2024年09月, 日本超音波医学会第54回北海道地方会学術集会, 優秀演題賞
Beyond severe TRにおける経胸壁三次元心エコー法を用いた重症度評価と三尖弁複合体の形態学的特徴の検討
鈴木那奈;阪口景太;村山迪史;加賀早苗;柳 祐介;横山しのぶ;西野久雄;石坂 傑;岩野弘幸;安斉俊久, 国内学会・会議・シンポジウム等の賞, 42085911

2024年09月, 日本超音波医学会第54回北海道地方会学術集会, 優秀演題賞
心房細動例におけるVMTスコアによる左室充満圧推定精度の検証
西野久雄;村山迪史;岩野弘幸;鍵山暢之;土岐美沙子;岡田大司;石坂 傑;加賀早苗;山下直樹;豊嶋崇徳;安斉俊久, 国内学会・会議・シンポジウム等の賞, 46865526

2023年12月, キヤノンメディカルシステムズ株式会社, 画論31st The Best Image 優秀賞
経胸壁三次元心エコー法による三尖弁逆流の重症度評価が治療効果判定に有用であった1例
村山迪史;石坂 傑, 42085911

2023年09月, 日本臨床検査医学会, 第57回日本臨床検査医学会北海道支部総会 学会賞　　　　　　　　　　　　　　　
健常人における門脈血流の拍動メカニズム
小林澄夏;小野田愛梨;村山迪史;永井優衣;塚本真帆;工藤悠輔;加賀早苗

2023年06月, 第48回日本超音波検査学会学術集会, Congress Chairperson's Award -THE YOUNG Generations Award- 準優秀賞　　　　　　　　　　　　　　　
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;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;安斉俊久

2022年05月, 国立大学臨床検査技師教育協議会, 国立大学臨床検査学系博士後期課程 最優秀賞　　　　　　　　　　　　　　　
村山迪史

2022年04月, 北海道大学大学院保健科学院, 保健科学院長賞　　　　　　　　　　　　　　　
村山迪史

2022年03月, 北海道大学, 総代（令和3年度 博士学位記授与式）　　　　　　　　　　　　　　　
村山迪史

2021年10月, 日本超音波医学会第51回北海道地方会学術集会, 優秀演題賞
房室弁開放時相差の視覚的評価に基づいた新たな心エコー指標によるHFpEFの予後予測
村山迪史,岩野弘幸,表 和徳,原田智成,辻永真吾,中鉢雅大,加賀早苗,西田 睦,小保方 優,安斉俊久, 36691110

2021年10月, 第 25 回日本心不全学会学術集会, YIA審査講演（ハートチーム） 優秀賞
心エコー法による新たな左房圧指標を用いたHFpEFの予後予測に関する検討
村山迪史,岩野弘幸,表 和徳,原田智成,小保方優,加藤寿光,中鉢雅弘,西野久雄,横山しのぶ,辻永真吾,千葉泰之,石坂 傑,本居 昂,西田 睦,安斉俊久, 36691110

2021年08月, 北海道大学大学院保健科学院, 研究奨励賞　　　　　　　　　　　　　　　
村山迪史

2020年12月, 第45回日本超音波検査学会学術集会, YIA優秀賞　　　　　　　　　　　　　　　
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

2020年12月, 日本超音波医学会第93回学術集会, 日本超音波医学会第21回奨励賞
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, 36700548

2020年10月, 日本超音波医学会第50回北海道地方会学術集会, 優秀演題賞　　　　　　　　　　　　　　　
Vector flow mapping法による拡張早期僧帽弁逆流発生機序の推察
村山迪史;岩野弘幸;更科美羽;辻永真吾;西野久雄;横山しのぶ;中鉢雅大;加賀早苗;西田 睦;安斉俊久

2019年05月, 一般社団法人日本心エコー図学会, 平成30年度海外学会発表優秀論文賞　　　　　　　　　　　　　　　
心房収縮期における肺動脈弁逆流速度波形の窪みと三尖弁輪移動距離の計測に基づく非侵襲的な右室 硬さの推定
村山迪史;加賀早苗;岡田一範;西野久雄;横山しのぶ;中鉢雅大;更科美羽;辻永真吾;西田 睦;澁谷 斉;永井利幸;岩野弘幸;安斉俊久;三神大世

2018年03月, 第25回北海道心血管エコー研究会, 優秀演題賞　　　　　　　　　　　　　　　
高度大動脈弁逆流により拡張末期の大動脈弁開放を認めた高安動脈炎の1例
村山迪史;岩野弘幸;西野久雄;横山しのぶ;中鉢雅大;市川絢子;林 大知;辻永真吾;更科美羽;岡田一範;加賀早苗;西田 睦;澁谷 斉;山田 聡;安斉俊久

Validation of Left Ventricular Filling Pressure Evaluation by Order of Tricuspid and Mitral Valve Opening in Patients With Atrial Fibrillation
Hisao Nishino, Michito Murayama, Hiroyuki Iwano, Nobuyuki Kagiyama, Yutaka Nakamura, Yuka Akama, Misako Toki, Sachiko Takamatsu, Taiji Okada, Yasuyuki Chiba, Masahiro Nakabachi, Shinobu Yokoyama, Mana Goto, Yukino Suzuki, Suguru Ishizaka, Ko Motoi, Yoji Tamaki, Hiroyuki Aoyagi, Kosuke Nakamura, Sanae Kaga, Chiaki Watanabe, Kiwamu Kamiya, Toshiyuki Nagai, Takanori Teshima, Toshihisa Anzai
Circulation: Cardiovascular Imaging, 2024年11月13日, ［査読有り］, ［筆頭著者］
研究論文（学術雑誌）, 46865526

A Novel Ultrasound Finding for the Diagnosis of Giant Cell Arteritis: Comparison With Temporal Artery Biopsy Findings.
Yusuke Kudo, Karin Hara, Michito Murayama, Sanae Kaga, Satomi Omotehara, Takahito Iwai, Masaru Kato, Utano Tomaru, Yoshihiro Matsuno, Akihiro Ishizu
Journal of clinical ultrasound : JCU, 2024年10月12日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, Hypoechoic halo is a typical ultrasound finding in giant cell arteritis (GCA), but it may be a false positive due to arteriosclerosis. Therefore, we focused on the segmental distribution of GCA lesions, defined the luminal irregularity in long-axis images as the string of beads sign, and examined its diagnostic ability. As a result, the C-statistic of hypoechoic halo and string of beads sign was better than that of hypoechoic halo alone (1.00 vs. 0.89). Based on the above, the diagnostic ability of GCA can be improved by adding the string of beads sign to the conventional hypoechoic halo.

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, 50, 9, 1352, 1360, 2024年06月03日, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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., 40002746

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, Elsevier BV, 2024年06月, ［査読有り］
研究論文（学術雑誌）

Exploratory analysis of the accuracy of echocardiographic parameters for the assessment of right ventricular function and right ventricular-pulmonary artery coupling.
Hideki Shima, Ichizo Tsujino, Junichi Nakamura, Toshitaka Nakaya, Ayako Sugimoto, Takahiro Sato, Taku Watanabe, Hiroshi Ohira, Masaru Suzuki, Satonori Tsuneta, Yasuyuki Chiba, Michito Murayama, Isao Yokota, Satoshi Konno
Pulmonary circulation, 14, 2, e12368, 2024年04月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, Echocardiography is a widely used modality for the assessment of right ventricular (RV) function; however, few studies have comprehensively compared the accuracy of echocardiographic parameters using invasively obtained reference values. Therefore, this exploratory study aimed to compare the accuracy of echocardiographic parameters of RV function and RV-pulmonary artery (PA) coupling. We calculated four indices of RV function (end-systolic elastance [Ees] for systolic function [contractility], τ for relaxation, and β and end-diastolic elastance [Eed] for stiffness), and an index of RV-PA coupling (Ees/arterial elastance [Ea]), using pressure catheterization, cardiac magnetic resonance imaging, and a single-beat method. We then compared the correlations of RV indices with echocardiographic parameters. In 63 participants (54 with pulmonary hypertension (PH) and nine without PH), Ees and τ correlated with several echocardiographic parameters, such as RV diameter and area, but the correlations were moderate (|correlation coefficients (ρ)| < 0.5 for all parameters). The correlations of β and Eed with echocardiographic parameters were weak, with |ρ| < 0.4. In contrast, Ees/Ea closely correlated with RV free wall longitudinal strain (RVFW-LS)/estimated systolic PA pressure (eSPAP) (ρ = -0.72). Ees/Ea also correlated with tricuspid annular plane systolic excursion/eSPAP, RV diameter, and RV end-systolic area, with |ρ | >0.65. In addition, RVFW-LS/eSPAP yielded high sensitivity (0.84) and specificity (0.75) for detecting reduced Ees/Ea. The present study indicated a limited accuracy of echocardiographic parameters in assessing RV systolic and diastolic function. In contrast to RV function, they showed high accuracy for assessing RV-PA coupling, with RVFW-LS/eSPAP exhibiting the highest accuracy.

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, 41, 4, e15812, 2024年04月, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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., 42909777

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, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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, 40, 5, 1123, 1134, 2024年03月27日, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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., 40464604

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, ［査読有り］, ［国際誌］
英語

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, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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08月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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07月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

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06月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

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, 2023年04月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Relevance of early-diastolic mitral regurgitation in dilated heart.
Asuka Tanemura, Michito Murayama, Hiroyuki Iwano, Yasuyuki Chiba, Mutsumi Nishida, Takanori Teshima, Toshihisa Anzai
Journal of echocardiography, 21, 1, 50, 52, SPRINGER JAPAN KK, 2023年03月, ［査読有り］, ［筆頭著者］, ［国内誌］
英語, 研究論文（学術雑誌）

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, 4, 384, 397, 一般社団法人 日本超音波検査学会, 2023年, ［査読有り］, ［招待有り］, ［筆頭著者］
日本語, 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．, 36700601

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, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

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, 39, 1, 23, 34, Springer Science and Business Media LLC, 2023年01月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, PURPOSE: This study investigated the novel non-invasive left atrial (LA) stiffness parameter using pulmonary venous (PV) flow measurements and the clinical usefulness of the novel LA stiffness parameter. METHODS: We retrospectively analyzed 237 patients who underwent right heart catheterization and echocardiography less than one week apart. From the pulmonary artery wedge pressure waveform, the difference between x-descent and v-wave (ΔP) was measured. Using the echocardiographic biplane method of disks, the difference between LA maximum volume and that just before atrial contraction (ΔVMOD) was calculated, and the ΔP/ΔVMOD was calculated as a standard LA stiffness index. From the PV flow waveform, the peak systolic velocity (S), peak diastolic velocity (D), and minimum velocity between them (R) were measured, and S/D, S/R, and D/R were calculated. From the speckle tracking echocardiography-derived time-LA volume curve, the difference between LA maximum volume and that just before atrial contraction (ΔVSTE) was measured. Each patient's prognosis was investigated until three years after echocardiography. RESULTS: Among the PV flow parameters, D/R was significantly correlated with ΔP (r = 0.62), and the correlation coefficient exceeded that between S/D and ΔP (r =  - 0.39) or S/R and ΔP (r = 0.14). The [D/R]/ΔVSTE was significantly correlated with ΔP/ΔVMOD (r = 0.61). During the follow-up, 37 (17%) composite endpoints occurred. Kaplan-Meier analysis showed that patients with [D/R]/ΔVSTE greater than 0.13 /mL were at higher risk of cardiac events. CONCLUSION: The [D/R]/ΔVSTE was useful for assessing LA stiffness non-invasively and might be valuable in the prognostic evaluation of patients with cardiac diseases.

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09月10日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

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, ［査読有り］
日本語, 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．

Two cases showing alterations of the order of tricuspid and mitral valve opening during loading manipulations: a new approach for quick assessment of stress-induced left ventricular filling pressure elevation.
Michito Murayama, Hiroyuki Iwano, Ko Motoi, Suguru Ishizaka, Shingo Tsujinaga, Toshiyuki Nagai, Toshihisa Anzai
Journal of medical ultrasonics (2001), 49, 3, 489, 491, SPRINGER JAPAN KK, 2022年07月, ［査読有り］, ［筆頭著者］, ［国内誌］
英語, 研究論文（学術雑誌）

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07月, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

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, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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., 36691110

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, 38, 8, 1781, 1791, SPRINGER, 2022年04月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

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, SPRINGER, 2022年04月, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

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, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

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, ELSEVIER, 2021年10月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

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, MOSBY-ELSEVIER, 2021年07月, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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., 36700548

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 : official publication of the American Society of Echocardiography, 34, 6, 690, 692, 2021年06月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）

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, WILEY, 2021年05月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

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, 2045894020983723, 2045894020983723, 2021年, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

Mechanism of Early-Diastolic Mitral Regurgitation.
Michito Murayama, Hiroyuki Iwano, Miwa Sarashina, Toshihisa Anzai
Circulation journal : official journal of the Japanese Circulation Society, 84, 11, 2036, 2036, JAPANESE CIRCULATION SOC, 2020年10月23日, ［査読有り］, ［筆頭著者］, ［国内誌］
英語, 研究論文（学術雑誌）

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, 35, 8, 1079, 1086, LIPPINCOTT WILLIAMS & WILKINS, 2020年08月, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, 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.

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04月07日, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, Background: Ventilatory inefficiency during exercise assessed using the lowest minute ventilation/carbon dioxide production (V̇E/V̇CO2) ratio was recently proven to be a strong prognostic marker of heart failure (HF) regardless of left ventricular ejection fraction (LVEF). Its physiological background, however, has not been elucidated. Methods and Results: Fifty-seven HF patients underwent cardiopulmonary exercise testing and exercise-stress echocardiography. The lowest V̇E/V̇CO2 ratio was assessed on respiratory gas analysis. Echocardiography was obtained at rest and at peak exercise. LVEF was measured using the method of disks. Cardiac output (CO) and the ratio of transmitral early filling velocity (E) to early diastolic tissue velocity (e') were calculated using the Doppler method. HF patients were divided into preserved EF (HFpEF) and reduced EF (HFrEF) using the LVEF cut-off 40% at rest. Twenty-four patients were classified as HFpEF and 33 as HFrEF. In HFpEF, age (r=0.58), CO (r=-0.44), e' (r=-0.48) and E/e' (r=0.45) during exercise correlated with the lowest V̇E/V̇CO2 ratio (P<0.05 for all). In contrast, in HFrEF, age (r=0.47) and CO (r=-0.54) during exercise, but not e' and E/e', correlated with the lowest V̇E/V̇CO2 ratio. Conclusions: Loss of CO augmentation was associated with ventilatory inefficiency in HF regardless of LVEF, although lung congestion determined ventilatory efficiency only in HFpEF.

Case with long-standing gout showing various ultrasonographic features caused by monosodium urate monohydrate crystal deposition.
Michito Murayama, Mutsumi Nishida, Yusuke Kudo, Takahiro Deguchi, Katsuji Marukawa, Yuichiro Fujieda, Nobuya Abe, Masaru Kato, Hitoshi Shibuya, Yoshihiro Matsuno, Tatsuya Atsumi
Modern rheumatology case reports, 4, 1, 110, 115, TAYLOR & FRANCIS LTD, 2020年01月, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, Gout, which is characterized by the deposition of monosodium urate monohydrate (MSU) in the synovial fluid and other tissues, is the most common form of inflammatory arthritis. Unlike the easily recognized acute and monoarticular gouty arthritis, advanced gout induces multiple finger joint disorders and may sometimes mimic rheumatoid arthritis (RA) or vice versa. The gold standard for gout diagnosis is the identification of MSU crystals via aspiration in the symptomatic joints or nodules; however, its feasibility and specificity may be inadequate. Recently, there have been important advances in imaging techniques, assisting in the non-invasive diagnosis of gout. Ultrasonography (US) has been known to have the ability to detect deposition of MSU crystals in patients with gout. Herein, we report an evocative case of long-standing gout with precisely detected specific US features indicating MSU crystal deposition and inflammation in multiple joints. Comprehensive US assessment included the bone, hyaline cartilage, soft tissue, subcutaneous nodules and tendon; we also discriminated gouty arthritis from RA.

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, SPRINGER, 2019年10月, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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, ［査読有り］
日本語, 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)

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, WILEY, 2019年09月, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 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.

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, CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS, 2019年04月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

A Case of Severe Aortic Regurgitation Caused by Takayasu's Arteritis Showing End-Diastolic Opening of Aortic Valve.
Michito Murayama, Hiroyuki Iwano, Yusuke Kudo, Mutsumi Nishida, Koji Akizawa, Hitoshi Shibuya, Toshihisa Anzai
CASE (Philadelphia, Pa.), 2, 6, 248, 253, 2018年12月, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, • Diastolic opening of the AV rarely occurs in severe AR. • Echocardiography plays a role in evaluation of the unique hemodynamics of severe AR. • A patient with Takayasu’s arteritis showed diastolic opening of the AV. • Serial echocardiographic findings suggested unique hemodynamics in this patient.

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, OXFORD UNIV PRESS, 2018年11月01日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

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］, ［国内誌］
英語, 研究論文（学術雑誌）, 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-RACATH), peak early diastolic PA-RV pressure gradient (PA-RVCATH), and mean PA pressure (MPAPCATH). 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-RACATH 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 ≤ 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 MPAPCATH ≥ 25 mmHg with the area under the curve of 0.93, 100% sensitivity, and 87% specificity. In conclusion, TRPG frequently overestimated RV-RACATH when VCTR was >11 mm and sometimes did when VCTR was >7 mm, where EMPAP using PRPG was useful for estimating PA pressure.

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 & biology, 43, 5, 958, 966, ELSEVIER SCIENCE INC, 2017年05月, ［査読有り］, ［筆頭著者］, ［国際誌］
英語, 研究論文（学術雑誌）, 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 (EPADPpreA and EPADPED, respectively) by adding the pressure gradients to the echocardiographically estimated RA pressure. Compared with EPADPED, EPADPpreA correlated better with PADP (r = 0.87) and MPAWP (r = 0.80), and direct fixed biases were detected for EPADPED but not for EPADPpreA. The area under the receiver operating characteristic curve distinguishing patients with MPAWP ≥18 mm Hg was greater for EPADPpreA (0.97) than for E/e' (0.94) and E/A (0.83). EPADPpreA is thus useful in estimating PADP and MPAWP in patients with heart disease.

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
The international journal of cardiovascular imaging, 33, 1, 31, 38, SPRINGER, 2017年01月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, 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.

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, 工藤悠輔, 村山迪史, 加賀早苗, 加賀早苗, 表原里実, 表原里実, 岩井孝仁, 岩井孝仁, 進藤由衣香, 進藤由衣香, 砂後谷華奈, 砂後谷華奈, 西田睦, 豊嶋崇徳, 豊嶋崇徳, 豊嶋崇徳, 石津明洋, 超音波医学 Supplement, 51, 2024年10月12日, ［国際誌］
Hypoechoic halo is a typical ultrasound finding in giant cell arteritis (GCA), but it may be a false positive due to arteriosclerosis. Therefore, we focused on the segmental distribution of GCA lesions, defined the luminal irregularity in long-axis images as the string of beads sign, and examined its diagnostic ability. As a result, the C-statistic of hypoechoic halo and string of beads sign was better than that of hypoechoic halo alone (1.00 vs. 0.89). Based on the above, the diagnostic ability of GCA can be improved by adding the string of beads sign to the conventional hypoechoic halo., 英語

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, 2024年06月
(一社)日本超音波検査学会, 日本語

健常人における門脈血流の拍動メカニズム:肝静脈血流との比較に基づく検討
小野田愛梨, 村山迪史, 小林澄夏, 永井優衣, 塚本真帆, 阪口景太, 工藤悠輔, 加賀早苗, 加賀早苗, 超音波医学 Supplement, 51, 2024年

経胸壁三次元心エコー法による三尖弁逆流の重症度評価が治療効果判定に有用であった1例
村山迪史, 村山迪史, 日本放射線技術学会雑誌, 80, 4, 42, 42, 2024年
(公社)日本放射線技術学会, 日本語

Point-of-Careの心臓超音波検査(FoCUS)の普及に向けて 急性心不全を断層図だけで診断する
岩野 弘幸, 玉置 陽生, 村山 迪史, 超音波医学, 50, Suppl., S278, S278, 2023年04月
(公社)日本超音波医学会, 日本語

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, 2023年04月
(公社)日本超音波医学会, 日本語

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
(一社)日本循環器学会, 英語

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, 2023年03月
(一社)日本循環器学会, 日本語

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, 2023年02月
(一社)日本脈管学会, 日本語

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, 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(Web), 63, 1, 2023年

急性心不全を断層図だけで診断する
岩野弘幸, 岩野弘幸, 玉置陽生, 村山迪史, 村山迪史, 超音波医学 Supplement, 50, 2023年

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
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(Web), 87th, PJ065, 2, 2023年
(一社)日本循環器学会, 英語

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, 村山迪史, 加賀早苗, 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, 岩野弘幸, 安斉俊久, 超音波医学 Supplement, 50, 2023年

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, CO1, 3, 2023年
(一社)日本循環器学会, 日本語

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

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, 2022年08月
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(ΔAdur)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(FPVA/FA)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ΔAdur(S-ΔAdur)を計測するとともにFPVA/FAを算出した。また、DD法によるPVFとTMFの同時記録から、ΔAdur(D-ΔAdur)と各々のA波の終了時相差(D-ΔAend)を計測した。結果:S-ΔAdur、D-ΔAdurおよびD-ΔAendはいずれもFPVA/FAと有意に相関した(順にr=0.50、0.51、0.71)。このうち、D-ΔAendとFPVA/FA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-ΔAdurよりもD-ΔAdurとD-ΔAendで良好であった。結論:DD法によるD-ΔAendは、通常のΔAdur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。(著者抄録), (一社)日本超音波検査学会, 日本語

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, 2022年04月
(公社)日本超音波医学会, 日本語

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, S176, S176, 2022年
一般社団法人 日本超音波検査学会, 日本語

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, 9, 9, 2022年
日臨技北日本支部医学検査学会, 日本語

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, 8, 8, 2022年
日臨技北日本支部医学検査学会, 日本語

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, 216, 216, 2022年
日本成人先天性心疾患学会, 日本語

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

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, 2021年04月
(公社)日本超音波医学会, 日本語

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, 2021年
一般社団法人 日本超音波検査学会, 日本語

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, 2021年
一般社団法人 日本超音波検査学会, 日本語

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, 2021年
一般社団法人 日本超音波検査学会, 日本語

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, 2021年
一般社団法人 日本超音波検査学会, 日本語

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, O, 029, 2021年
(一社)日本心臓病学会, 日本語

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

心エコー法による新たな左房圧指標を用いたHFpEFの予後予測に関する検討
村山迪史, 岩野弘幸, 岩野弘幸, 岩野弘幸, 表和徳, 原田智成, 小保方優, 加藤寿光, 中鉢雅弘, 西野久雄, 横山しのぶ, 辻永真吾, 千葉泰之, 石坂傑, 本居昂, 西田睦, 安斉俊久, 日本心不全学会学術集会プログラム・抄録集, 25th, 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
0, LIPPINCOTT WILLIAMS & WILKINS, 英語, 研究発表ペーパー・要旨（国際会議）

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, 2020年11月
(公社)日本超音波医学会, 日本語

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, 2020年11月
(公社)日本超音波医学会, 日本語

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, 2020年11月
(公社)日本超音波医学会, 日本語

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, LIPPINCOTT WILLIAMS & WILKINS, 英語, 研究発表ペーパー・要旨（国際会議）

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, 2020年
一般社団法人 日本超音波検査学会, 日本語

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, 2020年
一般社団法人 日本超音波検査学会, 日本語

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(Web), 9, 1, 288, 288, 2020年
日本成人先天性心疾患学会, 日本語

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, 217, 217, 2020年
(一社)日本超音波検査学会, 日本語

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

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
0, LIPPINCOTT WILLIAMS & WILKINS, 英語, 研究発表ペーパー・要旨（国際会議）

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 = Japanese journal of medical technology education : 日本臨床検査学教育学会機関誌 / 日本臨床検査学教育学会学術部編集委員会 編, 11, 2, 219, 226, 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), 日本臨床検査学教育協議会, 日本語

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, 超音波検査技術抄録集, 44, Suppl., S139, S139, 2019年04月
一般社団法人 日本超音波検査学会, 英語

心エコーで冠動脈瘻との鑑別に苦慮した左冠動脈肺動脈起始の1例
西野 久雄, 佐々木 理, 岩野 弘幸, 武田 充人, 横山 しのぶ, 中鉢 雅大, 村山 迪史, 西田 睦, 秋沢 宏次, 杉田 純一, 豊嶋 崇徳, 安斉 俊久, 超音波検査技術抄録集, 44, Suppl., S163, S163, 2019年04月
一般社団法人 日本超音波検査学会, 英語

心エコーで冠動脈瘻との鑑別に苦慮した左冠動脈肺動脈起始の1例
西野 久雄, 佐々木 理, 岩野 弘幸, 武田 充人, 横山 しのぶ, 中鉢 雅大, 村山 迪史, 西田 睦, 秋沢 宏次, 杉田 純一, 豊嶋 崇徳, 安斉 俊久, 超音波検査技術, 44, Suppl., S163, S163, 2019年04月
(一社)日本超音波検査学会, 日本語

多彩な尿酸塩結晶沈着所見を呈した慢性痛風性関節炎の1例
村山 迪史, 工藤 悠輔, 西田 睦, 佐藤 恵美, 表原 里実, 岩井 孝仁, 阿部 靖矢, 藤枝 雄一郎, 加藤 将, 澁谷 斉, 松野 吉宏, 渥美 達也, 超音波検査技術, 44, Suppl., S225, S225, 2019年04月
(一社)日本超音波検査学会, 日本語

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
(一社)日本循環器学会, 英語

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
(一社)日本循環器学会, 英語

Philips社製MicroFlow Imagingは滑膜炎の検出に有用か?
村山迪史, 工藤悠輔, 西田睦, 佐藤恵美, 表原里実, 岩井孝仁, 高杉莉佳, 坂野稜典, 樋岡拓馬, 道又理恵, 西野久雄, 澁谷斉, 超音波検査技術, 44, Suppl., S237, S237, 2019年
(一社)日本超音波検査学会, 日本語

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, Supplement (CD-ROM), S616, S616, 2019年
(公社)日本超音波医学会, 日本語

拡張後期に大動脈弁開放を認めた症例
村山迪史, 岩野弘幸, 心エコー, 20, 6, 638, 642, 2019年
(株)文光堂, 日本語

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
(一社)日本超音波検査学会, 日本語

心不全患者における左室動作時スティフネスの新たな心エコー指数の予後予測能
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(Web), 83rd, OJ08, 7, 2019年
(一社)日本循環器学会, 英語

心不全における運動中換気効率のメカニズム:駆出率保持および駆出率低下心不全の比較
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(Web), 83rd, OJ08, 2, 2019年
(一社)日本循環器学会, 英語

Diastolic Intra-Left Ventricular Pressure Difference During Exercise: Strong Determinant and Predictor of Exercise Capacity in Patients With Heart Failure
Hiroyuki Iwano, Shingo Tsujinaga, Miwa Sarashina, Michito Murayama, Masahiro Nakabachi, Hisao Nishino, Shinobu Yokoyama, Arata Fukushima, Takashi Yokota, Pavlos P. Vlachos, Toshihisa Anzai, CIRCULATION, 138, 2018年11月
0, LIPPINCOTT WILLIAMS & WILKINS, 英語, 研究発表ペーパー・要旨（国際会議）

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
0, LIPPINCOTT WILLIAMS & WILKINS, 英語, 研究発表ペーパー・要旨（国際会議）

Determinants of Ventilatory Efficiency in Patients With Heart Failure: Incites From Left Ventricular Suction During Exercise
Shingo Tsujinaga, Hiroyuki Iwano, Miwa Sarashina, Michito Murayama, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Arata Fukushima, Takashi Yokota, Pavlos P. Vlachos, Toshihisa Anzai, CIRCULATION, 138, 2018年11月
0, LIPPINCOTT WILLIAMS & WILKINS, 英語, 研究発表ペーパー・要旨（国際会議）

連続流型LVAD装着後遠隔期に心不全増悪を来すまで大動脈弁逆流の経時的変化を観察しえた1例
辻永 真吾, 岩野 弘幸, 大岡 智学, 更科 美羽, 林 大知, 永井 利幸, 福島 新, 村山 迪史, 市川 絢子, 中鉢 雅大, 西野 久雄, 横山 しのぶ, 松居 喜郎, 安斉 俊久, 日本心臓病学会学術集会抄録, 66回, np2, np2, 2018年09月
(一社)日本心臓病学会, 日本語

連続流型LVAD装着後遠隔期に心不全増悪を来すまで大動脈弁逆流の経時的変化を観察しえた1例
辻永 真吾, 岩野 弘幸, 大岡 智学, 更科 美羽, 林 大知, 永井 利幸, 福島 新, 村山 迪史, 市川 絢子, 中鉢 雅大, 西野 久雄, 横山 しのぶ, 松居 喜郎, 安斉 俊久, 日本心臓病学会学術集会抄録, 66回, np2, np2, 2018年09月
(一社)日本心臓病学会, 日本語

MicroFlow Imagingによる手指関節滑膜炎評価の妥当性検証
村山 迪史, 工藤 悠輔, 西田 睦, 佐藤 恵美, 表原 里実, 岩井 孝仁, 高杉 莉佳, 坂野 稜典, 樋岡 拓馬, 澁谷 斉, 超音波医学, 45, Suppl., S774, S774, 2018年04月
(公社)日本超音波医学会, 日本語

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
(公社)日本超音波医学会, 日本語

高安動脈炎に高度大動脈弁逆流を合併し拡張末期の大動脈弁開放を認めた1例
村山 迪史, 岩野 弘幸, 山田 聡, 西野 久雄, 横山 しのぶ, 中鉢 雅大, 市川 綾子, 西田 睦, 澁谷 斉, 安斉 俊之, 超音波医学, 45, Suppl., S814, S814, 2018年04月
(公社)日本超音波医学会, 日本語

低酸素血症を呈した高齢Ebstein病の1例
辻永真吾, 山田聡, 岩野弘幸, 更科美羽, 林大知, 村山迪史, 市川絢子, 中鉢雅大, 横山しのぶ, 西野久雄, 安斉俊久, 日本成人先天性心疾患学会雑誌(Web), 7, 1, 169, 169, 2018年
(一社)日本成人先天性心疾患学会, 日本語

全身に多数の痛風結節を認めた慢性痛風性関節炎の1例
村山迪史, 工藤悠輔, 西田睦, 佐藤恵美, 表原里実, 岩井孝仁, 高杉莉佳, 土井和尚, 松野吉宏, 阿部靖矢, 加藤将, 澁谷斉, 超音波検査技術, 43, 3, 378, 378, 2018年
(一社)日本超音波検査学会, 日本語

正常および拡張した心臓における左室内早期拡張期渦流の特性と重要性
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(Web), 82nd, PJ001, 5, 2018年
(一社)日本循環器学会, 英語

連続波ドップラーを用いる心房収縮前肺動脈-右室圧較差による肺動脈楔入圧の正確な推定
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(Web), 82nd, OJ25, 8, 2018年
(一社)日本循環器学会, 英語

慢性心不全患者における運動時の拡張早期左室内圧較差と運動耐容能との関連　　　　　　　　　　　　　　　
辻永 真吾, 岩野 弘幸, 林 大知, 更科 美羽, 市川 絢子, 中鉢 雅大, 西野 久雄, 横山 しのぶ, 村山 迪史, 山田 聡, 日本心臓病学会学術集会抄録, 65回, O, 120, 2017年09月
(一社)日本心臓病学会, 日本語

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, 2016年06月
(一社)日本超音波検査学会, 日本語

連続波ドプラ法による肺動脈弁逆流速度計測に基づく肺動脈圧推定の意義　　　　　　　　　　　　　　　
黒壁 大貴, 加賀 早苗, 三神 大世, 岡田 一範, 村山 迪史, 樋岡 拓馬, 横山 しのぶ, 榊原 守, 山田 聡, 筒井 裕之, 超音波医学, 43, 1, 125, 125, 2016年01月
(公社)日本超音波医学会, 日本語

肺動脈弁逆流速度計測に基づく新しい肺血管抵抗の非侵襲的推定法　　　　　　　　　　　　　　　
前田 理菜, 加賀 早苗, 三神 大世, 岡田 一範, 樋岡 拓馬, 村山 迪史, 横山 しのぶ, 榊原 守, 山田 聡, 筒井 裕之, 超音波医学, 43, 1, 125, 125, 2016年01月
(公社)日本超音波医学会, 日本語

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, 2016年
(一社)日本超音波検査学会, 日本語

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
村山迪史, 三神大世, 加賀早苗, 岡田一範, 樋岡拓馬, 横山しのぶ, 西田睦, 榊原守, 山田聡, 筒井裕之, 超音波医学, 42, 1, 85, 85, 2015年
(公社)日本超音波医学会, 日本語

心筋・心膜疾患の評価：血行動態を調べつくす　　　　　　　　　　　　　　　
村山迪史
The Echo WEB 北の国からフェス, 2024年08月31日, EchoBoys116
［招待講演］

「Step Up！高血圧症 〜ホリスティックアプローチを目指して〜」高血圧患者に対する心エコー
村山迪史
第237回北臨技講習会（生理機能部門）, 2024年07月27日, 一般社団法人 北海道臨床衛生検査技師会
［招待講演］

チーム医療論　　　　　　　　　　　　　　　
北海道大学
2024年05月 - 現在

医療安全管理学Ⅱ　　　　　　　　　　　　　　　
北海道大学
2024年04月 - 現在

技能修得到達度評価　　　　　　　　　　　　　　　
北海道大学
2024年04月 - 現在

臨床生理画像学実習Ⅱ　　　　　　　　　　　　　　　
北海道大学
2024年04月 - 現在

保健生理学　　　　　　　　　　　　　　　
北海道大学
2023年04月 - 現在

臨地実習（生理検査）　　　　　　　　　　　　　　　
北海道大学
2022年04月 - 現在

保健科学特別研究　　　　　　　　　　　　　　　
北海道大学
2022年04月 - 現在

健康と社会 メディカルLab．サイエンスの世界　　　　　　　　　　　　　　　
北海道大学
2022年04月 - 現在

画像検査学Ⅱ　　　　　　　　　　　　　　　
北海道大学
2022年04月 - 現在

生体機能学　　　　　　　　　　　　　　　
北海道大学
2022年04月 - 現在

臨床病態学Ⅰ　　　　　　　　　　　　　　　
北海道大学
2022年04月 - 現在

臨床生理画像学実習Ⅰ　　　　　　　　　　　　　　　
北海道大学
2022年04月 - 現在

生体機能学実習　　　　　　　　　　　　　　　
北海道大学
2022年04月 - 現在

臨床生理学Ⅰ　　　　　　　　　　　　　　　
北海道大学
2022年04月 - 現在

保健・医療概論　　　　　　　　　　　　　　　
北海道大学
2022年04月 - 現在

保健科学研究　　　　　　　　　　　　　　　
北海道大学
2022年04月 - 現在

臨床生理学実習Ⅰ　　　　　　　　　　　　　　　
日本医療大学
2023年01月 - 2023年01月

心臓超音波法による新規左房硬さ評価法に基づく心房細動高リスク例の検出
科学研究費助成事業
2023年04月01日 - 2028年03月31日
岡田 一範, 村山 迪史
日本学術振興会, 基盤研究(C), 日本医療大学, 23K11875

新規低侵襲治療の普及にむけた3次元イメージングによる三尖弁逆流の重症度診断法開発
科学研究費助成事業 若手研究
2023年04月01日 - 2026年03月31日
村山 迪史
日本学術振興会, 若手研究, 北海道大学, 23K17220

外来心臓リハビリが慢性心不全患者の心機能に与える影響の解明　　　　　　　　　　　　　　　
2024年08月 - 2025年03月
公益財団法人 北海道科学技術総合振興センター 若手研究人材育成事業（若手研究人材・ネットワーク育成補助金（ノースタレント補助金））, 研究代表者, 競争的資金

心臓超音波法による心房細動患者の高精度心不全診断法の開発
2024年度 研究助成〈奨励〉
2024年04月 - 2025年03月
公益財団法人 秋山記念生命科学振興財団, 研究代表者, 競争的資金

心房細動患者に適用可能な超音波ドプラ法による新しい右房圧推定法の確立
科学研究費助成事業 研究活動スタート支援
2022年08月31日 - 2024年03月31日
村山 迪史
日本学術振興会, 研究活動スタート支援, 北海道大学, 22K20497

人工知能を用いた肺高血圧症の非侵襲的心機能診断支援技術の開発
若手研究人材育成事業（若手研究人材・ネットワーク育成補助金（ノースタレント補助金））
2023年08月 - 2024年03月
村山 迪史
公益財団法人 北海道科学技術総合振興センター, 北海道大学, 研究代表者

前毛細管性肺高血圧症患者における肺動脈弁逆流速度波形分析に基づく非侵襲的右室スティフネスの評価法の開発：右室圧-容積曲線から求めた標準的右室スティフネスとの対比に基づく検討
令和4年度研究奨励金
2023年02月 - 2024年03月
村山迪史
公益信託 臨床検査医学研究振興基金, 北海道大学, 研究代表者

心房細動患者における房室弁開放時相の視覚的評価に基づく心不全診断法に関する検討
科学研究費助成事業
2022年04月01日 - 2023年03月31日
村山 迪史
ドプラ心エコー法による経僧帽弁血流速波形のE/Aは、心不全例における左室充満圧推定の中心となるが、心房細動に代表される単峰性の経僧帽弁血流速波形例ではE/Aが適用できず、E/Aに代わる左室充満圧推定指標の確立が望まれる。そこで、房室弁開放時相差の視覚的評価に基づいた新しい指標であるVMTスコアの精度を単峰性の経僧帽弁血流速波形例で検討した。
心エコー検査に近接して肺動脈楔入圧が計測され、経僧帽弁血流速波形が単峰性であった心不全患者102例（うち心房細動68例）を対象とした。肺動脈楔入圧≧15 mmHgを左室充満圧上昇と定義した。心房細動例における左室充満圧指標として、経僧帽弁血流速波形のE、等容弛緩時間、E/e'、三尖弁逆流最大速度を計測した。四腔像で評価した房室弁の開放時相差（三尖弁先行：0点、同時開放：1点、僧帽弁先行：2点）と下大静脈拡張の有無（無し：0点、あり：1点）を加算してVMTスコア（0～3点）を求めた。血漿脳性ナトリウム利尿ペプチド濃度（BNP）を調査した。その結果、VMTスコアの上昇とともに肺動脈楔入圧は高値をとり、VMT1と2の間で有意の上昇を認めた（0：10±5、1：14±6、2：24±6、3：28±7 mmHg）。VMTスコア2以上による左室充満圧上昇の予測成績は感度75%、特異度97%と良好であった。左室充満圧上昇を予測するロジスティック回帰モデルのC統計量は、E（0.55）、等容弛緩時間（0.64）、E/e'（0.61）、三尖弁逆流速度（0.68）に比し、VMTスコア（0.88）で有意に大きかった。BNPにVMTスコアを加えたモデルでは、BNP単独よりも左室充満圧上昇の予測成績が向上した（C統計量：0.83 vs 0.94、P＜0.001）。以上より、VMTスコアは、経僧帽弁血流速波形適用不能例における左室充満圧上昇の検出に有用と考えられた。
日本学術振興会, 奨励研究, 北海道大学, 22H04377

断層心エコー法による新たなスコアリングシステムを用いた拡張期心不全患者の予後予測
科学研究費助成事業
2021年04月 - 2022年03月
村山 迪史
心不全患者の約半数は左室駆出率が保たれた心不全（HFpEF）であり、その発症への左室拡張機能障害の関与が指摘されている。左室拡張機能障害に起因する左房圧の上昇はHFpEFの予後不良因子であるが、HFpEF患者ではその評価が困難な場合が多い。本研究では、心エコー検査を受けたHFpEF患者310例を対象として、近年考案された断層心エコー法の視覚的評価に基づいたスコアリングによる新しい左房圧指標を用いたHFpEFの予後予測成績を検討した。その結果、本スコア高値群で有意に心血管イベント発生リスクが高く、かつ本スコアは従来の心血管イベントの予測因子に対する付加的価値を有することがわかった。
日本学術振興会, 奨励研究, 北海道大学, 研究代表者, 競争的資金, 21H04272

日常的な右房圧評価において最も精度が高い超音波検査指標の探索
2019年度学術研究助成
2019年04月 - 2021年03月
村山迪史
一般社団法人日本超音波検査学会, 研究代表者, 競争的資金

僧帽弁および三尖弁の開放時相差と下大静脈径に基づく左心不全血行動態の視覚的評価法に関する検討
2018年度日本循環器学会メディカルスタッフ研究助成
2019年03月 - 2020年03月
村山迪史
日本循環器学会, 研究代表者, 競争的資金

三尖弁輪収縮期移動距離と右室の大きさとの関係：三次元心エコー法に基づく検討　　　　　　　　　　　　　　　
研究開発調査助成
2019年05月
村山迪史
一般財団法人 北海道心臓協会

北海道札幌西高等学校「北海道大学研究室訪問」
2024年09月30日
講師, 実演
その他
北海道大学
北海道大学 大学院保健科学研究院 病態解析学分野 心血管エコー研究室
高校生
46865526

心エコーハンズオンセミナー　　　　　　　　　　　　　　　
2024年06月08日
講師
フクダ電子北海道販売株式会社／GEヘルスケア・ジャパン株式会社

タスクシフト／シェアに関する厚生労働大臣指定講習会　　　　　　　　　　　　　　　
2023年12月02日
運営参加・支援
資格認定講習
北海道臨床検査技師会

令和5年度札臨技心エコーハンズオンセミナー　　　　　　　　　　　　　　　
2023年09月24日
講師
セミナー・ワークショップ
札幌臨床検査技師会

札幌肝がん検診　　　　　　　　　　　　　　　
2020年02月16日
その他
その他

検査deフェスティバル　　　　　　　　　　　　　　　
2019年08月25日
運営参加・支援
フェスティバル
札幌臨床検査技師会

札幌肝がん検診　　　　　　　　　　　　　　　
2019年02月17日
その他
その他

札幌肝がん検診　　　　　　　　　　　　　　　
2018年02月18日
その他
その他