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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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Tanaka Hiroki, Matsuura Yunosuke, Yamamoto Kinuko, Komaki Soichi, Yamaguchi Masashi, Moribayashi Kohei, Ideguchi Takeshi, Nakai Michikazu, Tsuruda Toshihiro, Kaikita Koichi
Circulation Reports 8 ( 3 ) 453 - 460 2026年3月
担当区分：筆頭著者 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> Although angiopoietin-like protein 3 (ANGPTL3) has emerged as a novel therapeutic target for lipid modulation, its prognostic significance in chronic coronary syndrome (CCS) remains unclear. This study aimed to evaluate the clinical determinants and prognostic value of circulating ANGPTL3 levels in patients with CCS.<b><i>Methods and Results:</i></b> We prospectively enrolled 264 consecutive patients with CCS (median age 74 years; 73% male) undergoing cardiac catheterization. Serum ANGPTL3 levels were measured using an enzyme-linked immunosorbent assay. The primary endpoint was major adverse cardiovascular events (MACE). Female sex, elevated C-reactive protein and B-type natriuretic peptide, low high-density lipoprotein cholesterol levels, and absence of statin use were independently associated with higher ANGPTL3 levels. During follow up, 35 patients experienced MACE. In multivariable Cox regression models, ANGPTL3 remained an independent predictor of MACE. Receiver operating characteristic analysis identified 90.7 ng/mL as the optimal cut-off value for event discrimination. Kaplan-Meier curves demonstrated significantly higher event rates among patients with ANGPTL3 >90.7 ng/mL. In patients with CCS with low-density lipoprotein cholesterol (LDL-C) <70 mg/dL, elevated ANGPTL3 levels were also associated with increased MACE risk.<b><i>Conclusions:</i></b> Circulating ANGPTL3 levels independently predict adverse cardiovascular outcomes in CCS, including those in patients who achieve LDL-C targets, and may help identify residual cardiovascular risk not captured by traditional lipid parameters.
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Harada K., Kawagoe K., Matsuura Y., Kawano M., Suiko Y., Tanaka H., Moribayashi K., Ishii H., Ideguchi T., Furukawa K., Kaikita K.
Journal of Cardiology Cases 31 ( 3 ) 76 - 79 2025年3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 Cases
We report a case of Salmonella cardiovascular infection presenting with acute pericarditis as a precursor to the rapid progression of aortic aneurysm. An 81-year-old man presented with persistent fever and chest pain worsened with inspiration and was admitted to a nearby hospital with a diagnosis of bacterial pericarditis. However, hoarseness emerged two days later, and the patient was transferred to our hospital because of concerns about extracardiac inflammatory foci. Computed tomography (CT) revealed a periaortic exudate and aortic arch aneurysm. After transfer, blood cultures confirmed Salmonella infection. Ampicillin (ABPC) was initiated for long-term treatment of Salmonella infection, and pericarditis was treated with ibuprofen and colchicine for approximately one month. The associated symptoms and inflammatory blood data significantly improved, but five weeks later, follow-up CT revealed enlargement of the arch aneurysm. Due to the patient's age and nutritional status, thoracic endovascular aortic repair (TEVAR) was performed along with continued ABPC. Postoperatively, the infection was well-controlled, and follow-up CT revealed a size reduction in the treated aneurysm. No recurrent Salmonella-related vascular events were observed for two years after TEVAR. Learning objective: Acute pericarditis can present as a precursor to life-threatening vascular lesions associated with Salmonella infection and requires timely and appropriate diagnosis of the etiology behind the manifestation. Patients with aortic aneurysms caused by Salmonella often do not tolerate invasive surgical treatment when diagnosed, and the lesions progress rapidly. Therefore, endovascular treatment combined with long-term antibiotic therapy may be a practical option.
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Komaki S., Moribayashi K., Matsuura Y., Tanaka H., Kaikita K.
Cardiovascular Intervention and Therapeutics 39 ( 4 ) 493 - 494 2024年10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：Cardiovascular Intervention and Therapeutics
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Tsuruda T., Nakada H., Yamamura Y., Matsuura Y., Ogata M., Tanaka M., Suiko Y., Komaki S., Tanaka H., Moribayashi K., Ideguchi T., Terada T., Ota T., Yamamoto K., Nishihira K., Shibata Y., Kaikita K.
European Heart Journal Open 4 ( 5 ) oeae076 2024年9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 Heart Journal Open
Aims. While the prevalence of transthyretin-derived amyloid cardiomyopathy (ATTR-CM) is on the rise, detailed understanding of its morphological and functional characteristics within the left ventricle (LV) across heart failure (HF) remains limited. Methods and results. Utilizing two-dimensional (2D) speckle-tracking echocardiography, we assessed longitudinal strain (LS) in 63 histology-confirmed ATTR-CM patients. Additionally, cardiac magnetic resonance (CMR) images measured native T1 and extracellular volume (ECV), compared with LS across 18 LV segments. Patients were categorized into three groups based on HF status: Group 1 (no HF symptoms), Group 2 (HF with preserved LV ejection fraction), and Group 3 (HF with reduced LV ejection fraction). LS analysis unveiled susceptibility to deformation in the basal inferoseptal segment, persisting even in asymptomatic cases. CMR demonstrated increasing native T1 deviation, particularly evident in segments distant from the inferoseptal region. Contrastingly, maximal ECV was consistently observed in the basal and mid-ventricular inferior-septum, even in asymptomatic individuals. Segmental LS decline correlated with ECV expansion but not with native T1 values. Conclusion. Our findings suggest that the inferoseptal segment is highly susceptible to amyloid infiltration, and 2D speckle-tracking echocardiography and CMR may serve as a valuable tool for its early detection.
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Shimazu H., Matsuura Y., Moribayashi K., Gi T., Suiko Y., Tanaka H., Komaki S., Ishikawa T., Yamashita A., Kaikita K.
JACC: Case Reports 24 102017 2023年10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：JACC: Case Reports
Immune thrombocytopenia (ITP) carries bleeding and thrombotic risks; however, thromboses associated with ITP have not been histologically examined. This report presents optical coherence tomography images of the culprit lesion and histology of coronary aspirates in very late stent thrombosis complicating severe ITP, providing evidence of platelet-rich thrombus formation. (Level of Difficulty: Advanced.)