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Faculty of Medicine School of Medicine Department of Medical Sciences, Cardiovascular Physiology |
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WATANABE Nozomi
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Papers 【 display / non-display 】
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Yokoyama R., Kodama Y., Takamura K., Takahashi M., Tanaka M., Watanabe N., Moritake H.
Journal of Cardiology Cases 2025
Publishing type：Research paper (scientific journal) Publisher：Journal of Cardiology Cases
Exercise stress echocardiography (ESE) is a feasible and valuable tool for evaluating subclinical pulmonary hypertension (PH). However, its utility in patients with unilateral pulmonary branch stenosis remains unclear. We present a case involving a 17-year-old patient with left pulmonary branch stenosis who exhibited exercise-induced PH in the contralateral pulmonary artery as detected by ESE. Standard echocardiography was unable to visualize the left pulmonary artery clearly; therefore, computed tomography was performed, revealing a left pulmonary branch stenosis with a minimum diameter of 4.2 mm. Resting echocardiography showed a pressure gradient of 17 mmHg, calculated using the tricuspid regurgitant velocity. During ESE with a prone ergometer, the slope of the mean pulmonary arterial pressure to systemic cardiac output was 3.1 mmHg/L/min, meeting the diagnostic criteria for exercise-induced PH. The patient underwent stent implantation to treat the left pulmonary branch stenosis. Follow-up ESE demonstrated improvement, with the slope of the mean pulmonary arterial pressure to systemic cardiac output decreasing to 1.5 mmHg/L/min. These findings underscore that ESE is both feasible and effective for assessing subclinical unilateral pulmonary branch stenosis. Learning objective: Patients with congenital unilateral peripheral branch pulmonary artery stenosis usually do not have pulmonary hypertension at rest, and identifying patients who require treatment is challenging. Exercise stress echocardiography can detect latent pulmonary hypertension of the contralateral pulmonary artery in some patients, providing valuable insights for determining treatment indications and evaluating the efficacy of catheter interventions for the stenotic lesion.
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Akashi J, Iwataki M, Nabeshima Y, Onoue T, Hayashi A, Tanaga T, Nishino S, Kimura T, Yano M, Watanabe N, Tsuda Y, Araki M, Shibata Y, Nishimura Y, Otsuji Y, Kataoka M.
Circ Cardiovasc Imaging. 17 ( 3 ) e016239 2024.3
Language：English Publishing type：Research paper (scientific journal) Publisher：Circulation: Cardiovascular Imaging
BACKGROUND: Patients with only moderate atrial secondary mitral regurgitation (asMR) frequently develop heart failure (HF). Mechanisms of HF with moderate asMR and the impact of mild asMR remain unclarified. Although mild/moderate primary mitral regurgitation is compensated by left ventricular (LV) dilatation, the LV is not dilated in asMR. We hypothesized that patients with mild asMR without LV dilatation may have impaired hemodynamics and higher risks of subsequent symptomatic HF deterioration. METHODS: Stroke volume, cardiac output, and systolic pulmonary artery pressure were measured by echocardiography in 142 patients with isolated atrial fibrillation and 30 healthy controls. The prognosis of patients with isolated atrial fibrillation was followed up. RESULTS: In the 142 patients with isolated atrial fibrillation, asMR was no/trivial in 55, mild in 83, moderate in 4, while none had severe asMR. Compared with controls and patients with no/trivial asMR, LV end-diastolic volume index was not increased and hemodynamic parameters were abnormal in patients with mild asMR (LV end-diastolic volume index, 65±6 versus 58±8 versus 60±8 mL/m²; stroke volume index, 42±4 versus 35±4 versus 29±6 mL/m²; P<0.001 versus other 2 groups; cardiac output index, 2.8±0.4 versus 2.8±0.5 versus 2.3±0.6 L/min per m²; P<0.001; systolic pulmonary artery pressure, 21±3 versus 26±5 versus 37±9 mm Hg; P<0.001). Although the event-free rate of HF symptomatic deterioration or hospitalization in patients with no/trivial asMR during a median 13.9 months follow-up was 86.9% and 100%, the rate in mild asMR was 59.4% and 85.0% (P<0.001 or P=0.032), respectively. CONCLUSIONS: In the presence of isolated AF and no compensatory LV dilatation, impaired hemodynamics and higher risks of symptomatic HF deterioration were associated with mild asMR, requiring further studies of causalities.
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Amano M, Izumi C, Toki M, Yanagi Y, Hayashida A, Kawamoto T, Hiraoka A, Fukushima S, Sakaguchi T, Watanabe N, Yoshida K.
Eur Heart J Cardiovasc Imaging 25 ( 6 ) 1 - 11 2024.1
Language：English Publishing type：Research paper (scientific journal) Publisher：European Heart Journal Cardiovascular Imaging
Aims Although systolic expansion of the annulus has been recognized in Barlow’s disease, the mechanisms of the unique pathological movement of the annulus and its relation to the leaflet augmentation have not yet been clarified. We aimed to investigate the detailed mechanisms of the characteristic mitral apparatus dynamics in Barlow’s disease by frame-by-frame sequential geometric analysis using real-time 3D transoesophageal echocardiography. Methods and results Fifty-three patients with Barlow’s disease and severe mitral regurgitation without torn chordae, as well as 10 controls, were included. We evaluated geometric changes in the mitral complex using 3D transoesophageal echocardiography at five points during systole. To identify early systolic billowing of leaflets, the annulo-leaflet angle was measured. We also performed a more detailed analysis in four consecutive frames just before and after leaflet free-edge prolapse above the annulus plane. The median annulo-leaflet angle of both leaflets in early systole was >0° (above annulus plane) in patients with Barlow’s disease, and billowing of the leaflet body was observed from early systole. The prolapse volume of both leaflets increased markedly from early to mid-systole [1.60 (0.85–2.80) to 4.00 (2.10–6.45) mL; analysis of variance (ANOVA), P < 0.001; post hoc, P < 0.05]. With frame-by-frame analysis, dynamic augmentation of the annulus and leaflets developed between frames just before and just after leaflet free-edge prolapse (ANOVA, P < 0.01; post hoc, P < 0.05). Conclusion In Barlow’s disease, early systolic billowing of the mitral leaflet induces systolic annulus expansion followed by leaflet augmentation and leaflet free-edge prolapse.
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Watanabe N., Ashikaga K.
Annals of Cardiothoracic Surgery 13 ( 1 ) 99 - 101 2024
Language：English Publishing type：Research paper (scientific journal) Publisher：Annals of Cardiothoracic Surgery
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Direct Oral Anticoagulants Would Be Best Choice for Atrial Fibrillation Patients After Coronary Stenting: Retrospective Study in a Japanese Population. Reviewed
Koiwaya H, Watanabe N, Kuriyama N, Shibata Y.
Kurume Medical Journal 68 ( 2 ) 97 - 106 2023.7
Language：English Publishing type：Research paper (scientific journal)
Books 【 display / non-display 】
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今日の診断指針 第9版
山村 善政（以上心音・心雑音）
医学書院 2025.2
Language：Japanese Book type：Scholarly book
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心筋症 Multimodalityを用いた診断・評価のすべて
渡邉 望（ Role： Contributor , 肥大型心筋症様のエコーを見たときの鑑別診断・重症度評価・予後予測）
日本医事新報社 2024.1
Language：Japanese Book type：Textbook, survey, introduction
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Emerging Materials and Technologies for Bone Repair and Regeneration
Madhyastha H., Madhyastha R., Banerjee K., Nakajima Y., Maruyama M., Watanabe N.（ Role： Sole author , Osteoblast and Osteoclast Crosstalk during Osteo-Homeostasis and Biotherapeutic Interventions）
CRC Press 2024.1 （ ISBN:9781040088616, 9781032309279 ）
Language：English Book type：Scholarly book
Age-related osteopathologies have become a global medical problem over the last two decades as their prevalence is escalating day by day. Bone remodeling is a continuous process of renewing the adult skeleton through various coordinated and sequential actions of master cells like osteoblasts and osteoclasts. Several mechanical, engineering, hormonal and pharmaco-therapies have offered sustained alternatives for treating bone metabolism disorders. Better understanding the associations between bone-promotive osteoblasts and inhibitive osteoclastic activity is a key target for achieving healthy bone hemostasis. The downsides can be overcome by applying nanotechnology, manipulating the properties and structures of materials at the nanometer scale to minimize bone damage. Recently, nano-formulated nutraceuticals and reverse-engineered chemical drugs are booming in clinical trials. In this chapter, we offer a snapshot commentary on the various nanotherapeutics both proven and yet-to-be-researched nanoformulations like surface-decorated nanoparticles, nanoclusters, nanocomposites, engineered nano-formulations and nutra-nanoceuticals and their interactions.
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臨牀と研究 100巻 9号
渡邉 望（ Role： Joint author , 心エコー図による評価）
大道學舘出版部 2023.9
Language：Japanese Book type：Textbook, survey, introduction
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循環器診療コンプリート 弁膜症
渡邉 望（ Role： Contributor , 機能性僧帽弁逆流症の成因と診断、治療ストラテジー）
秀潤社 2022.8
Language：Japanese Book type：Textbook, survey, introduction
MISC 【 display / non-display 】
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Mitral regurgitation improvement after successful atrial fibrillation ablation by using a 3D mapping system. Reviewed
Watanabe N, Ashikaga K.
Ann Cardiothoracsrg 13 ( 1 ) 99 - 101 2024.1
Authorship：Lead author Publishing type：Rapid communication, short report, research note, etc. (scientific journal)
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心エコー図による評価 Reviewed
渡邉 望
臨牀と研究 100 ( 9 ) 8 - 14 2023.9
Authorship：Lead author Language：Japanese Publishing type：Rapid communication, short report, research note, etc. (scientific journal)
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Dynamic Nature of the Mitral Valve Morphology: Consideration of the Normal Ranges Reviewed
Kagiyama N., Maekawara S., Izumi Y., Watanabe N., Otsuji Y., Yoshida K.
Journal of the American Society of Echocardiography 36 ( 1 ) 125 - 126 2023.1
Language：English Publishing type：Rapid communication, short report, research note, etc. (scientific journal) Publisher：Journal of the American Society of Echocardiography
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Multiple asymptomatic coronary plaque ruptures and fissures in acute myocardial infarction Reviewed
Gi T., Nishino S., Yamashita A., Watanabe N., Shibata Y., Asada Y.
Pathology International 72 ( 6 ) 355 - 357 2022.6
Language：English Publishing type：Rapid communication, short report, research note, etc. (scientific journal) Publisher：Pathology International
DOI： 10.1111/pin.13229
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機能性僧帽弁逆流と治療：弁膜症治療ガイドライン2020改定を踏まえて Reviewed
渡邉 望
宮崎県医師会医学会誌 46 ( 1 ) 1 - 7 2022.3
Authorship：Lead author Language：Japanese Publishing type：Article, review, commentary, editorial, etc. (scientific journal)
Presentations 【 display / non-display 】
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経カテーテル的大動脈弁留置後の感染性心内膜炎に対し外科的大動脈弁置換術・僧帽弁置換術を要した一 例
尾方 美幸、松浦 祐之介、山村 善政 、海野 光佑、伊藤 芽生 、田中 美与 、海北 幸一、古川 貢之、渡邉 望
一般社団法人日本心エコー図学会第35回学術集会
Event date： 2024.4.19 - 2024.4.21
Presentation type：Poster presentation
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未修復複雑先天性心疾患の60歳代男性：不整脈と構造的心疾患に対するハートチームとしてのアプローチ
田中美与、山村 善政、冨田 俊介、尾方 美幸、兒玉 祥彦、海北 幸一 、古川 貢之、渡邉 望
一般社団法人日本心エコー図学会第35回学術集会
Event date： 2024.4.19 - 2024.4.21
Presentation type：Oral presentation (general)
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心臓外科医と診る３Dエコー：最新技術を活かした術中経食道心エコー図の実際
渡邉 望
日本心エコー図学会第33回学術集会 2022.4.8
Event date： 2024.4.8 - 2024.4.10
Presentation type：Symposium, workshop panel (nominated)
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「三尖弁」未修復先天性心疾患の成人期に合併する高度TR:何をすべきか、何ができるのか
渡邉望
第8回江東豊洲心血管カンファレンス
Event date： 2024.3.23
Presentation type：Oral presentation (invited, special)
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成人領域における弁膜症、心筋症の心エコー図診断 up to date
渡邉望
第7回日本小児心臓MR研究会学術集会 2024.3.16
Event date： 2024.3.16
Presentation type：Oral presentation (invited, special)
Awards 【 display / non-display 】
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8. 9th Cardiovascular Clinical Research Investigator's Award "Clinical Research Investigator
2020.3 Japanese Circulation Society
Award type：Award from international society, conference, symposium, etc.
Grant-in-Aid for Scientific Research 【 display / non-display 】
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僧帽弁リモデリング現象への探求：分子細胞生物学的考察を加えた臨床基礎横断研究
Grant number：24K11244 2024.04 - 2027.03
独立行政法人日本学術振興会 科学研究費基金 基盤研究(C)
Authorship：Principal investigator
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FMR治療における病理、遺伝子発現機構からの検証に基づいた左房機能評価の意義の確立
Grant number：23K08239 2023.04 - 2027.03
独立行政法人日本学術振興会 科学研究費基金 基盤研究(C)
Authorship：Coinvestigator(s)
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Indo-Japan seminar: Future medical health by transdisciplinary approach
Grant number：JPJSBP 220227703 2023.02
Authorship：Principal investigator
Other external funds procured 【 display / non-display 】
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Educational Network for Early Diagnosis of Cardiac Amyloidosis: Kyushu-Okinawa Cardiovascular Imaging Academy for Noninvasive Cardiologists and Sonographers
Grant number：88780665 2021.11 - 2024.03
Pfizer Pfizer Independent Medical Education Grant
Authorship：Principal investigator
Available Technology 【 display / non-display 】
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Related fields where technical consultation is available：心臓超音波検査（三次元心エコー図解析・ストレイン解析など）
分子生物学的手法（PCR,ウエスタン・ブロットなど）、細胞生物学的手法（細胞培養、細胞・免疫染色、蛍光イメージングなど）Message：当教室では、循環生理学を基盤とした臨床と基礎の融合、他の基礎教室や宮崎大学の他学部との連携を深め、大学医学部ならではの領域を超えた活動を通し、新しい形での生理学教室として発展し、世界に向けて発信することを目指します。
大学病院や他の基幹病院、実地医家を含めた臨床病院との連携を強め、宮崎県の地域医療と大学医学部の発展に貢献できるよう、活動を進めています。
