Papers - KAIKITA Koichi
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アスピリンの適応と動向
海北幸一, 辻田賢一.
循環器内科 88 ( 6 ) 594 - 598 2020.12
Authorship：Lead author Publishing type：Research paper (scientific journal)
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Usuku H, Yamamoto E, Nishi M, Komorita T, Takae M, Nishihara T, Oike F, Ishii M, Fujisue K, Sueta D, Araki S, Takashio S, Oda S, Misumi Y, Ueda M, Nakamura T, Kawano H, Soejima H, Sakamoto K, Kaikita K, Ando Y, Matsui H, Tsujita K
Circulation reports 2 ( 12 ) 730 - 738 2020.11
Language：English Publishing type：Research paper (scientific journal) Publisher：一般社団法人 日本循環器学会
<b><i>Background:</i></b>Using transthoracic echocardiography, including 2D speckle tracking imaging (STI), this study examined cardiac function after domino liver transplantation (DLT) with liver grafts explanted from patients with hereditary amyloidogenic transthyretin amyloidosis.<b><i>Methods and Results:</i></b>In all, 14 patients who underwent DLT at Kumamoto University Hospital and for whom 2D STI information was available were enrolled in the study; time-dependent echocardiographic changes were evaluated in 7. Although left ventricular (LV) systolic and diastolic function did not differ between the pre- and post-DLT periods (mean [±SD] 5.4±1.0 years after DLT), there were significant (P<0.05 for all) increases in the post- vs. pre-DLT period in basal longitudinal strain (LS; −13.4±2.3 vs. −19.3±4.4), relative apical LS index (=apical LS/[basal LS+mid LS]; 0.75±0.20 vs. 0.58±0.08), and LV ejection fraction/global LS (3.91±0.58 vs. 3.06±0.44). Age at the time of DLT was significantly higher in the group with impaired (>−14%) than preserved basal LS (57.2±3.5 vs. 39.6±16.0 years; P<0.05). When control subjects (n=14) were added to the enrolled DLT recipients, multivariable logistic regression analysis revealed that a history of DLT was significantly associated with impaired basal LS (>−14%; odds ratio 28.39, 95% confidence interval 1.89–427.45, P<0.05).<b><i>Conclusions:</i></b>LV systolic and diastolic function was preserved in the long term after DLT. However, 2D STI revealed subtle cardiac dysfunction in DLT recipients, which may be an early manifestation of cardiac amyloidosis.
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Usuku H., Takashio S., Yamamoto E., Kinoshita Y., Nishi M., Oike F., Marume K., Hirakawa K., Tabata N., Oda S., Misumi Y., Ueda M., Kawano H., Kaikita K., Matsushita K., Ando Y., Matsui H., Tsujita K.
Echocardiography 37 ( 11 ) 1774 - 1783 2020.11
Language：English Publishing type：Research paper (scientific journal) Publisher：Echocardiography
Background: We previously reported that a high score (2 or 3 points) according to the Kumamoto criteria, a combination of high-sensitivity cardiac troponin T (hs-cTnT) ≥0.308 ng/mL, the length of QRS ≥ 120 ms in electrocardiogram, and left ventricular (LV) posterior wall thickness ≥ 13.6 mm, increases the pretest probability of Tc-labeled pyrophosphate ( Tc-PYP) scintigraphy in patients with suspected transthyretin amyloid cardiomyopathy (ATTR-CM). However, some patients with a low score (0 or 1 point) show positive findings on Tc-PYP scintigraphy. Therefore, we evaluated the usefulness of additional examinations, including echocardiographic assessment of myocardial strain, to raise the pretest probability of Tc-PYP scintigraphy for these patients. Methods and Results: We examined 109 consecutive patients aged ≥70 years with low scores according to the Kumamoto criteria who underwent Tc-PYP scintigraphy. Nineteen patients (17%) had positive Tc-PYP scintigraphy findings. The relative apical longitudinal strain (LS) index (apical LS/ basal LS + mid LS) (RapLSI) was significantly higher in patients with positive than negative Tc-PYP scintigraphy findings (1.04 ± 0.37 vs 0.70 ± 0.28, P <.01). Multivariable logistic regression analysis revealed that a high RapLSI (≥1.04) was significantly associated with Tc-PYP positivity (odds ratio, 14.14; 95% confidence interval, 3.36-59.47; P <.01). The sensitivity, specificity, and accuracy of the diagnostic model using the RapLSI for identification of Tc-PYP positivity were 53%, 94%, and 87%, respectively. Conclusions: A high RapLSI can raise the pretest probability of Tc-PYP scintigraphy in patients with a low score according to the Kumamoto criteria. The RapLSI can assist clinicians in determining strategies for these patients. 99m 99m 99m 99m 99m 99m 99m 99m 99m 99m
DOI： 10.1111/echo.14892
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Late-gadolinium enhancement in a subject with normal left ventricular function Reviewed
Misumi I., Sato K., Nagano M., Urata J., Usuku H., Kaikita K., Tsujita K.
Radiology Case Reports 15 ( 11 ) 2464 - 2470 2020.11
Language：English Publishing type：Research paper (scientific journal) Publisher：Radiology Case Reports
A 27-year-old man visited our hospital after experiencing palpitations. His 12-lead electrocardiogram and chest radiograph were unremarkable. Blood test results showed normal plasma brain natriuretic peptide level (<5.8 pg/mL). Transthoracic echocardiography revealed normal left ventricular structure and function by demonstrating left ventricular wall thickness of 10 mm, end-diastolic dimension of 46 mm, end-systolic dimension of 31 mm, and ejection fraction of 64%. Pulsed-wave Doppler echocardiography demonstrated normal E/e’ ratio of 7.5. Cardiac magnetic resonance imaging showed normal coronary artery. However, there was massive late-gadolinium enhancement at the mid-layer wall, suggesting massive left ventricular fibrosis. This case reveals that left ventricular function may be normal even in massive late-gadolinium enhancement. Pathophysiology other than fibrosis might have contributed to this specific finding in late-gadolinium enhancement.
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Assessment of diffuse ventricular fibrosis in atrial fibrillation using cardiac CT-derived myocardial extracellular volume fraction Reviewed
Kidoh M, Oda S, Takashio S, Kanazawa H, Ikebe S, Emoto T, Nakaura T, Nagayama Y, Sasao A, Inoue T, Funama Y, Araki S, Yamamoto E, Kaikita K, Tsujita K, Ikeda O
JACC Clin Electrophysiol 6 ( 12 ) 1573 - 1575 2020.11
Language：English Publishing type：Research paper (scientific journal)
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Yamada T., Takashio S., Arima Y., Nishi M., Morioka M., Hirakawa K., Hanatani S., Fujisue K., Yamanaga K., Kanazawa H., Sueta D., Araki S., Usuku H., Nakamura T., Suzuki S., Yamamoto E., Ueda M., Kaikita K., Tsujita K.
ESC Heart Failure 7 ( 5 ) 2829 - 2837 2020.10
Language：English Publishing type：Research paper (scientific journal) Publisher：ESC Heart Failure
Aims: The focus on wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) is increasing because of novel treatment options. There is currently no report on a large number of Japanese patients with ATTRwt-CM. The study aimed to examine the characteristics and prognosis of ATTRwt-CM in Japan. Methods and results: Consecutive patients (78.5 ± 6.4 years old at diagnosis) with ATTRwt-CM diagnosed at Kumamoto University Hospital between December 2002 and December 2019 were retrospectively reviewed. Data, including demographic characteristics, co-morbidities, clinical manifestations at diagnosis, laboratory results, electrocardiographic and echocardiographic data, imaging and pathological findings, and treatment were obtained. Of 129 patients included in this study, 110 patients (85%) were male. The median period from initial symptom onset to diagnosis was 15.5 (2–75) months. Heart failure was the most common clinical manifestation leading to diagnosis (61%) and initial manifestations (49%). Of 106 patients, carpal tunnel syndrome was observed in 57 patients (54%), and the median period from initial symptom onset to diagnosis was 96 (48–120) months. Histopathological confirmation of transthyretin amyloid was achieved in 94 patients (73%), including 66 (51%) and 28 cases (22%) with endomyocardial and extracardiac biopsies. During the observation period (median 15.0 [inter-quartile range, 5.4–33.2] months after diagnosis), 34 patients (26%) died. Of these, 27 patients (79%) had cardiovascular deaths (heart failure, 25; sudden death, two). The median survival duration was 58.9 months and the 5 years' survival rate was 48%. According to a multivariate Cox hazard analysis, age [hazard ratio (HR), 1.14; 95% confidence interval (CI), 1.05–1.23, P = 0.002] and low serum sodium levels (HR, 0.89; 95% CI, 0.79–0.996; P = 0.04) contributed to all-cause mortality, and low serum sodium levels contributed to hospitalization for heart failure (HR, 0.86; 95% CI, 0.77–0.96; P = 0.005). Conclusions: Clinical characteristics and prognosis of ATTRwt-CM patients in Japan were examined. Carpal tunnel syndrome can be considered an indication for diagnosis of ATTRwt-CM. Age and low serum sodium level were significant predictive factors of all survival outcomes. The clinical features of ATTRwt-CM should be recognized to provide appropriate treatment.
DOI： 10.1002/ehf2.12884
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Takashio S., Kaikita K., Nishi M., Morioka M., Higo T., Shiose A., Doman T., Horiuchi H., Fukui T., Tsujita K.
ESC Heart Failure 7 ( 5 ) 3235 - 3239 2020.10
Language：English Publishing type：Research paper (scientific journal) Publisher：ESC Heart Failure
Aims: Bleeding is a serious complication in patients with continuous-flow left ventricular assist device (CF-LVAD). Acquired von Willebrand syndrome (AVWS; type 2A) develops because of high shear stress inside the pumps and is a cause of bleeding complication. Although von Willebrand factor (vWF) multimer analysis is useful for diagnosing AVWS, it is only performed in specialized research institutes. A novel microchip flow chamber system, the total thrombus-formation analysis system (T-TAS), is a point-of-care system to evaluate the thrombus-formation process and useful for monitoring platelet thrombus-formation capacity in patients receiving antiplatelet therapy and the diagnosis and evaluation of the clinical severity of von Willebrand disease type 1. However, little is known about the association between AVWS and platelet thrombus-formation capacity evaluated by T-TAS in patients with CF-LVAD. We aimed to evaluate the utility of T-TAS for easy detection of AVWS in patients with CF-LVAD. Methods and results: We simultaneously evaluated the vWF large multimers and T-TAS parameters in four consecutive patients with axial-type CF-LVAD and eight control patients treated with aspirin and warfarin. vWF large multimer index was defined as the proportion of large multimers in total vWF derived from a normal control plasma. T-TAS analyses different thrombus-formation processes using two microchips with different thrombogenic surfaces. PL -AUC levels in the platelet (PL) chip are highly sensitive for platelet functions, while AR -AUC levels in the atheroma (AR) chip allow the assessment of the overall haemostatic ability. vWF large multimer index and T-TAS parameters were decreased in all patients with CF-LVAD. The mean PL -AUC level (5.4 ± 2.9 vs. 219 ± 67; P < 0.01), AR -AUC level (338 ± 460 vs. 1604 ± 160; P < 0.01) and vWF large multimer index (49 ± 11% vs. 112 ± 27%; P < 0.01) were significantly lower in the patients with CF-LVAD than in control patients. One patient showed changes in T-TAS levels before and after implantation of CF-LVAD. PL -AUC and AR -AUC levels decreased from 438.1 to 5.0 and from 1667.9 to 1134.3, respectively. Conclusions: In patients with CF-LVAD, the platelet thrombus-formation capacity was extremely impaired because of AVWS, and T-TAS parameters could detect the presence of AVWS. T-TAS can be used for easy detection of AVWS as a point-of-care testing. Further studies with a large sample size are needed to validate our results in several LVAD models and evaluate the prognostic value of bleeding complications and thromboembolism in patients with LVAD. 24 10 10 30 24 10 10 30 24 10 10 30
DOI： 10.1002/ehf2.12824
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Oike F., Yamamoto E., Sueta D., Tokitsu T., Usuku H., Nishihara T., Takae M., Fujisue K., Arima Y., Kanazawa H., Ito M., Hanatani S., Araki S., Takashio S., Sakamoto K., Suzuki S., Kawano H., Soejima H., Kaikita K., Tsujita K.
International Journal of Cardiology 316 145 - 151 2020.10
Language：English Publishing type：Research paper (scientific journal) Publisher：International Journal of Cardiology
Objectives: Because diastolic late mitral annular velocity (a') obtained by transthoracic-echocardiography (TTE) represents left atrial (LA) function, we investigated the clinical significance of a' in heart failure (HF) with a preserved left ventricular (LV) ejection fraction (HFpEF). Methods: We enrolled 448 consecutive HFpEF patients (sinus rhythm: 66.3%, atrial fibrillation [AF] rhythm: 33.7%) and performed TTE under stable conditions after optimal therapy. In patients with sinus rhythm, a' values were measured at septal mitral annuli. Results: A' had weak but significant negative correlations with the natural-logarithm-B-type natriuretic peptide (Ln-BNP), LA diameter, LV mass index and tricuspid regurgitation pressure gradient. Receiver operating characteristic (ROC) curve analysis showed that the best cut-off value of a' and systolic mitral annular velocity (s') for the prediction of HF-related events were 7.45 cm/s and 6.5 cm/s with areas under the curve (AUC) of 0.841 and 0.682, respectively. The AUC of ROC analysis for the logistic regression model of a' plus s' was improved to 0.97. In Kaplan-Meier analysis, HFpEF patients with low-a' (<7.45 cm/s) had a significantly higher risk of total cardiovascular and HF-related events (both p < .01 by log-rank test) than those with high-a' (≥ 7.45 cm/s) and were prognostically equivalent to those with AF. Multivariate Cox proportional hazard analysis identified low-a' as an independent predictor of both total cardiovascular (hazard ratio [HR]: 0.823, 95% confidence interval [CI]: 0.714–0.949, p = .007) and HF-related events (HR: 0.551, 95% CI: 0.422–0.720, p < .001). Conclusion: A' value measurement is a non-invasive and useful method for risk stratification in HFpEF.
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Left-dominant arrhythmogenic cardiomyopathy with a nonsense mutation in DSP Reviewed
Tsuruta Y., Sueta D., Takashio S., Oda S., Sakamoto K., Kaikita K., Kato K., Ohno S., Horie M., Tsujita K.
ESC Heart Failure 7 ( 5 ) 3174 - 3178 2020.10
Language：English Publishing type：Research paper (scientific journal) Publisher：ESC Heart Failure
A 74-year-old man had abnormal left ventricular (LV) function according to a perioperative test at a local hospital and was transferred to our institution for further evaluation and treatment. His electrocardiogram demonstrated the presence of premature ventricular contraction with a QRS complex of the right bundle branch block type and superior axis. His echocardiography showed systolic dysfunction of the LV (LV ejection fraction, 44.6%). Cardiac computed tomography imaging revealed banded and patchy densities observed frequently from the middle to epicardial layer of the LV wall. Cardiac magnetic resonance imaging showed fat signals on fat-selective images and late gadolinium enhancement in the mid-wall to subepicardial layers in the LV myocardium. Endomyocardial biopsy revealed the histological presence of fibrofatty replacement. A genetic analysis revealed a nonsense mutation in the desmoplakin gene. Thus, he was diagnosed with left-dominant arrhythmogenic cardiomyopathy. To prevent fatal ventricular arrhythmias, an implantable cardioverter defibrillator was successfully implanted.
DOI： 10.1002/ehf2.12790
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A case of severe pulmonary thromboembolism in mycoplasma infection during early pregnancy Reviewed
Ohno M., Yamada T., Otsuka Y., Nakashima N., Matsubara J., Matsukawa M., Sueta D., Arima Y., Yamamoto E., Tamaya S., Kaikita K., Fujimoto K., Tsujita K.
Journal of Cardiology Cases 22 ( 3 ) 140 - 142 2020.9
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Cardiology Cases
Mycoplasma infection and pregnancy are both characterized by thrombogenesis. A 38-year-old pregnant woman was admitted to a general hospital for mycoplasma pneumonia treatment. She experienced sudden dyspnea and fell into cardiopulmonary arrest. Emergent pulmonary arteriography revealed contrast deficits in the bilateral pulmonary arteries, and she was diagnosed with pulmonary thromboembolism (PTE). Reperfusion treatment and hemodynamic support were initiated. This is a rare case report of PTE attributed to mycoplasma infection during pregnancy. <Learning objective: Since mycoplasma infection has been reported to be a fatal extrapulmonary finding associated with pulmonary thromboembolism (PTE), if sudden respiratory failure occurs during the clinical course, PTE should be investigated, and pregnant women should be especially careful.>
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Komorita T., Yamamoto E., Sueta D., Tokitsu T., Fujisue K., Usuku H., Nishihara T., Oike F., Takae M., Egashira K., Takashio S., Ito M., Yamanaga K., Arima Y., Sakamoto K., Suzuki S., Kaikita K., Tsujita K.
IJC Heart and Vasculature 29 100563 2020.8
Language：English Publishing type：Research paper (scientific journal) Publisher：IJC Heart and Vasculature
Backgrounds: The relationship between cardiovascular outcomes and the Controlling Nutritional Status (CONUT) score in heart failure (HF) with preserved ejection fraction (HFpEF) patients is unknown. This study aimed to evaluate the relationship between the score and cardiovascular outcomes in HFpEF patients. Methods and results: A total of 506 consecutive HFpEF patients were prospectively observed for up to 1500 days or until the occurrence of cardiovascular events. The mean age was 71.6 ± 9.4 years. Cardiovascular outcomes were compared between the CONUT score 0–1 group with a normal nutritional state (normal group), the CONUT score 2–4 group with a light degree of undernutrition (light group), and the CONUT score 5–8 group with a moderate degree of undernutrition (moderate group). In this study, there were no patients who scored 9–12, which was defined as a severe state of undernutrition. Overall, 238 cardiovascular events were observed during the follow-up period (median: 1159 days). Kaplan–Meier analysis showed that the moderate group was at higher risk of composite cardiovascular events than the normal group (P < 0.001) and the light group (P = 0.031). The analysis also showed that the light group was at higher risk of composite cardiovascular events than the normal group (P = 0.038). Multivariable Cox proportional hazards analysis with the significant factors from the univariate analysis showed that the CONUT score (hazard ratio: 1.12, 95% confidence interval: 1.03–1.21, P = 0.005) significantly predicted future cardiovascular events. Conclusion: Nutritional screening using the CONUT score may be useful for predicting cardiovascular events in HFpEF patients.
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Mori H., Takahashi J., Sato K., Miyata S., Takagi Y., Tsunoda R., Sumiyoshi T., Matsui M., Tanabe Y., Sueda S., Momomura S., Kaikita K., Yasuda S., Ogawa H., Shimokawa H., Suzuki H.
IJC Heart and Vasculature 29 100561 2020.8
Language：English Publishing type：Research paper (scientific journal) Publisher：IJC Heart and Vasculature
Background: Antiplatelet therapy (APT) is generally used in patients with coronary artery disease. However, for patients with vasospastic angina (VSA), the impact of APT is not fully understood. Methods: In a multicenter registry study of the Japanese Coronary Spasm Association (n = 1429), patients with or without APT were compared. The primary endpoint was major adverse cardiac events (MACEs), defined as cardiac death, non-fatal myocardial infarction, unstable angina, heart failure and appropriate ICD (Implantable cardioverter defibrillator) shock. Propensity score matching and a multivariable cox proportional hazard model were used to adjust for selection bias for treatment and potential confounding factors. Results: In the whole population, 669 patients received APT, while 760 patients did not receive APT. Patients with APT had a greater prevalence of comorbidities, such as hypertension, diabetes, dyslipidemia and smoking, than those without APT. The prevalences of previous myocardial infarction, spontaneous ST changes, significant organic stenosis and medications including calcium channel blocker, nitrate, statin and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker were greater in patients with APT than those without APT. After propensity matching (n = 335 for both groups), during the median follow-up period of 32 months, the incidence rate of MACE was comparable between the patients with and without APT (P = 0.24). MACEs occurred in 5.7% of patients with APT and in 3.6% of those without APT (P = 0.20). All-cause death occurred in 0.6% of patients with APT and 1.8% of those without APT (p = 0.16). Conclusion: In this multicenter registry study, anti-platelet therapy exerted no beneficial effects for VSA patients.
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Marume K., Nagatomo K., Yamamoto N., Kaichi R., Mori T., Komaki S., Ishii M., Kusaka H., Toida R., Kurogi K., Nagamine Y., Takashio S., Arima Y., Sakamoto K., Yamamoto E., Kaikita K., Tsujita K.
Journal of Cardiology 76 ( 2 ) 184 - 190 2020.8
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Cardiology
Background: Owing to reduced staffing, patients hospitalized for acute myocardial infarction (AMI) during off-hours (nights, weekends, and holidays) have poorer outcomes than those admitted during regular hours. Whether the presence of an on-duty cardiologist in a hospital during off-hours is related to better outcomes for patients with AMI remains unclear. The Miyazaki Prefectural Nobeoka Hospital had a unique medical care system in that cardiologists were on call for half of the week and on duty for the other half during off-hours, thus providing an opportunity to assess the relationship between the presence of an on-duty cardiologist and patient outcomes. We examined clinical outcomes of patients admitted for AMI during off-hours according to the presence of an on-duty cardiologist. Methods: We recruited 225 consecutive patients with AMI hospitalized during off-hours, who underwent stent implantation at Miyazaki Prefecture Nobeoka Hospital from 2013 to 2017. The endpoints were in-hospital death or long-term major adverse cardiac events (MACE) including cardiovascular death, non-fatal MI, non-fatal stroke, stent thrombosis, ischemia-driven target-lesion revascularization, admission owing to unstable angina, or admission owing to heart failure. Results: Based on the presence of an on-call cardiologist at admission, we divided patients into the cardiologist on-call group (n = 112) or cardiologist on-duty group (n = 113). The presence of an on-duty cardiologist did not affect door-to-reperfusion time (p = 0.776), level of peak creatine kinase (p = 0.971), or in-hospital death (p = 0.776). The Kaplan–Meier curve analysis showed similar prognosis for the cardiologist on-duty and cardiologist on-call groups (p = 0.843), and multivariable Cox regression analysis showed that the presence of an on-duty cardiologist was not associated with MACE. Conclusions: The presence of an on-duty cardiologist is not a prognostic factor for patients hospitalized for AMI during off-hours in our medical system. Further prospective multicenter studies should confirm our results.
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Nagamatsu S., Sakamoto K., Yamashita T., Sato R., Tabata N., Motozato K., Yamanaga K., Ito M., Fujisue K., Kanazawa H., Sueta D., Usuku H., Araki S., Arima Y., Takashio S., Suzuki S., Yamamoto E., Izumiya Y., Soejima H., Utsunomiya D., Kaikita K., Yamashita Y., Tsujita K.
Journal of Cardiology 76 ( 1 ) 73 - 79 2020.7
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Cardiology
Background: Although pressure equalization of the sensor-tipped guidewire and systemic pressure is mandatory in measuring fractional flow reserve (FFR), pressure in the distal artery (Pd) with wire advancement can be influenced by hydrostatic pressure related to the height difference between the catheter tip and the distal pressure sensor. We therefore analyzed the impact of hydrostatic pressure on FFR in vivo by modification of the height difference. Methods: To reveal the anatomical height difference in human coronary arteries, measurement was performed during computed tomography angiography (CTA) of five consecutive patients. Utilizing the healthy coronary arteries of female swine, height difference diversity was reproduced by body rotation and vertical inclination. FFR measurements were performed during maximum hyperemia with adenosine. The height difference was calculated fluoroscopically with a contrast medium–filled balloon for reference. Results: In human coronary CTA, height averages from the ostium in the left anterior descending artery (34.6 mm) were significantly higher than in the left circumflex (−15.5 mm, p = 0.008) and right coronary arteries (−2.3 mm, p = 0.008). In our swine model, reproduced height variation ranged from −7.2 cm to +6.5 cm. Mean FFR was significantly lower in positive sensor height and higher in negative sensor height compared to the reference height. Linear regression analyses revealed significant correlations between height difference and FFR, observed among all coronary arteries, as well as between the height difference and Pd–aortic pressure mismatch. Subtracting 0.622 mmHg/cm height difference from Pd could correct the expected hydrostatic pressure influence. Conclusion: Hydrostatic pressure variation resulting from sensor height influenced FFR values might affect interpretation during FFR assessment.
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Long-Term Prognosis of Patients with Myocardial Infarction Type 1 and Type 2 with and without Involvement of Coronary Vasospasm. Reviewed
Sato R, Sakamoto K, Kaikita K, Tsujita K, Nakao K, Ozaki Y, Kimura K, Ako J, Noguchi T, Yasuda S, Suwa S, Fujimoto K, Nakama Y, Morita T, Shimizu W, Saito Y, Hirohata A, Morita Y, Inoue T, Okamura A, Mano T, Hirata K, Tanabe K, Shibata Y, Owa M, Funayama H, Kokubu N, Kozuma K, Uemura S, Toubaru T, Saku K, Ohshima S, Nishimura K, Miyamoto Y, Ogawa H, Ishihara M
Journal of clinical medicine 9 ( 6 ) 2020.6
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Kiyama T., Kanazawa H., Yamabe H., Ito M., Kaneko S., Kanemaru Y., Kawahara Y., Yamanaga K., Fujisue K., Sueta D., Takashio S., Arima Y., Araki S., Usuku H., Nakamura T., Izumiya Y., Sakamoto K., Suzuki S., Yamamoto E., Soejima H., Kaikita K., Tsujita K.
Journal of Cardiology 75 ( 6 ) 673 - 681 2020.6
Language：English Publishing type：Research paper (scientific journal) Publisher：Journal of Cardiology
Background: It has been shown that most paroxysmal atrial fibrillation (AF) can be terminated by pulmonary vein (PV) isolation alone, suggesting that rapid discharges from PV drive AF. To define the driving mechanism of AF, we compared the activation sequence in the body of left atrium (LA) to that within PV. Methods: Endocardial noncontact mapping of LA body (LA group; n = 16) and selective endocardial mapping of left superior PV (LSPV) (PV group; n = 13) were performed in 29 paroxysmal AF patients. The frequency of pivoting activation, wave breakup, and wave fusion observed in LA were compared to those in LSPV to define the driving mechanism of AF. Circumferential ablation lesion around left PV was performed after right PV isolation to examine the effect of linear lesion around PV on AF termination both in LA and PV groups. Results: The frequency of pivoting activation, wave breakup, and wave fusion in PV group were significantly higher than those in LA group (36.5 ± 17.7 vs 5.0 ± 2.2 times/seconds, p < 0.001, 10.1 ± 4.3 vs 5.0 ± 2.2 times/seconds, p = 0.004, 18.1 ± 5.7 vs 11.0 ± 5.2, p = 0.002). Especially in the PV group, the frequency of pivoting activation was significantly higher than that of wave breakup and wave fusion (36.5 ± 17.7 vs 10.1 ± 4.3 times/seconds, p < 0.001, 36.5 ± 17.7 vs 18.1 ± 5.7 times/seconds, p < 0.001). These disorganized activations in LSPV were eliminated by the circumferential ablation lesion around left PV (pivoting activation; 36.5 ± 17.7 vs 9.3 ± 2.3 times/seconds, p < 0.001, wave breakup; 10.1±1.3 times/seconds, p = 0.003, wave fusion; 18.1 ± 5.7 vs 5.7 ± 1.8, p < 0.001), resulted in AF termination in all patients in both LA and PV groups. Conclusions: Activation sequence within PV was more disorganized than that in LA body. Frequent episodes of pivoting activation rather than wave breakup and fusion observed within PV acted as the driving sources of paroxysmal AF.
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Minimum-contrast percutaneous coronary intervention guided by optical coherence tomography using low-molecular weight dextran Reviewed
Kurogi K, Ishii M, Sakamoto K, Kusaka H, Yamamoto N, Takashio S, Arima Y, Yamamoto E, Kaikita K, Tsujita K
JACC: Cardiovascular Interventions 13 ( 10 ) 1270 - 1272 2020.5
Language：English Publishing type：Research paper (scientific journal)
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Quantification of myocardial extracellular volume with planning computed tomography for transcatheter aortic valve replacement to identify occult cardiac amyloidosis in patients with severe aortic stenosis Reviewed
Oda S, Kidoh M, Takashio S, Inoue T, Nagayama Y, Nakaura T, Shiraishi S, Tabata N, Usuku H, Kaikita K, Tsujita K, Ikeda O.
Circ Cardiovasc Imaging 13 ( 5 ) e010358 2020.5
Language：English Publishing type：Research paper (scientific journal)
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Ishii M., Seki T., Kaikita K., Sakamoto K., Nakai M., Sumita Y., Nishimura K., Miyamoto Y., Noguchi T., Yasuda S., Tsutsui H., Komuro I., Saito Y., Ogawa H., Tsujita K., Kawakami K.
European Journal of Epidemiology 35 ( 5 ) 455 - 464 2020.5
Language：English Publishing type：Research paper (scientific journal) Publisher：European Journal of Epidemiology
Particulate matter from natural sources such as desert dust causes harmful effects for health. Asian dust (AD) increases the risk of acute myocardial infarction (AMI). However, little is known about the risk of myocardial infarction with nonobstructive coronary arteries (MINOCA), compared to myocardial infarction with coronary artery disease (MI-CAD). Using a time-stratified case-crossover design and conditional logistic regression models, the association between short-term exposure to AD whereby decreased visibility (< 10 km) observed at each monitoring station nearest to the hospitals was used for exposure measurements and admission for AMI in the spring was investigated using a nationwide administrative database between April 2012 and March 2016. According to presence of revascularization and coronary atherosclerosis, AMI patients (n = 30,435) were divided into 2 subtypes: MI-CAD (n = 27,202) or MINOCA (n = 3233). The single lag day-2 was used in AD exposure based on the lag effect analysis. The average level of meteorological variables and co-pollutants on the 3 days prior to the case/control days were used as covariates. The occurrence of AD events 2 days before the admission was associated with admission for MINOCA after adjustment for meteorological variables [odds ratio 1.65; 95% confidence interval (CI) 1.18–2.29], while the association was not observed in MI-CAD. The absolute risk difference of MINOCA admission was 1.79 (95% CI 1.21–2.38) per 100,000 person-year. These associations between AD exposure and the admission for MINOCA remained unchanged in two-pollutant models. This study provides evidence that short-term exposure to AD is associated with a higher risk of MINOCA, but not MI-CAD.
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Sueta D., Tabata N., Tanaka M., Hanatani S., Arima Y., Sakamoto K., Yamamoto E., Izumiya Y., Kaikita K., Arizono K., Matsui K., Tsujita K.
Hemodialysis International 24 ( 2 ) 202 - 211 2020.4
Language：English Publishing type：Research paper (scientific journal) Publisher：Hemodialysis International
Introduction: Mortality in hemodialysis patients is relatively high; thus, its risk stratification is very important. There are insufficient data describing the current status of the management of serum phosphate and calcium levels. Methods: We conducted a multicenter, prospective, registry study throughout the Kumamoto Prefecture in Japan. We enrolled 1993 patients at 58 facilities with complete explanatory data, including serum phosphate, corrected calcium, and intact parathyroid hormone levels. We categorized subjects into nine categories according to low, normal, and high levels of phosphate and corrected calcium levels. The endpoint was all-cause mortality. Results: Of the total number of subjects, 56.1% of the patients were in the normal phosphate and calcium category, and 72% and 77.1% had controlled serum phosphate and calcium levels, respectively. Two hundred twenty-six deaths occurred during the follow-up period. In the nine categories, the highest mortality rates were observed in the highest corrected calcium and lowest phosphate categories. Stepwise backward multivariate regression analyses identified the serum corrected calcium level (OR, 1.38; 95% CI, 1.06–1.79; P = 0.016) and the serum phosphate level (OR, 1.26; 95% CI, 1.08–1.48; P = 0.003) as significant and independent predictors of all-cause mortality. Conclusions: The corrected serum calcium and phosphate levels are associated with mortality in our dialysis population, with poorest survival in patients with high corrected serum calcium and low serum phosphorus.
DOI： 10.1111/hdi.12824