論文 - 海北 幸一
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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年8月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：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年8月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：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年8月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：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年7月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：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. 査読あり
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年6月
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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年6月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：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 査読あり
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年5月
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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 査読あり
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年5月
記述言語：英語 掲載種別：研究論文（学術雑誌）
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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年5月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：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年4月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：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
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Yamamoto M., Takashio S., Nakashima N., Hanatani S., Arima Y., Sakamoto K., Yamamoto E., Kaikita K., Aoki Y., Tsujita K.
ESC Heart Failure 7 ( 2 ) 721 - 726 2020年4月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：ESC Heart Failure
We present a case of double-chambered right ventricle (DCRV) complicated by hypertrophic obstructive cardiomyopathy (HOCM) in KRAS mutation-associated Noonan syndrome. The diagnosis was incidental and made during diagnostic testing for an intradural extramedullary tumour. Spinal compression, if not surgically treated, may cause paralysis of the extremities. We decided to pursue pharmacological therapy to control biventricular obstructions and reduce the perioperative complication rate. We initiated treatment with cibenzoline and bisoprolol; the doses were titrated according to the response. After 2 weeks, the peak pressure gradient of the two RV chambers decreased from 101 to 68 mmHg, and the LV peak pressure gradient decreased from 109 to 14 mmHg. Class 1A antiarrhythmic drugs and β-blockers decreased the severe pressure gradients of biventricular obstructions caused by DCRV and HOCM. The patient was able to undergo surgery to remove the intradural extramedullary tumour, which was diagnosed as schwannoma.
DOI： 10.1002/ehf2.12650
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A Mechanism for L-Wave Generation via Color M-Mode Imaging in a Patient with Mitral Regurgitation. 査読あり
Misumi I, Motozato K, Usuku H, Sakamoto K, Kaikita K, Tsujita K, Fukui T
CASE (Philadelphia, Pa.) 4 ( 2 ) 86 - 89 2020年4月
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Tabata N., Sueta D., Arima Y., Okamoto K., Shono T., Hanatani S., Takashio S., Oniki K., Saruwatari J., Sakamoto K., Kaikita K., Sinning J.M., Werner N., Nickenig G., Sasaki Y., Fukui T., Tsujita K.
IJC Heart and Vasculature 27 100498 2020年4月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：IJC Heart and Vasculature
Aims: Although the bacterial virulent factor of cytotoxin-associated gene-A (CagA)-seropositivity and the host genetic factors of interleukin (IL)-1 polymorphisms have been suggested to influence Helicobacter pylori (HP) -related diseases, the underlying mechanisms of the association between HP infection and acute coronary syndrome (ACS) remain unknown. Methods and results: Among 341 consecutive ACS patients, the clinical outcomes after ACS included composite cardiovascular events within the 2-year follow-up period. A significantly higher probability of primary outcomes was observed in HP positive patients than in HP negative patients. There were no significant differences in the rate of cardiovascular events between HP positive and HP negative patients in the absence of an IL-polymorphism, while there were significant differences in the presence of an IL-polymorphism. There were significant differences in the rate of cardiovascular events among CagA positive, CagA negative/ HP positive and CagA negative/HP negative patients. Moreover, via immunohistochemical staining, aortic CagA positive cells were confirmed in the vasa vasorum in CagA positive patients, whereas they could not be identified in CagA negative patients. Conclusions: The bacterial virulence factor CagA and host genetic IL-1 polymorphisms influence the incidence of adverse cardiovascular events, possibly through infection of atherosclerotic lesions. Registration: University Hospital Medical Information Network (UMIN)-CTR (http://www.umin.ac.jp/ctr/). Identifier: UMIN000035696.
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Utility of Kumamoto Criteria in Diagnosing Transthyretin Cardiac Amyloidosis in Real-World Practice - Reply. 査読あり
Takashio S, Marume K, Nishi M, Kaikita K, Tsujita K
Circulation journal : official journal of the Japanese Circulation Society 84 ( 4 ) 681 - 682 2020年3月
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Nakanishi N, Kaikita K, Ishii M, Oimatsu Y, Mitsuse T, Ito M, Yamanaga K, Fujisue K, Kanazawa H, Sueta D, Takashio S, Arima Y, Araki S, Nakamura T, Sakamoto K, Suzuki S, Yamamoto E, Soejima H, Tsujita K
Circulation reports 2 ( 3 ) 158 - 166 2020年3月
担当区分：責任著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：一般社団法人 日本循環器学会
<b><i>Background:</i></b>Direct-activated factor X (FXa) plays an important role in thrombosis and is also involved in inflammation via the protease-activated receptor (PAR)-1 and PAR-2 pathway. We hypothesized that rivaroxaban protects against cardiac remodeling after myocardial infarction (MI).<b><i>Methods and Results:</i></b>MI was induced in wild-type mice by permanent ligation of the left anterior descending coronary artery. At day 1 after MI, mice were randomly assigned to the rivaroxaban and vehicle groups. Mice in the rivaroxaban group were provided with a regular chow diet plus rivaroxaban. We evaluated cardiac function by echocardiography, pathology, expression of mRNA and protein at day 7 after MI. Rivaroxaban significantly improved cardiac systolic function, decreased infarct size and cardiac mass compared with the vehicle. Rivaroxaban also downregulated the mRNA expression levels of tumor necrosis factor-α, transforming growth factor-β, PAR-1 and PAR-2 in the infarcted area, and both A-type and B-type natriuretic peptides in the non-infarcted area compared with the vehicle. Furthermore, rivaroxaban attenuated cardiomyocyte hypertrophy and the phosphorylation of extracellular signal-regulated kinase in the non-infarcted area compared with the vehicle.<b><i>Conclusions:</i></b>Rivaroxaban protected against cardiac dysfunction in MI model mice. Reduction of PAR-1, PAR-2 and proinflammatory cytokines in the infarcted area may be involved in its cardioprotective effects.
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Sueta D., Yamamoto E., Sato M., Sato T., Fujisue K., Arima Y., Takashio S., Sakamoto K., Soejima H., Kaikita K., Shigaki N., Takasu Y., Tsujita K.
Circulation journal : official journal of the Japanese Circulation Society 84 ( 3 ) 524 - 528 2020年2月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Circulation journal : official journal of the Japanese Circulation Society
BACKGROUND: Although it has been discussed which measures against atherosclerotic diseases should be started in childhood, the current situation in Japan is unclear.Methods and Results:We conducted a health management survey of all 12-year-old children in a local town for 20 years. The body mass index tended to decrease over time. Although the serum low-density lipoprotein cholesterol level did not change, the levels of serum high-density lipoprotein cholesterol and serum triglycerides significantly increased over time. CONCLUSIONS: The serum triglyceride levels in school children increased significantly, probably through lifestyle changes, and the health management system should be reviewed.
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Ishii M., Kaikita K., Sakamoto K., Seki T., Kawakami K., Nakai M., Sumita Y., Nishimura K., Miyamoto Y., Noguchi T., Yasuda S., Tsutsui H., Komuro I., Saito Y., Ogawa H., Tsujita K.
International Journal of Cardiology 301 108 - 113 2020年2月
担当区分：責任著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：International Journal of Cardiology
Background: Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a common presentation of acute myocardial infarction (AMI) and has a better prognosis. However, there were few reports on large-scale, high aged population. The aim of this study was to determine the differences in the clinical characteristics and short-term prognosis between MINOCA and myocardial infarction with obstructive coronary artery disease (MI-CAD) using a nationwide administrative database in the super-aging society, Japan. Methods: This was an observational study using data of 137,678 AMI patients who underwent angiography between April 2012 through March 2016. Using the international classification of diseases 10th revision, AMI patients were divided into two groups based on the presence or absence of revascularization and coronary atherosclerosis, identifying 123,633 MI-CAD and 14,045 working diagnosis of MINOCA patients. The true MINOCA (n = 13,022) was defined as the MINOCA excluding non-ischemic causes. We assessed in-hospital mortality within 30 days. Results: Both MINOCA groups were typically found in non-obese, non-smoker young females, with a low grade on Killip classification, and non-low ADL status. Compared to MI-CAD, chronic pulmonary diseases, peripheral vascular diseases, liver diseases, renal diseases, and cerebrovascular diseases were more common, whereas diabetes was less common in the MINOCA groups. In-hospital mortality within 30 days was higher in both MINOCA groups than in MI-CAD. Multivariate frailty model identified both MINOCA groups as an independent risk factor for in-hospital mortality. Conclusions: Our large-population study demonstrated that MINOCA was associated with a high risk of in-hospital mortality compared with MI-CAD in the super-aging society.
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Kanemaru Y., Arima Y., Kaikita K., Kiyama T., Kaneko S., Ito M., Yamabe H., Motozato K., Yamanaga K., Fujisue K., Sueta D., Takashio S., Araki S., Usuku H., Nakamura T., Fukunaga T., Suzuki S., Izumiya Y., Sakamoto K., Soejima H., Yamamoto E., Kawano H., Kanazawa H., Tsujita K.
International Journal of Cardiology 300 147 - 153 2020年2月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：International Journal of Cardiology
Background: The impact of intra-atrial conduction delay on the recurrence of atrial tachyarrhythmia after radio frequency catheter ablation (RFCA) has not been fully elucidated. Methods: We retrospectively analyzed 155 AF patients who were sinus rhythm at the start of RFCA. The conduction time from the onset of the earliest atrial electrogram at the high right atrium (HRA) to the end of the latest electrogram at the coronary sinus (CS) during sinus rhythm was defined as HRA-CS conduction time. Pulmonary vein isolation (PVI) was performed followed by linear roof lesion and complex fractionated atrial electrogram (CFAE) ablation until AF termination. We evaluated atrial tachyarrhythmia recurrence 12 months after RFCA. Results: The follow-up data were available for 148 patients. The recurrence of atrial tachyarrhythmia was noted in 28 (18.9%) patients. Atrial tachyarrhythmia recurrence patients had longer HRA-CS conduction times (151.3 ± 22.1 ms vs 160.1 ± 32.6 ms, p =.017). The patients were divided into the long or short HRA-CS conduction time group. The Kaplan–Meier analysis revealed that the long HRA-CS conduction time group held a higher risk of atrial tachyarrhythmia recurrence (log-rank test, p =.019). The multivariable Cox hazard analysis revealed that a long HRA-CS conduction time was a significant risk factor for the recurrence of atrial tachyarrhythmia, despite a long AF duration, persistent AF, and larger left atrial diameter (LAD) were not statistically significant. Conclusions: The HRA-CS conduction time was the primary influencing factor that predicted the recurrence of atrial tachyarrhythmia after catheter ablation.
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Suzuki S., Kaikita K., Yamamoto E., Sueta D., Yamamoto M., Ishii M., Ito M., Fujisue K., Kanazawa H., Araki S., Arima Y., Takashio S., Usuku H., Nakamura T., Sakamoto K., Izumiya Y., Soejima H., Kawano H., Jinnouchi H., Matsui K., Tsujita K.
ESC Heart Failure 7 ( 1 ) 65 - 74 2020年2月
担当区分：責任著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：ESC Heart Failure
Aims: The prediction of future heart failure (HF) in stable outpatients is often difficult for general practitioners and cardiologists. Recently, the H FPEF score (0–9 points) has been proposed for the discrimination of HF with preserved ejection fraction from non-cardiac causes of dyspnoea. The six clinical and echocardiographic variables that constitute the H FPEF score include the following: (i) obesity (H); (ii) the use of ≥2 antihypertensive drugs (H); (iii) atrial fibrillation (F); (iv) pulmonary hypertension (P); (v) an age > 60 years (E); and (vi) E/e' > 9 (F). We performed an external validation study that investigated whether the H FPEF score could predict future HF-related events in stable outpatients with cardiovascular risk factor(s) in Japan. Methods and results: In this prospective cohort study, after exclusion of 195 from 551 consecutive, stable Japanese outpatients with at least one cardiovascular risk factor who were enrolled between September 2010 and July 2013, the remaining 356 outpatients (171 men, 185 women, mean age 73.2 years) were eligible for the analysis. We calculated the H FPEF score (0–9 points), and followed up the patients for an average of 517 days. In all of the 356 patients, the mean H FPEF score was 3.1 ± 1.8, and 15 developed HF-related events during the follow-up period, including cardiovascular death (n = 2) and hospitalization for HF decompensation (n = 13). Multivariate Cox proportional hazards analysis showed that the H FPEF score was an independent predictor of future HF-related events (P < 0.001 for all three models). Kaplan–Meier survival curves showed a significantly higher probability of HF-related events in the outpatients with a high H FPEF score (P < 0.001). In receiver operating characteristic (ROC) curve analysis, the H FPEF score was significantly associated with the occurrence of future HF-related events (P < 0.001). In ROC curve analysis, the sensitivity, specificity, and positive likelihood ratio of a H FPEF score of 7 points to predict HF-related events were 47%, 96%, and 11.4%, respectively. Conclusions: The H FPEF score could provide useful information for future HF-related events in stable outpatients with cardiovascular risk factor(s) in Japan. 2 2 2 2 2 2 2 2 2 2
DOI： 10.1002/ehf2.12570
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Emoto T., Kidoh M., Oda S., Nakaura T., Nagayama Y., Sasao A., Funama Y., Araki S., Takashio S., Sakamoto K., Yamamoto E., Kaikita K., Tsujita K., Yamashita Y.
European Radiology 30 ( 2 ) 691 - 701 2020年2月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：European Radiology
Objectives: To compare the effects of hybrid iterative reconstruction (HIR) and model-based iterative reconstruction (MBIR) that incorporates a beam-hardening model for myocardial extracellular volume (ECV) quantification by cardiac CT using MRI as a reference standard. Methods: In this retrospective study, a total of 34 patients were evaluated using cardiac CT and MRI. Paired CT image sets were created using HIR and MBIR with a beam-hardening model. We calculated mean absolute differences and correlations between the global mid-ventricular ECV derived from CT and MRI via Pearson correlation analysis. In addition, we performed qualitative analysis of image noise and beam-hardening artifacts on postcontrast images using a four-point scale: 1 = extensive, 2 = strong, 3 = mild, and 4 = minimal. Results: The mean absolute difference between the ECV derived from CT and MRI for MBIR was significantly smaller than that for HIR (MBIR 3.74 ± 3.59%; HIR 4.95 ± 3.48%, p = 0.034). MBIR improved the correlation between the ECV derived from CT and MRI when compared with HIR (MBIR, r = 0.60, p < 0.001; HIR, r = 0.47, p = 0.006). In qualitative analysis, MBIR significantly reduced image noise and beam-hardening artifacts when compared with HIR ([image noise, MBIR 3.4 ± 0.7; HIR 2.1 ± 0.8, p < 0.001], [beam-hardening artifacts, MBIR 3.8 ± 0.4; HIR 2.6 ± 1.0, p < 0.001]). Conclusions: MBIR with a beam-hardening model effectively reduced image noise and beam-hardening artifacts and improved myocardial ECV quantification when compared with HIR using MRI as a reference standard. Key Points: • MBIR with a beam-hardening model effectively reduced image noise and beam-hardening artifacts. • The mean absolute difference between the global mid-ventricular ECV derived from CT and MRI for MBIR was significantly smaller than that for conventional HIR. • MBIR provided more accurate myocardial CT number and improved ECV quantification when compared with HIR.