抗不整脈薬の減量や心房ペーシングレート低下によってもVTは出現はせず、社会復帰ができた。

大動脈弁人工弁(機械弁)置換術後遠隔期に生じたOMI-VT stormに対し経心房中隔的に施行したカテーテルアブレーションが著効した1例

四国医学雑誌 ( 徳島医学会 ) 74 ( 5-6 ) 226 - 226 2018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）

Left atrial functional response after a marathon in healthy amateur volunteers.

Hirata Y, Kusunose K, Yamada H, Morita S, Torii Y, Nishio S, Zheng R, Saijo Y, Fukuda D, Yagi S, Soeki T, Sata M

The international journal of cardiovascular imaging 35 ( 4 ) 633 - 643 2018年11月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Middle-aged marathon runners have an increased risk of developing atrial fibrillation (AF). A previous study described that repetitive marathon running was associated with left atrial (LA) dysfunction. However, whether this change is common in marathon runners and which runners are at risk of LA dysfunction remain unknown. The purpose of this study was to determine which factors could predict LA dysfunction. We prospectively examined 12 healthy amateur volunteers (9 males, 31 ± 8 years old) who participated in a full marathon. All echocardiographic measurements and speckle-tracking echocardiography were performed before and after the marathon. The endpoint was defined as reduced LA reservoir strain 1 day after the marathon (non-responder group). Seven participants were in the non-responder group. Age (35 ± 9 vs. 26 ± 2 years, p = 0.020), augmentation index (76 ± 12 vs. 55 ± 8, p = 0.002), and diastolic blood pressures (83 ± 11 vs. 70 ± 7 mmHg, p = 0.021) in the non-responder group were significantly higher compared with the responder group. In multivariate linear regression analysis, only the augmentation index was an independent predictor of reduced LA reservoir function after the marathon (β = - 0.646, p = 0.023). The augmentation index was a predictive marker for reduction in LA reservoir function after a marathon in healthy amateur volunteers.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Simultaneous Pulmonary Arterial and Venous Round Structures in Pulmonary Aspergillosis.

Yagi S, Yamazaki H, Nishio S, Kusunose K, Yamada H, Sata M

Circulation journal : official journal of the Japanese Circulation Society 83 ( 6 ) 1416 - 1416 2018年11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

Activation of Toll-Like Receptor 9 Impairs Blood Flow Recovery After Hind-Limb Ischemia.

Nishimoto S, Aini K, Fukuda D, Higashikuni Y, Tanaka K, Hirata Y, Yagi S, Kusunose K, Yamada H, Soeki T, Shimabukuro M, Sata M

Frontiers in cardiovascular medicine 5 144 - 144 2018年10月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Background: Peripheral artery disease causes significant functional disability and results in impaired quality of life. Ischemic tissue injury releases various endogenous ligands for Toll-like receptors (TLRs), suggesting the involvement of TLRs in blood flow recovery. However, the role of TLR9, which was originally known as a sensor for bacterial DNA, remains unknown. This study investigated the role of TLR9 in blood flow recovery in the ischemic limb using a mouse hind-limb ischemia model. Methods and Results: Unilateral femoral artery ligation was performed in TLR9-deficient (Tlr9 -/-) mice and wild-type mice. In wild-type mice, femoral artery ligation significantly increased mRNA expression of TLR9 in the ischemic limb (P < 0.001) and plasma levels of cell-free DNA (cfDNA) as determined by single-stranded DNA (ssDNA) (P < 0.05) and double-stranded DNA (dsDNA) (P < 0.01), which are endogenous ligands for TLR9, compared with the sham-operated group. Laser Doppler perfusion imaging demonstrated significantly improved ratio of blood flow in the ischemic to non-ischemic limb in Tlr9 -/- mice compared with wild-type mice at 2 weeks after ligation (P < 0.05). Tlr9 -/- mice showed increased capillary density and reduced macrophage infiltration in ischemic limb. Genetic deletion of TLR9 reduced the expression of TNF-α, and attenuated NF-κB activation in ischemic muscle compared with wild-type mice (P < 0.05, respectively) at 3 days after the surgery. ODN1826, a synthetic agonistic oligonucleotide for TLR9, or plasma obtained from mice with ischemic muscle promoted the expression of TNF-α in wild-type macrophages (P < 0.05), but not in Tlr9 -/- macrophages. ODN1826 also activated NF-κB signaling as determined by the degradation of IκBα in wild-type macrophages (P < 0.05), but not in Tlr9 -/- macrophages. In vitro experiments using human umbilical vein endothelial cells demonstrated that TNF-α, or conditioned medium obtained from wild-type macrophages treated with ODN1826 accelerated cell death as determined by MTS assay (P < 0.05 and P < 0.01, respectively). Conclusion: Our results suggest that ischemic muscle releases cfDNA, which activates TLR9 and enhances inflammation, leading to impairment of blood flow recovery in the ischemic limb. cfDNA-TLR9 signaling may serve as a potential therapeutic target in ischemic limb disease.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Protease-Activated Receptor-2 Plays a Critical Role in Vascular Inflammation and Atherosclerosis in Apolipoprotein E-Deficient Mice.

Hara T, Phuong PT, Fukuda D, Yamaguchi K, Murata C, Nishimoto S, Yagi S, Kusunose K, Yamada H, Soeki T, Wakatsuki T, Imoto I, Shimabukuro M, Sata M

Circulation 138 ( 16 ) 1706 - 1719 2018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）

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Protease-Activated Receptor-2 Plays a Critical Role in Vascular Inflammation and Atherosclerosis in Apolipoprotein E-Deficient Mice.

Tomoya Hara, Pham Tran Phuong, Daiju Fukuda, Koji Yamaguchi, Chie Murata, Sachiko Nishimoto, Shusuke Yagi, Kenya Kusunose, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Issei Imoto, Michio Shimabukuro, Masataka Sata

Circulation 138 ( 16 ) 1706 - 1719 2018年10月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

BACKGROUND: The coagulation system is closely linked with vascular inflammation, although the underlying mechanisms are still obscure. Recent studies show that protease-activated receptor (PAR)-2, a major receptor of activated factor X, is expressed in both vascular cells and leukocytes, suggesting that PAR-2 may contribute to the pathogenesis of inflammatory diseases. Here we investigated the role of PAR-2 in vascular inflammation and atherogenesis. METHODS: We generated apolipoprotein E-deficient ( ApoE-/-) mice lacking systemic PAR-2 expression ( PAR-2-/- ApoE-/-). ApoE-/- mice, which lack or express PAR-2 only in bone marrow (BM) cells, were also generated by BM transplantation. Atherosclerotic lesions were investigated after 20 weeks on a Western-type diet by histological analyses, quantitative reverse transcription polymerase chain reaction, and Western blotting. In vitro experiments using BM-derived macrophages were performed to confirm the proinflammatory roles of PAR-2. The association between plasma activated factor X level and the severity of coronary atherosclerosis was also examined in humans who underwent coronary intervention. RESULTS: PAR-2-/- ApoE-/- mice showed reduced atherosclerotic lesions in the aortic arch ( P<0.05) along with features of stabilized atherosclerotic plaques, such as less lipid deposition ( P<0.05), collagen loss ( P<0.01), macrophage accumulation ( P<0.05), and inflammatory molecule expression ( P<0.05) compared with ApoE-/- mice. Systemic PAR2 deletion in ApoE-/-mice significantly decreased the expression of inflammatory molecules in the aorta. The results of BM transplantation experiments demonstrated that PAR-2 in hematopoietic cells contributed to atherogenesis in ApoE-/- mice. PAR-2 deletion did not alter metabolic parameters. In vitro experiments demonstrated that activated factor X or a specific peptide agonist of PAR-2 significantly increased the expression of inflammatory molecules and lipid uptake in BM-derived macrophages from wild-type mice compared with those from PAR-2-deficient mice. Activation of nuclear factor-κB signaling was involved in PAR-2-associated vascular inflammation and macrophage activation. In humans who underwent coronary intervention, plasma activated factor X level independently correlated with the severity of coronary atherosclerosis as determined by Gensini score ( P<0.05) and plaque volume ( P<0.01). CONCLUSIONS: PAR-2 signaling activates macrophages and promotes vascular inflammation, increasing atherosclerosis in ApoE-/- mice. This signaling pathway may also participate in atherogenesis in humans.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Right Ventricular Function and Beneficial Effects of Cardiac Rehabilitation in Patients With Systolic Chronic Heart Failure.

Kusunose K, Seno H, Yamada H, Nishio S, Torii Y, Hirata Y, Saijo Y, Ise T, Yamaguchi K, Fukuda D, Yagi S, Soeki T, Wakatsuki T, Sata M

The Canadian journal of cardiology 34 ( 10 ) 1307 - 1315 2018年10月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

BACKGROUND: It has been recognized that a comprehensive cardiac rehabilitation (CR) program improves mortality in patients with chronic heart failure. On the other hand, the magnitude of the improvement in exercise capacity after CR differs among individuals. The aim of this study was to assess the echocardiographic determinants of responders to CR using preload stress echocardiography. METHODS: We prospectively enrolled 58 chronic heart failure patients with reduced left ventricular ejection fraction (aged 62 ± 11 years; 69% male; left ventricular ejection fraction 43% ± 7%) who had received optimized medical treatment in a CR program for 5 months. We performed preload echocardiographic studies using leg positive pressure (LPP) to assess the echocardiographic parameters during preload augmentation. We defined 41 patients as a development cohort to assess the predictive value of echocardiographic variables. Next, we validated results in the remaining 17 patients as a validation cohort. RESULTS: In the development cohort, significant improvement in peak oxygen uptake (VO2) (>10%) after CR was observed in 58% patients. In a multivariable logistic regression model, the significant predictor of improvement in exercise capacity was right ventricular (RV) strain during LPP (odds ratio: 3.96 per 1 standard deviation; P = 0.01). An RV strain value of -16% during LPP had a good sensitivity of 0.79 and a specificity of 0.71 to identify patients with improvement in peak VO2. In the validation cohort, an optimal cutoff value of RV strain value was the same (area under the curve: 0.77, sensitivity: 0.78, specificity: 0.65). CONCLUSIONS: RV strain during LPP may be an echocardiographic parameter for assessing beneficial effects of CR.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

経カテーテル大動脈弁植え込み術を施行した超高齢大動脈弁狭窄症の1例

八木秀介, 伊勢孝之, 川端豊, 伊藤浩敬, 楠瀬賢也, 山口浩司, 山田博胤, 若槻哲三, 赤池雅史, 佐田政隆

日本老年医学会雑誌 ( (一社)日本老年医学会 ) 55 ( 4 ) 722 - 723 2018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）

急性期脳卒中患者におけるB型ナトリウム利尿ペプチドの臨床的意義

西尾進, 楠瀬賢也, 鹿草宏, 平田有紀奈, 鳥居裕太, 天野里江, 山尾雅美, 西條良仁, 坂東美佳, 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 ) 66回 EP - 170 2018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）

過度に蓄積した心外膜下脂肪は薬剤溶出型ステント留置後の再狭窄を予測するマーカーとなる

平田有紀奈, 楠瀬賢也, 山田博胤, 鳥居裕太, 西尾進, 西條良仁, 坂東美佳, 伊勢孝之, 山口浩司, 添木武, 若槻哲三, 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 ) 66回 O - 047 2018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）

第三世代薬剤溶出性ステント留置後における局所凝固反応と総ステント長の関連性

山口浩司, 若槻哲三, 西條良仁, 上野理絵, 川端豊, 坂東美佳, 伊藤浩敬, 轟貴史, 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

日本心臓病学会学術集会抄録 ( (一社)日本心臓病学会 ) 66回 EP - 001 2018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）

深部静脈血栓症に対する各種DOACsの治療成績下肢静脈エコー検査を用いた検討

鳥居裕太, 楠瀬賢也, 西尾進, 松本力三, 平田有紀奈, 天野里江, 西條良仁, 坂東美佳, 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 ) 66回 EP - 187 2018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）

活性型血液凝固第X因子が冠動脈硬化に与える影響

福田大受, 山口浩司, 楠瀬賢也, 八木秀介, 山田博胤, 若槻哲三, 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 ) 66回 O - 044 2018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）

未固定遺体における冠動脈壁微小管腔構造と局所心臓周囲脂肪内炎症との関連

伊藤浩敬, 若槻哲三, 山口浩司, 福田大受, 川端豊, 伊勢孝之, 楠瀬賢也, 松浦朋美, 轟貴史, 飛梅威, 八木秀介, 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 ) 66回 P - 016 2018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）

未固定遺体において光干渉断層法で観察される冠動脈壁微小管腔構造と局所周囲脂肪炎症との関連

川端豊, 若槻哲三, 山口浩司, 伊藤浩敬, 福田大受, 伊勢孝之, 楠瀬賢也, 松浦朋美, 轟貴文, 飛梅威, 八木秀介, 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 ) 66回 P - 017 2018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）

Association of Decreased Docosahexaenoic Acid Level After Statin Therapy and Low Eicosapentaenoic Acid Level with In-Stent Restenosis in Patients with Acute Coronary Syndrome

八木秀介, D Kondo, 伊勢孝之, 福田大受, 山口浩司, 若槻哲三, 川端豊, 伊藤浩敬, 西條良仁, 瀬野弘光, 數藤久美子, 上野理絵, 轟貴史, 楠瀬賢也, 松浦朋美, 飛梅威, 山田博胤, 添木武, 島袋充生, KI Aihara, 赤池雅史, 佐田政隆

Journal of Atherosclerosis and Thrombosis 26 ( 3 ) 272 - 281 2018年08月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

AIM: It is speculated that statin therapy modulates the synthesis of polyunsaturated fatty acids (PUFA), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). However, the data available on the effects of statin therapy on the serum levels of PUFA and the subsequent impact on in-stent restenosis (ISR) in patients with acute coronary syndrome (ACS) are limited. METHODS: A total of 120 ACS patients who received emergent coronary stent implantation, follow-up coronary angiography to evaluate ISR, and new statin therapy were enrolled. We measured the serum levels of the PUFA and lipids at the onset of ACS and at the follow-up coronary angiography. RESULTS: The follow-up coronary angiography revealed 38 ISR cases. New statin therapy significantly reduced the serum levels of DHA and low-density lipoprotein cholesterol (LDL-C), while it did not affect EPA level. Single regression analysis revealed that a decreased serum level of LDL-C was associated with decreased DHA level. The multiple logistic regression analysis revealed that the decreased DHA level after statin therapy and low serum level of EPA on admission were determinants of prevalence of ISR. CONCLUSION: Statin therapy decreased the serum level of DHA with a parallel reduction in LDL-C level in patients with ACS. Decreased DHA level after statin therapy and low EPA level on admission are risk factors for ISR, indicating that in patients with ACS, decreased serum levels of DHA may be a residual target for the prevention of ISR.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Clinical, Electrocardiographic, and Echocardiographic Parameter Combination Predicts the Onset of Atrial Fibrillation.

Soeki T, Matsuura T, Tobiume T, Bando S, Matsumoto K, Nagano H, Uematsu E, Kusunose K, Ise T, Yamaguchi K, Yagi S, Fukuda D, Yamada H, Wakatsuki T, Shimabukuro M, Sata M

Circulation journal : official journal of the Japanese Circulation Society 82 ( 9 ) 2253 - 2258 2018年08月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

BACKGROUND: The ability to identify risk markers for new-onset atrial fibrillation (AF) is critical to the development of preventive strategies, but it remains unknown whether a combination of clinical, electrocardiographic, and echocardiographic parameters predicts the onset of AF. In the present study, we evaluated the predictive value of a combined score that includes these parameters. Methods and Results: We retrospectively studied 1,040 patients without AF who underwent both echocardiography and 24-h Holter electrocardiography between May 2005 and December 2010. During a median follow-up period of 68.4 months (IQR, 49.9-93.3 months), we investigated the incidence of new-onset AF. Of the 1,040 patients, 103 (9.9%) developed AF. Patients who developed AF were older than patients who did not. Total heart beats, premature atrial contraction (PAC) count, maximum RR interval, and frequency of sinus pause quantified on 24-h electrocardiography were associated with new-onset AF. LA diameter (LAD) on echocardiography was also associated with the development of AF. On multivariate Cox analysis, age ≥58 years, PAC count ≥80 beats/day, maximum RR interval ≥1.64 s, and LAD ≥4.5 cm were independently associated with the development of AF. The incidence rate of new-onset AF significantly increased as the combined score (i.e., the sum of the risk score determined using hazard ratios) increased. CONCLUSIONS: A combined score that includes age, PAC count, maximum RR interval, and LAD could help characterize the risk of new-onset AF.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

A clinical application of preload stress echocardiography for predicting future hemodynamic worsening in patients with early-stage heart failure.

西條良仁, 山田博胤, 楠瀬賢也, 坂東美佳, 西尾進, 鳥居裕太, 平田有紀奈, 瀬野弘光, 松浦朋美, 伊勢孝之, 飛梅威, 山口浩司, 八木秀介, 添木武, 若槻哲三, 佐田政隆

Echocardiography 35 ( 10 ) 1587 - 1595 2018年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

AIM: To improve the prognosis of patients with heart failure, risk stratification in their early stage is important. We assessed whether the change in transmitral flow (TMF) velocity pattern during preload augmentation can predict future hemodynamic worsening in early-stage heart failure patients with impaired relaxation TMF pattern. METHODS: We designed a prospective cohort study that included 155 consecutive patients with impaired relaxation (IR) pattern at rest. Preload stress echocardiography was achieved using leg-positive pressure (LPP), and changes in TMF pattern during the LPP was observed during baseline echocardiographic examination. The patients whose TMF pattern developed to pseudonormal (PN) pattern throughout the study period were classified into the change to PN group, and patients whose TMF pattern stayed in IR pattern were classified into the stay in IR group. RESULTS: The median follow-up period was 17 months. The average age was 68 ± 11 years old, and 97 patients (63%) were male. Among 155 patients, 27 were classified into the change to PN group. A Cox proportional hazard analysis confirmed that the change in the peak atrial systolic TMF velocity during the LPP (ΔA, hazard ratio = 0.58 per 1SD; 95% CI = 0.39-0.88, P = 0.010) was the powerful independent predictor of change into PN pattern. Kaplan-Meier analysis revealed that the patients with ΔA ≤ -7 cm/s had more likely to develop into PN pattern than patients with ΔA > -7 cm/s (P = 0.001). CONCLUSIONS: Evaluation of a response in TMF during the LPP might provide an incremental diagnostic value to detect future overt heart failure in patients with early-stage heart failure.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Novel Echocardiographic Parameters in Patients With Aortic Stenosis and Preserved Left Ventricular Systolic Function Undergoing Surgical Aortic Valve Replacement.

Huded CP, Kusunose K, Shahid F, Goodman AL, Alashi A, Grimm RA, Gillinov AM, Johnston DR, Rodriguez LL, Popovic ZB, Sato, Kimi, Svensson LG, Griffin BP, Desai MY

Am J Cardiol. 2018年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Reduced variability of visual left ventricular ejection fraction assessment with reference images: The Japanese Association of Young Echocardiography Fellows multicenter study.

Kenya Kusunose, Kentaro Shibayama, Hiroyuki Iwano, Masaki Izumo, Nobuyuki Kagiyama, Koji Kurosawa, Hirotsugu Mihara, Hiroki Oe, Tetsuari Onishi, Toshinari Onishi, Mitsuhiko Ota, Shunsuke Sasaki, Yumi Shiina, Hikaru Tsuruta, Hidekazu Tanaka

Journal of cardiology 72 ( 1 ) 74 - 80 2018年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

BACKGROUND: Visual estimation of left ventricular ejection fraction (LVEF) is widely applied to confirm quantitative EF. However, visual assessment is subjective, and variability may be influenced by observer experience. We hypothesized that a learning session might reduce the misclassification rate. METHODS: Protocol 1: Visual LVEFs for 30 cases were measured by 79 readers from 13 cardiovascular tertiary care centers. Readers were divided into 3 groups by their experience: limited (1-5 years, n=28), intermediate (6-11 years, n=26), and highly experienced (12-years, n=25). Protocol 2: All readers were randomized to assess the effect of a learning session with reference images only or feedback plus reference images. After the session, 20 new cases were shown to all readers following the same methodology. To assess the concordance and accuracy pre- and post-intervention, each visual LVEF measurement was compared to overall average values as a reference. RESULTS: Experience affected the concordance in visual EF values among the readers. Groups with intermediate and high experience showed significantly better mean difference (MD), standard deviation (SD), and coefficient of variation (CV) than those with limited experience at baseline. The learning session with reference image reduced the MD, SD, and CV in readers with limited experience. The learning session with reference images plus feedback also reduced proportional bias. Importantly, the misclassification rate for mid-range EF cases was reduced regardless of experience. CONCLUSION: This large multicenter study suggested that a simple learning session with reference images can successfully reduce the misclassification rate for LVEF assessment.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Prognostic Value of Frailty and Diastolic Dysfunction in Elderly Patients.

Kusunose K, Okushi Y, Yamada H, Nishio S, Torii Y, Hirata Y, Saijo Y, Ise T, Yamaguchi K, Yagi S, Soeki T, Wakatsuki T, Sata M

Circulation journal : official journal of the Japanese Circulation Society 82 ( 8 ) 2103 - 2110 2018年07月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

BACKGROUND: High prevalence of frailty and of diastolic dysfunction (DD) in heart failure and high mortality in frail adults have been noted. We characterized frailty by quantifying differences on echocardiography, and assessed the added prognostic utility of frailty and DD grade in an elderly population. METHODS AND RESULTS: One hundred and ninety-one patients ≥65 years who had at least 1 cardiovascular risk factor were prospectively recruited for clinically indicated echocardiography at the present institute. Weight loss, exhaustion, and deficits in physical activity, gait speed, and handgrip strength were used to categorize patients as frail (≥3 features), intermediately frail (1 or 2 features), or non-frail (0 features). DD grade ≥2 was defined as severe. Frailty was associated with larger left atrial volume, smaller stroke volume, and worse DD grade after adjustment for age. In a period of 14 months, 29 patients (15%) had cardiovascular events. The addition of frailty score and severe DD significantly improved the prognostic power of a model containing male gender (model 1, male gender, χ2=6.4; model 2, model 1 plus frailty score, χ2=16.7, P=0.004; model 3, model 2 plus severe DD, χ2=25.5, P=0.015). CONCLUSIONS: Both frailty and DD grade were significantly associated with future cardiovascular events in an elderly population with preserved ejection fraction and ≥1 risk factor of cardiovascular disease.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Clinical, Electrocardiographic, and Echocardiographic Parameter Combination Predicts the Onset of Atrial Fibrillation.

添木武, 松浦朋美, 飛梅威, 坂東佐知子, 松本和久, H Nagano, E Uematsu, 楠瀬賢也, 伊勢孝之, 山口浩司, 八木秀介, 福田大受, 山田博胤, 若槻哲三, 島袋充生, 佐田政隆

Circulation Journal 82 ( 9 ) 2253 - 2258 2018年05月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

The ability to identify risk markers for new-onset atrial fibrillation (AF) is critical to the development of preventive strategies, but it remains unknown whether a combination of clinical, electrocardiographic, and echocardiographic parameters predicts the onset of AF. In the present study, we evaluated the predictive value of a combined score that includes these parameters.Methods and Results:We retrospectively studied 1,040 patients without AF who underwent both echocardiography and 24-h Holter electrocardiography between May 2005 and December 2010. During a median follow-up period of 68.4 months (IQR, 49.9-93.3 months), we investigated the incidence of new-onset AF. Of the 1,040 patients, 103 (9.9%) developed AF. Patients who developed AF were older than patients who did not. Total heart beats, premature atrial contraction (PAC) count, maximum RR interval, and frequency of sinus pause quantified on 24-h electrocardiography were associated with new-onset AF. LA diameter (LAD) on echocardiography was also associated with the development of AF. On multivariate Cox analysis, age ?58 years, PAC count ?80 beats/day, maximum RR interval ?1.64 s, and LAD ?4.5 cm were independently associated with the development of AF. The incidence rate of new-onset AF significantly increased as the combined score (i.e., the sum of the risk score determined using hazard ratios) increased. A combined score that includes age, PAC count, maximum RR interval, and LAD could help characterize the risk of new-onset AF.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Noninvasive Assessment of Preload Reserve Enhances Risk Stratification of Patients With Heart Failure With Reduced Ejection Fraction.

Kensuke Matsumoto, Akira Onishi, Hirotsugu Yamada, Kenya Kusunose, Makiko Suto, Yutaka Hatani, Hiroki Matsuzoe, Kazuhiro Tatsumi, Hidekazu Tanaka, Ken-Ichi Hirata

Circulation. Cardiovascular imaging 11 ( 5 ) e007160 - e007160 2018年05月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

BACKGROUND: The leg-positive pressure maneuver can safely and noninvasively apply preload stress without increase in total body fluid volume. The purpose of this study was to determine whether preload stress could be useful for risk stratification of patients with heart failure with reduced ejection fraction. METHODS AND RESULTS: For this study, 120 consecutive patients with heart failure with reduced ejection fraction were prospectively recruited. The stroke work index was estimated as product of stroke volume index and mean blood pressure, and the E/e' ratio was calculated to estimate ventricular filling pressure. The echocardiographic parameters were obtained both at rest and during leg-positive pressure stress. During the median follow-up period of 20 months, 30 patients developed adverse cardiovascular events. During preload stress, stroke work index increased significantly (from 3280±1371 to 3857±1581 mm Hg·mL/m2; P<0.001) along with minimal changes in ventricular filling pressure (E/e', from 16±10 to 17±9; P<0.05) in patients without cardiovascular events. However, patients with cardiovascular events showed impairment of Frank-Starling mechanism (stroke work index, from 2863±969 to 2903±1084 mm Hg·mL/m2; P=0.70) and a serious increase in E/e' ratio (from 19±11 to 25±14; P<0.001). Both the patients without contractile reserve and those without diastolic reserve exhibited worse event-free survival than the others (P<0.001). In a Cox proportional-hazards analysis, the changes in stroke work index (hazard ratio: 0.44 per 500 mm Hg·mL/m2 increase; P=0.001) and in E/e' (hazard ratio: 2.58 per 5-U increase; P<0.001) were predictors of cardiovascular events. CONCLUSION: Contractile reserve and diastolic reserve during leg-positive pressure stress are important determinants of cardiovascular outcomes for patients with heart failure with reduced ejection fraction.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Prognostic Value of Frailty and Diastolic Dysfunction in Elderly Patients.

楠瀬賢也, Y Okushi, 山田博胤, 西尾進, 鳥居裕太, 平田有紀奈, 西條良仁, 伊勢孝之, 山口浩司, 八木秀介, 添木武, 若槻哲三, 佐田政隆

Circulation Journal 82 ( 8 ) 2103 - 2110 2018年04月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

High prevalence of frailty and of diastolic dysfunction (DD) in heart failure and high mortality in frail adults have been noted. We characterized frailty by quantifying differences on echocardiography, and assessed the added prognostic utility of frailty and DD grade in an elderly population. One hundred and ninety-one patients ?65 years who had at least 1 cardiovascular risk factor were prospectively recruited for clinically indicated echocardiography at the present institute. Weight loss, exhaustion, and deficits in physical activity, gait speed, and handgrip strength were used to categorize patients as frail (?3 features), intermediately frail (1 or 2 features), or non-frail (0 features). DD grade ?2 was defined as severe. Frailty was associated with larger left atrial volume, smaller stroke volume, and worse DD grade after adjustment for age. In a period of 14 months, 29 patients (15%) had cardiovascular events. The addition of frailty score and severe DD significantly improved the prognostic power of a model containing male gender (model 1, male gender, χ=6.4; model 2, model 1 plus frailty score, χ=16.7, P=0.004; model 3, model 2 plus severe DD, χ=25.5, P=0.015). Both frailty and DD grade were significantly associated with future cardiovascular events in an elderly population with preserved ejection fraction and ?1 risk factor of cardiovascular disease.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Calcified Amorphous Tumorに対し腫瘍摘出術を行った一例

清水郁子, 瀬野弘光, 山口浩司, 楠瀬賢也, 山田博胤, 若槻哲三, 添木武, 佐田政隆, 岩瀬俊, 黒部裕嗣, 北川哲也

四国医学雑誌 ( 徳島医学会 ) 74 ( 1-2 ) 84 - 84 2018年04月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Local Thickness of Epicardial Adipose Tissue Surrounding the Left Anterior Descending Artery Is a Simple Predictor of Coronary Artery Disease - New Prediction Model in Combination With Framingham Risk Score.

Maimaituxun G, Shimabukuro M, Fukuda D, Yagi S, Hirata Y, Iwase T, Takao S, Matsuura T, Ise T, Kusunose K, Tobiume T, Yamaguchi K, Yamada H, Soeki T, Wakatsuki T, Harada M, Sata M

Circulation journal : official journal of the Japanese Circulation Society 82 ( 5 ) 1369 - 1378 2018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）

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Paclitaxel投与を併用した冠動脈形成術後の局所凝固療法への反応の差(Differential Response of Local Coagulation after Coronary Angioplasty with Paclitaxel)

山口浩司, 若槻哲三, 川端豊, 伊藤浩敬, 轟貴史, 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 ) 82回 PJ022 - 1 2018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）

心血管系イベント予測のための上腕収縮期血圧左右差の至適カットオフ値の設定および検証(Development and Validation of Optimal Cut-off Value in inter-armsystolic Blood Pressure Difference for Prediction of Cardiovascular Events)

廣野明, 楠瀬賢也, 蔭山徳人, 藤永裕之, 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 ) 82回 PJ033 - 2 2018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）

栄養血管の増殖は新鮮遺体において冠動脈プラーク周囲の局所炎症と関連する(Growth of Vasa Vasorum is Associated with Local Inflammation around Coronary Plaque in Fresh Cadavers)

伊藤浩敬, 若槻哲三, 山口浩司, 福田大受, 川端豊, 轟貴史, 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 ) 82回 PJ007 - 3 2018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）

高血圧患者におけるL/N型カルシウム拮抗薬が蛋白尿およびangiotensin II-reninフィードバックに及ぼす効果(Effects of L-/N-type Calcium Channel Blocker on Proteinuria and Angiotensin II-renin Feedback in Hypertensive Patients)

川端豊, 添木武, 伊勢孝之, 松浦朋美, 楠瀬賢也, 飛梅威, 八木秀介, 山口浩司, 山田博胤, 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 ) 82回 PJ067 - 4 2018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）

退院前の推定左室充満圧および収縮期肺動脈圧は心不全患者の再入院と関連する

鳥居裕太, 楠瀬賢也, 山田博胤, 瀬野弘光, 西條良仁, 西尾進, 平田有紀奈, 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 ) 82回 CP17 - 2 2018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）

Age-related changes in morphology of left atrial appendage in patients with atrial fibrillation.

Hirata Y, Kusunose K, Yamada H, Shimizu R, Torii Y, Nishio S, Saijo Y, Takao S, Soeki T, Sata M

The international journal of cardiovascular imaging 34 ( 2 ) 321 - 328 2018年02月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

The purpose of this study was to evaluate the relationship between age and frequency of left atrial appendage (LAA) morphology in patients with atrial fibrillation (AF) compared with sinus rhythm (SR). We enrolled 145 AF patients, and 199 SR patients for the control group without any cardiovascular disease. LAA volume index (LAAVi) and morphology were assessed by electrocardiogram-gated computed tomography angiography. LAA morphology was classified into "chicken wing" or "non-chicken wing" according to the previously described classification. There was no significant trend in frequency of non-chicken wing morphology among ages in the SR group (p = 0.36 for trend), whereas the frequency was negatively related to age in the AF group (p = 0.002 for trend). In multivariable logistic regression, age > 65 (odds ratio [OR] 0.42, p = 0.002) and duration of AF (OR 0.53, p = 0.010) and LAAVi (OR 0.62, p = 0.017) were independent factors of non-chicken wing LAA morphology in the AF group. LAA morphology is affected by age, especially in patients with AF. When we utilize non-chicken wing LAA morphology as a stroke risk factor in patients with AF, we should pay attention to their age.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Provocation of clinically significant left ventricular outflow tract obstruction by postural change in patients with sigmoid septum

Yukina Hirata, Hirotsugu Yamada, Kenya Kusunose, Susumu Nishio, Yuta Torii, Yuki Horike, Masataka Sata

Journal of Echocardiography ( Springer Tokyo ) Vol.- ( No.- ) 1 - 2 2018年01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

Development and validation of optimal cut-off value in inter-arm systolic blood pressure difference for prediction of cardiovascular events

Akira Hirono, Kenya Kusunose, Norihito Kageyama, Masayuki Sumitomo, Masahiro Abe, Hiroyuki Fujinaga, Masataka Sata

Journal of Cardiology ( Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai) ) 71 ( 1 ) 24 - 30 2018年01月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Background An inter-arm systolic blood pressure difference (IAD) is associated with cardiovascular disease. The aim of this study was to develop and validate the optimal cut-off value of IAD as a predictor of major adverse cardiac events in patients with arteriosclerosis risk factors. Methods From 2009 to 2014, 1076 patients who had at least one cardiovascular risk factor were included in the analysis. We defined 700 randomly selected patients as a development cohort to confirm that IAD was the predictor of cardiovascular events and to determine optimal cut-off value of IAD. Next, we validated outcomes in the remaining 376 patients as a validation cohort. The blood pressure (BP) of both arms measurements were done simultaneously using the ankle-brachial blood pressure index (ABI) form of automatic device. The primary endpoint was the cardiovascular event and secondary endpoint was the all-cause mortality. Results During a median period of 2.8 years, 143 patients reached the primary endpoint in the development cohort. In the multivariate Cox proportional hazards analysis, IAD was the strong predictor of cardiovascular events (hazard ratio: 1.03, 95% confidence interval: 1.01–1.05, p = 0.005). The receiver operating characteristic curve revealed that 5 mmHg was the optimal cut-off point of IAD to predict cardiovascular events (p &lt 0.001). In the validation cohort, the presence of a large IAD (IAD ≥5 mmHg) was significantly associated with the primary endpoint (p = 0.021). Conclusions IAD is significantly associated with future cardiovascular events in patients with arteriosclerosis risk factors. The optimal cut-off value of IAD is 5 mmHg.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Predictors for the Treatment Effect of Sodium Glucose Co-transporter 2 Inhibitors in Patients with Type 2 Diabetes Mellitus

Shusuke Yagi, Ken-ichi Aihara, Takeshi Kondo, Kiyoe Kurahashi, Sumiko Yoshida, Itsuro Endo, Daiju Fukuda, Yutaka Nakaya, Kin-ichiro Suwaki, Takashi Takeji, Toshihiro Wada, Hotimah Masdan Salim, Saori Hama, Tomomi Matsuura, Takayuki Ise, Kenya Kusunose, Koji Yamaguchi, Takeshi Tobiume, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Munehide Matsuhisa, Michio Shimabukuro, Masashi Akaike, Masataka Sata

Advances in Therapy ( Springer Healthcare ) 35 ( 1 ) 124 - 134 2018年01月 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Introduction: Predictors for the effect of sodium glucose co-transporter 2 (SGLT2) inhibitors at lowering hemoglobin A1c (HbA1c) levels in type 2 diabetes mellitus patients remain unclear. We therefore aimed to elucidate these predictors in type 2 diabetes patients after 3 months of SGLT2 treatment. Methods: A total of 302 consecutive type 2 diabetes patients who had been treated with SGLT2 inhibitors as monotherapy or add-on therapy to existing antidiabetic treatments were enrolled retrospectively. After excluding 27 patients whose HbA1c levels could not be evaluated 3 months after treatment, the glucose-lowering effects of SGLT2 inhibitors were assessed in 275 patients by measuring HbA1c levels before and 3 months after treatment. The predictors for changes in HbA1c levels after 3 months of treatment were evaluated. Results: SGLT2 inhibitor treatment for 3 months decreased HbA1c levels from 7.8 ± 1.2% to 7.4 ± 1.0% (p &lt 0.0001). A multiple regression analysis showed that the independent determinants for SGLT2 inhibitor treatment effect included decreased HbA1c levels after 1 month of treatment, high baseline HbA1c levels, and a high estimated glomerular filtration rate (eGFR). Conclusion: We show that type 2 diabetes patients who received the greatest glucose-lowering effect with SGLT2 inhibitor treatment were those with preserved renal function (high baseline eGFR) and high baseline HbA1c levels. Moreover, SGLT2 inhibitor treatment efficacy could be predicted by the patients’ initial response to treatment.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Effect of the epicardial adipose tissue volume on the prevalence of paroxysmal and persistent atrial fibrillation

Kageyuki Oba, Minetaka Maeda, Gulinu Maimaituxun, Satoshi Yamaguchi, Osamu Arasaki, Daiju Fukuda, Shusuke Yagi, Yukina Hirata, Susumu Nishio, Takashi Iwase, Shoichiro Takao, Kenya Kusunose, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Masafumi Harada, Hiroaki Masuzaki, Masataka Sata, Michio Shimabukuro

Circulation Journal ( Japanese Circulation Society ) 82 ( 7 ) 1778 - 1787 2018年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Background: Although increasing evidence suggests that epicardial adipose tissue volume (EATV) is associated with atrial fibrillation (AF), it is controversial whether there is a dose-response relationship of increasing EATV along the continuum of AF. We evaluated the effect of the EATV on the prevalence of paroxysmal AF (PAF) and persistent AF (PeAF) and the relationships with cardiac structure and functional remodeling. Methods and Results: Subjects who underwent multidetector computed tomography (MDCT) coronary angiography because of symptoms suggestive of coronary artery disease were divided into sinus rhythm (SR) (n=112), PAF (n=133), and PeAF (n=71) groups. The EATV index (EATV/body surface area, mL/m2) was strongly associated with the prevalence of PAF and PeAF on the model adjusted for known AF risk factors. The effect of the EATV index on the prevalence of PeAF, but not on that of PAF, was modified by the left atrial (LA) dimension, suggesting that extension of the LA dimension is related to EATV expansion in PeAF. The cutoff value of the EATV index for the prevalence was higher in PeAF than in PAF (64 vs. 55 mL/m2, P&lt 0.01). Conclusions: The EATV index is associated with the prevalence of PAF and PeAF, and its cutoff values are predictive for PAF and PeAF development independently of other AF risk factors.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Local thickness of epicardial adipose tissue surrounding the left anterior descending artery is a simple predictor of coronary artery disease ― new prediction model in combination with framingham risk score ―

Gulinu Maimaituxun, Michio Shimabukuro, Daiju Fukuda, Shusuke Yagi, Yukina Hirata, Takashi Iwase, Shoichiro Takao, Tomomi Matsuura, Takayuki Ise, Kenya Kusunose, Takeshi Tobiume, Koji Yamaguchi, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Masafumi Harada, Masataka Sata

Circulation Journal ( Japanese Circulation Society ) 82 ( 5 ) 1369 - 1378 2018年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Background: Compared with global cardiac adiposity, the local accumulation of fat surrounding coronary arteries might have a more direct impact on coronary artery disease (CAD). Here, we compared the local epicardial adipose tissue (EAT) thickness and global cardiac adiposity volumes for predicting CAD. Methods and Results: A total of 197 consecutive subjects underwent 320-slice multi-detector computed tomography coronary angiography and were segregated into CAD (≥1 coronary artery branch stenosis ≥50%) and non-CAD groups. EAT thickness was measured at the right coronary artery (EATRCA), the left anterior descending artery (EATLAD), and the left circumflex artery (EATLCX). Although EATRCA and EATLCX were similar between the 2 groups, EATLAD was larger in the CAD group than in the non-CAD group (5.45±2.16 mm vs. 6.86±2.19 mm, P&lt 0.001). EATLAD, after correcting for confounding factors, was strongly associated with CAD (r=0.276, P&lt 0.001) and Gensini score (r=0.239, P&lt 0.001). On multiple regression analysis, Framingham risk score combined with EATLAD was a strong predictor of CAD (adjusted R2=0.121 P&lt 0.001). Conclusions: The local fat thickness surrounding the LAD is a simple and useful surrogate marker for estimating the presence, severity, and extent of CAD, independent of classical cardiovascular risk factors.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Left ventricular mass influences relationship between filling pressure and early-diastolic ratio of inflow velocity to mitral annular velocity (E/e′)

Masahiro Nakabachi, Satoshi Yamada, Hiroyuki Iwano, Taichi Hayashi, Kazunori Okada, Kenya Kusunose, Kiyotaka Watanabe, Tomoko Ishizu, Kazuaki Wakami, Hirotsugu Yamada, Kaoru Dohi, Yoshihiro Seo, Nobuyuki Ohte, Chikara Shimizu, Taisei Mikami

Circulation Journal ( Japanese Circulation Society ) 82 ( 3 ) 732 - 738 2018年 [ 査読有り ]

掲載種別: 研究論文（学術雑誌）

Background: Early-diastolic mitral annular velocity (e′) and the ratio of early-diastolic left ventricular (LV) inflow velocity (E) to e′ (E/e′) have been widely used as indexes of LV relaxation and filling pressure, respectively. However, many recent studies have demonstrated that they are not reliable in various clinical settings. We thus investigated the factors influencing these echocardiographic parameters in a multicenter study. Methods and Results: The study group comprised 69 patients, referred for cardiac catheterization, and enrolled in 5 university hospitals. Time constant (τ) and LV mean diastolic pressure (LVMDP) were measured using a micromanometer-tipped catheter. Although e′ only weakly correlated with τ (r=−0.35, P&lt 0.01), E/e′ modestly correlated with LVMDP (r=0.48, P&lt 0.001). Multivariable analysis revealed that hypertension (β=−0.33, P&lt 0.01) and LV ejection fraction (LVEF) (β=0.44, P&lt 0.001) were the independent determinants of e′, and LV mass index (LVMI) (β=0.37, P&lt 0.001) and LVMDP (β=0.47, P&lt 0.001) were those of E/e′. Additionally, E/e′ significantly correlated with LVMDP in patients with normal LVMI (r=0.74, P&lt 0.001) but not in those with increased LVMI. Conclusions: The coincidence of hypertension and LVEF affected the relationship between LV relaxation and e′, whereas LVMI altered the relationship between LV filling pressure and E/e′. Thus, clinical conditions associated with an increase in LVMI, such as LV hypertrophy and LV dilatation, should be considered when estimating the filling pressure from E/e′.

この論文にアクセスする

DOI
関連情報を調べる

PubMed

Activated Factor X Signaling Pathway via Protease-Activated Receptor-2 is a Novel Therapeutic Target to Prevent Atrial Fibrillation

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