研究者情報

マスター

アカウント（マスター）

• 氏名

  加賀　早苗(カガ　サナエ), カガ　サナエ

所属（マスター）

• 保健科学研究院　保健科学部門　病態解析学分野

所属（マスター）

• 保健科学研究院　保健科学部門　病態解析学分野

独自項目

syllabus

• 2021, 循環機能検査学演習, Seminar on Comprehensive Assessment of Cardiovascular Function, 修士課程, 保健科学院, 超音波検査、超音波装置、循環機能計測
• 2021, 循環機能検査学特論, Comprehensive Assessment of Cardiovascular Function, 修士課程, 保健科学院, 循環器疾患、血行動態、左室機能、心不全
• 2021, 医用画像科学特講, Advanced Study of Medical Imaging Science, 博士後期課程, 保健科学院, 画像診断　単純写真　超音波　CT　MRI
• 2021, 医用画像科学特講演習, Advanced Seminar on Medical Imaging Science, 博士後期課程, 保健科学院, 画像診断　単純写真　超音波　CT　MRI
• 2021, 臨床生理学Ⅰ, Clinical Physiology Ⅰ, 学士課程, 医学部, 呼吸機能、換気機能検査、肺胞機能検査、肺胞気-動脈酸素分圧較差、換気血流不均等、心雑音、心音図検査、末梢動脈検査
• 2021, 臨床生理画像学実習Ⅰ, Practice in Clinical Physiology and Imaging Ⅰ, 学士課程, 医学部, 超音波検査、脈波検査、眼底検査、心音図検査
• 2021, 生体機能学, Medical Physiology, 学士課程, 医学部, 生理学、病態生理学、心不全、不整脈、呼吸機能、酸塩基平衡、生理機能検査学
• 2021, 一般教育演習(ﾌﾚｯｼｭﾏﾝｾﾐﾅｰ), Freshman Seminar, 学士課程, 全学教育, 健康、医学、検査、画像診断、がん、血球形態検査、臨床化学、寄生虫、細菌、細胞検査、免疫検査、食品、細菌・共生と感染、心疾患、低比重リポタンパク質、硬さ, 脂質化学
• 2021, 臨床生理画像学実習Ⅱ, Practice in Clinical Physiology and Imaging Ⅱ, 学士課程, 医学部, 呼吸機能検査、心電図検査、脳波検査、超音波検査
• 2021, 臨床生理学Ⅲ, Clinical Physiology Ⅲ, 学士課程, 医学部, 脳神経系、運動系、感覚系、脳波検査、誘発脳波検査、筋電図検査、誘発筋電図検査、神経伝導検査、感覚機能検査、眼底検査、熱画像検査（サーモグラフィ）
• 2021, 生体機能学実習, Practice in Medical Physiology, 学士課程, 医学部, 患者接遇、患者移動法、救急蘇生法、脳波検査、十二誘導心電図検査、モニター心電図検査、呼吸機能検査、平衡機能検査、感覚機能検査
• 2021, 画像検査学Ⅱ, Medical Imaging Ⅱ, 学士課程, 医学部, 超音波検査、心臓、消化器、泌尿器、体表臓器、血管
• 2021, 臨床生理学Ⅱ, Clinical Physiology Ⅱ, 学士課程, 医学部, 心臓電気生理、12誘導心電図、心電図波形異常、不整脈、ホルター心電図検査、運動負荷心電図検査
• 2021, 画像検査学Ⅰ, Medical Imaging Ⅰ, 学士課程, 医学部, 超音波検査、消化器領域、乳腺･甲状腺領域、循環器領域、産婦人科領域、MRI
• 2021, 臨床病態学Ⅰ, Clinical Pathophysiology Ⅰ, 学士課程, 医学部, 感染症、心臓系、血管系、肝臓系疾患の病態(病因、症候、検査、治療などを含む)

researchmap

プロフィール情報

学位

• 博士（医学）（北海道大学）

プロフィール情報

• 姓

  加賀, カガ

• 名

  早苗, サナエ

• ID各種

  201201060340475336

対象リソース

http://cvecho.hs.hokudai.ac.jp/lab3/

業績リスト

研究キーワード

• 心エコー   超音波検査   

研究分野

• その他 / その他 / 病態検査学

受賞

• 2015年03月 日本心エコー図学会 海外学会発表優秀論文賞
   Practical Role of Continuous-Wave Doppler Measurements of Diastolic Velocities of Pulmonary Regurgitation for the Assessment of Pulmonary Hypertension. 

  受賞者: 加賀 早苗
• 2010年05月 日本心エコー図学会 2009 Best Manuscript Award, J Echocardiogr.
   Right ventricular diastolic dysfunction in patients with left ventricular hypertrophy: analysis of right ventricular myocardial relaxation using two-dimensional speckle tracking imaging 

  受賞者: 加賀 早苗
• 2008年04月 日本心エコー図学会 第19回日本心エコー図学会学術集会Sonographer's Session最優秀賞
   左室肥大における右室機能障害の機序: 2Dスぺックルトラッキング法による検討. 

  受賞者: 加賀 早苗

論文

• Head-to-Head Comparison of Hepatic Vein and Superior Vena Cava Flow Velocity Waveform Analyses for Predicting Elevated Right Atrial Pressure.

  Michito Murayama, Sanae Kaga, Airi Onoda, Hisao Nishino, Shinobu Yokoyama, Mana Goto, Yukino Suzuki, Yusuke Yanagi, Yui Shimono, Kosuke Nakamura, Hiroyuki Aoyagi, Yoji Tamaki, Suguru Ishizaka, Hiroyuki Iwano, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai

  Ultrasound in medicine & biology 2024年06月03日 

  OBJECTIVE: Blood flow in the hepatic veins and superior vena cava (SVC) reflects right heart filling; however, their Doppler profiles are often not identical, and no studies have compared their diagnostic efficacies. We aimed to determine which venous Doppler profile is reliable for detecting elevated right atrial pressure (RAP). METHODS: In 193 patients with cardiovascular diseases who underwent cardiac catheterization within 2 d of echocardiography, the hepatic vein systolic filling fraction (HV-SFF) and the ratio of the peak systolic to diastolic forward velocities of the SVC (SVC-S/D) were measured. HV-SFF < 55% and SVC-S/D < 1.9 were regarded as elevated RAP. We also calculated the fibrosis 4 index (FIB-4) as a serum liver fibrosis marker. RESULTS: HV-SFF and SVC-S/D were feasible in 177 (92%) and 173 (90%) patients, respectively. In the 161 patients in whom both venous Doppler waveforms could be measured, HV-SFF and SVC-S/D were inversely correlated with RAP (r = -0.350, p < 0.001; r = -0.430, p < 0.001, respectively). SVC-S/D > 1.9 showed a significantly higher diagnostic accuracy of RAP elevation compared with HV-SFF < 55% (area under the curve, 0.842 vs. 0.614, p < 0.001). Multivariate analyses showed that both FIB-4 (β = -0.211, p = 0.013) and mean RAP (β = -0.319, p < 0.001) were independent determinants of HV-SFF. In contrast, not FIB-4 but mean RAP (β = -0.471, p < 0.001) was an independent determinant of SVC-S/D. The diagnostic accuracy remained unchanged when HV-SFF < 55% was considered in conjunction with the estimated RAP based on the inferior vena cava morphology. Conversely, SVC-S/D showed an incremental diagnostic value over the estimated RAP. CONCLUSIONS: SVC-S/D enabled a more accurate diagnosis of RAP elevation than HV-SFF.
• 肺動脈弁逆流速度計測に基づく右室一回仕事係数の非侵襲的推定法

  立石 優太, 村山 迪史, 加賀 早苗, 塚本 真帆, 後藤 真奈, 鈴木 ゆき乃, 柳 裕介, 横山 しのぶ, 西野 久雄, 石坂 傑, 岩野 弘幸, 安斉 俊久

  超音波検査技術 49 3 271 - 271 (一社)日本超音波検査学会 2024年06月
• Appropriate Body Position and Site for Diaphragm Ultrasound: Comparison with Inspiratory Mouth Pressure

  Kazunori Okada, Akiko Kamiya, Yusuke Yanagi, Masahiro Nakabachi, Yasuhiro Hayashi, Michito Murayama, Sanae Kaga

  WFUMB Ultrasound Open 100052 - 100052 2024年06月
• Deep learning to assess right ventricular ejection fraction from two-dimensional echocardiograms in precapillary pulmonary hypertension.

  Michito Murayama, Hiroyuki Sugimori, Takaaki Yoshimura, Sanae Kaga, Hideki Shima, Satonori Tsuneta, Aoi Mukai, Yui Nagai, Shinobu Yokoyama, Hisao Nishino, Junichi Nakamura, Takahiro Sato, Ichizo Tsujino

  Echocardiography (Mount Kisco, N.Y.) 41 4 e15812  2024年04月 

  BACKGROUND: Precapillary pulmonary hypertension (PH) is characterized by a sustained increase in right ventricular (RV) afterload, impairing systolic function. Two-dimensional (2D) echocardiography is the most performed cardiac imaging tool to assess RV systolic function; however, an accurate evaluation requires expertise. We aimed to develop a fully automated deep learning (DL)-based tool to estimate the RV ejection fraction (RVEF) from 2D echocardiographic videos of apical four-chamber views in patients with precapillary PH. METHODS: We identified 85 patients with suspected precapillary PH who underwent cardiac magnetic resonance imaging (MRI) and echocardiography. The data was divided into training (80%) and testing (20%) datasets, and a regression model was constructed using 3D-ResNet50. Accuracy was assessed using five-fold cross validation. RESULTS: The DL model predicted the cardiac MRI-derived RVEF with a mean absolute error of 7.67%. The DL model identified severe RV systolic dysfunction (defined as cardiac MRI-derived RVEF < 37%) with an area under the curve (AUC) of .84, which was comparable to the AUC of RV fractional area change (FAC) and tricuspid annular plane systolic excursion (TAPSE) measured by experienced sonographers (.87 and .72, respectively). To detect mild RV systolic dysfunction (defined as RVEF ≤ 45%), the AUC from the DL-predicted RVEF also demonstrated a high discriminatory power of .87, comparable to that of FAC (.90), and significantly higher than that of TAPSE (.67). CONCLUSION: The fully automated DL-based tool using 2D echocardiography could accurately estimate RVEF and exhibited a diagnostic performance for RV systolic dysfunction comparable to that of human readers.
• Non-invasive assessment of left ventricular filling pressure in aortic stenosis.

  Hiroyuki Aoyagi, Hiroyuki Iwano, Yoji Tamaki, Michito Murayama, Suguru Ishizaka, Ko Motoi, Kosuke Nakamura, Mana Goto, Yukino Suzuki, Shinobu Yokoyama, Hisao Nishino, Sanae Kaga, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai

  Echocardiography (Mount Kisco, N.Y.) 41 4 e15808  2024年04月 

  BACKGROUND: The assessment of left ventricular (LV) filling pressure (FP) is important for the management of aortic stenosis (AS) patients. Although, it is often restricted for predict LV FP in AS because of mitral annular calcification and a certain left ventricular hypertrophy. Thus, we tested the predictive ability of the algorithm for elevated LV FP in AS patients and also applied a recently-proposed echocardiographic scoring system of LV FP, visually assessed time difference between the mitral valve and tricuspid valve opening (VMT) score. METHODS: We enrolled consecutive 116 patients with at least moderate AS in sinus rhythm who underwent right heart catheterization and echocardiography within 7 days. Mean pulmonary artery wedge pressure (PAWP) was measured as invasive parameter of LV FP. LV diastolic dysfunction (DD) was graded according to the ASE/EACVI guidelines. The VMT score was defined as follows: time sequence of opening of mitral and tricuspid valves was scored to 0-2 (0: tricuspid valve first, 1: simultaneous, 2: mitral valve first). When the inferior vena cava was dilated, one point was added and VMT score was finally calculated as 0-3. RESULTS: Of the 116 patients, 29 patients showed elevated PAWP. Ninety patients (93%) and 67 patients (63%) showed increased values for left atrium volume index (LAVI) and E/e', respectively when the cut-off values recommended by the guidelines were applied and thus the algorism predicted elevated PAWP with a low specificity and positive predictive value (PPV). VMT ≥ 2 predicted elevated PAWP with a sensitivity of 59%, specificity of 90%, PPV of 59%, and negative predictive value of 89%. An alternative algorithm that applied tricuspid regurgitation velocity and VMT scores was tested, and its predictive ability was markedly improved. CONCLUSION: VMT score was applicable for AS patients. Alternative use of VMT score improved diagnostic accuracy of guideline-recommended algorism.
• Echocardiographic estimation of right ventricular diastolic stiffness based on pulmonary regurgitant velocity waveform analysis in precapillary pulmonary hypertension.

  Yui Nagai, Michito Murayama, Sanae Kaga, Hideki Shima, Satonori Tsuneta, Shinobu Yokoyama, Hisao Nishino, Mana Goto, Yukino Suzuki, Yusuke Yanagi, Suguru Ishizaka, Hiroyuki Iwano, Junichi Nakamura, Takahiro Sato, Ichizo Tsujino

  The international journal of cardiovascular imaging 2024年03月27日 

  Right ventricular (RV) diastolic stiffness is an independent predictor of survival and is strongly associated with disease severity in patients with precapillary pulmonary hypertension (PH). Therefore, a fully validated echocardiographic method for assessing RV diastolic stiffness needs to be established. This study aimed to compare echocardiography-derived RV diastolic stiffness and invasively measured pressure-volume loop-derived RV diastolic stiffness in patients with precapillary PH. We studied 50 consecutive patients with suspected or confirmed precapillary PH who underwent cardiac catheterization, magnetic resonance imaging, and echocardiography within a 1-week interval. Single-beat RV pressure-volume analysis was performed to determine the gold standard for RV diastolic stiffness. Elevated RV end-diastolic pressure (RVEDP) was defined as RVEDP ≥ 8 mmHg. Using continuous-wave Doppler and M-mode echocardiography, an echocardiographic index of RV diastolic stiffness was calculated as the ratio of the atrial-systolic descent of the pulmonary artery-RV pressure gradient derived from pulmonary regurgitant velocity (PRPGDAC) to the tricuspid annular plane movement during atrial contraction (TAPMAC). PRPGDAC/TAPMAC showed significant correlation with β (r = 0.54, p < 0.001) and RVEDP (r = 0.61, p < 0.001). A cut-off value of 0.74 mmHg/mm for PRPGDAC/TAPMAC showed 83% sensitivity and 93% specificity for identifying elevated RVEDP. Multivariate analyses indicated that PRPGDAC/TAPMAC was independently associated with disease severity in patients with precapillary PH, including substantial PH symptoms, stroke volume index, right atrial size, and pressure. PRPGDAC/TAPMAC, based on pulmonary regurgitation velocity waveform analysis, is useful for the noninvasive assessment of RV diastolic stiffness and is associated with prognostic risk factors in precapillary PH.
• Correction: Venous dilation effect of hot towel (moist and dry heat) versus hot pack for peripheral intravenous catheterization: a quasi-experimental study.

  Kae Yasuda, Inaho Shishido, Michito Murayama, Sanae Kaga, Rika Yano

  Journal of physiological anthropology 43 1 9 - 9 2024年02月13日
• Venous dilation effect of hot towel (moist and dry heat) versus hot pack for peripheral intravenous catheterization: a quasi-experimental study.

  Kae Yasuda, Inaho Shishido, Michito Murayama, Sanae Kaga, Rika Yano

  Journal of physiological anthropology 42 1 23 - 23 2023年10月19日 

  BACKGROUND: Heat application before peripheral intravenous catheterization is recommended for venous dilation. Hot pack application enlarges the venous diameter in healthy adults; however, hot towels (moist and dry heat) are used often in some medical cases. However, it is unclear whether hot towel application promotes venous dilation better than hot pack application. This study compared the venous dilation effect of using a hot towel (moist and dry heat) to a hot pack before applying the tourniquet at an access site for peripheral intravenous catheterization. METHODS: Eighty-eight healthy females aged 18-29 years were recruited for this quasi-experimental study. They underwent three types of heat applications (hot pack, moist hot towel, and dry hot towel [moist hot towel wrapped in a dry plastic bag], all of which were warmed to 40 ± 2 °C and performed for 7 min) to their forearm and tourniquet application for 30 s after each heating. Venous diameter and depth were measured using ultrasonography, and venous palpability and visibility (venous assessment score) was observed as venous dilatation effects. In addition, the skin temperature, stratum corneum hydration, and subjective evaluation of the warmth were measured. RESULTS: There were no significant differences in venous diameter and assessment scores after intervention between the dry hot towel and the hot pack groups, and the effect size was negligible (Cohen's d < 0.20). However, these measurements were significantly lower for the moist hot towel than for the other two heat applications (P < .001). Although there was no significant difference in skin temperature and warmth rating score between the dry hot towel and the hot pack, these were significantly lower for the moist hot towel than for the other two heat applications (P < .001). The amount of change in stratum corneum hydration of the dry hot towel was not significantly different from that of the hot pack; however, that of the moist hot towel was significantly larger than that of the other two heat applications (P < . 001.) CONCLUSIONS: A method in which a towel warmed in hot water is wrapped in a dry barrier may be an alternative to a hot pack. TRIAL REGISTRATION: This study was registered with University Hospital Medical Information Network in Japan (Registration No.: UMIN000048308. Registered on July 7, 2022).
• Paradoxical increase in global longitudinal strain by handgrip exercise despite left ventricular diastolic dysfunction.

  Ko Motoi, Hiroyuki Iwano, Suguru Ishizaka, Kosuke Nakamura, Yoji Tamaki, Hiroyuki Aoyagi, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Michito Murayama, Sanae Kaga, Toshihisa Anzai

  Echocardiography (Mount Kisco, N.Y.) 40 8 810 - 821 2023年07月14日 

  BACKGROUND: Although global longitudinal strain (GLS) is recognized as a sensitive marker of intrinsic left ventricular (LV) dysfunction, its afterload dependency has also been pointed. We hypothesized that decrease in GLS during handgrip exercise could be more sensitive marker of intrinsic myocardial dysfunction. METHODS: Handgrip exercise-stress echocardiography was performed in 90 cardiovascular disease patients with preserved LV ejection fraction. LV diastolic function was graded according to the guidelines. Diastolic wall stress (DWS) and ratio of left atrial (LA) volume index to late-diastolic mitral annular velocity (LAVI/a') were measured at rest as LV stiffness. As well, LA strains were measured to assess LA function. GLS was expressed as absolute value and significant changes in GLS by handgrip exercise was defined as changes over prespecified mean absolute test-retest variability (2.65%). RESULTS: While mean value of GLS did not change by the exercise, substantial patients showed significant changes in GLS: decreased (group I, n = 28), unchanged (group II, n = 34), and increased (group III, n = 28). Unexpectedly, patients in group I did not show any clinical and echocardiographic characteristics, while those in group III were characterized by elevated natriuretic peptide levels, blunted heart rate response to handgrip exercise, and advanced LV diastolic dysfunction. Multivariable analyses revealed that DWS, left atrial booster strain, and grade II or more diastolic dysfunction determined the increase in GLS even after adjustment for elevated natriuretic peptides and the changes in heart rate by the exercise. CONCLUSION: In contrast to our hypothesis, paradoxical increase in GLS by handgrip exercise could be associated with advanced LV diastolic dysfunction in cardiovascular patients with preserved LV ejection fraction. Our findings suggest that HG exercise for heart failure patients does not enhance the afterload straightforward, resulting in variable changes of GLS according to the individual conditions.
• Application of an echocardiographic scoring system of left ventricular filling pressure to diagnose acute heart failure in patients complaining dyspnea.

  Yoji Tamaki, Hiroyuki Iwano, Michito Murayama, Suguru Ishizaka, Ko Motoi, Hiroyuki Aoyagi, Kosuke Nakamura, Mana Goto, Yukino Suzuki, Shinobu Yokoyama, Hisao Nishino, Masahiro Nakabachi, Sanae Kaga, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai

  Journal of cardiology 82 1 62 - 68 2023年04月27日 

  BACKGROUND: Dyspnea is a common symptom in acute heart failure (AHF) patients. Although an accurate and rapid diagnosis of AHF is essential to improve prognosis, estimation of left ventricular (LV) filling pressure (FP) remains challenging, especially for noncardiologists. We evaluated the usefulness of a recently-proposed parameter of LV FP, visually assessed time difference between the mitral valve and tricuspid valve opening (VMT) score, to detect AHF in patients complaining of dyspnea. METHODS: Echocardiography and lung ultrasonography (LUS) were performed in 121 consecutive patients (68 ± 14 years old, 75 males) presenting with dyspnea. The VMT score was determined from the atrioventricular valve opening phase (tricuspid valve first: 0, simultaneous: 1, mitral valve first: 2) and inferior vena cava dilatation (absent: 0, present: 1), and VMT ≥2 was judged as positive. LUS was performed with the 8 zones method and judged as positive if 3 or more B-lines were observed in bilateral regions. The AHF diagnosis was performed by certified cardiologists according to recent guidelines. RESULTS: Of the 121 patients, 33 were diagnosed with AHF. The sensitivity and specificity for diagnosing AHF were 64 % and 84 % for LUS and 94 % and 88 % for VMT score. In logistic regression analysis, VMT score showed a significantly higher c-index than LUS (0.91 vs 0.74, p = 0.002). In multivariable analyses, VMT score was associated with AHF independently of clinically relevant covariates and LUS. In addition, serial assessment of VMT score followed by LUS provided a diagnostic flow chart to diagnose AHF (VMT 3: AHF definitive, VMT 2 and LUS positive: AHF highly suspicious; VMT 2 and LUS negative: further investigation is needed; VMT ≤ 1: AHF rejected). CONCLUSIONS: VMT score showed high diagnostic accuracy in diagnosing AHF. Combined assessment of the VMT score and LUS could become a reliable strategy for diagnosis of AHF by non-cardiologists.
• 静脈血流速度波形分析に基づく右房圧推定に肝静脈と上大静脈のどちらが優れるか

  村山 迪史, 加賀 早苗, 境田 ひな, 小野田 愛梨, 中鉢 雅大, 西野 久雄, 横山 しのぶ, 石坂 傑, 岩野 弘幸, 安斉 俊久

  超音波医学 50 Suppl. S740 - S740 (公社)日本超音波医学会 2023年04月
• 静脈血流速度波形分析に基づく右房圧推定に肝静脈と上大静脈のどちらが優れるか

  村山 迪史, 加賀 早苗, 境田 ひな, 小野田 愛梨, 中鉢 雅大, 西野 久雄, 横山 しのぶ, 石坂 傑, 岩野 弘幸, 安斉 俊久

  超音波医学 50 Suppl. S740 - S740 (公社)日本超音波医学会 2023年04月
• Impact of right ventricular stiffness on discordance between hemodynamic parameter and regurgitant volume in patients with pulmonary regurgitation.

  Ko Motoi, Hiroyuki Iwano, Satonori Tsuneta, Suguru Ishizaka, Yoji Tamaki, Hiroyuki Aoyagi, Kosuke Nakamura, Michito Murayama, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Sanae Kaga, Atsuhito Takeda, Toshihisa Anzai

  The international journal of cardiovascular imaging 39 6 1133 - 1142 2023年03月17日 

  BACKGROUND: Accurate detection of significant pulmonary regurgitation (PR) is critical in management of patients after right ventricular (RV) outflow reconstruction in Tetralogy of Fallot (TOF) patients, because of its influence on adverse outcomes. Although pressure half time (PHT) of PR velocity is one of the widely used echocardiographic markers of the severity, shortened PHT is suggested to be seen in conditions with increased RV stiffness with mild PR. However, little has been reported about the exact characteristics of patients showing discrepancy between PHT and PR volume in this population. METHODS: Echocardiography and cardiac magnetic resonance imaging (MRI) were performed in 74 TOF patients after right ventricular outflow tract (RVOT) reconstruction [32 ± 10 years old]. PHT was measured from the continuous Doppler PR flow velocity profile and PHT < 100 ms was used as a sign of significant PR. Presence of end-diastolic RVOT forward flow was defined as RV restrictive physiology. By using phase-contrast MRI, forward and regurgitant volumes through the RVOT were measured and regurgitation fraction was calculated. Significant PR was defined as regurgitant fraction ≥ 25%. RESULTS: Significant PR was observed in 54 of 74 patients. While PHT < 100 ms well predicted significant PR with sensitivity of 96%, specificity of 52%, and c-index of 0.72, 10 patients showed shortened PHT despite regurgitant fraction < 25% (discordant group). Tricuspid annular plane systolic excursion and left ventricular (LV) ejection fraction were comparable between discordant group and patients showing PHT < 100 ms and regurgitant fraction ≥ 25% (concordant group). However, discordant group showed significantly smaller mid RV diameter (30.7 ± 4.5 vs. 39.2 ± 7.3 mm, P < 0.001) and higher prevalence of restrictive physiology (100% vs. 42%, P < 0.01) than concordant group. When mid RV diameter ≥ 32 mm and presence of restrictive physiology were added to PHT, the predictive value was significantly improved (sensitivity: 81%, specificity: 90%, and c-index: 0.89, P < 0.001 vs. PHT alone by multivariable logistic regression model). CONCLUSION: Patients with increased RV stiffness and non-enlarged right ventricle showed short PHT despite mild PR. Although it has been expected, this was the first study to demonstrate the exact characteristics of patients showing discrepancy between PHT and PR volume in TOF patients after RVOT reconstruction.
• 大動脈弁狭窄症患者に対する左室充満圧の心エコースコアリングシステムの適用(Application of an Echocardiographic Scoring System of Left Ventricular Filling Pressure for Patients with Aortic Stenosis)

  青柳 裕之, 岩野 弘幸, 後藤 真奈, 鈴木 ゆき乃, 村山 迪史, 横山 しのぶ, 西野 久雄, 中鉢 雅大, 中村 公亮, 玉置 陽生, 本居 昂, 石坂 傑, 加賀 早苗, 神谷 究, 永井 利幸, 安斉 俊久

  日本循環器学会学術集会抄録集 87回 PJ065 - 2 2023年03月
• 心不全患者における複数の超音波指標を組み合わせたうっ血肝診断モデルの確立

  小野田 愛梨, 村山 迪史, 加賀 早苗, 中鉢 雅大, 横山 しのぶ, 西野 久雄, 石坂 傑, 本居 昴, 青柳 裕之, 玉置 陽生, 中村 公亮, 岩野 弘幸, 安斉 俊久

  日本循環器学会学術集会抄録集 87回 CO1 - 3 (一社)日本循環器学会 2023年03月
• 巨細胞性動脈炎の診断に寄与する新たな超音波所見 生検所見との比較に基づく検討

  工藤 悠輔, 原 花梨, 村山 迪史, 加賀 早苗, 表原 里実, 岩井 孝仁, 進藤 由衣香, 菊池 桃佳, 加藤 将, 外丸 詩野, 松野 吉宏, 石津 明洋

  脈管学 63 1 16 - 16 (一社)日本脈管学会 2023年02月
• 巨細胞性動脈炎の診断に寄与する新たな超音波所見 生検所見との比較に基づく検討

  工藤 悠輔, 原 花梨, 村山 迪史, 加賀 早苗, 表原 里実, 岩井 孝仁, 進藤 由衣香, 菊池 桃佳, 加藤 将, 外丸 詩野, 松野 吉宏, 石津 明洋

  脈管学 63 1 16 - 16 (一社)日本脈管学会 2023年02月
• 心エコー法による右房圧推定精度の検証：ガイドラインに基づく副次的指標の再考

  村山 迪史, 加賀 早苗, 小野田 愛梨, 岡田 一範, 中鉢 雅大, 横山 しのぶ, 西野 久雄, 青柳 裕之, 玉置 陽生, 本居 昂, 石坂 傑, 岩野 弘幸, 永井 利幸, 辻野 一三, 安斉 俊久

  超音波検査技術 advpub 一般社団法人 日本超音波検査学会 2023年 

  目的：アメリカ心エコー図学会のガイドラインには，下大静脈計測に基づく右房圧推定の精度を補完するものとして，拘束型の右室流入血流速波形，拡張早期の右室流入血流速度と三尖弁輪運動速度との比，肝静脈血流速波形のsystolic filling fractionが示されている．本研究では，これらの副次的指標が右房圧上昇の予測能を改善させるかを明らかにするとともに，右房面積計測の付加的価値を検討する． 対象と方法：心疾患患者128例において右心カテーテル検査で平均右房圧を計測し，≧8 mmHgを上昇とした．下大静脈の径とsniffによる虚脱率から，推定右房圧を3, 8，15 mmHgに分類した（モデル1）．右室流入血流速波形の拘束型パターン，拡張早期の右室流入血流速度と三尖弁輪運動速度との比，systolic filling fractionを評価に加えて，推定右房圧の再分類を行った（モデル2）．右房の最小と最大面積および容積を計測し，それぞれのexpansion indexを算出した． 結果：右房圧の上昇を29例に認めた．ロジスティック回帰分析で，モデル1における推定右房圧とsystolic filling fractionは，平均右房圧上昇と有意に関連した（ともにp＜0.05）．拘束型パターンを呈した例はなく，拡張早期の右室流入血流速度と三尖弁輪運動速度との比は右房圧上昇と関連しなかった．右房の形態・機能指標は，いずれも右房圧上昇と関連し（すべてp＜0.05），最小右房面積が最も強く関連した（右室面積変化率で補正後のオッズ比：10.64, p＜0.01）．尤度比検定では，モデル2の右房圧上昇の予測能はモデル1と同等であったが，systolic filling fractionと最小右房面積を用いた新しいモデルは，モデル1より良好に右房圧上昇を予測できた． 結論：従来の副次的指標を用いた再分類により右房圧上昇の予測能は改善しなかった．肝静脈血流速波形のsystolic filling fractionと最小右房面積を右房圧の評価に加えると，右房圧上昇の予測能は改善した．
• Determinants of exercise capacity in patients with heart failure without left ventricular hypertrophy.

  Suguru Ishizaka, Hiroyuki Iwano, Shingo Tsujinaga, Michito Murayama, Satonori Tsuneta, Hiroyuki Aoyagi, Yoji Tamaki, Ko Motoi, Yasuyuki Chiba, Asuka Tanemura, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Kazunori Okada, Brett A Meyers, Pavlos P Vlachos, Takuma Sato, Kiwamu Kamiya, Masaya Watanabe, Sanae Kaga, Toshiyuki Nagai, Noriko Oyama-Manabe, Toshihisa Anzai

  Journal of cardiology 81 1 33 - 41 2023年01月 

  BACKGROUND: Determinants of exercise intolerance in a phenotype of heart failure with preserved ejection fraction (HFpEF) with normal left ventricular (LV) structure have not been fully elucidated. METHODS: Cardiopulmonary exercise testing and exercise-stress echocardiography were performed in 44 HFpEF patients without LV hypertrophy. Exercise capacity was determined by peak oxygen consumption (peak VO2). Doppler-derived cardiac output (CO), transmitral E velocity, systolic (LV-s') and early diastolic mitral annular velocities (e'), systolic pulmonary artery (PA) pressure (SPAP), tricuspid annular plane systolic excursion (TAPSE), and peak systolic right ventricular (RV) free wall velocity (RV-s') were measured at rest and exercise. E/e' and TAPSE/SPAP were used as an LV filling pressure parameter and RV-PA coupling, respectively. RESULTS: During exercise, CO, LV-s', RV-s', e', and SPAP were significantly increased (p < 0.05 for all), whereas E/e' remained unchanged and TAPSE/SPAP was significantly reduced (p < 0.001). SPAP was higher and TAPSE/SPAP was lower at peak exercise in patients showing lower-half peak VO2. In univariable analyses, LV-s' (R = 0.35, p = 0.022), SPAP (R = -0.40, p = 0.008), RV-s' (R = 0.47, p = 0.002), and TAPSE/SPAP (R = 0.42, p = 0.005) were significantly correlated with peak VO2. In multivariable analyses, not only SPAP, but also TAPSE/SPAP independently determined peak VO2 even after the adjustment for clinically relevant parameters. CONCLUSIONS: In HFpEF patients without LV hypertrophy, altered RV-PA coupling by exercise could be associated with exercise intolerance, which might not be caused by elevated LV filling pressure.
• Associations of right ventricular pulsatile load and cardiac power output to clinical outcomes in heart failure: Difference from systemic circulation.

  Yasuyuki Chiba, Hiroyuki Iwano, Hiroyuki Aoyagi, Yoji Tamaki, Ko Motoi, Suguru Ishizaka, Michito Murayama, Shinobu Yokoyama, Masahiro Nakabachi, Hisao Nishino, Sanae Kaga, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai

  Journal of cardiology 81 4 404 - 412 2022年12月08日 

  BACKGROUND: Although left ventricular (LV) cardiac power output (CPO) is a powerful prognostic indicator in heart failure (HF), the significance of right ventricular (RV) CPO is unknown. In contrast, RV pulsatile load is a key prognostic marker in HF. We investigated the impact of RV-CPO and pulsatile load on cardiac outcome and the prognostic performance of the combined systemic and pulmonary circulation parameters in HF. METHODS: Right heart catheterization and echocardiography were performed in 231 HF patients (62 ± 16 years, LV ejection fraction 42 ± 18 %). Invasive and noninvasive CPOs were calculated from mean systemic or pulmonary arterial pressure and cardiac output. LV-CPO was then normalized to LV mass (LV-P/M). Pulmonary arterial capacitance and the ratio of acceleration time to ejection time (AcT/ET) of RV outflow were used as parameters of RV pulsatile load. The primary endpoints, defined as a composite of cardiac death, HF hospitalization, ventricular arrythmia, and LVAD implantation after the examination, were recorded. RESULTS: Noninvasive CPOs were moderately correlated with invasive ones (LV: ρ = 0.787, RV: ρ = 0.568, and p < 0.001 for both). During a median follow-up period of 441 days, 57 cardiovascular events occurred. Lower LV-P/M and higher RV pulsatile load were associated with cardiovascular events; however, RV-CPO was not associated with the outcome. Echocardiographic LV-P/M and AcT/ET showed significant incremental prognostic value over the clinical parameters. CONCLUSIONS: RV pulsatile load assessed by AcT/ET may be a predictor of clinical events in HF patients. The combination of echocardiographic LV-P/M and AcT/ET could be a novel noninvasive prognostic indicator in HF patients.
• Evaluation of two semi-supervised learning methods and their combination for automatic classification of bone marrow cells

  Iori Nakamura, Haruhi Ida, Mayu Yabuta, Wataru Kashiwa, Maho Tsukamoto, Shigeki Sato, Syuichi Ota, Naoki Kobayashi, Hiromi Masauzi, Kazunori Okada, Sanae Kaga, Keiko Miwa, Hiroshi Kanai, Nobuo Masauzi

  Scientific Reports 12 1 2022年10月06日 

  Abstract Differential bone marrow (BM) cell counting is an important test for the diagnosis of various hematological diseases. However, it is difficult to accurately classify BM cells due to non-uniformity and the lack of reproducibility of differential counting. Therefore, automatic classification systems have been developed in which deep learning is used. These systems requires large and accurately labeled datasets for training. To overcome this, we used semi-supervised learning (SSL), in which learning proceeds while labeling. We used three methods: self-training (ST), active learning (AL), and a combination of these methods, and attempted to automatically classify 16 types of BM cell images. ST involves data verification, as in AL, before adding them to the training dataset (confirmed self-training: CST). After 25 rounds of CST, AL, and CST + AL, the initial number of training data increased from 425 to 40,518; 3682; and 47,843, respectively. Accuracies for the test data of 50 images for each cell type were 0.944, 0.941, and 0.976, respectively. Data added with CST or AL showed some imbalances between classes, while CST + AL exhibited fewer imbalances. We suggest that CST + AL, when combined with two SSL methods, is efficient in increasing training data for the development of automatic BM cells classification systems.
• Dual Gate Doppler法による左房収縮時の肺静脈血流と経僧帽弁血流の時相解析

  岡田 一範, 岡田 由佳, 村山 迪史, 加賀 早苗, 政氏 伸夫, 西野 久雄, 横山 しのぶ, 中鉢 雅大, 西田 睦, 本居 昂, 石坂 傑, 千葉 泰之, 辻永 真吾, 岩野 弘幸, 安斉 俊久

  超音波検査技術 47 4 353 - 362 一般社団法人 日本超音波検査学会 2022年08月01日 

  目的：肺静脈血流（PVF）と経僧帽弁血流（TMF）の心房収縮期（A）波の持続時間の差（ΔA_dur）は拡張後期の左室硬さを反映する指標として知られるが，再現性に問題がある．最近，我々は，PVF全体に占める逆行性A波の割合とTMF全体に占めるA波の割合との比（F_PVA/F_A）が，侵襲的左室硬さ指標ときわめてよく対応することを報告したが，この計測はやや煩雑である．今回，Dual Gate Doppler（DD）法によるPVFとTMFの同時記録から得られる指標の有用性を検討した． 対象と方法: DD法が施行された80例において，通常のパルスドプラ法でΔA_dur（S-ΔA_dur）を計測するとともにF_PVA/F_Aを算出した．また，DD法によるPVFとTMFの同時記録から，ΔA_dur（D-ΔA_dur）と各々のA波の終了時相差（D-ΔA_end）を計測した． 結果: S-ΔA_dur，D-ΔA_durおよびD-ΔA_endはいずれもF_PVA/F_Aと有意に相関した（順にr＝0.50, 0.51, 0.71）．このうち，D-ΔA_endとF_PVA/F_Aとの相関は，他2者より有意に良好であった．対象中の20例における検者間および検者内再現性は，S-ΔA_durよりもD-ΔA_durとD-ΔA_endで良好であった． 結論: DD法によるD-ΔA_endは，通常のΔA_durよりも再現性よく拡張後期左室硬さを評価できると考えられた．
• Usefulness of the pulmonary venous flow waveform for assessing left atrial stiffness

  Takehiro Abe, Kazunori Okada, Michito Murayama, Sanae Kaga, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Hiroyuki Aoyagi, Yoji Tamaki, Ko Motoi, Yasuyuki Chiba, Suguru Ishizaka, Shingo Tsujinaga, Hiroyuki Iwano, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai

  The International Journal of Cardiovascular Imaging 2022年07月16日
• Visual echocardiographic scoring system of the left ventricular filling pressure and outcomes of heart failure with preserved ejection fraction.

  Michito Murayama, Hiroyuki Iwano, Masaru Obokata, Tomonari Harada, Kazunori Omote, Kazuki Kagami, Shingo Tsujinaga, Yasuyuki Chiba, Suguru Ishizaka, Ko Motoi, Yoji Tamaki, Hiroyuki Aoyagi, Masahiro Nakabachi, Hisao Nishino, Shinobu Yokoyama, Asuka Tanemura, Kazunori Okada, Sanae Kaga, Mutsumi Nishida, Toshiyuki Nagai, Masahiko Kurabayashi, Toshihisa Anzai

  European heart journal. Cardiovascular Imaging 23 5 616 - 626 2022年04月18日 

  AIMS: Elevated left ventricular filling pressure (LVFP) is a powerful indicator of worsening clinical outcomes in heart failure with preserved ejection fraction (HFpEF); however, detection of elevated LVFP is often challenging. This study aimed to determine the association between the newly proposed echocardiographic LVFP parameter, visually assessed time difference between the mitral valve and tricuspid valve opening (VMT) score, and clinical outcomes of HFpEF. METHODS AND RESULTS: We retrospectively investigated 310 well-differentiated HFpEF patients in stable conditions. VMT was scored from 0 to 3 using two-dimensional echocardiographic images, and VMT ≥2 was regarded as a sign of elevated LVFP. The primary endpoint was a composite of cardiac death or heart failure hospitalization during the 2 years after the echocardiographic examination. In all patients, Kaplan-Meier curves showed that VMT ≥2 (n = 54) was associated with worse outcomes than the VMT ≤1 group (n = 256) (P < 0.001). Furthermore, VMT ≥2 was associated with worse outcomes when tested in 100 HFpEF patients with atrial fibrillation (AF) (P = 0.026). In the adjusted model, VMT ≥2 was independently associated with the primary outcome (hazard ratio 2.60, 95% confidence interval 1.46-4.61; P = 0.001). Additionally, VMT scoring provided an incremental prognostic value over clinically relevant variables and diastolic function grading (χ2 10.8-16.3, P = 0.035). CONCLUSIONS: In patients with HFpEF, the VMT score was independently and incrementally associated with adverse clinical outcomes. Moreover, it could also predict clinical outcomes in HFpEF patients with AF.
• 前毛細管性肺高血圧症における心筋遅延造影像と左室収縮障害との関連

  新川 未緒, 加賀 早苗, 岩野 弘幸, 千葉 泰之, 宮本 知佳, 岡田 一範, 村山 迪史, 中鉢 雅大, 常田 慧徳, 辻野 一三

  超音波医学 49 Suppl. S706 - S706 (公社)日本超音波医学会 2022年04月
• Difference in left atrial myocardial dynamics during reservoir phase between hypertrophic cardiomyopathy and hypertensive heart determined using three-dimensional speckle tracking echocardiography

  Yusuke Yanagi, Kazunori Okada, Sanae Kaga, Taisei Mikami, Miho Aiba, Nobuo Masauzi, Michito Murayama, Asuka Tanemura, Shinobu Yokoyama, Hisao Nishino, Masahiro Nakabachi, Yoji Tamaki, Hiroyuki Aoyagi, Ko Motoi, Suguru Ishizaka, Yasuyuki Chiba, Shingo Tsujinaga, Hiroyuki Iwano, Toshihisa Anzai

  INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2022年04月 

  We aimed to investigate left atrial (LA) myocardial dynamics during reservoir phase using three-dimensional speckle-tracking echocardiography (3DSTE) focusing on its longitudinal-circumferential relationship in patients with left ventricular (LV) hypertrophy and clarifying the difference in LA myocardial reservoir dynamics between hypertrophic cardiomyopathy (HCM) and hypertension with LV hypertrophy (HT-LVH). We studied 4 age-matched groups consisting of 27 patients with HCM, 16 with HT-LVH, 22 hypertensive patients without LV hypertrophy (HT), and 18 normal controls. Using 3DSTE, we measured LA global longitudinal strain (LA-LSR), global circumferential strain (LA-CSR), and global area strain (LA-AS(R)) during the reservoir phase, as well as LV global longitudinal strain (LV-LS), global circumferential strain (LV-CS), and global area strain (LV-AS). LA-LSR was significantly lower in the HCM and HT-LVH groups than in the controls, but there was no significant difference between the HCM and HT-LVH groups. LA-CSR and LA-AS(R) were significantly lower in the HCM group than in the other three groups, among which no significant difference was detected. In all subjects, LA-LSR was significantly correlated with LV-LS but not with LV-CS. LA-CSR was correlated with neither LV-LS nor LV-CS. In conclusion, both longitudinal and circumferential LA myocardial expansion during reservoir phase were reduced in HCM, while only the longitudinal one was reduced in HT-LVH. Reduction of LA circumferential expansion may reflect a more serious and intrinsic impairment of LA myocardial distensibility in HCM. Measuring LA-CSR and LA-AS(R) using 3DSTE would contribute to a more accurate understanding of LA reservoir function abnormality in HCM.
• Prognostic value of an echocardiographic index reflecting right ventricular operating stiffness in patients with heart failure.

  Ryosuke Fujisawa, Kazunori Okada, Sanae Kaga, Michito Murayama, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Asuka Tanemura, Nobuo Masauzi, Ko Motoi, Suguru Ishizaka, Yasuyuki Chiba, Shingo Tsujinaga, Hiroyuki Iwano, Toshihisa Anzai

  Heart and vessels 37 4 583 - 592 2022年04月 

  PURPOSE: We recently reported a noninvasive method for the assessment of right ventricular (RV) operating stiffness that is obtained by dividing the atrial-systolic descent of the pulmonary artery-RV pressure gradient (PRPGDAC) derived from the pulmonary regurgitant velocity by the tricuspid annular plane movement during atrial contraction (TAPMAC). Here, we investigated whether this parameter of RV operating stiffness, PRPGDAC/TAPMAC, is useful for predicting the prognosis of patients with heart failure (HF). METHODS: We retrospectively included 127 hospitalized patients with HF who underwent an echocardiographic examination immediately pre-discharge. The PRPGDAC/TAPMAC was measured in addition to standard echocardiographic parameters. Patients were followed until 2 years post-discharge. The endpoint was the composite of cardiac death, readmission for acute decompensation, and increased diuretic dose due to worsening HF. RESULTS: 58 patients (46%) experienced the endpoint during follow-up. Univariable and multivariable Cox regression analyses demonstrated that the PRPGDAC/TAPMAC was associated with the endpoint. In a Kaplan-Meier analysis, the event rate of the greater PRPGDAC/TAPMAC group was significantly higher than that of the lesser PRPGDAC/TAPMAC group. In a sequential Cox analysis for predicting the endpoint's occurrence, the addition of PRPGDAC/TAPMAC to the model including age, sex, NYHA functional classification, brain natriuretic peptide level, and several echocardiographic parameters including tricuspid annular plane systolic excursion significantly improved the predictive power for prognosis. CONCLUSION: A completely noninvasive index of RV operating stiffness, PRPGDAC/TAPMAC, was useful for predicting prognoses in patients with HF, and it showed an incremental prognostic value over RV systolic function.
• Clinical Utility of Superior Vena Cava Flow Velocity Waveform Measured from the Subcostal Window for Estimating Right Atrial Pressure.

  Michito Murayama, Sanae Kaga, Kazunori Okada, Hiroyuki Iwano, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Shingo Tsujinaga, Yasuyuki Chiba, Suguru Ishizaka, Ko Motoi, Kiwamu Kamiya, Mutsumi Nishida, Toshiyuki Nagai, Toshihisa Anzai

  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 35 7 727 - 737 2022年02月09日 

  BACKGROUND: The superior vena cava (SVC) flow velocity waveform from the supraclavicular window reflects right atrial pressure (RAP) status. Recent guidelines have stated that the subcostal window is an alternative view for recording SVC flow, but the validity of this approach remains unclear. The aim of this study was to determine the usefulness of SVC flow evaluation from the subcostal window for estimating RAP. METHODS: Differences in SVC flow characteristics between opposite approaches were examined in 38 healthy adults. In 115 patients with cardiovascular diseases who underwent cardiac catheterization and echocardiography within 48 hours, the ratio of peak systolic to diastolic forward SVC flow (SVC-S/D) was measured, and the diagnostic ability of SVC-S/D for elevated RAP was tested. A validation cohort was used to confirm the diagnostic ability of SVC-S/D in 48 patients who underwent both cardiac catheterization and echocardiography within 24 hours. In 59 patients in the derivation and validation cohorts, the relationship between SVC flow and RAP was compared between the opposite windows. RESULTS: Both systolic and diastolic SVC flow velocities were higher in the subcostal than in the supraclavicular approach, and effect of position change on subcostal SVC-S/D was smaller than that on supraclavicular SVC-S/D in healthy adults. Measurement of SVC-S/D from the subcostal window was feasible in 98 patients (85%). RAP was inversely correlated with SVC-S/D (r = -0.50, P < .001) and was an independent determinant of SVC-S/D after adjustment for right ventricular systolic function (β = -0.48, P < .001). A cutoff value of 1.9 for SVC-S/D showed 85% sensitivity and 74% specificity in identifying elevated RAP. Additionally, SVC-S/D showed an incremental diagnostic value combined with inferior vena cava size and collapsibility (P = .006). When a cutoff value of SVC-S/D < 1.9 was applied to the validation cohort, it showed acceptable accuracy of 72% and incremental diagnostic value combined with inferior vena cava parameters (P = .033). SVC-S/D from the subcostal window correlated better with RAP than that from the supraclavicular window (P < .001, Meng's test). CONCLUSIONS: Measurement of SVC flow velocity from the subcostal window was feasible, and SVC-S/D from the subcostal window could be an additive parameter for estimating RAP.
• Determinants of altered left ventricular suction in pre-capillary pulmonary hypertension.

  Yasuyuki Chiba, Hiroyuki Iwano, Satonori Tsuneta, Shingo Tsujinaga, Brett Meyers, Pavlos Vlachos, Suguru Ishizaka, Ko Motoi, Hiroyuki Aoyagi, Yoji Tamaki, Asuka Tanemura, Michito Murayama, Shinobu Yokoyama, Masahiro Nakabachi, Hisao Nishino, Sanae Kaga, Kiwamu Kamiya, Hiroshi Ohira, Ichizo Tsujino, Toshihisa Anzai

  European heart journal. Cardiovascular Imaging 23 10 1399 - 1406 2022年01月10日 

  AIMS: Although the left ventricular (LV) dysfunction in pre-capillary pulmonary hypertension (PH) has been recently recognized, the mechanism of LV dysfunction in this entity is not completely understood. We thus aimed to elucidate the determinants of intraventricular pressure difference (IVPD), a measure of LV suction, in pre-capillary PH. METHODS AND RESULTS: Right heart catheterization and echocardiography were performed in 86 consecutive patients with pre-capillary PH (57 ± 18 years, 85% female). IVPD was determined using colour M-mode Doppler to integrate the Euler equation. In overall, IVPD was reduced compared to previously reported value in normal subjects. In univariable analyses, QRS duration (P = 0.028), LV ejection fraction (P = 0.006), right ventricular (RV) end-diastolic area (P < 0.001), tricuspid annular plane systolic excursion (P = 0.004), and LV early-diastolic eccentricity index (P = 0.009) were associated with IVPD. In the multivariable analyses, RV end-diastolic area and LV eccentricity index independently determined the IVPD. CONCLUSION: Aberrant ventricular interdependence caused by RV enlargement could impair the LV suction. This study first applied echocardiographic IVPD, a reliable marker of LV diastolic suction, to investigate the mechanism of LV diastolic dysfunction in pre-capillary PH.
• ドプラ心エコー法による肺動脈弁逆流重症度の過大評価の要因に関する検討

  本居 昂, 岩野 弘幸, 常田 慧徳, 村山 迪史, 加賀 早苗, 青柳 裕之, 玉置 陽生, 石坂 傑, 千葉 泰之, 辻永 真吾, 種村 明日香, 横山 しのぶ, 中鉢 雅大, 西野 久雄, 岡田 一範, 武田 充人, 安斉 俊久

  日本成人先天性心疾患学会雑誌 11 1 216 - 216 日本成人先天性心疾患学会 2022年01月
• Influence of left ventricular systolic dysfunction on occurrence of pulsus tardus in patients with aortic stenosis.

  Suguru Ishizaka, Hiroyuki Iwano, Ko Motoi, Yasuyuki Chiba, Shingo Tsujinaga, Asuka Tanemura, Michito Murayama, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Kazunori Okada, Sanae Kaga, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai

  Journal of cardiology 78 4 322 - 327 2021年10月 

  BACKGROUND: Although the time difference between peak of left ventricular (LV) and aortic systolic pressures (TLV-Ao), which is considered to in part reflect pulsus tardus, is reported to be associated with clinical outcome in aortic stenosis (AS), its physiological determinants remain to be elucidated. We hypothesized that not only AS severity but also LV systolic dysfunction could be associated with occurrence of pulsus tardus. METHODS: TLV-Ao was measured by simultaneous LV and aortic pressure tracing in 74 AS patients and prolonged TLV-Ao was defined as ≥66 ms according to the previous report. Mean transaortic valvular pressure gradient (mPG) and effective orifice area index (EOAI) were estimated by Doppler echocardiography and severe AS was defined as EOAI ≤0.60 cm2/m2. Global longitudinal strain (GLS) was measured by using speckle-tracking method. RESULTS: Although a weak correlation was observed between EOAI and TLV-Ao, there was substantial population showing discordance between the parameters: severe AS despite normal TLV-Ao (10 of 47 patients) and moderate AS despite prolonged TLV-Ao (9 of 17 patients). In severe AS, mPG was significantly higher in patients showing prolonged TLV-Ao (57±20 vs 36±10 mmHg, p<0.0001) whereas GLS was comparable between the groups (-15.2±3.5% vs -14.8±3.2%). In contrast, in moderate AS, GLS was significantly smaller in patients showing prolonged TLV-Ao (-12.6±4.7% vs -17.4±3.4%, p=0.0271) while mPG was comparable (34±7 mmHg vs 35±8 mmHg). Multivariable analysis revealed that not only mPG but also GLS was an independent determinant of TLV-Ao. CONCLUSIONS: The occurrence of pulsus tardus could be associated with not only AS severity but also LV systolic dysfunction in AS patients.
• Application of the proximal isovelocity surface area method for estimation of the effective orifice area in aortic stenosis.

  Masahiro Nakabachi, Hiroyuki Iwano, Michito Murayama, Hisao Nishino, Shinobu Yokoyama, Shingo Tsujinaga, Yasuyuki Chiba, Suguru Ishizaka, Ko Motoi, Kazunori Okada, Sanae Kaga, Mutsumi Nishida, Takanori Teshima, Toshihisa Anzai

  Heart and vessels 37 4 638 - 646 2021年09月25日 

  Although the echocardiographic effective orifice area (EOA) calculated using the continuity equation is widely used for the assessment of severity in aortic stenosis (AS), the existence of high flow velocity at the left ventricular outflow tract (LVOT) potentially causes its overestimation. The proximal isovelocity surface area (PISA) method could be an alternative tool for the estimation of EOA that limits the influence of upstream flow velocity. EOA was calculated using the continuity equation (EOACont) and PISA method (EOAPISA), respectively, in 114 patients with at least moderate AS. The geometric orifice area (GOA) was also measured using the planimetry method in 51 patients who also underwent three-dimensional transesophageal echocardiography. Patients were divided into two groups according to the median LVOT flow velocity. EOAPISA could be obtained in 108 of the 114 patients (95%). Although there was a strong correlation between EOACont and EOAPISA (r = 0.78, P < 0.001), EOACont was statistically significantly larger than EOAPISA (0.86 ± 0.33 vs 0.75 ± 0.29 cm2, P < 0.001). Both EOACont and EOAPISA similarly correlated with GOA (r = 0.70, P < 0.001 and r = 0.77, P < 0.001, respectively). However, a fixed bias, which is hydrodynamically supposed to exist between EOA and GOA, was not observed between EOACont and GOA. In contrast, there was a negative fixed bias between EOAPISA and GOA with smaller EOAPISA than GOA. The difference between EOACont and GOA was significantly greater with a larger EOACont relative to GOA in patients with high LVOT flow velocity than in those without (0.16 ± 0.25 vs - 0.07 ± 0.10 cm2, P < 0.001). In contrast, the difference between EOAPISA and GOA was consistent regardless of the LVOT flow velocity (- 0.07 ± 0.12 vs - 0.07 ± 0.15 cm2, P = 0.936). The PISA method was applied to estimate EOA in patients with AS. EOAPISA could be an alternative parameter for AS severity grading in patients with high LVOT flow velocity in whom EOACont would potentially overestimate the orifice area.
• 慢性心不全における右室cardiac power outputの意義

  千葉 泰之, 岩野 弘幸, 本居 昂, 石坂 傑, 辻永 真吾, 村山 迪史, 横山 しのぶ, 中鉢 雅大, 西野 久雄, 岡田 一範, 加賀 早苗, 神谷 究, 永井 利幸, 安斉 俊久

  日本心臓病学会学術集会抄録 69回 O - 029 (一社)日本心臓病学会 2021年09月
• Simple Two-Dimensional Echocardiographic Scoring System for the Estimation of Left Ventricular Filling Pressure.

  Michito Murayama, Hiroyuki Iwano, Hisao Nishino, Shingo Tsujinaga, Masahiro Nakabachi, Shinobu Yokoyama, Miho Aiba, Kazunori Okada, Sanae Kaga, Miwa Sarashina, Yasuyuki Chiba, Suguru Ishizaka, Ko Motoi, Mutsumi Nishida, Hitoshi Shibuya, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai

  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 34 7 723 - 734 2021年07月 

  BACKGROUND: When left ventricular filling pressure (LVFP) increases, the mitral valve opens early and precedes tricuspid valve opening in early diastole. The authors hypothesized that a visually assessed time sequence of atrioventricular valve opening could become a new marker of elevated LVFP. The aim of this study was to test the diagnostic ability of a novel echocardiographic scoring system, the visually assessed time difference between mitral valve and tricuspid valve opening (VMT) score, in patients with heart failure. METHODS: One hundred nineteen consecutive patients who underwent cardiac catheterization within 24 hours of echocardiographic examination were retrospectively analyzed as a derivation cohort. In addition, a prospective study was conducted to validate the diagnostic ability of the VMT score in 50 patients. Elevated LVFP was defined as mean pulmonary artery wedge pressure (PAWP) ≥ 15 mm Hg. The time sequence of atrioventricular valve opening was visually assessed and scored (0 = tricuspid valve first, 1 = simultaneous, 2 = mitral valve first). When the inferior vena cava was dilated, 1 point was added, and VMT score was ultimately graded as 0 to 3. Cardiac events were recorded for 1 year after echocardiography. RESULTS: In the derivation cohort, PAWP was elevated with higher VMT scores (score 0, 10 ± 5; score 1, 12 ± 4; score 2, 22 ± 8; score 3, 28 ± 4 mm Hg; P < .001, analysis of variance). VMT score ≥ 2 predicted elevated PAWP with accuracy of 86% and showed incremental predictive value over clinical variables and guideline-recommended diastolic function grading. These observations were confirmed in the prospective validation cohort. Importantly, VMT score ≥ 2 discriminated elevated PAWP with accuracy of 82% in 33 patients with monophasic left ventricular inflow in the derivation cohort. Kaplan-Meier analysis demonstrated that patients with VMT scores ≥ 2 were at higher risk for cardiac events than those with VMT scores ≤ 1 (P < .001). CONCLUSIONS: VMT scoring could be a novel additive marker of elevated LVFP and might also be associated with adverse outcomes in patients with heart failure.
• Functional significance of intra-left ventricular vortices on energy efficiency in normal, dilated, and hypertrophied hearts.

  Miwa Sarashina-Motoi, Hiroyuki Iwano, Ko Motoi, Suguru Ishizaka, Yasuyuki Chiba, Shingo Tsujinaga, Michito Murayama, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Kazunori Okada, Sanae Kaga, Toshihisa Anzai

  Journal of clinical ultrasound : JCU 49 4 358 - 367 2021年05月 

  PURPOSE: To investigate the influence of changes in vortices within the left ventricle (LV) on energy efficiency (EE) in normal and diseased hearts. METHODS: We performed vector flow mapping echocardiography in 36 normal participants (N), 36 patients with dilated cardiomyopathy (D), and 36 patients with LV hypertrophy (H). The circulation of the main anterior vortex was measured as a parameter of vortex strength. Energy loss (EL) was measured for one cardiac cycle, and EE was calculated as EL divided by stroke work (SW), which represents the loss of kinetic energy per unit of LV external work. RESULTS: Circulation increased in the order of N, H, and D (N: 15 ± 4, D: 19 ± 8, H: 17 ± 6 × 10-3 m2 /s; analysis of variance [ANOVA] P < .01). Conversely, EE increased in the order of N, D, and H (N: 0.22 ± 0.07, D: 0.26 ± 0.16, H: 0.30 ± 0.16 10-5 J/mm Hg mL m s; ANOVA P = .04), suggesting worst EE in group H. We found a positive correlation between circulation and SW only in group N, and positive correlation between circulation and EE only in diseased groups (D: R = 0.55, P < .01; H: R = 0.44, P < .01). Multivariable analyses revealed that circulation was the independent determinant of EE in groups D and H. CONCLUSIONS: Enhanced vortices could be associated with effective increase in LV external work in normal hearts. Conversely, they were associated with loss of EE without an optimal increase in external work in failing hearts, regardless of the LV morphology.
• 拡張機能学再考:beyond E/E' 時相解析に基づく新たな左室充満圧推定指標 僧帽弁輪石灰化例、心房細動例への適用

  岩野 弘幸, 村山 迪史, 辻永 真吾, 千葉 泰之, 石坂 傑, 本居 昂, 中鉢 雅大, 加賀 早苗, 安斉 俊久

  超音波医学 48 Suppl. S205 - S205 (公社)日本超音波医学会 2021年04月
• 右房圧の推定に用いられる超音波指標の精度比較

  小野田 愛梨, 村山 迪史, 加賀 早苗, 岡田 一範, 相庭 美穂, 藤澤 亮介, 中鉢 雅大, 横山 しのぶ, 西野 久雄, 西田 睦, 岩野 弘幸, 安斉 俊久

  超音波検査技術抄録集 46 S197 - S197 一般社団法人 日本超音波検査学会 2021年
• 上大静脈血流速度波形計測における心窩部アプローチの有用性

  村山 迪史, 加賀 早苗, 岡田 一範, 中鉢 雅大, 西野 久雄, 横山 しのぶ, 種村 明日香, 石坂 傑, 千葉 泰之, 辻永 真吾, 西田 睦, 岩野 弘幸

  超音波検査技術抄録集 46 S136 - S136 一般社団法人 日本超音波検査学会 2021年
• 混合性肺高血圧症を合併する心不全患者の左房機能と予後との関連

  後藤 真奈, 加賀 早苗, 岡田 一範, 相庭 美穂, 藤澤 亮介, 村山 迪史, 中鉢 雅大, 西野 久雄, 横山 しのぶ, 種村 明日香, 辻永 真吾, 岩野 弘幸

  超音波検査技術抄録集 46 S135 - S135 一般社団法人 日本超音波検査学会 2021年
• 心内圧波形に基づく拡張早期僧帽弁逆流の発生機序に関する考察

  種村 明日香, 村山 迪史, 岩野 弘幸, 西野 久雄, 横山 しのぶ, 中鉢 雅大, 本居 昂, 辻永 真吾, 岡田 一範, 加賀 早苗, 西田 睦, 豊嶋 崇徳

  超音波検査技術抄録集 46 S132 - S132 一般社団法人 日本超音波検査学会 2021年
• Deep Learning-Based Nuclear Lobe Count Method for Differential Count of Neutrophils

  Mayu Yabuta, Iori Nakamura, Haruhi Ida, Hiromi Masauzi, Kazunori Okada, Sanae Kaga, Keiko Miwa, Nobuo Masauzi

  The Tohoku Journal of Experimental Medicine 254 3 199 - 206 2021年
• Influence of advanced pulmonary vascular remodeling on accuracy of echocardiographic parameters of left ventricular filling pressure

  Yasuyuki Chiba, Hiroyuki Iwano, Sanae Kaga, Mio Shinkawa, Michito Murayama, Hiroshi Ohira, Suguru Ishizaka, Miwa Sarashina, Shingo Tsujinaga, Shinobu Yokoyama, Masahiro Nakabachi, Hisao Nishino, Kazunori Okada, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai

  Pulmonary Circulation 11 1 204589402098372 - 204589402098372 2021年01月 

  Evaluation of left ventricular filling pressure plays an important role in the clinical management of pulmonary hypertension. However, the accuracy of echocardiographic parameters for the determination of left ventricular filling pressure in the presence of pulmonary vascular lesions has not been fully addressed. We retrospectively investigated 124 patients with pulmonary hypertension due to pulmonary vascular lesions (noncardiac pulmonary hypertension group) and 113 patients with ischemic heart disease (control group) who underwent right heart catheterization and echocardiography. The noncardiac pulmonary hypertension group was subdivided into less-advanced and advanced groups according to median pulmonary vascular resistance. Pulmonary artery wedge pressure was determined as left ventricular filling pressure. As echocardiographic parameters of left ventricular filling pressure, the ratio of early- (E) to late-diastolic transmitral flow velocity (E/A), ratio of E to early-diastolic mitral annular velocity (E/e′), and left atrial volume index were measured. In the less-advanced noncardiac pulmonary hypertension and control groups, positive correlations were observed between pulmonary artery wedge pressure and late-diastolic transmitral flow velocity ( R = 0.41, P = 0.002 and R = 0.71, P < 0.001, respectively) and left atrial volume index ( R = 0.53, P < 0.001 and R = 0.41, P < 0.001), whereas in the advanced noncardiac pulmonary hypertension group, pulmonary artery wedge pressure was only correlated with left atrial volume index ( R = 0.27, P = 0.032). In the controls, only pulmonary artery wedge pressure determined E (β = 0.48, P < 0.001), whereas both pulmonary artery wedge pressure and pulmonary vascular resistance were independent determinants of E (β = 0.29, P < 0.001 and β = –0.28, P = 0.001, respectively) in the noncardiac pulmonary hypertension group. In conclusion, in the presence of advanced pulmonary vascular lesions, conventional echocardiographic parameters may not accurately reflect left ventricular filling pressure. Elevated pulmonary vascular resistance would lower the E, even when pulmonary artery wedge pressure is elevated, resulting in blunting of echocardiographic parameters for the detection of elevated left ventricular filling pressure.
• Presence and Relevance of Midsystolic Notching on Right Ventricular Outflow Tract Flow Velocity Envelopes in Pulmonary Hypertension due to Heart Failure

  Yasuyuki Chiba, Hiroyuki Iwano, Michito Murayama, Sanae Kaga, Ko Motoi, Suguru Ishizaka, Shingo Tsujinaga, Asuka Tanemura, Shinobu Yokoyama, Masahiro Nakabachi, Hisao Nishino, Kazunori Okada, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai

  Journal of the American Society of Echocardiography 2020年12月
• 三次元スペックルトラッキング法による右室機能解析に関する初期検討

  岡田 一範, 加賀 早苗, 上田 龍一郎, 柳 裕介, 相庭 美穂, 政氏 伸夫, 三神 大世, 中鉢 雅大, 岩野 弘幸, 安斉 俊久

  超音波医学 47 Suppl. S221 - S221 (公社)日本超音波医学会 2020年11月
• 肺静脈血流速度波形を用いたリザーバ期の左房硬さの非侵襲的評価法の検討

  阿部 剛大, 岡田 一範, 加賀 早苗, 政氏 伸夫, 三神 大世, 村山 迪史, 中鉢 雅大, 辻永 真吾, 岩野 弘幸, 安斉 俊久

  超音波医学 47 Suppl. S246 - S246 (公社)日本超音波医学会 2020年11月
• 房室弁開放時相差の視覚的評価に基づいたスコアリングによる左室充満圧推定と予後予測

  村山 迪史, 岩野 弘幸, 辻永 真吾, 西野 久雄, 中鉢 雅大, 横山 しのぶ, 西田 睦, 渋谷 斉, 加賀 早苗, 安斉 俊久

  超音波医学 47 Suppl. S165 - S165 (公社)日本超音波医学会 2020年11月
• 収縮期の右房容量負荷が三尖弁輪収縮期移動距離と右室駆出率との関係に及ぼす影響

  村山 迪史, 加賀 早苗, 岡田 一範, 三神 大世, 中鉢 雅大, 横山 しのぶ, 西野 久雄, 西田 睦, 岩野 弘幸, 安斉 俊久

  超音波医学 47 Suppl. S222 - S222 (公社)日本超音波医学会 2020年11月
• Heart Failure With Preserved Ejection Fraction vs. Reduced Ejection Fraction ― Mechanisms of Ventilatory Inefficiency During Exercise in Heart Failure ―

  Shingo Tsujinaga, Hiroyuki Iwano, Yasuyuki Chiba, Suguru Ishizaka, Miwa Sarashina, Michito Murayama, Masahiro Nakabachi, Hisao Nishino, Shinobu Yokoyama, Kazunori Okada, Sanae Kaga, Toshihisa Anzai

  Circulation Reports 2 5 271 - 279 2020年05月08日 [査読有り][通常論文]
  
• 収縮期の右房容量負荷が三尖弁輪収縮期移動距離に及ぼす影響

  村山 迪史, 加賀 早苗, 岡田 一範, 三神 大世, 中鉢 雅大, 横山 しのぶ, 西野 久雄, 西田 睦, 澁谷 斉, 辻永 真吾, 岩野 弘幸, 安斉 俊久

  超音波検査技術 45 2 217 - 217 (一社)日本超音波検査学会 2020年04月
• Significance and prognostic impact of v wave on pulmonary artery pressure in patients with heart failure: beyond the wedge pressure.

  Hiroyuki Iwano, Shinobu Yokoyama, Kiwamu Kamiya, Toshiyuki Nagai, Shingo Tsujinaga, Miwa Sarashina, Suguru Ishizaka, Yasuyuki Chiba, Masahiro Nakabachi, Hisao Nishino, Michito Murayama, Kazunori Okada, Sanae Kaga, Toshihisa Anzai

  Heart and vessels 2020年03月11日 [査読有り][通常論文]
   

  BACKGROUND: A v wave on pulmonary artery wedge (PAW) pressure sometimes augments and appears on pulmonary artery (PA) pressure wave in patients with heart failure (HF). However, the significance of PA v wave in HF remains to be elucidated. METHODS: We retrospectively analyzed pressure waveforms in 61 HF patients (left ventricular ejection fraction 35 ± 15%). On the PAW and PA pressure waveforms, mean pressure as well as peak and amplitude of v waves (ampPAWv and ampPAv, respectively) were measured. Occurrence of worsening HF and cardiac death was recorded for 2 years after the catheterization. RESULTS: The ampPAWv did not correlate with ampPAv. When the patients were divided into 4 groups: I (high-ampPAWv/high-ampPAv), II (high-ampPAWv/low-ampPAv), III (low-ampPAWv/high-ampPAv), and IV (low-ampPAWv/low-ampPAv), the prevalence of group III was low (I: 13, II: 17, III: 4, IV: 27). Mean pressures of PAW and PA were similarly elevated in groups I and II. Cardiac index was lowest (I: 2.0 ± 0.4, II: 2.8 ± 0.6, III: 2.2 ± 0.2, IV: 2.4 ± 0.6 L/min/m2, ANOVA P < 0.01, P < 0.01 for I vs II) and tricuspid annular plane systolic excursion / systolic PA pressure was impaired (I: 0.27 ± 0.07, II: 0.48 ± 0.22, III: 0.59 ± 0.35, IV: 0.68 ± 0.35 mm/mmHg, ANOVA P < 0.01) in group I. During the follow-up, 13 events were observed. Kaplan-Meier analysis showed that patients in group I were at highest risk of cardiac events. CONCLUSIONS: PA v was observed mainly in patients with augmented PAW v wave and decreased cardiac index, suggesting an advanced stage of HF. Moreover, augmented PAv was associated with worse outcome in HF patients.
• Dual Gate Doppler法による左房収縮時の血流時相解析

  岡田 一範, 岡田 由佳, 加賀 早苗, 村山 迪史, 中鉢 雅大, 横山 しのぶ, 西野 久雄, 三神 大世, 更科 美羽, 辻永 真吾, 岩野 弘幸, 安斉 俊久

  超音波検査技術抄録集 45 S110 - S110 一般社団法人 日本超音波検査学会 2020年
• 呼吸筋力評価のための横隔膜筋厚計測における適切な手技と体位

  岡田 一範, 神谷 明子, 加賀 早苗, 柳 裕介, 相庭 美穂, 藤澤 亮介, 村山 迪史, 岡田 由佳, 政氏 伸夫, 三神 大世

  超音波検査技術抄録集 45 S212 - S212 一般社団法人 日本超音波検査学会 2020年
• Left ventricular global longitudinal strain calculated from manually traced endocardial border lengths utilizing the images for routine ejection fraction measurement by biplane method of disks.

  Kazunori Okada, Sanae Kaga, Minami Araki, Kosuke Tsujita, Ayaka Yoshikawa, Mizuki Hara, Yoichi Sakamoto, Nobuo Masauzi, Taisei Mikami

  Journal of medical ultrasonics (2001) 47 1 91 - 96 2020年01月 

  PURPOSE: The purpose of this study was to test whether the fractional change in the endocardial border length between end-diastole and end-systole as manually traced in left ventricular ejection fraction (LVEF) measurement using the biplane method of disks (MOD) was consistent with the global longitudinal strain derived from speckle-tracking echocardiography. METHODS: For 105 patients who underwent echocardiography, two- and four-chamber images with manually traced endocardial lines for LVEF measurement by MOD were stored. LV endocardial lengths at end-diastole and at end-systole were measured on both images to calculate the fractional length changes, which were averaged (GLSMOD). Speckle-tracking analysis was performed to measure global longitudinal strains in the apical two- and four-chamber and long-axis images, and the three values were averaged (GLSSTE) according to the ASE and EACVI guidelines. RESULTS: There was no significant difference between GLSMOD and GLSSTE. GLSMOD correlated well with GLSSTE (r = 0.81, p < 0.001), and there was no fixed bias in the Bland-Altman analysis. The intraclass correlations for the intra- and inter-observer comparisons for GLSSTE were excellent, and those for GLSMOD were adequate. CONCLUSION: The fractional LV endocardial border length change, GLSMOD, showed sufficient agreement with GLSSTE to justify its use as a substitute for the STE-derived global longitudinal strain.
• 心エコー法とMRIによる肺動脈弁逆流重症度に乖離を認めた総動脈幹症の術後症例

  岩野 弘幸, 村山 迪史, 山澤 弘州, 武田 充人, 真鍋 徳子, 石森 直樹, 千葉 泰之, 石坂 傑, 更科 美羽, 辻永 真吾, 中鉢 雅大, 加賀 早苗, 安斉 俊久

  日本成人先天性心疾患学会雑誌 9 1 288 - 288 日本成人先天性心疾患学会 2020年01月 [査読有り][通常論文]
  
• Impact of Left Ventricular Suction During Exercise on Clinical Outcomes in Patients With Heart Failure

  Shingo Tsujinaga, Hiroyuki Iwano, Suguru Ishizaka, Yasuyuki Chiba, Miwa Sarashina, Michito Murayama, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Kazunori Okada, Sanae Kaga, Takuma Sato, Toshihisa Anzai

  CIRCULATION 140 2019年11月 [査読有り][通常論文]
   

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• Simple and noninvasive method to estimate right ventricular operating stiffness based on echocardiographic pulmonary regurgitant velocity and tricuspid annular plane movement measurements during atrial contraction.

  Michito Murayama, Kazunori Okada, Sanae Kaga, Hiroyuki Iwano, Shingo Tsujinaga, Miwa Sarashina, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Mutsumi Nishida, Hitoshi Shibuya, Nobuo Masauzi, Toshihisa Anzai, Taisei Mikami

  The international journal of cardiovascular imaging 35 10 1871 - 1880 2019年10月 [査読有り][通常論文]
   

  It was recently shown that invasively determined right ventricular (RV) stiffness was more closely related to the prognosis of patients with pulmonary hypertension than RV systolic function. So far, a completely noninvasive method to access RV stiffness has not been reported. We aimed to clarify the clinical usefulness of our new echocardiographic index of RV operating stiffness using atrial-systolic descent of the pulmonary artery-RV pressure gradient derived from pulmonary regurgitant velocity (PRPGDAC) and tricuspid annular plane movement during atrial contraction (TAPMAC). We studied 81 consecutive patients with various cardiac diseases who underwent echocardiography and cardiac catheterization. We measured PRPGDAC and TAPMAC using continuous-wave Doppler and M-mode echocardiography, respectively, and calculated PRPGDAC/TAPMAC. RV end-diastolic pressure (RVEDP) and RV pressure increase during atrial contraction (ΔRVPAC) were invasively measured, and RV volume change during atrial contraction (ΔVAC) was calculated from echocardiographic late-diastolic transtricuspid flow time-velocity integral and tricuspid annular area; thus ΔRVPAC/ΔVAC was used as the standard index for RV operating stiffness. PRPGDAC/TAPMAC well correlated with ΔRVPAC/ΔVAC (r = 0.84, p < 0.001) and RVEDP (r = 0.80, p < 0.001), and the area under the receiver operating characteristic curve to discriminate RVEDP > 12 mmHg was 0.94. Multivariate regression analysis revealed that PRPGDAC/TAPMAC was the single independent determinant of ΔRVPAC/ΔVAC (β = 0.86, p < 0.001). PRPGDAC/TAPMAC is useful to estimate RV operating stiffness and a good practical indicator of RVEDP.
• これからの超音波検査を牽引する人材の育成を目指す大学院教育

  岡田 一範, 加賀 早苗, 政氏 伸夫, 三神 大世, 中鉢 雅大, 村山 迪史, 横山 しのぶ, 西野 久雄, 西田 睦, 澁谷 斉, 更科 美羽, 辻永 真吾, 岩野 弘幸, 安斉 俊久

  臨床検査学教育 11 2 219 - 226 (一社)日本臨床検査学教育協議会 2019年09月 

  かつては医師が担ってきた超音波(エコー)検査は、現在、そのほとんどを臨床検査技師を中心とする技師(ソノグラファー)が担うようになってきた。ソノグラファーは、検査装置の管理・調整、検査手技、計測・画像法に習熟することはもちろん、検査対象となる疾患や病態についての十分な知識に基づき、個々例の所見や病態に応じて検査を自ら組み立てる必要がある。このため、超音波検査の検者依存性は、他の検査に比べてたいへん大きい。本学院・研究院の心血管エコー研究室では、超音波検査の実技に精通したうえで、その研究者としても活躍できる指導的な人材の育成を目的とし、北海道大学病院検査・輸血部、超音波センターならびに医学研究院循環病態内科学教室の協力を得つつ、教育・研究活動を行っている。本稿では、その取り組みの一端を紹介する。(著者抄録)
• 心不全における肺動脈圧波形上のv波出現の意義に関する検討

  岩野 弘幸, 横山 しのぶ, 石坂 傑, 千葉 泰之, 更科 美羽, 辻永 真吾, 中鉢 雅大, 加賀 早苗, 神谷 究, 永井 利幸, 安斉 俊久

  日本心臓病学会学術集会抄録 67回 O - 281 (一社)日本心臓病学会 2019年09月
• Tricuspid regurgitation occurring in the early-diastolic phase in a case of heart failure: Insights from echocardiographic and invasive hemodynamic findings.

  Michito Murayama, Hiroyuki Iwano, Shingo Tsujinaga, Miwa Sarashina, Suguru Ishizaka, Yasuyuki Chiba, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Kazunori Okada, Sanae Kaga, Hitoshi Shibuya, Mutsumi Nishida, Toshihisa Anzai

  Echocardiography (Mount Kisco, N.Y.) 36 9 1771 - 1775 2019年09月 [査読有り][通常論文]
   

  Although the presence and physiological significance of late-diastolic tricuspid regurgitation (TR) have been reported, those in TR occurring in early diastole have not been well known. We herein first presented a case of heart failure due to dilated cardiomyopathy showing functional TR occurring in the early-diastolic phase in whom the mechanism for its genesis could be precisely assessed from echocardiographic findings and intra-cardiac pressure recordings.
• Clinical significance of end-diastolic opening of pulmonary valve in a case complicating left ventricular systolic dysfunction.

  Nishino H, Iwano H, Kaga S, Nishida M, Akizawa K, Teshima T, Anzai T

  Journal of echocardiography 19 1 53 - 55 2019年08月 [査読有り][通常論文]
  
• Right ventricular basal inflow and outflow tract diameters overestimate right ventricular size in subjects with sigmoid-shaped interventricular septum: a study using three-dimensional echocardiography

  Okada K, Kaga S, Tsujita K, Sakamoto Y, Masauzi N, Mikami T

  Int J Cardiovasc Imaging 35 7 1211 - 1219 2019年07月 [査読有り][通常論文]
   

  Sigmoid-shaped ventricular septum (SS), a frequently encountered minor abnormality in echocardiographic examinations of the elderly, may have some influence on RV shape. We aimed to determine the influence of SS on the accuracy of the 6 RV linear diameter measurements in the light of three-dimensional echocardiographic (3DE) RV volume. The aorto-septal angle (ASA) was measured in the parasternal long-axis view using two-dimensional echocardiography (2DE) as an index of SS in 70 patients without major cardiac abnormalities who were subdivided into 35 with SS (ASA ≤ 120°) and 35 without SS (NSS). We measured RV end-diastolic volume (RVEDV) using 3DE; in addition, using 2DE, we measured basal RV diameter, mid-cavity diameter, longitudinal diameter and end-diastolic area in the apical four-chamber view; proximal RV outflow tract (RVOT) diameter in the parasternal long-axis view; and proximal and distal RVOT diameters in the parasternal short-axis view. RVEDV did not differ between the SS and NSS groups. The SS group had greater basal RV diameter and proximal and distal RVOT diameters than the NSS group. RV mid-cavity diameter, longitudinal diameter, and end-diastolic area did not differ between the groups. Among the 2DE parameters of RV size, RV end-diastolic area was most strongly correlated with RVEDV (r = 0.67), followed by RV mid-cavity diameter (r = 0.58). When SS is present, the echocardiographic basal RV diameter and RVOT diameters overestimate RV size, and the measurement of RV end-diastolic area and mid-cavity diameter more correctly reflect 3D RV volume.
• Diastolic Intra-Left Ventricular Pressure Difference During Exercise: Strong Determinant and Predictor of Exercise Capacity in Patients With Heart Failure.

  Shingo Tsujinaga, Hiroyuki Iwano, Miwa Sarashina, Taichi Hayashi, Michito Murayama, Ayako Ichikawa, Masahiro Nakabachi, Hisao Nishino, Shinobu Yokoyama, Arata Fukushima, Takashi Yokota, Kazunori Okada, Sanae Kaga, Pavlos P Vlachos, Toshihisa Anzai

  Journal of cardiac failure 25 4 268 - 277 2019年04月 [査読有り][通常論文]
   

  BACKGROUND: Although the enhancement of early-diastolic intra-left ventricular pressure difference (IVPD) during exercise is considered to maintain exercise capacity, little is known about their relationship in heart failure (HF). METHODS AND RESULTS: Cardiopulmonary exercise testing and exercise-stress echocardiography were performed in 50 HF patients (left ventricular [LV] ejection fraction 39 ± 15%). Echocardiographic images were obtained at rest and submaximal and peak exercise. Color M-mode Doppler images of LV inflow were used to determine IVPD. Thirty-five patients had preserved exercise capacity (peak oxygen consumption [VO2] ≥14 mL·kg-1·min-1; group 1) and 15 patients had reduced exercise capacity (group 2). During exercise, IVPD increased only in group 1 (group 1: 1.9 ± 0.9 mm Hg at rest, 4.1 ± 2.0 mm Hg at submaximum, 4.7 ± 2.1 mm Hg at peak; group 2: 1.9 ± 0.8 mm Hg at rest, 2.1 ± 0.9 mm Hg at submaximum, 2.1 ± 0.9 mm Hg at peak). Submaximal IVPD (r = 0.54) and peak IVPD (r = 0.69) were significantly correlated with peak VO2. Peak IVPD determined peak VO2 independently of LV ejection fraction. Moreover, submaximal IVPD could well predict the reduced exercise capacity. CONCLUSION: Early-diastolic IVPD during exercise was closely associated with exercise capacity in HF. In addition, submaximal IVPD could be a useful predictor of exercise capacity without peak exercise in HF patients.
• 心不全患者における運動中の換気効率のメカニズム 駆出率の保たれた心不全と駆出率が低下した心不全の比較(Mechanisms of Ventilatory Efficiency during Exercise in Heart Failure: Comparison between Heart Failure with Preserved Ejection Fraction and Reduced Ejection Fraction)

  辻永 真吾, 岩野 弘幸, 更科 美羽, 村山 迪史, 中鉢 雅大, 横山 しのぶ, 西野 久雄, 岡田 一範, 加賀 早苗, 福島 新, 横田 卓, 安斉 俊久

  日本循環器学会学術集会抄録集 83回 OJ08 - 2 2019年03月
• 心不全患者における左室動作時スティフネスに関する新規心エコー指標の予後に対する価値(Prognostic Value of Novel Echocardiographic Index of Left Ventricular Operating Stiffness in Patients with Heart Failure)

  岡田 一範, 藤澤 亮介, 加賀 早苗, 政氏 伸夫, 三神 大世, 村山 迪史, 中鉢 雅大, 西野 久雄, 横山 しのぶ, 更科 美羽, 辻永 真吾, 岩野 弘幸, 安斉 俊久

  日本循環器学会学術集会抄録集 83回 OJ08 - 7 2019年03月
• Novel echocardiographic method to assess left ventricular chamber stiffness and elevated end-diastolic pressure based on time-velocity integral measurements of pulmonary venous and transmitral flows.

  Kazunori Okada, Sanae Kaga, Rika Abiko, Michito Murayama, Takuma Hioka, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Ayako Ichikawa, Ayumu Abe, Mutsumi Nishida, Naoya Asakawa, Shingo Tsujinaga, Taichi Hayashi, Hiroyuki Iwano, Satoshi Yamada, Nobuo Masauzi, Taisei Mikami

  European heart journal cardiovascular Imaging 19 11 1260 - 1267 2018年11月01日 [査読有り][通常論文]
   

  Aims: The detection of increased left ventricular (LV) chamber stiffness may play an important role in assessing cardiac patients with potential but not overt heart failure. A non-invasive method to estimate it is not established. We investigated whether the echocardiographic backward/forward flow volume ratio from the left atrium (LA) during atrial contraction reflects the LV chamber stiffness. Methods and results: We studied 62 patients who underwent cardiac catheterization and measured their left ventricular end-diastolic pressure (LVEDP) and pressure increase during atrial contraction (ΔPa) from the LV pressure waveform. Using the echocardiographic biplane method of disks, we measured the LV volume change during atrial contraction indexed to the body surface area (ΔVa), and ΔPa/ΔVa was calculated as a standard for the LV operating chamber stiffness. Using pulsed Doppler echocardiography, we measured the time-velocity integral (TVI) of the backward pulmonary venous (PV) flow during atrial contraction (IPVA) and the ratio of IPVA to the PV flow TVI throughout a cardiac cycle (FPVA). We also measured the TVI of the atrial systolic forward transmitral flow (IA) and the ratio of the IA to the transmitral TVI during a cardiac cycle (FA) and calculated IPVA/IA and FPVA/FA. IPVA/IA and FPVA/FA were well correlated with ΔPa/ΔVa (r = 0.79 and r = 0.81) and LVEDP (r = 0.73 and r = 0.77). The areas under the ROC curve to discriminate LVEDP >18 mmHg were 0.90 for IPVA/IA and 0.93 for FPVA/FA. Conclusion: The FPVA/FA, the backward/forward flow volume ratio from the LA during atrial contraction, is useful for non-invasive assessments of LV chamber stiffness and elevated LVEDP.
• Correction to: Altered oscillation of Doppler-derived renal and renal interlobar venous flow velocities in hypertensive and diabetic patients.

  Kudo Y, Mikami T, Nishida M, Okada K, Kaga S, Masauzi N, Omotehara S, Shibuya H, Kahata K, Shimizu C

  Journal of medical ultrasonics (2001) 45 1 197 - 197 2018年01月 [査読有り][通常論文]
   

  In the original publication of this paper the legend of Fig. 1 should read as: Fig. 1 Pulsed Doppler flow velocity recordings of the aorta (a), right renal artery (b), right renal interlobar artery (c), inferior vena cava (d), right renal vein (e), and right renal interlobar vein (f). PSV peak systolic velocity, EDV end-diastolic velocity, V MAX maximum velocity, V MIN minimum velocity.
• Quantitative distinction of morphological characteristics of white blood cells in peripheral blood through texture analysis using gray level co-occurrence matrix

  Yamamoto M, Kono K, Kuroki M, Murakami S, Hayata R, Nanato K, Shao M, Miwa K, Tsutsumi Y, Okada K, Kaga S, Masauzi N

  Clin Lab 63 11 1851 - 1868 2017年11月 [査読有り][通常論文]
  
• Altered oscillation of Doppler-derived renal and renal interlobar venous flow velocities in hypertensive and diabetic patients

  Yusuke Kudo, Taisei Mikami, Mutsumi Nishida, Kazunori Okada, Sanae Kaga, Nobuo Masauzi, Satomi Omotehara, Hitoshi Shibuya, Kaoru Kahata, Chikara Shimizu

  JOURNAL OF MEDICAL ULTRASONICS 44 4 305 - 314 2017年10月 [査読有り][通常論文]
   

  Flow velocity oscillation rate (FVOR) of the renal interlobar vein has been reported to be decreased in patients with urinary obstruction or diabetic nephropathy, and increased in those with hypertension during pregnancy. To clarify the clinical role of the renal interlobar venous FVOR, we investigated the flow velocity patterns of the renal vessels in patients with hypertension (HT) and/or diabetes (DM). Pulsed-wave Doppler sonography was performed in 34 patients: 15 with HT, 10 with DM, and nine with both HT and DM (HT-DM). Each FVOR of the right and left interlobar veins was closely and positively correlated with the ipsilateral interlobar arterial resistive index (RI), especially in the HT group, but not with the estimated glomerular filtration rate. The right interlobar venous FVOR was decreased in the DM and HT-DM groups compared to the HT group. The renal interlobar venous FVOR is strongly influenced by the arterial RI in HT patients, and is reduced in DM patients without an obvious relationship with diabetic nephropathy. These findings should be noted for the clinical application of renal interlobar venous flow analysis.
• Overestimation by echocardiography of the peak systolic pressure gradient between the right ventricle and right atrium due to tricuspid regurgitation and the usefulness of the early diastolic transpulmonary valve pressure gradient for estimating pulmonary artery pressure

  Takuma Hioka, Sanae Kaga, Taisei Mikami, Kazunori Okada, Michito Murayama, Nobuo Masauzi, Masahiro Nakabachi, Hisao Nishino, Shinobu Yokoyama, Mutsumi Nishida, Hiroyuki Iwano, Mamoru Sakakibara, Satoshi Yamada, Hiroyuki Tsutsui

  HEART AND VESSELS 32 7 833 - 842 2017年07月 [査読有り][通常論文]
   

  We investigated the influence of tricuspid regurgitation (TR) severity on the echocardiographic peak systolic transtricuspid pressure gradient (TRPG) and evaluated the usefulness of the peak early diastolic transpulmonary valve pressure gradient (PRPG) for estimating pulmonary artery (PA) pressure. In 55 consecutive right heart-catheterized patients, we measured the peak systolic right ventricular (RV)-right atrial (RA) pressure gradient (RV-RA(CATH)), peak early diastolic PA-RV pressure gradient (PA-RVCATH), and mean PA pressure (MPAP(CATH)). Using echocardiography, we obtained the TRPG, PRPG, and an estimate of the mean PA pressure (EMPAP) as the sum of PRPG and the estimated RA pressure, and measured the vena contracta width of TR (VCTR). The difference between the TRPG and RV-RA(CATH) was significantly greater in the very severe TR group (VCTR > 11 mm) than in the mild, moderate, and severe TR groups, and significantly greater in the severe TR group (7 < VCTR ae<currency> 11 mm) than in the mild TR group. The overestimation of the pressure gradient > 10 mmHg by TRPG was not seen in the mild or moderate TR groups, but was observed in the severe and very severe TR groups (22 and 83%, respectively). In the ROC analysis, EMPAP could distinguish patients with MPAP(CATH) ae<yen> 25 mmHg with the area under the curve of 0.93, 100% sensitivity, and 87% specificity. In conclusion, TRPG frequently overestimated RV-RA(CATH) when VCTR was > 11 mm and sometimes did when VCTR was > 7 mm, where EMPAP using PRPG was useful for estimating PA pressure.
• Relationships of left ventricular strain and strain rate to wall stress and their afterload dependency

  Daisuke Murai, Satoshi Yamada, Taichi Hayashi, Kazunori Okada, Hisao Nishino, Masahiro Nakabachi, Shinobu Yokoyama, Ayumu Abe, Ayako Ichikawa, Kota Ono, Sanae Kaga, Hiroyuki Iwano, Taisei Mikami, Hiroyuki Tsutsui

  HEART AND VESSELS 32 5 574 - 583 2017年05月 [査読有り][通常論文]
   

  Whether and how left ventricular (LV) strain and strain rate correlate with wall stress is not known. Furthermore, it is not determined whether strain or strain rate is less dependent on the afterload. In 41 healthy young adults, LV global peak strain and systolic peak strain rate in the longitudinal direction (LS and LSR, respectively) and circumferential direction (CS and CSR, respectively) were measured layer-specifically using speckle tracking echocardiography (STE) before and during a handgrip exercise. Among all the points before and during the exercise, all the STE parameters significantly correlated linearly with wall stress (LS: r = -0.53, p < 0.01, LSR: r = -0.28, p < 0.05, CS in the inner layer: r = -0.72, p < 0.01, CSR in the inner layer: r = -0.47, p < 0.01). Strain more strongly correlated with wall stress than strain rate (r = -0.53 for LS vs. r = -0.28 for LSR, p < 0.05; r = -0.72 for CS vs. r = -0.47 for CSR in the inner layer, p < 0.05), whereas the interobserver variability was similar between strain and strain rate (longitudinal 6.2 vs. 5.2 %, inner circumferential 4.8 vs. 4.7 %, mid-circumferential 7.9 vs. 6.9 %, outer circumferential 10.4 vs. 9.7 %), indicating that the differences in correlation coefficients reflect those in afterload dependency. It was thus concluded that LV strain and strain rate linearly and inversely correlated with wall stress in the longitudinal and circumferential directions, and strain more strongly depended on afterload than did strain rate. Myocardial shortening should be evaluated based on the relationships between these parameters and wall stress.
• Characteristic systolic waveform of left ventricular longitudinal strain rate in patients with hypertrophic cardiomyopathy

  Kazunori Okada, Sanae Kaga, Taisei Mikami, Nobuo Masauzi, Ayumu Abe, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Ayako Ichikawa, Mutsumi Nishida, Daisuke Murai, Taichi Hayashi, Chikara Shimizu, Hiroyuki Iwano, Satoshi Yamada, Hiroyuki Tsutsui

  HEART AND VESSELS 32 5 591 - 599 2017年05月 [査読有り][通常論文]
   

  We analyzed the waveform of systolic strain and strain-rate curves to find a characteristic left ventricular (LV) myocardial contraction pattern in patients with hypertrophic cardiomyopathy (HCM), and evaluated the utility of these parameters for the differentiation of HCM and LV hypertrophy secondary to hypertension (HT). From global strain and strain-rate curves in the longitudinal and circumferential directions, the time from mitral valve closure to the peak strains (T-LS and T-CS, respectively) and the peak systolic strain rates (T-LSSR and T-CSSR, respectively) were measured in 34 patients with HCM, 30 patients with HT, and 25 control subjects. The systolic strain-rate waveform was classified into 3 patterns ("V", "W", and "root" pattern). In the HCM group, T-LS was prolonged, but T-LSSR was shortened; consequently, T-LSSR/TLS ratio was distinctly lower than in the HT and control groups. The "root" pattern of longitudinal strain-rate waveform was more frequently seen in the HCM group (74 %) than in the control (4 %) and HT (20 %) groups. Similar but less distinct results were obtained in the circumferential direction. To differentiate HCM from HT, the sensitivity and specificity of the T-LSSR/TLS ratio <0.34 and the "root"-shaped longitudinal strain-rate waveform were 85 and 63 %, and 74 and 80 %, respectively. In conclusion, in patients with HCM, a reduced T-LSSR/T-LS ratio and a characteristic "root"- shaped waveform of LV systolic strain rate was seen, especially in the longitudinal direction. The timing and waveform analyses of systolic strain rate may be useful to distinguish between HCM and HT.
• USEFULNESS OF THE CONTINUOUS-WAVE DOPPLER-DERIVED PULMONARY ARTERIAL-RIGHT VENTRICULAR PRESSURE GRADIENT JUST BEFORE ATRIAL CONTRACTION FOR THE ESTIMATION OF PULMONARY ARTERIAL DIASTOLIC AND WEDGE PRESSURES

  Michito Murayama, Taisei Mikami, Sanae Kaga, Kazunori Okada, Takuma Hioka, Nobuo Masauzi, Masahiro Nakabachi, Hisao Nishino, Shinobu Yokoyama, Mutsumi Nishida, Hiroyuki Iwano, Mamoru Sakakibara, Satoshi Yamada, Hiroyuki Tsutsui

  ULTRASOUND IN MEDICINE AND BIOLOGY 43 5 958 - 966 2017年05月 [査読有り][通常論文]
   

  In our new echocardiographic method, pulmonary regurgitant velocity immediately before right atrial (RA) contraction is used to estimate pulmonary artery diastolic pressure (PADP) and mean PA wedge pressure (MPAWP). Our aim here was to compare the usefulness of this new method with that of the conventional method, which uses pulmonary regurgitant velocity at end diastole. We studied 55 consecutive patients who underwent echocardiography and right-sided heart catheterization. The pulmonary regurgitant velocities just before RA contraction and at end diastole were measured to obtain echocardiographic estimates of PADP (EPADP(preA) and EPADP(ED), respectively) by adding the pressure gradients to the echocardiographically estimated RA pressure. Compared with EPADP(ED), EPADP(preA) correlated better with PADP (r = 0.87) and MPAWP (r = 0.80), and direct fixed biases were detected for EPADP(ED) but not for EPADP(preA). The area under the receiver operating characteristic curve distinguishing patients with MPAWP > 18 mm Hg was greater for EPADP(preA) (0.97) than for E/e' (0.94) and E/A (0.83). EPADP(preA) is thus useful in estimating PADP and MPAWP in patients with heart disease. (C) 2017 World Federation for Ultrasound in Medicine & Biology.
• Quantitative distinction of the morphological characteristic of erythrocyte precursor cells with texture analysis using gray level co-occurrence matrix

  Kono K, Hayata R, Murakami S, Yamamoto M, Kuroki M, Nanato K, Takahashi K, Miwa K, Okada K, Kaga S, Mikami T, Masauzi N

  J Clin Lab Anal 32 1 2017年02月 [査読有り][通常論文]
  
• Semi-Automatic Rating Method for Neutrophil Alkaline Phosphatase Activity

  Kanae Sugano, Kotomi Hashi, Misaki Goto, Kiyotaka Nishi, Rie Maeda, Keigo Kono, Mai Yamamoto, Kazunori Okada, Sanae Kaga, Keiko Miwa, Taisei Mikami, Nobuo Masauzi

  JOURNAL OF CLINICAL LABORATORY ANALYSIS 31 1 2017年01月 [査読有り][通常論文]
   

  Background: The neutrophil alkaline phosphatase (NAP) score is a valuable test for the diagnosis of myeloproliferative neoplasms, but it has still manually rated. Therefore, we developed a semi-automatic rating method using Photoshop (R) and Image-J, called NAP-PS-IJ. Methods: Neutrophil alkaline phosphatase staining was conducted with Tomonaga's method to films of peripheral blood taken from three healthy volunteers. At least 30 neutrophils with NAP scores from 0 to 5+ were observed and taken their images. From which the outer part of neutrophil was removed away with Image-J. These were binarized with two different procedures (P1 and P2) using Photoshop (R). NAP-positive area (NAP-PA) and granule (NAP-PGC) were measured and counted with Image-J. Results: The NAP-PA in images binarized with P1 significantly (P < 0.05) differed between images with NAP scores from 0 to 3+ (group 1) and those from 4+ to 5+ (group 2). The original images in group 1 were binarized with P2. NAP-PGC of them significantly (P < 0.05) differed among all four NAP score groups. The mean NAP-PGC with NAP-PS-IJ indicated a good correlation (r = 0.92, P < 0.001) to results by human examiners. Conclusions: The sensitivity and specificity of NAP-PS-IJ were 60% and 92%, which might be considered as a prototypic method for the full-automatic rating NAP score. (C) 2016 Wiley Periodicals, Inc.
• A new method to estimate pulmonary vascular resistance using diastolic pulmonary artery-right ventricular pressure gradients derived from continuous-wave Doppler velocity measurements of pulmonary regurgitation

  Sanae Kaga, Taisei Mikami, Michito Murayama, Kazunori Okada, Nobuo Masauzi, Masahiro Nakabachi, Hisao Nishino, Shinobu Yokoyama, Mutsumi Nishida, Taichi Hayashi, Daisuke Murai, Hiroyuki Iwano, Mamoru Sakakibara, Satoshi Yamada, Hiroyuki Tsutsui

  INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 33 1 31 - 38 2017年01月 [査読有り][通常論文]
   

  Pulmonary vascular resistance (PVR) is an important hemodynamic parameter in patients with heart failure, especially when the pulmonary arterial pressure is lower due to reduced stroke volume. Several echocardiographic methods to estimate PVR have been proposed, but their applications in patients with organic left-sided heart diseases have been limited. The aim of the present study was to examine the usefulness of our new method to estimate PVR (PVRPR) based on the continuous-wave Doppler velocity measurements of pulmonary regurgitation in these patients. In 43 patients who underwent right heart catheterization, PVRPR was calculated as the difference between the Doppler-derived early- and end-diastolic pulmonary artery (PA)-right ventricular (RV) pressure gradients divided by the cardiac output measured in the left ventricular outflow tract by echocardiography. The PVRPR correlated well with invasive PVR (PVRCATH) (r = 0.81, p < 0.001) without any fixed bias in Bland-Altman analysis. The conventional echocardiographic PVRs showed inadequate correlations with PVRCATH, or a obvious overestimation of PVRCATH. In the receiver operating characteristic analyses to determine the patients with abnormal elevation of PVRCATH (> 3 Wood units, WU), the area under the curve was the greatest for PVRPR (0.964) compared to the conventional PVRs (0.649-0.839). PVRPR had 83 % sensitivity and 100 % specificity at the optimal cut-off value of 3.10 WU in identifying patients with PVRCATH > 3 WU. Our simple and theoretical PVRPR is useful for the noninvasive estimation of PVR.
• Additive Predictive Value of Strain Rate Dispersion Index for Responses to Cardiac Resynchronization Therapy: Substudy From the START Study

  Iwano Hiroyuki, Yamada Satoshi, Okada Kazunori, Hayashi Taichi, Tsujinaga Shingo, Yokoyama Shinobu, Nakabachi Masahiro, Nishino Hisao, Ichikawa Ayako, Abe Ayumu, Kaga Sanae, Mikami Taisei, Tsutsui Hiroyuki

  CIRCULATION 134 2016年11月11日 [査読有り][通常論文]
  
• Semiautomated Segmentation and Measurement of Cytoplasmic Vacuoles in a Neutrophil With General-Purpose Image Analysis Software

  Maki Mizukami, Misaki Yamada, Sayaka Fukui, Nao Fujimoto, Shigeru Yoshida, Sanae Kaga, Keiko Obata, Shigeki Jin, Keiko Miwa, Nobuo Masauzi

  JOURNAL OF CLINICAL LABORATORY ANALYSIS 30 6 918 - 923 2016年11月 [査読有り][通常論文]
   

  BackgroundMorphological observation of blood or marrow film is still described nonquantitatively. We developed a semiautomatic method for segmenting vacuoles from the cytoplasm using Photoshop (PS) and Image-J (IJ), called PS-IJ, and measured the relative entire cell area (rECA) and relative areas of vacuoles (rAV) in the cytoplasm of neutrophil with PS-IJ. MethodsWhole-blood samples were stored at 4 degrees C with ethylenediaminetetraacetate and in two different preserving manners (P1 and P2). Color-tone intensity levels of neutrophil images were semiautomatically compensated using PS, and then vacuole portions were automatically segmented by IJ. The rAV and rECA were measured by counting pixels by IJ. For evaluating the accuracy in segmentations of vacuoles with PS-IJ, the rAV/rECA ratios calculated with results from PS-IJ were compared with those calculated with human eye and IJ (HE-IJ). ResultsThe rECA and rAV/ in P1 significantly (P < 0.05, P < 0.05) were enlarged and increased, but did not significantly (P = 0.46, P = 0.21) change in P2. The rAV/rECA ratios by PS-IJ were significantly correlated (r = 0.90, P < 0.01) with those by HE-IJ. ConclusionPS-IJ method can successfully segment vacuoles and measure the rAV and rECA, becoming a useful tool for quantitative description of morphological observation of blood and marrow film.
• Long-term echocardiographic evaluation of valvular lesions in a patients with nonbacterial thrombotic endocarditis associated with advanced uterine cancer

  Yokoyama S, Iwano H, Yamada S, Takeda M, Kaga S, Nakabachi M, Nishino H, Ichikawa A, Abe A, Okada K, Murai D, Hayashi T, Nishida M, Shibuya H, Kahata K, Shimizu C, Mikami T, Tsutsui H

  J Cardiol Cases 14 3 82 - 86 2016年09月 [査読有り][通常論文]
   

  Nonbacterial thrombotic endocarditis (NBTE) is characterized by the deposition of thrombi on previously undamaged heart valves in the absence of bacteremia and predominantly affects patients with hypercoagulable state. Although the diagnosis is usually based on transthoracic echocardiography, little is known about the serial changes of the vegetation in response to treatment. We experienced a 42-year-old woman with advanced uterine cancer and asymptomatic cerebral embolization. Plasma d-dimer level was markedly elevated and echocardiography showed highly mobile masses attached to the anterior and posterior mitral leaflets with moderate regurgitation. Based on these findings, she was diagnosed as having NBTE associated with uterine cancer and intravenous administration of heparin and chemotherapy were performed. Follow-up echocardiography revealed the disappearance of the vegetation and reduction of mitral regurgitation. Uterine cancer was successfully treated by surgery and recurrence of the valvular lesion did not occur. .
• 心エコー法による肺高血圧症の診断と病型分類

  喜田 真由子, 加賀 早苗, 岡田 一範, 村山 迪史, 阿部 歩, 市川 絢子, 中鉢 雅大, 西野 久雄, 横山 しのぶ, 西田 睦, 山田 聡, 三神 大世

  超音波検査技術 41 3 314 - 314 (一社)日本超音波検査学会 2016年06月
• 肺動脈拡張期圧の推定は心房収縮の前後いずれで行うべきか?

  村山 迪史, 加賀 早苗, 岡田 一範, 樋岡 拓馬, 阿部 歩, 市川 絢子, 中鉢 雅大, 西野 久雄, 横山 しのぶ, 西田 睦, 山田 聡, 三神 大世

  超音波検査技術 41 3 314 - 314 (一社)日本超音波検査学会 2016年06月
• SONOGRAPHIC DETECTION OF ABNORMAL PLAQUE MOTION OF THE CAROTID ARTERY: ITS USEFULNESS IN DIAGNOSING HIGH-RISK LESIONS RANGING FROM PLAQUE RUPTURE TO ULCER FORMATION

  Mutsuko Muraki, Taisei Mikami, Tetsuyuki Yoshimoto, Shin Fujimoto, Zmayumi Kitaguchi, Sanae Kaga, Tomoko Sugawara, Kouichi Tokuda, Sadao Kaneko, Takeshi Kashiwaba

  ULTRASOUND IN MEDICINE AND BIOLOGY 42 2 358 - 364 2016年02月 [査読有り][通常論文]
   

  We investigated the feasibility of using sonography of abnormal plaque motion to diagnose high-risk carotid lesions ranging from plaque rupture to ulcer formation. Fifty consecutive carotid arteries of 49 patients (71 +/- 7 y, 37 males) who underwent carotid endarterectomy were investigated by carotid sonography to find a plaque concavity (sonographic ulcer [SU]), fine trembling motion inside the plaque (FTMI) and systolic retractive motion of the plaque surface (SRMS). Plaque rupture or ulcer, necrotic core and intra-plaque hemorrhage were determined at carotid endarterectomy. Twenty-two SUs, 41 cases of FTMI and 20 cases of SRMS were detected by carotid sonography. The sensitivity and specificity of SU in diagnosing plaque rupture or ulcer at carotid endarterectomy were 48% and 90%, and those of FTMI were 93% and 60%. Plaques with SRMS more frequently had both a necrotic core and intra-plaque hemorrhage than those without SRMS (80% vs. 30%, p = 0.0005). Abnormal plaque motion detected by carotid sonography is useful in detecting a ruptured or ulcerated plaque with a necrotic core and/or hemorrhage. (C) 2016 World Federation for Ultrasound in Medicine & Biology.
• Myocardial Shortening in 3 Orthogonal Directions and Its Transmural Variation in Patients With Nonobstructive Hypertrophic Cardiomyopathy

  Kazunori Okada, Satoshi Yamada, Hiroyuki Iwano, Hisao Nishino, Masahiro Nakabachi, Shinobu Yokoyama, Ayumu Abe, Ayako Ichikawa, Sanae Kaga, Mutsumi Nishida, Taichi Hayashi, Daisuke Murai, Taisei Mikami, Hiroyuki Tsutsui

  CIRCULATION JOURNAL 79 11 2471 - 2479 2015年11月 [査読有り][通常論文]
   

  Background: Although longitudinal strain (LS) is known to be reduced in patients with hypertrophic cardiomyopathy (HCM), it has not been elucidated whether or not circumferential strain (CS) is reduced. We aimed to determine whether multidirectional and layer-specific myocardial strain is reduced in patients with nonobstructive HCM. Methods and Results: Speckle-tracking echocardiography was performed in 41 HCM patients and 27 control subjects. Segmental and global LS and CS were measured in the inner, mid, and outer layers. Global LS was significantly lower in the HCM group than in controls in the inner (-10.3 +/- 2.9 vs. -14.8 +/- 2.0%, P<0.001), mid (-8.7 +/- 2.6 vs. -13.8 +/- 1.9%, P<0.001), and outer (-7.2 +/- 2.6 vs. -11.9 +/- 1.9%, P<0.001) layers. Global CS was preserved in the inner layer (-23.8 +/- 4.7 vs. -24.3 +/- 3.3%, P=0.69) but reduced in the mid (-10.3 +/- 3.1 vs. -13.3 +/- 2.5%, P<0.001) and outer layers (-6.7 +/- 2.3 vs. -8.6 +/- 2.3%, P=0.002). Differences in CS between the inner and outer layers correlated with segmental relative wall thickness (r=-0.20, P=0.002). Furthermore, only the absolute value of global CS in the inner layer positively correlated with left ventricular ejection fraction (r=0.32, P<0.01) among these multidirectional and layer-specific strains. Conclusions: In patients with HCM, not only the LS in all layers but also CS in the mid and outer layers was reduced, presumably reflecting impaired myocardial function. In contrast, CS in the inner layer was preserved, being associated with maintenance of chamber function.
• Quantitative and Pattern Analyses of Continuous-Wave Doppler-Derived Pulmonary Regurgitant Flow Velocity for the Diagnosis of Constrictive Pericarditis

  Sanae Kaga, Taisei Mikami, Yuka Takamatsu, Ayumu Abe, Kazunori Okada, Masahiro Nakabachi, Hisao Nishino, Shinobu Yokoyama, Mutsumi Nishida, Chikara Shimizu, Hiroyuki Iwano, Satoshi Yamada, Hiroyuki Tsutsui

  JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY 27 11 1223 - 1229 2014年11月 [査読有り][通常論文]
   

  Background: Many echocardiographic features of constrictive pericarditis (CP) have been reported, but each alone has a limitation either in sensitivity or in specificity. Continuous-wave Doppler-derived flow velocity of pulmonary regurgitation can reflect the diastolic right ventricular pressure pattern characteristic of CP and be useful for its detection. Methods: Fifteen patients with CP, 18 patients with restrictive cardiomyopathy, and 20 normal subjects were studied retrospectively. Using continuous-wave Doppler echocardiography, pulmonary regurgitation velocities were measured at the early diastolic peak (V-MAx), mid-diastolic inflection point (V-IFL), and late diastolic minimal point (V-MIN). Results: V-IFL, V-IFL/V-MAx, V-MIN, and V-MIN/V-MAx were significantly lower in the CP group compared with the restrictive cardiomyopathy and normal groups. Prevalence rates of patients with early mid-diastolic inflection, V-IFL/V-MAx < 0.5, V-MIN < 50 cm/sec, and V-MIN/V-MAx < 0.33 were significantly greater in the CP group compared with the other groups. Sensitivity and specificity for the diagnosis of CP were 93% and 74%, respectively, for the presence of early mid-diastolic inflection, 73% and 100% for V-IFL/V-MAx < 0.5, 73% and 97% for V-MIN < 50 cm/sec, and 93% and 92% for V-MIN/V-MAx < 0.33. Conclusions: The quantitative and pattern analyses of continuous-wave Doppler-derived pulmonary regurgitation velocity could enhance the accuracy of echocardiographic detection of CP.
• Decreased Aorto-septal Angle May Contribute to Left Ventricular Diastolic Dysfunction in Healthy Subjects

  Kazunori Okada, Taisei Mikami, Sanae Kaga, Masahiro Nakabachi, Ayumu Abe, Shinobu Yokoyama, Hisao Nishino, Mutsumi Nishida, Chikara Shimizu, Hiroyuki Iwano, Satoshi Yamada, Hiroyuki Tsutsui

  JOURNAL OF CLINICAL ULTRASOUND 42 6 341 - 347 2014年07月 [査読有り][通常論文]
   

  Background. Left ventricular (LV) diastolic dysfunction is often observed in healthy older subjects without structural heart disease, although its exact mechanisms have not been established. A decrease in the aorto-septal angle (ASA), an alteration of LV shape due to aortic elongation, is also frequently seen in elderly subjects. The objective of this study was to evaluate whether it can contribute to LV diastolic dysfunction in healthy subjects. Methods. Echocardiography was performed in 77 healthy subjects (42 men, mean age 43.2 +/- 13.8 years) to measure the ASA, early diastolic transmitral flow velocity (E), isovolumic relaxation time (IRT), and early diastolic mitral annular velocity (e'). The LV peak early diastolic longitudinal strain rate (GSR(E)) was measured using a two-dimensional speckle tracking imaging technique. Results. ASA was significantly correlated with E (r=0.54, p<0.001), IRT (r=-0.41, p<0.001), e' (r=0.57, p<0.001), and GSRE (r=0.63, p<0.001) and shown by stepwise multivariate analysis to be the strongest independent determinant of E, IRT, and GSRE, and one of the independent determinants of e'. Conclusions. The alteration of LV shape associated with reduced ASA may be one of the causes of LV diastolic dysfunction independently of age in otherwise healthy subjects. (C) 2014 Wiley Periodicals, Inc.
• 超音波診断!その時あなたはどう考える? エキスパートのバーチャルルーチン検査に迫る!! 膵疾患に迫る!!

  西田 睦, 佐藤 恵美, 工藤 悠輔, 井上 真美子, 表原 里実, 堀江 達則, 和田 妙子, 岩井 孝仁, 石坂 欣也, 加賀 早苗

  超音波検査技術 38 Suppl. S75 - S76 (一社)日本超音波検査学会 2013年06月
• Coexisting cardiac diseases and pressure recovery phenomenon contribute to discrepancy between the echocardiographic severity of aortic stenosis and left ventricular hypertrophy

  Ayumu Abe, Taisei Mikami, Sanae Kaga, Kanako Tsuji, Kazunori Okada, Shinobu Yokoyama, Hisao Nishino, Masahiro Nakabachi, Mutsumi Nishida, Chikara Shimizu, Hiroyuki Iwano, Satoshi Yamada, Hiroyuki Tsutsui

  Journal of Echocardiography 11 2 41 - 49 2013年06月 [査読有り][通常論文]
   

  Background: Assessing left ventricular (LV) hypertrophy (LVH) is an important step in the echocardiographic diagnosis of aortic stenosis (AS). We aimed to investigate the causes of discrepancies between the degrees of AS and LVH. Methods: The study subjects consisted of 149 consecutive patients with AS having aortic valve area < 2.0 cm2 (mean age 72.5 ± 11.9 years, 67 men and 82 women). Coexisting cardiac diseases were determined based on echocardiographic findings and comprehensive clinical judgment. Echocardiographic measurements included LV mass index (LVMI), aortic valve area index (AVAI), transaortic mean pressure gradient (MPG), valvulo-arterial impedance (Zva), energy loss coefficient (ELCo), and energy loss index (ELI). Results: LVMI was not significantly correlated with AVAI and Zva, and had a weak correlation with MPG (r = 0.305, p = 0.0001). There were 55 patients in group A (non-severe AS without significant LVH), 58 in group B (non-severe AS with significant LVH), 7 in group C (severe AS without significant LVH), and 29 in group D (severe AS with significant LVH). Coexisting cardiac diseases were more frequently observed (p = 0.0003) in group B (50 %) than in group A (18 %). In group C, ELCo and (ELI - AVAI)/ELI were significantly greater than in group D (p = 0.043 and 0.007, respectively). Conclusion: Significant LVH seen in less than moderate AS is often due to coexisting cardiac diseases, and there may be an overestimation of AS severity due to pressure recovery among patients with apparently severe AS who do not have significant LVH. © 2013 Japanese Society of Echocardiography.
• Coexisting cardiac diseases and pressure recovery phenomenon contribute to discrepancy between the echocardiographic severity of aortic stenosis and left ventricular hypertrophy

  Ayumu Abe, Taisei Mikami, Sanae Kaga, Kanako Tsuji, Kazunori Okada, Shinobu Yokoyama, Hisao Nishino, Masahiro Nakabachi, Mutsumi Nishida, Chikara Shimizu, Hiroyuki Iwano, Satoshi Yamada, Hiroyuki Tsutsui

  Journal of Echocardiography 11 2 41 - 49 2013年06月 [査読有り][通常論文]
   

  Background: Assessing left ventricular (LV) hypertrophy (LVH) is an important step in the echocardiographic diagnosis of aortic stenosis (AS). We aimed to investigate the causes of discrepancies between the degrees of AS and LVH. Methods: The study subjects consisted of 149 consecutive patients with AS having aortic valve area < 2.0 cm2 (mean age 72.5 ± 11.9 years, 67 men and 82 women). Coexisting cardiac diseases were determined based on echocardiographic findings and comprehensive clinical judgment. Echocardiographic measurements included LV mass index (LVMI), aortic valve area index (AVAI), transaortic mean pressure gradient (MPG), valvulo-arterial impedance (Zva), energy loss coefficient (ELCo), and energy loss index (ELI). Results: LVMI was not significantly correlated with AVAI and Zva, and had a weak correlation with MPG (r = 0.305, p = 0.0001). There were 55 patients in group A (non-severe AS without significant LVH), 58 in group B (non-severe AS with significant LVH), 7 in group C (severe AS without significant LVH), and 29 in group D (severe AS with significant LVH). Coexisting cardiac diseases were more frequently observed (p = 0.0003) in group B (50 %) than in group A (18 %). In group C, ELCo and (ELI - AVAI)/ELI were significantly greater than in group D (p = 0.043 and 0.007, respectively). Conclusion: Significant LVH seen in less than moderate AS is often due to coexisting cardiac diseases, and there may be an overestimation of AS severity due to pressure recovery among patients with apparently severe AS who do not have significant LVH. © 2013 Japanese Society of Echocardiography.
• Strain rate dispersion index can predict changes in left ventricular volume and adverse cardiac events following cardiac resynchronization therapy

  Hiroyuki Iwano, Satoshi Yamada, Masaya Watanabe, Hirofumi Mitsuyama, Kazuya Mizukami, Hisao Nishino, Shinobu Yokoyama, Sanae Kaga, Kazunori Okada, Mutsumi Nishida, Hisashi Yokoshiki, Taisei Mikami, Hiroyuki Tsutsui

  Circulation Journal 77 11 2757 - 2765 2013年 [査読有り][通常論文]
   

  Background: We previously reported that the strain rate dispersion index (SRDI), an index of left ventricular (LV) contractility loss because of mechanical dyssynchrony, better predicted the acute response to cardiac resynchronization therapy (CRT) than time-delay indices. However, it remains unclear whether the SRDI can predict the chronic response. Additionally, the SRDI needs to be simplified for use in clinical practice. Methods and Results: Echocardiography was performed in 40 heart failure patients who underwent CRT. The SRDI, the average of segmental peak systolic strain rates minus global peak systolic strain rate, was calculated, together with strain-derived time-delay indices (St-SD) in the longitudinal, circumferential and radial directions using a speckle-tracking method. As simplified indices, the longitudinal parameters were calculated from the apical 4-chamber view in addition to 3 apical views. LV end-systolic volume (ESV) significantly decreased 6 months after CRT. Although circumferential St-SD and all SRDIs correlated with the changes in ESV (ΔESV), multivariate analysis revealed that the circumferential SRDI was the single independent determinant of ΔESV. During the 20±14 months after CRT, cardiac events occurred in 14 patients. Kaplan-Meier analyses revealed that all SRDIs were significant predictors of cardiac events whereas none of St-SDs was. Conclusions: The SRDI predicted the reduction in both LV volume and cardiac events after CRT better than timedelay indices. Additionally, a simplified SRDI could be as good a predictor of CRT response as the original.
• Overweight causes left ventricular diastolic asynchrony and diastolic dysfunction: A study based on speckle tracking echocardiography in healthy subjects

  Masahiro Nakabachi, Taisei Mikami, Kazunori Okada, Hisao Onozuka, Sanae Kaga, Mamiko Inoue, Shinobu Yokoyama, Mutsumi Nishida, Chikara Shimizu, Kazuhiko Matsuno, Hiroyuki Iwano, Satoshi Yamada, Hiroyuki Tsutsui

  Journal of Echocardiography 10 3 83 - 89 2012年09月 [査読有り][通常論文]
   

  Background: Left ventricular (LV) diastolic dysfunction is often observed in healthy subjects and can be a cause of heart failure with preserved ejection fraction (EF). We aimed to investigate the role of LV diastolic asynchrony as a cause of diastolic dysfunction in healthy subjects. Methods: In 40 healthy subjects, two-dimensional speckle tracking imaging (2DSTI) was performed to measure the peak early diastolic longitudinal strain rates (Esr) of the apical, mid-ventricular, and basal segments of the septum and posterior wall. A mean value of the Esr of the 6 segments (mEsr) was calculated. The time from aortic valve closure to the Esr was measured for each segment, and the standard deviation (SDTEsr) was calculated. The peak global early diastolic strain rate (gEsr) was measured with a region of interest (ROI) on the whole LV myocardium. LV flow propagation velocity (FPV) was measured using conventional Doppler techniques. Results: SDTEsr was not correlated with age, but was significantly correlated with body mass index (BMI) (r = 0.41, p < 0.01). Although no significant correlation was observed between mEsr and FPV, gEsr and SDTEsr significantly correlated with FPV (r = 0.41, p < 0.01 r = -0.54, p < 0.001). As a result of the multiple regression analysis, SDTEsr was the single determinant of FPV. Conclusions: Diastolic asynchrony, associated with overweight but not with aging, may contribute to diastolic dysfunction in healthy subjects. © 2012 Japanese Society of Echocardiography.
• Early diastolic mitral annular velocity at the interventricular septal annulus correctly reflects left ventricular longitudinal myocardial relaxation

  Kazunori Okada, Taisei Mikami, Sanae Kaga, Hisao Onozuka, Mamiko Inoue, Shinobu Yokoyama, Hisao Nishino, Mutsumi Nishida, Kazuhiko Matsuno, Hiroyuki Iwano, Satoshi Yamada, Hiroyuki Tsutsui

  EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 12 12 917 - 923 2011年12月 [査読有り][通常論文]
   

  Aims Early diastolic mitral annular velocity (e') obtained by tissue Doppler imaging (TDI) is widely used to evaluate left ventricular (LV) diastolic function based on the assumption that it reflects myocardial relaxation in the long-axis direction. In this study, we aimed to determine whether or not e' truly reflects early diastolic longitudinal myocardial relaxation, and which is the most useful for evaluating LV diastolic function among e' measured at the interventricular-septal annulus (IS-e'), that measured at the lateral annulus (LW-e') or their mean value (M-e'). Methods and results IS-e', LW-e', and M-e' were measured using colour TDI in 15 patients with hypertrophic cardiomyopathy, 13 patients with hypertension, and 19 control subjects. Using two-dimensional speckle-tracking imaging, early diastolic myocardial strain rates (SR(E)) were measured for the IS (IS-SR(E)), LW(LW-SR(E)), and entire LV myocardium (G-SR(E)). IS-e' was excellently correlated with IS-SR(E) (r = 0.90, P < 0.001); the correlation was better than that between LW-e' and LW-SR(E) (r = 0.75, P < 0.001). IS-e' and M-e' were well correlated with G-SR(E) (r = 0.88, P < 0.001 and r = 0.86, P < 0.001, respectively) and with LV early diastolic flow propagation velocity (FPV) (r = 0.77, P < 0.001 and r = 0.78, P < 0.001, respectively). The correlations of LW-e' to G-SRE (r = 0.80, P < 0.001) and FPV (r = 0.75, P < 0.001) did not reach this level. Conclusion IS-e' well reflected LV longitudinal myocardial relaxation and LV diastolic function, and was found to be more useful in evaluating LV diastolic function than LW-e'.
• Novel Strain Rate Index of Contractility Loss Caused by Mechanical Dyssynchrony - A Predictor of Response to Cardiac Resynchronization Therapy -

  Hiroyuki Iwano, Satoshi Yamada, Masaya Watanabe, Hirofumi Mitsuyama, Hisao Nishino, Shinobu Yokoyama, Sanae Kaga, Mutsumi Nishida, Hisashi Yokoshiki, Hisao Onozuka, Taisei Mikami, Hiroyuki Tsutsui

  CIRCULATION JOURNAL 75 9 2167 - 2175 2011年09月 [査読有り][通常論文]
   

  Background: Time-delay indexes are limited in predicting the response to cardiac resynchronization therapy (CRT), partly because they do not reflect the residual left ventricular (LV) contractility. We computed a novel index of LV contractility loss due to dyssynchrony (the strain rate (SR) dispersion index: SRDI) by using the speckle-tracking SR and compared the efficacy of the SRDI, time-delay indexes, and strain delay index (SDI), the previously reported index of wasted energy due to dyssynchrony, for predicting the acute response to CRT. Methods and Results: Echocardiography was performed in 19 heart failure patients (LV ejection fraction (EF) 25 +/- 6%) before and 2 weeks after CRT. The standard deviation of time to peak velocity, or strain, was calculated as time-delay indexes. The SRDI was calculated as the average of segmental peak systolic SR minus global peak systolic SR. Longitudinal SDI (L-SDI), longitudinal SRDI (L-SRDI), and circumferential SRDI (C-SRDI) significantly correlated with the change in global longitudinal strain (Delta global LSt), whereas the time-delay indexes did not. Although the time-delay indexes were comparable between responders (Delta global LSt >= 0.3%) and nonresponders, the L-SDI, L-SRDI, and C-SRDI were greater in responders. The area under the receiver operating characteristic curve of the L-SRDI, L-SDI, and C-SRDI for predicting responders was 0.89, 0.81, and 0.78, respectively. Conclusions: The SRDI correlated fairly well with an improvement in global LV systolic function after CRT. (Circ J 2011; 75: 2167-2175)
• 造影超音波検査はIgG4関連硬化性胆管炎と胆管癌の鑑別に有用か

  西田 睦, 佐藤 恵美, 工藤 悠輔, 井上 真美子, 表原 里実, 堀江 達則, 加賀 早苗, 河上 洋, 清水 力, 松野 一彦

  超音波医学 38 Suppl. S410 - S410 (公社)日本超音波医学会 2011年04月
• 上腕駆血によるFMD検査の再現性の検討

  井上 真美子, 西田 睦, 吉永 恵一郎, 佐藤 恵美, 石坂 香織, 工藤 悠輔, 表原 里実, 堀江 達則, 加賀 早苗, 横山 しのぶ, 西野 久雄, 鈴木 春樹, 清水 力, 松野 一彦

  超音波医学 38 2 160 - 161 (公社)日本超音波医学会 2011年03月
• 僧帽弁輪石灰化により拡張早期僧帽弁輪運動速度が低下する機序

  柿本 悠太, 三神 大世, 岡田 一範, 小野塚 久夫, 加賀 早苗, 西田 睦, 松野 一彦, 岩野 弘幸, 山田 聡, 筒井 裕之

  超音波医学 38 2 161 - 162 (公社)日本超音波医学会 2011年03月
• 左室収縮障害患者における左室後壁屈曲の機序とその意義

  三谷 麻子, 三神 大世, 岩井 孝仁, 小野塚 久夫, 加賀 早苗, 西田 睦, 松野 一彦, 岩野 弘幸, 山田 聡, 筒井 裕之

  超音波医学 38 2 162 - 162 (公社)日本超音波医学会 2011年03月
• 乳腺腫瘍の良・悪性鑑別におけるstrain ratioの有用性

  工藤 悠輔, 西田 睦, 石坂 香織, 佐藤 恵美, 井上 真美子, 表原 里実, 堀江 達則, 加賀 早苗, 横山 しのぶ, 西野 久雄, 細田 充主, 高橋 弘昌, 鈴木 春樹, 清水 力, 松野 一彦

  超音波医学 38 2 162 - 163 (公社)日本超音波医学会 2011年03月
• 3Dスペックルトラッキング法による左室拡張機能評価 Area tracking rate計測の意義

  加賀 早苗, 小野塚 久夫, 山田 聡, 三神 大世, 岩野 弘幸, 横山 しのぶ, 西野 久雄, 西田 睦, 清水 力, 筒井 裕之, 松野 一彦

  日本心臓病学会誌 5 Suppl.I 266 - 266 (一社)日本心臓病学会 2010年08月
• 拡張型心筋症における心筋内血液量と左室収縮予備能の関係

  山田 聡, 岩野 弘幸, 小室 薫, 岡田 昌子, 小松 博史, 加賀 早苗, 西田 睦, 小野塚 久夫, 三神 大世, 筒井 裕之

  Japanese journal of medical ultrasonics = 超音波医学 37 4 491 - 497 2010年07月15日 [査読無し][通常論文]
  
• 拡張早期の僧帽弁輪運動速度と左室心筋伸展との関係 健常例と肥大心における検討

  岡田 一範, 三神 大世, 加賀 早苗, 小野塚 久夫, 横山 しのぶ, 西田 睦, 松野 一彦, 岩野 弘幸, 山田 聡, 筒井 裕之

  超音波医学 37 4 533 - 533 (公社)日本超音波医学会 2010年07月
• 健常人における左室拡張機能障害の機序の二次元スペックルトラッキング法による分析

  中鉢 雅大, 三神 大世, 小野塚 久夫, 中村 安岐, 岡田 一範, 加賀 早苗, 西田 睦, 岩野 弘幸, 山田 聡, 筒井 裕之

  超音波医学 37 4 533 - 533 (公社)日本超音波医学会 2010年07月
• 3Dグローバルストレインレートによる左室拡張機能評価

  加賀 早苗, 小野塚 久夫, 三神 大世, 佐々木 洸太, 西野 久雄, 横山 しのぶ, 西田 睦, 松野 一彦, 山田 聡, 筒井 裕之

  超音波医学 37 4 533 - 533 (公社)日本超音波医学会 2010年07月
• 大動脈弁口部圧較差への圧力回復現象補正の要否についての検討

  西野 久雄, 三神 大世, 山田 聡, 佐藤 陽子, 岩野 弘幸, 筒井 裕之, 横山 しのぶ, 加賀 早苗, 西田 睦, 松野 一彦

  超音波医学 37 4 534 - 535 (公社)日本超音波医学会 2010年07月
• 大動脈弁狭窄の心エコー評価に圧力回復現象の補正は必要か?

  西野 久雄, 三神 大世, 山田 聡, 佐藤 陽子, 岩野 弘幸, 筒井 裕之, 小野塚 久夫, 横山 しのぶ, 加賀 早苗, 西田 睦, 松野 一彦

  超音波検査技術 35 2 257 - 257 (一社)日本超音波検査学会 2010年04月
• 非協調運動による左室全体収縮能の損失分を表す新しいストレインレート指標

  岩野 弘幸, 山田 聡, 佐藤 陽子, 西野 久雄, 横山 しのぶ, 加賀 早苗, 西田 睦, 小野塚 久夫, 三神 大世, 筒井 裕之

  超音波医学 37 Suppl. S312 - S312 (公社)日本超音波医学会 2010年04月
• 慢性心房細動患者における機能的僧帽弁逆流の機序の心エコーによる分析

  小泉 遥香, 三神 大世, 岩井 孝仁, 小野塚 久夫, 岡田 一範, 横山 しのぶ, 加賀 早苗, 井上 真美子, 西田 睦, 鈴木 春樹, 清水 力, 松野 一彦, 佐藤 陽子, 岩野 弘幸, 山田 聡, 筒井 裕之

  超音波医学 37 1 41 - 41 (公社)日本超音波医学会 2010年01月
• 左室充満圧推定における肺動脈弁逆流血流速度計測の臨床的意義の検討

  高松 由佳, 小野塚 久夫, 三神 大世, 井上 真美子, 佐々木 洸太, 加賀 早苗, 横山 しのぶ, 表原 里実, 西野 久雄, 西田 睦, 松野 一彦, 佐藤 陽子, 岩野 弘幸, 山田 聡, 筒井 裕之

  超音波医学 37 1 41 - 42 (公社)日本超音波医学会 2010年01月
• 健常人における左室拡張機能障害の分析 二次元スペックルトラッキング法による心筋弛緩速度とその同期性の分析に基づく検討

  中村 安岐, 三神 大世, 中鉢 雅大, 岡田 一範, 加賀 早苗, 井上 真美子, 横山 しのぶ, 表原 里実, 西田 睦, 松野 一彦, 佐藤 陽子, 岩野 弘幸, 山田 聡, 小野塚 久夫, 筒井 裕之

  超音波医学 37 1 43 - 44 (公社)日本超音波医学会 2010年01月
• Angiotensin II Receptor Blocker, Valsartan, Increases Myocardial Blood Volume and Regresses Hypertrophy in Hypertensive Patients

  Hiroshi Komatsu, Satoshi Yamada, Hiroyuki Iwano, Masako Okada, Hisao Onozuka, Taisei Mikami, Shinobu Yokoyama, Mamiko Inoue, Sanae Kaga, Mutsumi Nishida, Chikara Shimizu, Kazuhiko Matsuno, Hiroyuki Tsutsui

  CIRCULATION JOURNAL 73 11 2098 - 2103 2009年11月 [査読有り][通常論文]
   

  Background: Although a reduction in myocardial blood volume (MBV), an in vivo index of the myocardial microvasculature, measured by myocardial contrast echocardiography in patients with hypertension (HT), can be demonstrated, it is still unknown whether a decreased MBV call be improved by antihypertensive treatment. Methods and Results: Eleven HT patients (mean age 58 years, 7 men) with left ventricular hypertrophy (LVH) and 10 age- and sex-matched normal controls were studied. Harmonic power Doppler images were acquired at end-diastole of every 6(th) beat and MBV was calculated as 10(X/10)X100%. where X (dB) is myocardial contrast intensity minus the contrast intensity of the adjacent intracavity blood pool. Baseline blood pressure (BP) and left ventricular mass index (LVMI) in the HT patients were higher and MBV was lower than in the controls (252 +/- 0.37% vs 3.31 +/- 0.61%. P<0.01). MBV did not correlate with mean BP. but was inversely correlated with LVMI (r=-0.61, P<0.01). After treatment with valsartan for 6 months, LVMI significantly decreased and MBV increased (2.72 +/- 0.26%, P<0.05 vs baseline) in the patients With HT. There wits a significant inverse correlation between the changes in MBV and those of LVMI (r=-0.62, P<0.05), but not between MBV and mean BP. Conclusions: Valsartan, an angiotensin II receptor blocker, corrected the decreased MBV in association with regression of LVH in patients with HT. (Circ J 2009: 73: 2098-2103)
• 組織ドプラ法による僧帽弁輪運動速度は左室心筋伸展を正しく反映するか? 健常例と高血圧患者における検討

  岡田 一範, 三神 大世, 小野塚 久夫, 本田 舞, 加賀 早苗, 井上 真美子, 横山 しのぶ, 西田 睦, 鈴木 春樹, 清水 力, 松野 一彦, 佐藤 陽子, 岩野 弘幸, 山田 聡, 筒井 裕之

  臨床病理 57 補冊 150 - 150 (一社)日本臨床検査医学会 2009年07月
• 慢性心房細動患者における機能的僧帽弁逆流の機序の心エコーによる分析

  岩井 孝仁, 三神 大世, 小野塚 久夫, 小泉 遥香, 岡田 一範, 横山 しのぶ, 加賀 早苗, 井上 真美子, 西田 睦, 鈴木 春樹, 清水 力, 松野 一彦, 佐藤 陽子, 岩野 弘幸, 山田 聡, 筒井 裕之

  臨床病理 57 補冊 150 - 150 (一社)日本臨床検査医学会 2009年07月
• 無痛性甲状腺炎の超音波像

  工藤 悠輔, 西田 睦, 石坂 香織, 佐藤 恵美, 井上 真美子, 加賀 早苗, 横山 しのぶ, 表原 里美, 鈴木 春樹, 清水 力, 松野 一彦

  超音波検査技術 34 3 361 - 361 (一社)日本超音波検査学会 2009年06月
• Right ventricular diastolic dysfunction in patients with left ventricular hypertrophy: Analysis of right ventricular myocardial relaxation using two-dimensional speckle tracking imaging

  Sanae Kaga, Taisei Mikami, Hisao Onozuka, Satomi Omotehara, Ayumu Abe, Satoshi Yamada, Masako Okada, Hiroshi Komatsu, Mamiko Inoue, Shinobu Yokoyama, Mutsumi Nishida, Chikara Shimizu, Kazuhiko Matsuno, Hiroyuki Tsutsui

  Journal of Echocardiography 7 2 25 - 33 2009年06月 [査読有り][通常論文]
   

  Background: Although several previous studies have suggested the presence of right ventricular (RV) diastolic dysfunction in patients with hypertrophic cardiomyopathy (HCM) and those with hypertensive left ventricular hypertrophy (HT-LVH), the mechanisms are still unclear. This study aimed to clarify the relationship between the RV global diastolic dysfunction in these patients and the regional myocardial diastolic function, including synchronicity of the interventricular septum and RV free wall. Methods: In 20 age-matched patients with HT-LVH, 20 patients with HCM and 22 control subjects without pulmonary hypertension, RV isovolumic relaxation time (IRTR) was measured using continuous-wave Doppler echocardiography. The early diastolic peak strain rate (ESR) and time from QRS to ESR (T-ESR) were measured in the apical, mid-ventricular and basal segments of the interventricular septum and RV free wall using two-dimensional speckle tracking imaging (2DST). Results: IRTR was more prolonged both in HT-LVH and in HCM than in the controls. The averaged septal ESR was reduced both in HT-LVH and in HCM (P < 0.0001, respectively), but the averaged RV free wall ESR was decreased only in HCM (P = 0.0007). ESR averaged for six septal and RV free wall segments was correlated with IRTR (r = -0.46, P = 0.0001). Neither intergroup difference nor correlation with IRTR was observed in a coefficient of variation of T-ESR for the six segments. Conclusions: RV global diastolic function is impaired in patients with HT-LVH and HCM due to relaxation abnormalities, not an asynchrony, of the myocardium surrounding the RV cavity. The detection of RV free wall relaxation abnormality using 2DST may be useful to differentiate HCM from HT-LVH. © 2009 Japanese Society of Echocardiography.
• 心不全のない左室肥大患者の拡張機能評価 どの指標が有用か?

  表原 里実, 三神 大世, 小野塚 久夫, 加賀 早苗, 井上 真美子, 横山 しのぶ, 西田 睦, 清水 力, 松野 一彦, 山田 聡, 筒井 裕之

  超音波検査技術 34 2 214 - 214 (一社)日本超音波検査学会 2009年04月
• 二次元スペックルトラッキング法による短軸心筋ストレイン計測の心臓再同期療法適応判定における意義

  加賀 早苗, 小野塚 久夫, 三神 大世, 井上 真美子, 横山 しのぶ, 西田 睦, 鈴木 春樹, 清水 力, 松野 一彦, 岩野 弘幸, 小松 博史, 岡田 昌子, 山田 聡, 筒井 裕之

  超音波医学 35 4 460 - 460 (公社)日本超音波医学会 2008年07月
• CT/MRIにて確定診断に至らなかった結節に対する造影超音波(CEUS)の位置づけ

  西田 睦, 増田 香織, 佐藤 恵美, 溝口 恵美, 小野寺 祐也, 尾松 徳彦, 神島 保, 加藤 扶美, 加賀 早苗, 井上 真美子, 横山 しのぶ, 鈴木 春樹, 清水 力, 松野 一彦, 玉木 長良, 白土 博樹

  超音波医学 35 4 463 - 463 (公社)日本超音波医学会 2008年07月
• 心房収縮期の僧帽弁輪運動速度と左室スティッフネスとの関係

  吉原 明日香, 三神 大世, 山田 聡, 小室 薫, 小松 博史, 岡田 昌子, 井上 真美子, 加賀 早苗, 横山 しのぶ, 西田 睦, 松野 一彦, 阿部 歩, 小野塚 久夫, 筒井 裕之

  超音波医学 35 1 69 - 69 (公社)日本超音波医学会 2008年01月
• 左室肥大が右室全体機能に与える影響とその機序:血流ドプラ法と二次元スペックルトラッキング法による検討

  表原 里実, 三神 大世, 加賀 早苗, 小野塚 久夫, 阿部 歩, 井上 真美子, 横山 しのぶ, 西田 睦, 鈴木 春樹, 清水 力, 松野 一彦, 小松 博史, 岡田 昌子, 山田 聡, 筒井 裕之

  超音波医学 35 1 69 - 70 (公社)日本超音波医学会 2008年01月
• 肥大型心筋症における左右両心室の局所心筋機能 二次元スペックルトラッキング法による評価

  加賀 早苗, 三神 大世, 小野塚 久夫, 井上 真美子, 横山 しのぶ, 西田 睦, 鈴木 春樹, 清水 力, 松野 一彦, 小松 博史, 岡田 昌子, 山田 聡, 筒井 裕之

  臨床化学 36 Suppl.2 193 - 193 (一社)日本臨床化学会 2007年10月
• 左室収縮不全のない心疾患患者におけるE/E'の意義 左室充満圧と血流伝播速度との比較に基づく検討

  井上 真美子, 山田 聡, 三神 大世, 小室 薫, 小松 博史, 岡田 昌子, 横山 しのぶ, 加賀 早苗, 西田 睦, 北村 忠代, 清水 力, 千葉 仁志, 小野塚 久夫, 筒井 裕之

  超音波医学 34 4 471 - 472 (公社)日本超音波医学会 2007年07月
• 肥大心における右室局所機能 2次元スペックルトラッキング法に基づく検討

  加賀 早苗, 三神 大世, 小野塚 久夫, 井上 真美子, 横山 しのぶ, 西田 睦, 北村 忠代, 清水 力, 千葉 仁志, 小松 博史, 岡田 昌子, 山田 聡, 筒井 裕之

  超音波医学 34 4 472 - 472 (公社)日本超音波医学会 2007年07月
• 心エコーで発見し手術で確認された心外膜下心室瘤の1例

  井上 真美子, 三神 大世, 岡田 昌子, 小松 博史, 山田 聡, 小野塚 久夫, 筒井 裕之, 横山 しのぶ, 加賀 早苗, 西田 睦, 北村 忠代, 清水 力, 千葉 仁志, 松居 喜郎

  超音波検査技術 32 3 386 - 386 (一社)日本超音波検査学会 2007年06月
• LevovistとSonazoid造影超音波(US)画像の対比検討

  西田 睦, 増田 香織, 佐藤 恵美, 溝口 恵美, 加賀 早苗, 井上 真美子, 横山 しのぶ, 北村 忠代, 清水 力, 千葉 仁志

  超音波検査技術 32 2 200 - 200 (一社)日本超音波検査学会 2007年04月
• 2次元スペックルトラッキング法による肥大心の右室収縮機能評価

  加賀 早苗, 三神 大世, 小野塚 久夫, 井上 真美子, 横山 しのぶ, 西田 睦, 北村 忠代, 清水 力, 千葉 仁志, 岡田 昌子, 山田 聡, 筒井 裕之

  超音波検査技術 32 2 206 - 206 (一社)日本超音波検査学会 2007年04月
• 超音波診断装置精度管理点検表の試用経験

  溝口 恵美, 西田 睦, 佐藤 恵美, 増田 香織, 横山 しのぶ, 井上 真美子, 加賀 早苗, 北村 忠代, 清水 力, 千葉 仁志

  超音波検査技術 32 2 228 - 228 (一社)日本超音波検査学会 2007年04月
• 心房細動患者におけるE/E'の1心拍計測は可能か?

  横山 しのぶ, 三神 大世, 加賀 早苗, 井上 真美子, 西田 睦, 北村 忠代, 清水 力, 千葉 仁志, 小松 博史, 岡田 昌子, 山田 聡, 小野塚 久夫, 筒井 裕之

  超音波医学 33 6 693 - 693 (公社)日本超音波医学会 2006年11月
• 2次元スペックルトラッキング法を用いて方向別にみた心筋局所収縮様式の部位差 正常心と高血圧性肥大心における検討

  加賀 早苗, 三神 大世, 井上 真美子, 横山 しのぶ, 阿部 歩, 西田 睦, 北村 忠代, 清水 力, 千葉 仁志, 後藤 数智, 小松 博史, 岡田 昌子, 山田 聡, 小野塚 久夫, 筒井 裕之

  超音波医学 33 6 694 - 694 (公社)日本超音波医学会 2006年11月
• 造影超音波が有用であった消化管急性腹症の2例

  西田 睦, 清水 力, 千葉 仁志, 今井 希一, 木村 もと子, 新山 智美, 佐川 直美, 北村 忠代, 井上 真美子, 加賀 早苗, 横山 しのぶ

  超音波医学 33 6 698 - 699 (公社)日本超音波医学会 2006年11月
• 心房細動患者における左室拡張機能評価 計測の簡略化の限界についての検討

  横山 しのぶ, 三神 大世, 加賀 早苗, 井上 真美子, 西田 睦, 北村 忠代, 清水 力, 千葉 仁志, 小松 博史, 岡田 昌子, 山田 聡, 小野塚 久夫, 筒井 裕之

  臨床病理 54 補冊 218 - 218 (一社)日本臨床検査医学会 2006年10月
• Role of left ventricular regional diastolic abnormalities for global diastolic dysfunction in patients with hypertrophic cardiomyopathy

  Kazutomo Goto, Taisei Mikami, Hisao Onozuka, Sanae Kaga, Mamiko Inoue, Hiroshi Komatsu, Kaoru Komuro, Satoshi Yamada, Hiroyuki Tsutsui, Akira Kitabatake

  JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY 19 7 857 - 864 2006年07月 [査読有り][通常論文]
   

  Background: The usefulness of Doppler strain rate imaging for assessment of left ventricular regional diastolic function has not been fully determined. Objective: We aimed to clarify the relationships between diastolic strain rates and global diastolic function and find a useful index for regional diastolic function in patients with hypertrophic cardiomyopathy (HCM). Methods: Strain rate curves were obtained using an apical approach at 12 different sites of the left ventricular myocardium in 25 patients with HCM and 20 control subjects, and peak early diastolic strain rate (E-SR), peak late diastolic strain rate, and the time from QRS to E-SR were measured. The flow propagation velocity was measured using color M-mode Doppler echocardiography as a global diastolic index. Results: Each of the spatially averaged values of E-SR and E-SR/peak late diastolic strain rate and the coefficients of variation of time from QRS to E-SR was significantly correlated with flow propagation velocity, but the best correlation was observed in E-SR. Although both E-SR and peak late diastolic strain rate of each myocardial segment of patients with HCM tended to decrease as the wall thickness increased, only E-SR significantly decreased even in the segments without apparent hypertrophy. Conclusions: In patients with HCM, the reduction of E-SR was more closely associated with global diastolic dysfunction than asynchrony, and E-SR may be a useful and sensitive index for regional diastolic function.
• Increased plasma concentrations of N-terminal pro-brain natriuretic peptide reflect the presence of mildly reduced left ventricular diastolic function in hypertension

  T Furumoto, S Fujii, T Mikami, M Inoue, K Nishihara, S Kaga, S Imagawa, K Goto, K Komuro, S Yamada, H Onozuka, A Kitabatake, BE Sobel

  CORONARY ARTERY DISEASE 17 1 45 - 50 2006年02月 [査読有り][通常論文]
   

  Background The potential use of assays of N-terminal pro-brain natriuretic peptide for detection of diastolic abnormalities associated with alterations in blood pressure has not been elucidated. This study was designed to determine whether increased plasma concentrations of N-terminal pro-brain natriuretic peptide sensitively reflect abnormal diastolic function associated with hypertension. Methods Concentrations of N-terminal pro-brain natriuretic peptide in plasma were assayed in 40 previously untreated hypertensive patients without overt congestive heart failure and in 20 age and sex-matched controls. Hypertensive patients were studied with the use of pulsed Doppler and color M-mode Doppler echocardiography for the evaluation of left ventricular diastolic function. Results Concentrations of N-terminal pro-brain natriuretic peptide were elevated in hypertensive patients [75.1 +/- 75.2 (SD) pg/ml compared with 37.9 +/- 38.5 in controls, P < 0.051. In hypertensive patients, concentrations of N-terminal pro-brain natriuretic peptide were negatively correlated with the ratio of color M-mode flow propagation velocity to transmitral E velocity consistent with the view that increased concentrations of N-terminal pro-brain natriuretic peptide are indicative of alterations in diastolic function. Hypertensive patients with N-terminal pro-brain natriuretic peptide values above the mean value in the control group exhibited significantly increased brachial intimal-medial thickness and reduced wall stress, consistent with the view that increased N-terminal pro-brain natriuretic peptide was associated with favorable peripheral arterial remodeling. Conclusions Elevated concentrations of N-terminal pro-brain natriuretic peptide in plasma reflect the presence of left ventricular diastolic abnormalities and peripheral arterial remodeling in asymptomatic patients with hypertension.
• Dilation of the brachial artery in response to sublingual nitroglycerin can predict the antihypertensive effects of valsartan: A study using novel high-frequency high-frame-rate ultrasound imaging

  Mamiko Inoue, Satoshi Fujii, Taisei Mikami, Tomoo Furumoto, Sanae Kaga, Hiroshi Komatsu, Kazutomo Goto, Kaoru Komuro, Satoshi Yamada, Hisao Onozuka, Akira Kitabatake, Hiroyuki Tsutsui

  Journal of Cardiology 47 1 9 - 14 2006年 [査読有り][通常論文]
   

  Objectives. The efficacy of antihypertensive agents can vary in patients. Four to 8 weeks may be required before antihypertensive agents become fully effective. Predicting the efficacy can help agent selection and dose setting. This study determined whether nitroglycerin-induced vasodilation of brachial arteries can predict the antihypertensive action of angiotensin II receptor antagonist. Methods. Untreated uncomplicated patients with essential hypertension, who gave informed consent, were studied (n = 20, mean age 55 years). Before antihypertensive treatment, nitroglycerin-induced vasodilation of the brachial arteries was measured using a novel method of 15 MHz high-frequency high-frame-rate ultrasound imaging (Hitachi EUB8000). Diameter of the brachial artery at the end-systolic phase was measured before and after 0.3 mg nitroglycerin sublingual spray and percentage vasodilation (%D-N) was calculated. The reduction of mean blood pressure after nitroglycerin (%BP-N) was calculated. Valsartan monotherapy (40-80 mg/day) was administered for 3-6 months (mean 132 days). Reduction of mean blood pressure after valsartan monotherapy (%BP-V) was calculated. Results. Valsartan decreased systolic blood pressure from 138 ± 13 to 130 ± 17mmHg, and diastolic blood pressure from 83 ± 11 to 78 ± 11 mmHg (p < 0.05). %D-N was correlated closely with %BP-V (r = -0.70, p < 0.001). %BP-N had no correlation with %BP-V (r = 0.13, p = 0.58). Conclusions. Direct vasodilatory action of nitroglycerin on vascular smooth muscle cells may predict the chronic antihypertensive effect of angiotensin II receptor antagonist.
• Usefulness of left parasternal approach for the continuous-wave Doppler measurement of left ventricular outflow tract pressure gradient in patients with hypertrophic cardiomyopathy

  Hisao Onozuka, Taisei Mikami, Sanae Kaga, Satoshi Yamada, Keiko Nishihara, Kaoru Kamuro, Mamiko Inoue, Jun-ichi Teranishi, Kazushi Urasawa, Hiroyuki Tsutsui, Akira Kitabatake

  Journal of Echocardiography 3 4 140 - 147 Japanese Society of Echocardiography 2005年 [査読有り][通常論文]
   

  Background. The apical approach (ApA) has been usually employed for the continuous-wave Doppler (CWD) measurement of pressure gradient in the left ventricular outflow tract (LVOT) in patients with hypertrophic obstructive cardiomyopathy (HOCM). This study aimed to assess the usefulness of a left parasternal approach (LPA) using the most cranial part of the echo-window for the measurement of the LVOT pressure gradient.
  Methods. CWD using LPA and ApA was performed in 19 patients with HOCM to measure LVOT peak pressure gradients (PG_LPA and PG_ApA, respectively) and record a signal of mitral regurgitation (MR). The beam incident angles to LVOT flow in LPA (θ_LPA) and in ApA (θ_ApA) were measured using color Doppler flow imaging.
  Results. PG_LPA was distinctly greater (>= 10mmHg) than PG_ApA in 7 patients (37%); they were similar in 6 (32%); and PG_LPA was distinctly smaller (<= -10mmHg) than PG_ApA in 6 (32%). All patients had MR. While all the MR jets in ApA shifted away from the probe, i.e. to the same side of the LVOT flow, 18 of the 19 MR jets shifted to the opposite side of the LVOT flow, when using LPA. Cos θ_LPA was significantly smaller and Cos θ_ApA was significantly greater in the HOCM patients than 10 control subjects (p<0.001 for both). Both PG_LPA and PG_ApA correlated with the invasive pressure gradient (r=0.99 and r=0.97) in 7 patients who underwent invasive study. PG_LPA was closer to the invasive pressure gradient than PG_ApA in 6 patients.
  Conclusions. LPA provided a more accurate measurement of pressure gradient than ApA in about one third of HOCM patients, probably due to the altered direction of LVOT flow in HOCM. LPA is also useful in distinguishing LVOT flow from MR jet commonly seen in these patients.
• Prognostic Significance of Left Ventricular Diastolic Dysfunction Assessed by Color M-mode Doppler Echocardiography in Patients With Chronic Left Ventricular Systolic Dysfunction

  Norifumi Hirao, Hisao Onozuka, Satoshi Yamada, Kaoru Komuro, Hiroshi Okamoto, Akira Kitabatake, Taisei Mikami, Sanae Kaga, Mamiko Inoue

  Journal of Echocardiography 2 3 68 - 77 2004年 [査読有り][通常論文]
   

  Background. Color M-mode Doppler echocardiography provides accurate evaluation of LV diastolic function noninvasively and is reportedly preload independent compared with pulsed Doppler transmitral velocity indexes. This study aimed to determine the prognostic significance of left ventricular (LV) diastolic function in patients with different degrees of chronic LV systolic dysfunction using color M-mode Doppler echocardiography. Methods. A total of 98 consecutive subjects (mean age 57 years, 78 males) with LV systolic dysfunction (61 with previous myocardial infarction and 37 with dilated cardiomyopathy) underwent clinical and echocardiographic evaluation to determine functional status. Measurements of LV and left atrial dimensions, LV ejection fraction (EF), the peak of early and late diastolic transmitral velocities (E and A, respectively), the E/A ratio, deceleration time of E velocity and isovolu-mic relaxation time using conventional echo-Doppler techniques, and LV flow propagation velocity (FPV) and FPV/E using color M-mode Doppler echocardiography were taken. Results. During the mean follow-up period of 37±28 months, 26 patients had cardiovascular events (death in 4, congestive heart failure in 13, ventricular tachycardia in 6, and cerebral infarction in 3). EF was the single independent predictor of cardiovascular events. While, in the subgroup with EF < 0.35, the functional class was the single significant predictor of cardiovascular events, FPV/E was the single best predictor of cardiovascular events in the subgroup with EF > 0.35. Conclusions. The evaluation of LV diastolic function using color M-mode Doppler-derived FPV/E contributes to predicting clinical outcomes of patients with mildly depressed LV systolic function. © 2004, Japanese Society of Echocardiography. All rights reserved.

MISC

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• 大動脈狭窄症の患者に対する左室充満圧の心エコー検査スコアリングシステムの適応

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• 静脈血流速度波形分析に基づく右房圧推定に肝静脈と上大静脈のどちらが優れるか

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• 心不全患者における複数の超音波指標を組み合わせたうっ血肝診断モデルの確立

  小野田愛梨, 村山迪史, 加賀早苗, 中鉢雅大, 横山しのぶ, 西野久雄, 石坂傑, 本居昴, 青柳裕之, 玉置陽生, 中村公亮, 岩野弘幸, 安斉俊久 日本循環器学会学術集会(Web) 87th 2023年
• 超音波法を用いたスコアリングによるうっ血肝診断と予後予測

  小野田愛梨, 村山迪史, 村山迪史, 加賀早苗, 加賀早苗, 工藤悠輔, 岩井孝仁, 中鉢雅大, 横山しのぶ, 西野久雄, 西田睦, 石坂傑, 岩野弘幸, 岩野弘幸, 安斉俊久 日本超音波検査学会学術集会講演抄録集(Web) 48th 2023年
• ガイドラインに基づく右房圧推定における副次的指標の再考

  村山迪史, 村山迪史, 加賀早苗, 岡田一範, 小野田愛梨, 種村明日香, 中鉢雅大, 横山しのぶ, 西野久雄, 西田睦, 辻永真吾, 岩野弘幸, 岩野弘幸, 安斉俊久 日本超音波検査学会学術集会講演抄録集(Web) 47th 2022年
• 肺動脈弁逆流速度波形に基づく抵抗-コンプライアンス時間推定値と予後との関連

  阿部穂乃加, 塚本真帆, 村山迪史, 後藤真奈, 中鉢雅大, 西野久雄, 横山しのぶ, 加賀早苗 日臨技北日本支部医学検査学会(Web) 10th 2022年
• 経胸壁三次元心エコー法を用いた三尖弁閉鎖不全症の逆流重症度評価の試み 解剖学的逆流弁口面積計測の妥当性の検討

  阪口景太, 村山迪史, 中鉢雅大, 西野久雄, 横山しのぶ, 後藤真奈, 加賀早苗 日臨技北日本支部医学検査学会(Web) 10th 2022年
• ドプラ心エコー法による肺動脈弁逆流重症度の過大評価の要因に関する検討

  本居昂, 岩野弘幸, 岩野弘幸, 常田慧徳, 村山迪史, 加賀早苗, 青柳裕之, 玉置陽生, 石坂傑, 千葉泰之, 辻永真吾, 種村明日香, 横山しのぶ, 中鉢雅大, 西野久雄, 岡田一範, 武田充人, 安斉俊久 日本成人先天性心疾患学会雑誌(Web) 11 (1) 2022年
• 前毛細管性肺高血圧症における心筋遅延造影像と左室収縮障害との関連

  新川未緒, 加賀早苗, 岩野弘幸, 千葉泰之, 宮本知佳, 岡田一範, 村山迪史, 村山迪史, 中鉢雅大, 常田慧徳, 辻野一三 超音波医学 Supplement 49 2022年
• 慢性心不全における右室cardiac power outputの意義

  千葉泰之, 岩野弘幸, 岩野弘幸, 本居昂, 石坂傑, 辻永真吾, 村山迪史, 横山しのぶ, 中鉢雅大, 西野久雄, 岡田一範, 加賀早苗, 神谷究, 永井利幸, 安斉俊久 日本心臓病学会学術集会(Web) 69th 2021年
• 時相解析に基づく新たな左室充満圧推定指標:僧帽弁輪石灰化例,心房細動例への適用

  岩野弘幸, 村山迪史, 辻永真吾, 千葉泰之, 石坂傑, 本居昂, 中鉢雅大, 加賀早苗, 安斉俊久 超音波医学 Supplement 48 2021年
• Influence of Advanced Pulmonary Vascular Remodeling on Accuracy of Echocardiographic Parameters of Left Ventricular Filling Pressure

  Yasuyuki Chiba, Hiroyuki Iwano, Sanae Kaga, Mio Shinkawa, Michito Murayama, Hiroshi Ohira, Ko Motoi, Suguru Ishizaka, Shingo Tsujinaga, Shinobu Yokoyama, Masahiro Nakabachi, Hisao Nishino, Kazunori Okada, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai CIRCULATION 142 2020年11月 

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• Left Ventricular External Work as a Marker of Cardiac Functional Recovery and Outcome After Transcatheter Aortic Valve Replacement in Patients With Aortic Stenosis

  Shingo Tsujinaga, Hiroyuki Iwano, Ko Motoi, Yasuyuki Chiba, Suguru Ishizaka, Michito Murayama, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Kazunori Okada, Sanae Kaga, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai CIRCULATION 142 2020年11月 

  0
• 収縮期の右房容量負荷が三尖弁輪収縮期移動距離に及ぼす影響

  村山迪史, 村山迪史, 加賀早苗, 岡田一範, 三神大世, 中鉢雅大, 横山しのぶ, 西野久雄, 西田睦, 澁谷斉, 辻永真吾, 岩野弘幸, 安斉俊久 超音波検査技術 45 (2) 2020年
• 房室弁開放時相差の視覚的評価に基づいたスコアリングによる左室充満圧推定と予後予測

  村山迪史, 村山迪史, 岩野弘幸, 辻永真吾, 西野久雄, 中鉢雅大, 横山しのぶ, 西田睦, 渋谷斉, 加賀早苗, 安斉俊久 超音波医学 Supplement 47 2020年
• 収縮期の右房容量負荷が三尖弁輪収縮期移動距離と右室駆出率との関係に及ぼす影響

  村山迪史, 村山迪史, 加賀早苗, 岡田一範, 三神大世, 中鉢雅大, 横山しのぶ, 西野久雄, 西田睦, 岩野弘幸, 安斉俊久 超音波医学 Supplement 47 2020年
• 肺静脈血流速度波形を用いたリザーバ期の左房硬さの非侵襲的評価法の検討

  阿部剛大, 岡田一範, 加賀早苗, 政氏伸夫, 三神大世, 村山迪史, 中鉢雅大, 辻永真吾, 岩野弘幸, 安斉俊久 超音波医学 Supplement 47 2020年
• 心不全における肺動脈圧波形上のv波出現の意義に関する検討

  岩野 弘幸, 横山 しのぶ, 石坂 傑, 千葉 泰之, 更科 美羽, 辻永 真吾, 中鉢 雅大, 加賀 早苗, 神谷 究, 永井 利幸, 安斉 俊久 日本心臓病学会学術集会抄録 67回 O -281 2019年09月 [査読無し][通常論文]
  
• これからの超音波検査を牽引する人材の育成を目指す大学院教育

  岡田 一範, 加賀 早苗, 政氏 伸夫, 三神 大世, 中鉢 雅大, 村山 迪史, 横山 しのぶ, 西野 久雄, 西田 睦, 澁谷 斉, 更科 美羽, 辻永 真吾, 岩野 弘幸, 安斉 俊久 臨床検査学教育 11 (2) 219 -226 2019年09月 [査読無し][通常論文]
   

  かつては医師が担ってきた超音波(エコー)検査は、現在、そのほとんどを臨床検査技師を中心とする技師(ソノグラファー)が担うようになってきた。ソノグラファーは、検査装置の管理・調整、検査手技、計測・画像法に習熟することはもちろん、検査対象となる疾患や病態についての十分な知識に基づき、個々例の所見や病態に応じて検査を自ら組み立てる必要がある。このため、超音波検査の検者依存性は、他の検査に比べてたいへん大きい。本学院・研究院の心血管エコー研究室では、超音波検査の実技に精通したうえで、その研究者としても活躍できる指導的な人材の育成を目的とし、北海道大学病院検査・輸血部、超音波センターならびに医学研究院循環病態内科学教室の協力を得つつ、教育・研究活動を行っている。本稿では、その取り組みの一端を紹介する。(著者抄録)
• 日常的な左室充満圧上昇判定における肺動脈弁逆流速度計測の意義

  村山 迪史, 加賀 早苗, 岡田 一範, 三神 大世, 中鉢 雅大, 横山 しのぶ, 西野 久雄, 辻永 真吾, 西田 睦, 澁谷 斉, 岩野 弘幸, 安斉 俊久 超音波検査技術 44 (Suppl.) S139 -S139 2019年04月 [査読無し][通常論文]
  
• 三尖弁輪収縮期移動距離と三尖弁輪収縮期運動速度の計測に最も適する断面はどれか?

  加賀 早苗, 村山 迪史, 岡田 一範, 三神 大世, 中鉢 雅大, 西野 久雄, 横山 しのぶ, 辻永 真吾, 岩野 弘幸, 安斉 俊久 超音波医学 46 (Suppl.) S616 -S616 2019年04月 [査読無し][通常論文]
  
• 日常的な左室充満圧上昇判定における肺動脈弁逆流速度計測の意義

  村山 迪史, 加賀 早苗, 岡田 一範, 三神 大世, 中鉢 雅大, 横山 しのぶ, 西野 久雄, 辻永 真吾, 西田 睦, 澁谷 斉, 岩野 弘幸, 安斉 俊久 超音波検査技術 44 (Suppl.) S139 -S139 2019年04月 [査読無し][通常論文]
  
• Mechanisms of Ventilatory Efficiency during Exercise in Heart Failure: Comparison between Heart Failure with Preserved Ejection Fraction and Reduced Ejection Fraction(和訳中)

  辻永 真吾, 岩野 弘幸, 更科 美羽, 村山 迪史, 中鉢 雅大, 横山 しのぶ, 西野 久雄, 岡田 一範, 加賀 早苗, 福島 新, 横田 卓, 安斉 俊久 日本循環器学会学術集会抄録集 83回 OJ08 -2 2019年03月 [査読無し][通常論文]
  
• Prognostic Value of Novel Echocardiographic Index of Left Ventricular Operating Stiffness in Patients with Heart Failure(和訳中)

  岡田 一範, 藤澤 亮介, 加賀 早苗, 政氏 伸夫, 三神 大世, 村山 迪史, 中鉢 雅大, 西野 久雄, 横山 しのぶ, 更科 美羽, 辻永 真吾, 岩野 弘幸, 安斉 俊久 日本循環器学会学術集会抄録集 83回 OJ08 -7 2019年03月 [査読無し][通常論文]
  
• Simple and Completely Noninvasive Method to Estimate Right Ventricular Operating Stiffness Based on Pulmonary Regurgitant Velocity and Tricuspid Annular Plane Movement Measurements During Atrial Contraction

  Michito Murayama, Sanae Kaga, Kazunori Okada, Hisao Nishino, Shinobu Yokoyama, Masahiro Nakabachi, Miwa Sarashina, Shingo Tsujinaga, Mutsumi Nishida, Hitoshi Shibuya, Toshiyuki Nagai, Hiroyuki Iwano, Toshihisa Anzai, Taisei Mikami CIRCULATION 138 2018年11月 

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• 混合性肺高血圧患者の左房心筋機能障害

  加賀 早苗, 岡田 一範, 三神 大世, 川村 希実, 政氏 伸夫, 村山 迪史, 横山 しのぶ, 岩野 弘幸, 山田 聡, 安斉 俊久 超音波医学 45 (Suppl.) S604 -S604 2018年04月 [査読無し][通常論文]
  
• 三次元心エコー法による肥大型心筋症のリザーバ期左房心筋伸展障害の実態と機序の検討

  柳 裕介, 岡田 一範, 加賀 早苗, 三神 大世, 政氏 伸夫, 西野 久雄, 横山 しのぶ, 岩野 弘幸, 山田 聡, 安斉 俊久 超音波医学 45 (Suppl.) S618 -S618 2018年04月 [査読無し][通常論文]
  
• 連続波ドップラーを用いた心房収縮前肺動脈-右室圧較差による肺動脈楔入圧の正確な推定(Accurate Estimation of Pulmonary Artery Wedge Pressure by Pre-Atrial Contraction Pulmonary Arterial-Right Ventricular Pressure Gradient Using Continuous-Wave Doppler)

  村山 迪史, 加賀 早苗, 岡田 一範, 市川 絢子, 中鉢 雅大, 横山 しのぶ, 西野 久雄, 更科 美羽, 辻永 真吾, 林 大知, 岩野 弘幸, 西田 睦, 澁谷 斉, 山田 聡, 三神 大世, 安斉 俊久 日本循環器学会学術集会抄録集 82回 OJ25 -8 2018年03月 [査読無し][通常論文]
  
• 正常心および拡張心における左心室内拡張早期の渦の特性と重要性(Property and Significance of Intra-Left Ventricular Early-Diastolic Vortex in Normal and Dilated Heart)

  更科 美羽, 山田 聡, 岩野 弘幸, 岡田 一範, 辻永 真吾, 林 大知, 村山 迪史, 市川 絢子, 中鉢 雅大, 横山 しのぶ, 西野 久雄, 加賀 早苗, 安斉 俊久 日本循環器学会学術集会抄録集 82回 PJ001 -5 2018年03月 [査読無し][通常論文]
  
• 抗酸化剤、鉄キレート剤添加血液検体における血球計数の経時的変化

  七戸 加奈, 後藤 美沙紀, 前田 里衣, 橋 ことみ, 菅野 加奈絵, 西 清孝, 邵 旻蓉, 河野 圭伍, 山本 麻衣, 岡田 一範, 加賀 早苗, 政氏 伸夫 臨床血液 58 (12) 2463 -2463 2017年12月 [査読無し][通常論文]
  
• 血液細胞画像のテクスチャ解析により作成した判定行列の判定能の検討

  河野 圭伍, 山本 麻衣, 七戸 加奈, 邵 旻蓉, 村上 悟, 早田 瑠架, 三輪 佳子, 堤 豊, 岡田 一範, 加賀 早苗, 政氏 伸夫 臨床血液 58 (12) 2464 -2464 2017年12月 [査読無し][通常論文]
  
• フローサイトメトリーを用いた胎児赤血球計量系の構築

  政氏 伸夫, 馬詰 武, 山田 崇弘, 長 和俊, 岡田 一範, 加賀 早苗, 森川 守 臨床血液 58 (12) 2464 -2464 2017年12月
• 分類基準に準じて初学者が行った骨髄有核細胞鑑別の精度

  七戸 加奈, 邵 旻蓉, 山本 麻衣, 河野 圭伍, 高橋 一人, 堤 豊, 三輪 佳子, 加賀 早苗, 岡田 一範, 政氏 伸夫 臨床血液 58 (11) 2296 -2296 2017年11月 [査読無し][通常論文]
  
• 分類基準に準じて初学者が行った正常末梢血白血球分類の精度

  邵 旻蓉, 七戸 加奈, 山本 麻衣, 河野 圭伍, 高橋 一人, 堤 豊, 三輪 佳子, 加賀 早苗, 岡田 一範, 政氏 伸夫 臨床血液 58 (11) 2296 -2297 2017年11月 [査読無し][通常論文]
  
• 実例で学ぶ心エコー手法の適材適所 左室収縮能―EF?GLS?

  山田聡, 加賀早苗 心エコー 18 (8) 726‐735 2017年08月01日 [査読無し][通常論文]
  
• 凝固検査用検体の遠心条件と保管による凝固検査と残存血小板数の検討

  山本 麻衣, 黒木 麻衣子, 河野 圭伍, 七戸 加奈, 三輪 佳子, 高橋 一人, 岡田 一範, 加賀 早苗, 三神 大世, 家子 正裕, 政氏 伸夫 日本検査血液学会雑誌 18 (2) 258 -265 2017年07月 [査読無し][通常論文]
   

  採血から検査に至る凝固検査用検体の取扱いは、臨床現場によって異なる場合も多く、取扱い条件の統一化が求められている。本研究では健常ボランティア5人の末梢血検体を用いて、異なる遠心条件として、遠心加速度は500×g、1,000×g、1,500×g、遠心時間は5分、10分、15分で分離した血漿検体の活性化部分はトロンボプラスチン時間(APTT)、プロトロンビン時間(PT)、トロンビン時間法によるフィブリノゲン(Fibrinogen;Fbg)濃度(Clauss法)、残存血小板数(rPLT)を測定し、各遠心条件及びrPLTによる凝固時間の変化を検討した。検体中のrPLTは、遠心加速度や遠心時間の増加に伴い減少したが、PT、APTT、Fbgは今回の検討では遠心条件による測定値の変化は認めなかった。rPLTとPT、APTT、Fbgとの相関も認めなかった。翌日までの血漿検体の室温保管ではPT、APTTは有意に延長し、Fbgは有意に増加した。「凝固検査検体取り扱いに関するコンセンサス」が推奨するrPLT 10×10^9/L未満を満たすためには1,500×g、15分間以上の遠心が必要であることが示された。今回の検討では、Fbgは必ずしもrPLTに依存しないことが示された。翌日までの室温保管では全ての項目において測定結果に有意な変化を認め、翌日までの血漿検体の保管は適切ではないことが示された。(著者抄録)
• 正常骨髄有核細胞分類における熟練検査技師間での差異

  七戸 加奈, 河野 圭佑, 山本 麻衣, 邵 旻蓉, 黒木 麻衣子, 高橋 一人, 堤 豊, 岡田 一範, 加賀 早苗, 政氏 伸夫 日本検査血液学会雑誌 18 (学術集会) S175 -S175 2017年06月 [査読無し][通常論文]
  
• 正常末梢血白血球分類における熟練検査技師間での差異

  邵 旻蓉, 山本 麻衣, 河野 圭伍, 黒木 麻衣子, 七戸 加奈, 高橋 一人, 堤 豊, 岡田 一範, 加賀 早苗, 政氏 伸夫 日本検査血液学会雑誌 18 (学術集会) S176 -S176 2017年06月 [査読無し][通常論文]
  
• テクスチャ解析を用いた末梢血白血球形態の定量的定義と判別

  山本 麻衣, 河野 圭伍, 早田 瑠架, 村上 悟, 黒木 麻衣子, 七戸 加奈, 邵 旻蓉, 岡田 一範, 加賀 早苗, 政氏 伸夫 日本検査血液学会雑誌 18 (学術集会) S187 -S187 2017年06月 [査読無し][通常論文]
  
• 濃度共起行列を用いたテクスチャ解析による赤芽球系前駆細胞形態特徴の定量的定義と判別

  河野 圭伍, 早田 瑠架, 村上 悟, 山本 麻衣, 黒木 麻衣子, 邵 旻蓉, 七戸 加奈, 岡田 一範, 加賀 早苗, 政氏 伸夫 日本検査血液学会雑誌 18 (学術集会) S236 -S236 2017年06月 [査読無し][通常論文]
  
• 両室心筋ストレイン計測に基づく肺高血圧症の病型分類

  加賀早苗, 前田祥子, 喜田真由子, 岡田一範, 政氏伸夫, 横山しのぶ, 西田睦, 浅川直也, 岩野弘幸, 山田聡, 辻野一三, 三神大世 超音波検査技術 42 S227 2017年06月01日 [査読無し][通常論文]
  
• S字状中隔例の右室形態の特徴:3次元心エコー法を用いた検討

  岡田一範, 加賀早苗, 辻田孝輔, 原瑞希, 長尾裕子, 坂本洋一, 政氏伸夫, 三神大世 超音波検査技術 42 S122 2017年06月01日 [査読無し][通常論文]
  
• TEXTURE ANALYSIS FOR QUANTITATIVE DISTINCTION OF ERYTHROCYTE PRECURSOR CELL STAGES

  Keigo Kono, Ruka Hayata, Satoru Murakami, Mai Yamamoto, Maiko Kuroki, Kana Nanato, Kazuto Takahashi, Keiko Miwa, Yutaka Tsutsumi, Kazunori Okada, Sanae Kaga, Nobuo Masauzi INTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY 39 61 -61 2017年05月 [査読無し][通常論文]
  
• TEXTURE ANALYSIS FOR QUANTITATIVE DISTINCTION OF THE MORPHOLOGICAL CHARACTERISTICS OF WHITE BLOOD CELLS IN PERIPHERAL BLOOD

  Mai Yamamoto, Keigo Kono, Maiko Kuroki, Satoru Murakami, Ruka Hayata, Kana Nanato, Keiko Miwa, Kazuto Takahashi, Yutaka Tsutsumi, Kazunori Okada, Sanae Kaga, Nobuo Masauzi INTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY 39 128 -128 2017年05月 [査読無し][通常論文]
  
• 年齢を考慮した血行動態推定のポイント

  山田聡, 林大知, 加賀早苗, 岩野弘幸 日本心エコー図学会学術集会プログラム・抄録集(Web) 28th ROMBUNNO.S15‐5 (WEB ONLY) 2017年 [査読無し][通常論文]
  
• 心房収縮期における肺動脈弁逆流流速波形の窪みと三尖弁輪移動距離の計測に基づく右室拡張末期圧の推定

  村山迪史, 三神大世, 加賀早苗, 岡田一範, 中鉢雅大, 西野久雄, 横山しのぶ, 市川絢子, 阿部歩, 辻永真吾, 林大知, 岩野弘幸, 山田聡 日本心エコー図学会学術集会プログラム・抄録集(Web) 28th ROMBUNNO.O31‐1 (WEB ONLY) 2017年 [査読無し][通常論文]
  
• 肺静脈血流と経僧帽弁血流の時間速度積分値計測に基づく心房収縮期逆行/順行血流量比の左室拡張末期圧推定における有用性

  岡田一範, 加賀早苗, 安彦里佳, 阿部歩, 中鉢雅大, 西野久雄, 市川絢子, 横山しのぶ, 西田睦, 辻永真吾, 林大知, 浅川直也, 岩野弘幸, 山田聡, 三神大世 日本心エコー図学会学術集会プログラム・抄録集(Web) 28th ROMBUNNO.O24‐3 (WEB ONLY) 2017年 [査読無し][通常論文]
  
• 肺動脈弁逆流速度と経僧帽弁血流速度の計測に基づく新しい肺血管抵抗の非侵襲的推定法

  黒壁大貴, 加賀早苗, 岡田一範, 政氏伸夫, 村山迪史, 喜田真由子, 横山しのぶ, 西野久雄, 中鉢雅大, 辻永真吾, 林大知, 浅川直也, 岩野弘幸, 山田聡, 辻野一三, 三神大世 日本心エコー図学会学術集会プログラム・抄録集(Web) 28th ROMBUNNO.O31.3 (WEB ONLY) 2017年 [査読無し][通常論文]
  
• Additive Predictive Value of Strain Rate Dispersion Index for Responses to Cardiac Resynchronization Therapy: Substudy From the START Study

  Hiroyuki Iwano, Satoshi Yamada, Kazunori Okada, Taichi Hayashi, Shingo Tsujinaga, Shinobu Yokoyama, Masahiro Nakabachi, Hisao Nishino, Ayako Ichikawa, Ayumu Abe, Sanae Kaga, Taisei Mikami, Hiroyuki Tsutsui CIRCULATION 134 2016年11月 [査読無し][通常論文]
  
• Single Beat Determination of Measurements of Echocardiographic Left Ventricular Diastolic Parameters in Patients With Atrial Fibrillation

  Satoshi Yamada, Ayako Ichikawa, Hiroyuki Iwano, Kazunori Okada, Shinobu Yokoyama, Hisao Nishino, Masahiro Nakabachi, Ayumu Abe, Taichi Hayashi, Daisuke Murai, Sanae Kaga, Taisei Mikami, Hiroyuki Tsutsui CIRCULATION 134 2016年11月 [査読無し][通常論文]
  
• 【ドプラ法における匠の技】<基礎編>各種ドプラ法の原理と使い方 カラーMモードドプラ法

  加賀 早苗, 岩野 弘幸, 三神 大世 心エコー 17 (11) 974 -980 2016年11月 [査読無し][通常論文]
  
• テクスチャ識別指標を用いた骨髄球系幼若細胞形態の定量的定義の試み

  河野 圭伍, 村上 悟, 早田 瑠架, 黒木 麻衣子, 山本 麻衣, 岡田 一範, 加賀 早苗, 三神 大世, 政氏 伸夫 日本検査血液学会雑誌 17 (学術集会) S141 -S141 2016年07月 [査読無し][通常論文]
  
• 凝固検査用検体の遠心条件と保管に関する検討 PT、APTT

  黒木 麻衣子, 河野 圭伍, 山本 麻衣, 岡田 一範, 加賀 早苗, 三輪 佳子, 三神 大世, 政氏 伸夫 日本検査血液学会雑誌 17 (学術集会) S203 -S203 2016年07月 [査読無し][通常論文]
  
• 凝固検査用検体の遠心条件と保管に関する検討 Fib、Ca再加時間

  山本 麻衣, 黒木 麻衣子, 河野 圭伍, 岡田 一範, 加賀 早苗, 三輪 佳子, 三神 大世, 政氏 伸夫 日本検査血液学会雑誌 17 (学術集会) S203 -S203 2016年07月 [査読無し][通常論文]
  
• NUMERICAL DEFINITIONS OF MORPHOLOGICAL CHARACTERISTICS (MCS) OF GRANULOCYTE PRECURSOR CELLS (GPCS) WITH TEXTURE ANALYSIS (TXA) USING GRAY LEVEL CO-OCCURRENCE MATRIX (GLCM)

  Keigo Kono, Satoru Murakami, Ruka Hayata, Mai Yamamoto, Kazunori Okada, Sanae Kaga, Taisei Mikami, Nobuo Masauzi INTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY 38 57 -57 2016年05月 [査読無し][通常論文]
  
• SEMI-AUTOMATIC RATING AND SCORING METHOD FOR NEUTROPHIL ALKALINE PHOSPHATASE (NAP) ACTIVITY AND INDEX

  Kanae Sugano, Kotomi Hashi, Misaki Goto, Kiyotaka Nishi, Rie Maeda, Keigo Kohno, Mai Yamamoto, Kazunori Okada, Sanae Kaga, Taisei Mikami, Nobuo Masauzi INTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY 38 102 -103 2016年05月 [査読無し][通常論文]
  
• 心不全患者における低心拍出量と静脈圧上昇の肝・腎障害との関係

  米田球士, 三神大世, 加賀早苗, 岡田一範, 政氏伸夫, 横山しのぶ, 西田睦, 岩野弘幸, 山田聡, 筒井裕之 超音波医学 43 S607(J‐STAGE) 2016年04月15日 [査読無し][通常論文]
  
• 左室肥大における心筋機能と心腔機能の関連

  岡田一範, 山田聡, 岩野弘幸, 村井大輔, 西野久雄, 中鉢雅大, 林大知, 加賀早苗, 三神大世, 筒井裕之 超音波医学 43 S266(J‐STAGE) 2016年04月15日 [査読無し][通常論文]
  
• 今こそ知りたい右心機能の重要性と評価法 3.心エコーによる右心機能評価 1)肺高血圧の推定と注意点

  加賀早苗, 三神大世 Medical Technology 44 (3) 249‐254 2016年03月15日 [査読無し][通常論文]
  
• 三尖弁と右室機能 三尖弁逆流の評価

  加賀早苗, 三神大世 心エコー 17 (3) 212‐218 2016年03月01日 [査読無し][通常論文]
  
• 検体、標本保管に伴うミエロペルオキシダーゼ染色強度の経時的安定性 市販染色キットでの検討

  橋 ことみ, 西 清孝, 後藤 美沙紀, 前田 里衣, 菅野 加奈絵, 山田 実早希, 福井 彩佳, 藤本 奈緒, 岡田 一範, 加賀 早苗, 三神 大世, 政氏 伸夫 日本検査血液学会雑誌 17 (1) 25 -35 2016年02月 [査読無し][通常論文]
   

  好中球ペルオキシダーゼ(Myeloperoxidase:MPO)染色は血液悪性疾患のFAB分類およびWHO分類に不可欠である。所見は診断、治療に直結し、特殊染色のなかでも基本的かつ重要である。MPO染色のための塗抹と染色は、採血あるいは骨髄穿刺直後に行うこととされている。しかし、実医療現場では塗抹以降の工程を直ちに行なえない場合も少なくない。MPO染色キットの添付文書には、検体や標本を保管した場合、染色強度が低下するとの記載もある。そこで、我々は4種類の市販MPO染色キットを用いて、採血から塗抹、塗抹から固定と染色の各工程間で一定時間経過後に以降の工程を行った時、および封入後の染色強度の変化を検討した。その結果、採血後1週間以内に塗抹、染色を行えば、直後に行った場合とほぼ同様の染色強度が得られ、封入後も1週間までは同等であった。今回の検討は正常末梢血を対象としており、患者骨髄検体については、同様な検討が必要と考えられる。本研究では染色強度はImage-Jを用いて相対輝度によって評価した。この方法は定量性、客観性の点から有用であり、比較的簡便であった。しかし、この相対輝度による染色強度の評価では、目視による染色の良否の評価と一致しない場合もあった。染色の良否の判断には輝度以外の要素が関与していると考えられた。その定量的評価には、染色の良否の判断に影響する輝度以外の要素を同定し、それらを定量的に評価する必要がある。(著者抄録)
• 肺静脈血流速度計測に基づく左室硬さの新しい指標の有用性

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• 心エコー法による収縮期と急速充満期の肺動脈圧推定と左房容積計測は肺高血圧症の診断と病型分類に有用である

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  早田 瑠架, 河野 圭伍, 村上 悟, 岡田 一範, 加賀 早苗, 三神 大世, 政氏 伸夫 臨床血液 56 (12) 2522 -2522 2015年12月 [査読無し][通常論文]
  
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  河野 圭伍, 村上 悟, 早田 瑠架, 岡田 一範, 加賀 早苗, 三神 大世, 政氏 伸夫 臨床血液 56 (12) 2522 -2522 2015年12月 [査読無し][通常論文]
  
• Comparison of Afterload Dependency Between Left Ventricular Myocardial Strain and Strain Rate in Healthy Subjects

  Daisuke Murai, Satoshi Yamada, Hiroyuki Iwano, Taichi Hayashi, Kazunori Okada, Hisao Nishino, Masahiro Nakabachi, Ayumu Abe, Ayako Ichikawa, Shinobu Yokoyama, Sanae Kaga, Taisei Mikami, Hiroyuki Tsutsui CIRCULATION 132 2015年11月 [査読無し][通常論文]
  
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  政氏 伸夫, 水上 真喜, 山田 実早希, 福井 彩佳, 藤本 奈緒, 河野 圭伍, 村上 悟, 早田 瑠架, 加賀 早苗 日本検査血液学会雑誌 16 (学術集会) S163 -S163 2015年06月 [査読無し][通常論文]
  
• 北海道内主要病院の末梢血検査に関するアンケート調査

  河野 圭伍, 村上 悟, 早田 瑠架, 加賀 早苗, 政氏 伸夫 日本検査血液学会雑誌 16 (学術集会) S183 -S183 2015年06月 [査読無し][通常論文]
  
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  片山拓也, 三神大世, 加賀早苗, 岡田一範, 政氏伸夫, 横山しのぶ, 西田睦, 岩野弘幸, 山田聡, 筒井裕之 超音波医学 42 S514(J-STAGE) 2015年04月15日 [査読無し][通常論文]
  
• 三尖弁通過リードと三尖弁逆流との関係:心エコー法による検討

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• 大動脈弁狭窄症患者における腎障害の合併が心臓の形態と機能に及ぼす影響

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• 三尖弁逆流の程度が連続波ドプラ法の右室収縮期圧推定に及ぼす影響:心カテーテル法との比較に基づく検討

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• 肝硬変患者に合併する肺高血圧症の心エコーによる病態分析

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• 血圧変動による壁応力とスペックルストレインの変化:健常者での応力―ストレイン関係の検討

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• S字状心室中隔に伴う左室流出路狭窄と弁穿孔による僧帽弁逆流が溶血性貧血の原因となった僧帽弁形成術後症例

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• 肝硬変患者における左室形態の多様性

  竹村盛二朗, 三神大世, 岡田一範, 加賀早苗, 阿部歩, 中鉢雅大, 西野久雄, 横山しのぶ, 西田睦, 岩野弘幸, 山田聡, 筒井裕之 日本心エコー図学会学術集会抄録集 26th 178 2015年 [査読無し][通常論文]
  
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• 高度三尖弁逆流が連続波ドプラ法による収縮期右室‐右房圧較差計測に及ぼす影響とその対策

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• 肥大型心筋症における心血管合併症と心筋ストレインの関連:左室グローバルおよび局所ストレインとそのばらつきの検討

  西野久雄, 山田聡, 岡田一範, 岩野弘幸, 村井大輔, 林大知, 阿部歩, 市川絢子, 中鉢雅大, 横山しのぶ, 加賀早苗, 西田睦, 渋谷斉, 清水力, 三神大世, 筒井裕之 日本心臓病学会学術集会(Web) 63rd ROMBUNNO.P‐691 (WEB ONLY) 2015年 [査読無し][通常論文]
  
• 心房細動例での左室拡張機能評価に有効な代表心拍の決定法:各指標の心周期変動に対する依存性の比較に基づく検討

  市川絢子, 山田聡, 横山しのぶ, 阿部歩, 岡田一範, 西野久雄, 中鉢雅大, 加賀早苗, 西田睦, 澁谷斉, 清水力, 林大知, 村井大輔, 岩野弘幸, 三神大世, 筒井裕之 日本心臓病学会学術集会(Web) 63rd ROMBUNNO.P‐120 (WEB ONLY) 2015年 [査読無し][通常論文]
  
• Left Ventricular Longitudinal Myocardial Workload is More Severely Reduced in Hypertensive Patients with Concentric Hypertrophy Than in Those with Eccentric Hypertrophy

  Satoshi Yamada, Kazunori Okada, Hisao Nishino, Hiroyuki Iwano, Daisuke Murai, Taichi Hayashi, Masahiro Nakabachi, Ayako Ichikawa, Shinobu Yokoyama, Sanae Kaga, Taisei Mikami, Hiroyuki Tsutsui CIRCULATION 130 2014年11月 [査読無し][通常論文]
  
• Impaired Intrinsic Myocardial Shortening in Both Two Directions and Compensatory Mechanism to Maintain Left Ventricular Ejection Fraction in Patients With Hypertensive Heart Disease

  Satoshi Yamada, Kazunori Okada, Hisao Nishino, Hiroyuki Iwano, Daisuke Murai, Taichi Hayashi, Masahiro Nakabachi, Ayako Ichikawa, Shinobu Yokoyama, Sanae Kaga, Taisei Mikami, Hiroyuki Tsutsui CIRCULATION 130 2014年11月 [査読無し][通常論文]
  
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  加賀早苗, 山田聡 心エコー 15 (5) 422 -433 2014年05月01日 [査読無し][通常論文]
  
• 拡張能評価Up‐Date

  加賀早苗 医学検査 63 ROMBUNNO.GAKKAICHOTOKUBETSUKIKAKU,SHINZO,KAGA 2014年04月25日 [査読無し][通常論文]
  
• 肝硬変患者の心臓形態・機能異常の特徴

  竹村盛二朗, 三神大世, 岡田一範, 加賀早苗, 中鉢雅大, 西野久雄, 横山しのぶ, 西田睦, 山田聡, 筒井裕之 超音波医学 41 S508 2014年04月15日 [査読無し][通常論文]
  
• 機能的三尖弁逆流の機序:弁テザリングか弁輪拡大か?

  西田翼, 三神大世, 加賀早苗, 中元雅章, 岡田一範, 阿部歩, 中鉢雅大, 西野久雄, 横山しのぶ, 西田睦, 岩野弘幸, 山田聡, 筒井裕之 超音波医学 41 (1) 51 2014年01月15日 [査読無し][通常論文]
  
• 高度三尖弁逆流例における右室‐右房圧較差の連続波ドプラ計測はどこまで信頼できるか

  樋岡拓馬, 加賀早苗, 三神大世, 中野彩, 岡田一範, 阿部歩, 中鉢雅大, 西野久雄, 横山しのぶ, 西田睦, 林大知, 村井大輔, 山田聡, 筒井裕之 超音波医学 41 (1) 51 2014年01月15日 [査読無し][通常論文]
  
• 肝硬変患者において心エコー検査で検出される心形態・機能異常の特徴

  竹村盛二朗, 三神大世, 大野瞬, 岡田一範, 加賀早苗, 阿部歩, 中鉢雅大, 西野久雄, 横山しのぶ, 西田睦, 林大知, 村井大輔, 山田聡, 筒井裕之 超音波医学 41 (1) 54 2014年01月15日 [査読無し][通常論文]
  
• 肥大心における左室長軸方向収縮速度の時相的変化の特徴

  岡田一範, 三神大世, 加賀早苗, 阿部歩, 中鉢雅大, 西野久雄, 横山しのぶ, 西田睦, 林大知, 村井大輔, 山田聡, 筒井裕之 超音波医学 41 (1) 51 2014年01月15日 [査読無し][通常論文]
  
• 肺動脈弁逆流速波形が拘束型血行動態の診断に有用であった心アミロイドーシスの1例

  西野久雄, 山田聡, 林大知, 村井大輔, 市川絢子, 中鉢雅大, 横山しのぶ, 加賀早苗, 西田睦, 清水力, 三神大世, 筒井裕之 超音波医学 41 (1) 52 2014年01月15日 [査読無し][通常論文]
  
• 加齢変性による大動脈弁狭窄症の収縮期弁口形態と狭窄重症度との関係

  辻香菜子, 三神大世, 加賀早苗, 長多真美, 阿部歩, 岡田一範, 横山しのぶ, 西野久雄, 中鉢雅大, 西田睦, 岩野弘幸, 山田聡, 筒井裕之 超音波医学 41 (1) 53 2014年01月15日 [査読無し][通常論文]
  
• 高血圧における長軸方向心筋短縮能は遠心性肥大より求心性肥大でより高度に低下する

  岡田一範, 山田聡, 西野久雄, 村井大輔, 林大知, 中鉢雅大, 横山しのぶ, 加賀早苗, 三神大世, 筒井裕之 日本心エコー図学会学術集会抄録集 25th 191 2014年 [査読無し][通常論文]
  
• 大動脈弁狭窄の診療における弁‐動脈インピーダンスの意義:左室肥大との関連について

  市川絢子, 山田聡, 阿部歩, 辻香菜子, 岡田一範, 横山しのぶ, 西野久雄, 中鉢雅大, 加賀早苗, 西田睦, 澁谷斉, 清水力, 林大知, 村井大輔, 三神大世, 筒井裕之 日本心エコー図学会学術集会抄録集 25th 239 2014年 [査読無し][通常論文]
  
• スペックルトラッキング法を用いた長軸方向心筋仕事量算出の試み:高血圧性心疾患と肥大型心筋症への応用

  西野久雄, 山田聡, 岡田一範, 村井大輔, 林大知, 市川絢子, 中鉢雅大, 横山しのぶ, 加賀早苗, 西田睦, 清水力, 三神大世, 筒井裕之 日本心エコー図学会学術集会抄録集 25th 191 2014年 [査読無し][通常論文]
  
• どのくらい高度の三尖弁逆流まで連続波ドプラ法による右室‐右房圧較差の評価は可能か?

  加賀早苗, 三神大世, 樋岡拓馬, 中野彩, 岡田一範, 阿部歩, 中鉢雅大, 西野久雄, 横山しのぶ, 西田睦, 林大知, 村井大輔, 岩野弘幸, 山田聡, 筒井裕之 日本心エコー図学会学術集会抄録集 25th 210 2014年 [査読無し][通常論文]
  
• 肥大型心筋症における左室長軸方向ストレインレートの時相・波形異常の特徴

  岡田一範, 三神大世, 加賀早苗, 阿部歩, 中鉢雅大, 西野久雄, 横山しのぶ, 西田睦, 林大知, 村井大輔, 山田聡, 筒井裕之 日本心エコー図学会学術集会抄録集 25th 175 2014年 [査読無し][通常論文]
  
• Relationship Between Left Ventricular Myocardial Shortening in the Three Orthogonal Directions and Cardiovascular Complications in Patients With Nonobstructive Hypertrophic Cardiomyopathy

  Hisao Nishino, Satoshi Yamada, Kazunori Okada, Masahiro Nakabachi, Shinobu Yokoyama, Hiroyuki Iwano, Sanae Kaga, Mutsumi Nishida, Hitoshi Shibuya, Chikara Shimizu, Taisei Mikami, Hiroyuki Tsutsui CIRCULATION 128 (22) 2013年11月 [査読無し][通常論文]
  
• 頸動脈エコーによるプラークの異常な動きの評価:プラーク破綻から潰瘍に至る一連の危険な病変の診断における役割

  村木睦子, 三神大世, 吉本哲之, 藤本真, 北口真弓, 菅原智子, 加賀早苗, 徳田耕一, 金子貞男, 柏葉武 Neurosonology 26 (Supplement) 111 2013年06月01日 [査読無し][通常論文]
  
• 連続波ドプラ法による肺動脈弁逆流速度波形の分析に基づく収縮性心膜炎の診断

  加賀早苗, 三神大世, 高松由佳, 中鉢雅大, 横山しのぶ, 西野久雄, 西田睦, 岩野弘幸, 山田聡, 筒井裕之 超音波医学 40 S487 2013年04月15日 [査読無し][通常論文]
  
• 機能的三尖弁逆流の成因と病態の分析

  野澤弥生, 三神大世, 加賀早苗, 岡田一範, 阿部歩, 中鉢雅大, 横山しのぶ, 西野久雄, 西田睦, 岩野弘幸, 山田聡, 筒井裕之 超音波医学 40 (1) 31 2013年01月15日 [査読無し][通常論文]
  
• 肺高血圧症の診断における連続波ドプラ法による肺動脈弁逆流の拡張期流速測定の意義

  北南文絵, 三神大世, 加賀早苗, 柴瀟, 中野彩, 岡田一範, 阿部歩, 中鉢雅大, 横山しのぶ, 西野久雄, 西田睦, 岩野弘幸, 山田聡, 筒井裕之 超音波医学 40 (1) 31 2013年01月15日 [査読無し][通常論文]
  
• 肥大型心筋症では円周方向ではなく長軸方向左室心筋ストレインが心血管合併症の有無と関連する

  西野久雄, 山田聡, 岡田一範, 岩野弘幸, 横山しのぶ, 中鉢雅大, 加賀早苗, 西田睦, 清水力, 三神大世, 筒井裕之 超音波医学 40 (1) 34 2013年01月15日 [査読無し][通常論文]
  
• 連続波ドプラ法による肺動脈弁逆流流速波形にみられる心房収縮期窪みとその近傍の波形変化

  中野彩, 三神大世, 加賀早苗, 北南文絵, 岡田一範, 阿部歩, 横山しのぶ, 西野久雄, 西田睦, 岩野弘幸, 山田聡, 筒井裕之 超音波医学 40 (1) 34 -35 2013年01月15日 [査読無し][通常論文]
  
• 重症大動脈弁狭窄にみあう左室肥大の欠如:圧回復現象との関係

  辻香菜子, 加賀早苗, 三神大世, 鎌田美穂, 阿部歩, 岡田一範, 横山しのぶ, 西野久雄, 西田睦, 岩野弘幸, 山田聡, 筒井裕之 超音波医学 40 (1) 30 -31 2013年01月15日 [査読無し][通常論文]
  
• S字状中隔における左室流出路狭窄と左室形態との関係

  竹村盛二朗, 三神大世, 岡田一範, 加賀早苗, 阿部歩, 中鉢雅大, 西野久雄, 横山しのぶ, 西田睦, 岩野弘幸, 山田聡, 筒井裕之 超音波医学 40 (1) 34 2013年01月15日 [査読無し][通常論文]
  
• 3次元スペックルトラッキングによる左室容積自動計測の有用性:同一画像データでの2次元用手トレース法との比較に基づく検討

  中鉢雅大, 山田聡, 西野久雄, 岡田一範, 横山しのぶ, 西田睦, 渋谷斉, 清水力, 加賀早苗, 三神大世, 筒井裕之 日本心エコー図学会学術集会抄録集 24th 162 2013年 [査読無し][通常論文]
  
• 肺動脈弁逆流の拡張後期流速波形のバリエーションとその意義

  中野彩, 三神大世, 加賀早苗, 北南文絵, 岡田一範, 阿部歩, 横山しのぶ, 西野久雄, 中鉢雅大, 山田聡, 筒井裕之 日本心エコー図学会学術集会抄録集 24th 173 2013年 [査読無し][通常論文]
  
• 機能的三尖弁逆流の成因と機序:とくに慢性心房細動の関与について

  岡田一範, 三神大世, 加賀早苗, 野澤弥生, 西田翼, 阿部歩, 中鉢雅大, 西野久雄, 横山しのぶ, 西田睦, 山田聡, 筒井裕之 日本心エコー図学会学術集会抄録集 24th 175 2013年 [査読無し][通常論文]
  
• エコースペックルトラッキング法により実現した多方向心筋ストレインの層別解析:その概念と臨床応用

  山田聡, 阿部康彦, 岡田一範, 西野久雄, 中鉢雅大, 横山しのぶ, 加賀早苗, 三神大世, 筒井裕之 日本心エコー図学会学術集会抄録集 24th 99 2013年 [査読無し][通常論文]
  
• Stress-Corrected Circumferential Myocardial Shortening is Reduced in All Layers in Patients with Hypertrophic Cardiomyopathy

  Kazunori Okada, Satoshi Yamada, Hiroyuki Iwano, Hisao Nishino, Masahiro Nakabachi, Shinobu Yokoyama, Sanae Kaga, Taisei Mikami, Hiroyuki Tsutsui CIRCULATION 126 (21) 2012年11月 [査読無し][通常論文]
  
• 心臓再同期療法後のVV delay調整に苦慮した左脚ブロックの2例

  岩野弘幸, 山田聡, 西野久雄, 横山しのぶ, 加賀早苗, 三神大世, 筒井裕之 日本心エコー図学会学術集会抄録集 23rd 84 2012年 [査読無し][通常論文]
  
• 子宮体癌に合併しヘパリン療法が奏効した無菌性血栓性心内膜炎の1例

  横山しのぶ, 山田聡, 加賀早苗, 小田切哲二, 西野久雄, 岩野弘幸, 西田睦, 澁谷斉, 重松明男, 渡利英道, 小野塚久夫, 清水力, 三神大世, 筒井裕之 日本心エコー図学会学術集会抄録集 23rd 211 2012年 [査読無し][通常論文]
  
• 肥大型心筋症で低下した長軸・円周方向心筋短縮と壁厚増大による円周方向内膜機能の代償

  岡田一範, 山田聡, 岩野弘幸, 加賀早苗, 横山しのぶ, 西野久雄, 小野塚久夫, 三神大世, 筒井裕之 日本心エコー図学会学術集会抄録集 23rd 92 2012年 [査読無し][通常論文]
  
• 拡張機能を見直す 心エコーで左室弛緩能は評価可能か?

  三神大世, 加賀早苗 心エコー 12 (12) 1126 -1132 2011年12月01日 [査読無し][通常論文]
  
• S字状中隔と左室心筋弛緩との関係:二次元スペックルトラッキング法による検討

  岡田一範, 三神大世, 加賀早苗, 小野塚久夫, 横山しのぶ, 西野久雄, 中鉢雅大, 岩野弘幸, 山田聡, 筒井裕之 超音波医学 38 (6) 675 2011年11月15日 [査読無し][通常論文]
  
• 子宮体癌に合併しヘパリン療法が奏効した無菌性血栓性心内膜炎の1例

  横山しのぶ, 山田聡, 加賀早苗, 小田切哲二, 西野久雄, 岩野弘幸, 西田睦, 澁谷斉, 重松明男, 渡利英道, 小野塚久夫, 清水力, 三神大世, 筒井裕之 超音波医学 38 (6) 677 2011年11月15日 [査読無し][通常論文]
  
• 心筋層別ストレイン計測による心筋機能と心室機能の評価:肥大型心筋症における検討

  岡田一範, 山田聡, 三神大世, 岩野弘幸, 小野塚久矢, 加賀早苗, 横山しのぶ, 西野久雄, 筒井裕之 超音波医学 38 (6) 675 2011年11月15日 [査読無し][通常論文]
  
• 心エコーで観察されるS字状中隔と体格指数との関係

  水岡由佳理, 三神大世, 岡田一範, 小野塚久夫, 加賀早苗, 横山しのぶ, 西野久雄, 岩野弘幸, 山田聡, 筒井裕之 超音波医学 38 (6) 672 -673 2011年11月15日 [査読無し][通常論文]
  
• 収縮同期不全による左室全体収縮機能の損失分を表すストレインレート指標:心臓再同期療法慢性効果の予測

  岩野弘幸, 山田聡, 西野久雄, 横山しのぶ, 加賀早苗, 小野塚久夫, 三神大世, 筒井裕之 超音波医学 38 (6) 676 2011年11月15日 [査読無し][通常論文]
  
• 心内膜側と中層の円周方向ストレインによる左室機能評価の意義:肥大型心筋症における検討

  岡田一範, 山田聡, 三神大世, 岩野弘幸, 加賀早苗, 小野塚久夫, 横山しのぶ, 西野久雄, 筒井裕之 日本心臓病学会誌 6 (Supplement 1) 339 2011年08月14日 [査読無し][通常論文]
  
• 肥大心における心筋中層ストレインによる心筋機能の評価:Endocardial indexesとの意義の違い

  山田聡, 岡田一範, 三神大世, 岩野弘幸, 加賀早苗, 小野塚久夫, 横山しのぶ, 西野久雄, 筒井裕之 日本心臓病学会誌 6 (Supplement 1) 157 2011年08月14日 [査読無し][通常論文]
  
• 各種成因に基づく左室収縮障害患者における左室後壁屈曲の頻度と機序

  岩井孝仁, 三神大世, 小野塚久夫, 加賀早苗, 横山しのぶ, 西野久雄, 西田睦, 岩野弘幸, 山田聡, 筒井裕之 超音波医学 38 (3) 303 2011年05月15日 [査読無し][通常論文]
  
• 等容弛緩期の左室心筋ストレインレートは急速流入期ストレインレートよりも良好に左室弛緩能と関連する

  岩野弘幸, 山田聡, 西野久雄, 横山しのぶ, 加賀早苗, 小野塚久夫, 三神大世, 筒井裕之 超音波医学 38 (3) 304 2011年05月15日 [査読無し][通常論文]
  
• 左室右房交通症の1例:肺高血圧症を伴う三尖弁逆流との鑑別について

  西野久雄, 三神大世, 岩野弘幸, 山田聡, 筒井裕之, 小野塚久夫, 横山しのぶ, 加賀早苗, 西田睦, 松野一彦 超音波医学 38 (3) 304 2011年05月15日 [査読無し][通常論文]
  
• 加齢による左室変形と左室弛緩機能との関係:二次元スペックルトラッキング法による検討

  岡田一範, 三神大世, 加賀早苗, 小野塚久夫, 西野久雄, 横山しのぶ, 西田睦, 岩野弘幸, 山田聡, 筒井裕之 超音波医学 38 (3) 303 -304 2011年05月15日 [査読無し][通常論文]
  
• 二次元スペックルトラッキング法を用いた左室心内膜全体の面積変化速度による弛緩能の推定

  岩野弘幸, 山田聡, 西野久雄, 横山しのぶ, 加賀早苗, 小野塚久雄, 三神大世, 筒井裕之 超音波医学 38 (3) 304 2011年05月15日 [査読無し][通常論文]
  
• 左室収縮障害患者における左室後壁の内腔への屈曲・突出の頻度,機序および臨床的意義

  岩井孝仁, 三神大世, 小野塚久夫, 加賀早苗, 横山しのぶ, 西野久雄, 西田睦, 岩野弘幸, 山田聡, 筒井裕之 超音波医学 38 S346 2011年04月15日 [査読無し][通常論文]
  
• 収縮同期不全による左室全体収縮機能の損失分を表すストレインレート指標

  岩野弘幸, 山田聡, 西野久雄, 横山しのぶ, 加賀早苗, 小野塚久夫, 三神大世, 筒井裕之 超音波医学 38 S229 2011年04月15日 [査読無し][通常論文]
  
• 体外式超音波による胃・大腸癌の進行度診断

  西田睦, 加藤元嗣, 西田麗, 石坂香織, 佐藤恵美, 井上真美子, 工藤悠輔, 表原里実, 加賀早苗, 横山しのぶ, 西野久雄, 小野寺祐也, 寺江聡, 七戸俊明, 近藤哲, 久保田佳奈子, 松野吉宏 超音波医学 37 (1) 46 2010年01月15日 [査読無し][通常論文]
  
• CT/MRIにて診断に到らなかった肝結節に対する造影超音波検査の位置づけ

  西田睦, 小野寺祐也, 尾松徳彦, 佐藤恵美, 石坂香織, 溝口恵美, 工藤祐輔, 加賀早苗, 井上真美子, 横山しのぶ, 表原里美, 鈴木春樹, 清水力, 寺江聡, 久保田佳奈子, 松野吉宏, 松野一彦 臨床病理 56 115 2008年10月31日 [査読無し][通常論文]
  
• Plasma NT-proBNP concentration is a sensitive marker of diastolic dysfunction and arterial remodeling in hypertension

  Tomoo Furumoto, Mamiko Inoue, Sanae Kaga, Satoshi Yamada, Hisao Onozuka, Miwako Fujii, Akiko Aita, Taisei Mikami, Satoshi Fujii, Burton E. Sobel, Hiroyuki Tsutsui JOURNAL OF HYPERTENSION 24 305 -305 2006年12月 [査読無し][通常論文]
  
• PJ-169 Abnormal Apical Rotation in Patients with Left Ventricular Hypertrophy Determined by Two-Dimensional Ultrasound Speckle Tracking Imaging(Echo/Doppler-13 (I) PJ29,Poster Session (Japanese),The 70th Anniversary Annual Scientific Meeting of the Japanese Circulation Society)

  Goto Kazutomo, Mikami Taisei, Onozuka Hisao, Kaga Sanae, Inoue Mamiko, Yokoyama Shinobu, Komatsu Hiroshi, Yamada Satoshi, Tsutsui Hiroyuki Circulation journal : official journal of the Japanese Circulation Society 70 531 -531 2006年03月01日
• PE-584 Plasma NT-proBNP Concentration is a Sensitive Marker of Diastolic Dysfunction and Arterial Remodeling in Hypertension(Hypertension, clinical-7 (H) PE102,Poster Session (English),The 70th Anniversary Annual Scientific Meeting of the Japanese Circulation Society)

  Furumoto Tomoo, Fujii Satoshi, Mikami Taisei, Inoue Mamiko, Nishihara Keiko, Kaga Sanae, Gotoh Kazutomo, Imagawa Shogo, Komuro Kaoru, Yamada Satoshi, Onozuka Hisao, Kitabatake Akira, Sobel Burton E, Tsutsui Hiroyuki Circulation journal : official journal of the Japanese Circulation Society 70 478 -479 2006年03月01日
• Increased plasma concentrations of N-terminal pro brain natriuretic peptide is a more sensitive marker of subclinical diastolic dysfunction and arterial remodeling in hypertension: Analytical performance comparison with BNP

  T Furumoto, S Fujii, T Mikami, M Inoue, K Nishihara, S Kaga, K Goto, S Imagawa, K Komuro, S Yamada, H Onozuka, A Kitabatake, BE Sobel, H Tsutsui JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 47 (4) 372A -372A 2006年02月 [査読無し][通常論文]
  
• PJ-135 Feasibility of the Assessment of Left Ventricular Diastolic Function Using Doppler-Derived Early Diastolic Peak Strain Rate(Echo/Doppler 6 (I) : PJ23)(Poster Session (Japanese))

  Onozuka Hisao, Mikami Taisei, Kaga Sanae, Goto Kazutomo, Inoue Mamiko, Yokoyama Shinobu, Komuro Kaoru, Yamada Satoshi, Kitabatake Akira Circulation journal : official journal of the Japanese Circulation Society 68 513 -513 2004年03月01日
• OJ-392 A New Method to Measure Myocardial Strain along the Left Ventricular Circumference Using Tissue Doppler Echocardiography(Echo/Doppler 14 (I) : OJ48)(Oral Presentation (Japanese))

  Onozuka Hisao, Mikami Taisei, Kaga Sanae, Gotoh Kazutomo, Yokoyama Shinobu, Mamiko Mamiko, Komuro Kaoru, Yamada Satoshi, Kitabatake Akira Circulation journal : official journal of the Japanese Circulation Society 68 325 -325 2004年03月01日
• PJ-020 Evaluation of Circumferential and Longitudinal Myocardial Contraction Using Tissue Doppler Strain Measurement in Patients with Generalized Left Ventricular Myocardial Impairment(Echo/Doppler 2 (I) : PJ4)(Poster Session (Japanese))

  Goto Kazutomo, Mikami Taisei, Kaga Sanae, Onozuka Hisao, Yokoyama Shinobu, Inoue Mamiko, Komuro Kaoru, Yamada Satoshi, Kitabatake Akira Circulation journal : official journal of the Japanese Circulation Society 68 484 -484 2004年03月01日
• Usefulness of Color Tissue Doppler Imaging in the Assessment of Left Ventricular Diastolic Function : Comparison with Color M-Mode Doppler Technique

  Onozuka Hisao, Mikami Taisei, Kaga Sanae, Goto Kazutomo, Wu Di, Inoue Mamiko, Komuro Kaoru, Yamada Satoshi, Kitabatake Akira Circulation journal : official journal of the Japanese Circulation Society 67 613 -613 2003年03月01日
• Abnormal Diastolic Flow Velocity Pattern in the Distal Left Anterior Descending Coronary Artery in Patients with Apical Hypertrophy

  Goto Kazutomo, Onozuka Hisao, Mikami Taisei, Inoue Mamiko, Kaga Sanae, Wu Di, Komuro Kaoru, Yamada Satoshi, Kitabatake Akira Circulation journal : official journal of the Japanese Circulation Society 67 326 -326 2003年03月01日

書籍等出版物

• 心不全治療に心エコーを生かすQ&A115

  加賀 早苗 (担当:分担執筆)
  メジカルビュー 2017年04月
• JAMT技術教本シリーズ 超音波検査症例集

  加賀 早苗 (担当:分担執筆範囲:僧帽弁狭窄症)
  じほう 2016年

講演・口頭発表等

• 右心系を極める～右心機能評価の断面設定と計測のポイント～  [招待講演]

  加賀 早苗

  日本心エコー図学会第29回学術集会 2018年04月 シンポジウム・ワークショップパネル（指名）
• 心不全患者の生理機能検査データを読み解こう  [招待講演]

  加賀 早苗

  北海道臨床衛生検査技師会第14回しばれセミナー 2018年02月 公開講演，セミナー，チュートリアル，講習，講義等
• 基礎疾患で考える：膠原病  [招待講演]

  加賀 早苗

  第26回日本心エコー図学会学術集会 2015年03月 シンポジウム・ワークショップパネル（指名）
• 拡張機能Update  [招待講演]

  加賀 早苗

  第63回日本医学検査学会 2014年05月 シンポジウム・ワークショップパネル（指名）
• 肺高血圧症の心エコー検査の実際  [招待講演]

  加賀 早苗

  講演会「肺高血圧症と心エコー」 2012年07月 公開講演，セミナー，チュートリアル，講習，講義等

共同研究・競争的資金等の研究課題

• 心エコー法による左心不全患者の右室後負荷の包括的評価法の確立

  日本学術振興会：科学研究費助成事業

  研究期間 : 2019年04月 -2023年03月 

  代表者 : 加賀 早苗

   

  心不全は、心疾患による死亡の大半に関わる重篤かつ頻度の高い合併症であるが、最近、左心不全患者の予後が右室機能の良否に左右されることが注目されている。これは肺循環系が右室に与える後負荷に起因すると考えられる。従って、肺循環動態を精密に把握する意義は大きいと考えられる。本研究の目的は、左心不全患者の肺循環系が右室に与える後負荷を、非侵襲的な心エコー法で包括的に評価するための方法論を確立し、その右室機能や患者予後との関係を明らかにすることである。 肺循環動態指標のひとつである肺血管抵抗（PVR）と肺動脈キャパシタンスの積である抵抗-コンプライアンス時間（RCT）の算出法として、対数法と積算法とではRCT計測値に差があることが問題点として指摘されている。本研究では、簡易的な対数法と積算法で求めたRCTを、時定数τとして標準的に求めたRCTとの比較に基づき、その妥当性を検討した。右心カテーテル検査が施行され、良好な記録が得られた洞調律例46例を対象に、肺動脈圧波形から平均肺動脈楔入圧（PAWP）を差し引いた圧曲線を作成し、拡張期時定数τを求め、これを標準RCTとした。また、簡易的対数法により、拡張早期と心房収縮直前の二点の圧とその間の時間およびPAWPから簡易RCTを算出した。さらに、肺動脈収縮期圧、肺動脈拡張期圧、平均肺動脈圧、PAWP、1回拍出量および心拍出量から、PVRとPACをそれぞれ求め、それらの積を積算RCTとした。 全46例における標準RCTは0.28±0.14秒であり、簡易RCTは標準RCTとよく相関し（r＝0.93、p＜0.01）、標準RCTに対する加算誤差を示さなかった。積算RCTも標準RCTとよく対応したが（r＝0.76、p＜0.01）、標準RCTに対して正の加算誤差を認め、RCTを過大評価した。