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医学部 医学科 内科学講座循環器・腎臓内科学分野 |
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助教 |
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鶴田 敏博, 大田 智美, 寺田 珠沙, 中田 博, 尾方 美幸, 水光 洋輔, 松浦 祐之介, 小牧 聡一, 森林 耕平, 山下 篤, 海北 幸一
ESC heart failure 13 ( 2 ) xvag055 2026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：Oxford University Press
Wild-type transthyretin cardiac amyloidosis (ATTRwt-CA) is now increasingly identified as a cause of heart failure in older adults. This study aimed to clarify the morphological and functional alterations of the left ventricle (LV) that define the early stage of this condition./We prospectively evaluated 81 patients diagnosed with wild-type ATTR (ATTRwt) amyloidosis (mean age 77 ± 6 years; 88% male), categorized into three groups based on myocardial uptake on radioactive pyrophosphate scintigraphy and histological confirmation: (i) carpal ATTR without cardiac involvement (Group 1, n = 13), (ii) asymptomatic cardiac involvement (Group 2, n = 10) and (iii) overt heart failure (Group 3, n = 58). Results Compared with Group 3, Group 1 showed higher absolute global longitudinal strain (GLS) (median 19.0 [13.2-23.8]%, P < 0.001), a lower apical-sparing ratio (median 0.66 [0.55-1.04], P < 0.001) and lower brain natriuretic peptide (BNP) (median 13.5 [6-49] pg/mL, P < 0.001) and troponin-T concentrations (0.012 [0.006-0.022] ng/mL, P < 0.001), while the estimated glomerular filtration rate remained preserved (64 ± 9 mL/mL/1.73 m², P = 0.022). Segmental longitudinal strain (LS) differentiated Group 1 from Group 2, with basal inferoseptal LS significantly lower in patients with elevated troponin-T (> 0.014 ng/mL) than in those with lower values (13.9 ± 5.6 % vs. 7.4 ± 1.8 %, P = 0.046) in Group 1. A basal inferoseptal LS cutoff of 9.1% identified high troponin-T with an area under the curve (AUC) of 0.833 (P = 0.005), outperforming GLS (AUC 0.306, P = 0.217), BNP (AUC 0.667, P = 0.292) and LV ejection fraction (AUC 0.556, P = 0.743)./Basal inferoseptal LS impairment may indicate early cardiac involvement in individuals with carpal tunnel syndrome carrying ATTRwt deposits.
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Basal inferoseptal longitudinal strain deformation may indicate early cardiac involvement in wild-type carpal ATTR. 査読あり 国際誌
Tsuruda T, Ota T, Terada T, Nakada H, Ogata M, Tanaka M, Suiko Y, Matsuura Y, Komaki S, Moribayashi K, Yamada R, Yamashita A, Yamamoto K, Nishihira K, Shibata Y, Kaikita K
ESC heart failure 13 ( 2 ) 2026年2月
記述言語：英語 掲載種別：研究論文（学術雑誌）
AIMS: Wild-type transthyretin cardiac amyloidosis (ATTRwt-CA) is now increasingly identified as a cause of heart failure in older adults. This study aimed to clarify the morphological and functional alterations of the left ventricle (LV) that define the early stage of this condition. METHODS: We prospectively evaluated 81 patients diagnosed with wild-type ATTR (ATTRwt) amyloidosis (mean age 77 ± 6 years; 88% male), categorized into three groups based on myocardial uptake on radioactive pyrophosphate scintigraphy and histological confirmation: (i) carpal ATTR without cardiac involvement (Group 1, n = 13), (ii) asymptomatic cardiac involvement (Group 2, n = 10) and (iii) overt heart failure (Group 3, n = 58). Results Compared with Group 3, Group 1 showed higher absolute global longitudinal strain (GLS) (median 19.0 [13.2-23.8]%, P < 0.001), a lower apical-sparing ratio (median 0.66 [0.55-1.04], P < 0.001) and lower brain natriuretic peptide (BNP) (median 13.5 [6-49] pg/mL, P < 0.001) and troponin-T concentrations (0.012 [0.006-0.022] ng/mL, P < 0.001), while the estimated glomerular filtration rate remained preserved (64 ± 9 mL/mL/1.73 m², P = 0.022). Segmental longitudinal strain (LS) differentiated Group 1 from Group 2, with basal inferoseptal LS significantly lower in patients with elevated troponin-T (> 0.014 ng/mL) than in those with lower values (13.9 ± 5.6 % vs. 7.4 ± 1.8 %, P = 0.046) in Group 1. A basal inferoseptal LS cutoff of 9.1% identified high troponin-T with an area under the curve (AUC) of 0.833 (P = 0.005), outperforming GLS (AUC 0.306, P = 0.217), BNP (AUC 0.667, P = 0.292) and LV ejection fraction (AUC 0.556, P = 0.743). CONCLUSIONS: Basal inferoseptal LS impairment may indicate early cardiac involvement in individuals with carpal tunnel syndrome carrying ATTRwt deposits.
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小牧 聡一, 中井 陸運, 松浦 祐之介, 田中 浩喜, 山口 昌志, 森林 耕平, 井手口 武史, 河上 洋, 鶴田 敏博, 海北 幸一
Diabetic medicine : a journal of the British Diabetic Association e70250 2026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：Wiley
Aims
To evaluate the impact of diabetes on in-hospital outcomes among patients with metabolic dysfunction-associated steatotic liver disease (MASLD) who were hospitalized for cardiovascular disease (CVD).
Methods
We conducted a retrospective cross-sectional study using data from the nationwide Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure Combination, from April 2012 to March 2023. A total of 10,614 patients with MASLD hospitalized for CVD were identified, of whom 4550 (42.9%) had diabetes. The primary outcome was in-hospital mortality, and secondary outcomes were major cardiac and non-cardiac complications.
Results
The median age was 66 years, and 66.9% were male. Compared with patients without diabetes, those with diabetes had higher rates of ischaemic heart disease (35.5% vs. 30.8%), acute coronary syndrome (18.8% vs. 16.9%) and heart failure (27.3% vs. 25.4%) (all p < 0.05). In-hospital mortality (5.6% vs. 3.3%; p < 0.001) and overall complication rates (23.6% vs. 19.7%; p < 0.001) were significantly greater in the diabetes group, driven mainly by cardiac events (16.8% vs. 10.5%; p < 0.001). Multivariable logistic regression confirmed diabetes as an independent predictor of in-hospital mortality (odds ratio, 1.99; 95% confidence interval, 1.60–2.47; p < 0.001).
Conclusions
Diabetes was associated with higher in-hospital mortality and complication rates among patients with MASLD hospitalized for CVD. Stratification of MASLD by metabolic phenotype, particularly in the presence of diabetes, may help improve risk assessment and inform more personalized clinical management in this population. -
Association between diabetes and in-hospital outcomes in patients with metabolic dysfunction-associated steatotic liver disease hospitalized for cardiovascular disease: A nationwide database study. 査読あり 国際誌
Komaki S, Nakai M, Matsuura Y, Yamamoto K, Tanaka H, Komaki Y, Yamaguchi M, Moribayashi K, Ideguchi T, Kawakami H, Tsuruda T, Kaikita K
Diabetic medicine : a journal of the British Diabetic Association 43 ( 5 ) e70250 2026年2月
記述言語：英語 掲載種別：研究論文（学術雑誌）
AIMS: To evaluate the impact of diabetes on in-hospital outcomes among patients with metabolic dysfunction-associated steatotic liver disease (MASLD) who were hospitalized for cardiovascular disease (CVD). METHODS: We conducted a retrospective cross-sectional study using data from the nationwide Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure Combination, from April 2012 to March 2023. A total of 10,614 patients with MASLD hospitalized for CVD were identified, of whom 4550 (42.9%) had diabetes. The primary outcome was in-hospital mortality, and secondary outcomes were major cardiac and non-cardiac complications. RESULTS: The median age was 66 years, and 66.9% were male. Compared with patients without diabetes, those with diabetes had higher rates of ischaemic heart disease (35.5% vs. 30.8%), acute coronary syndrome (18.8% vs. 16.9%) and heart failure (27.3% vs. 25.4%) (all p < 0.05). In-hospital mortality (5.6% vs. 3.3%; p < 0.001) and overall complication rates (23.6% vs. 19.7%; p < 0.001) were significantly greater in the diabetes group, driven mainly by cardiac events (16.8% vs. 10.5%; p < 0.001). Multivariable logistic regression confirmed diabetes as an independent predictor of in-hospital mortality (odds ratio, 1.99; 95% confidence interval, 1.60-2.47; p < 0.001). CONCLUSIONS: Diabetes was associated with higher in-hospital mortality and complication rates among patients with MASLD hospitalized for CVD. Stratification of MASLD by metabolic phenotype, particularly in the presence of diabetes, may help improve risk assessment and inform more personalized clinical management in this population.
DOI： 10.1111/dme.70250
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Tsuruda T, Kodama N, Tanahashi T, Suiko Y, Yamamoto K, Komaki S, Moribayashi K, Terakawa C, Iwai M, Sakai K, Shiomi K, Terada T, Nakada H, Ogata M, Tanaka M, Yamashita A, Iida H, Matsuura Y, Kaikita K
Internal medicine (Tokyo, Japan) 2026年
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Japanese Society of Internal Medicine