Head-to-Head Comparison of Hepatic Vein and Superior Vena Cava Flow Velocity Waveform Analyses for Predicting Elevated Right Atrial Pressure.
Michito Murayama, Sanae Kaga, Airi Onoda, Hisao Nishino, Shinobu Yokoyama, Mana Goto, Yukino Suzuki, Yusuke Yanagi, Yui Shimono, Kosuke Nakamura, Hiroyuki Aoyagi, Yoji Tamaki, Suguru Ishizaka, Hiroyuki Iwano, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai
Ultrasound in medicine & biology, 2024年06月03日, ［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.

Validity and reliability of the palliative care needs assessment tool in Japanese patients with heart failure
Daishiro Tatsuta, Takuma Sato, Toshiyuki Nagai, Jiro Koya, Kotaro Nishino, Seiichiro Naito, Yoshifumi Mizuguchi, Taro Temma, Kiwamu Kamiya, Hisashi Narita, Kenkichi Tsuruga, Toshihisa Anzai
ESC Heart Failure, Wiley, 2024年05月29日
研究論文（学術雑誌）, Abstract

Aims

Although patients with heart failure (HF) frequently experience considerable symptom burden and require significant care, most HF patients do not receive timely intervention due to the absence of a standardized method for identifying those in need of palliative care. The Needs Assessment Tool: Progressive Disease‐Heart Failure (NAT: PD‐HF) assesses the palliative care needs of patients with HF. However, its validity and reliability have yet to be fully examined. We aimed to assess the validity and reliability of the NAT: PD‐HF in Japanese patients with HF.

Methods

We prospectively enrolled 106 consecutive patients with chronic HF admitted to our university hospital between February 2023 and July 2023. Their caregivers (n = 95) and healthcare providers (n = 17) were also included. The NAT: PD‐HF was translated from English to Japanese using a forward–backward translation procedure and adapted based on Japanese cultural and medical backgrounds by our professional multidisciplinary team. We assessed the internal consistency of the Japanese NAT: PD‐HF version with Cronbach's alpha coefficient and the inter‐rater and test–retest reliabilities with Cohen's kappa coefficient. After using the tool, all participants were asked to complete a questionnaire about the tool to determine its validity.

Results

The proportion of female patients in this study was 47 (44%). The median age was 72 years [interquartile range (IQR) 59–81]. The median time spent assessing the patients' and their caregivers' needs using the Japanese NAT: PD‐HF was 14 min (IQR 12–17). The Cronbach's alpha coefficient was 0.82, and the minimum kappa coefficient was 0.77 for inter‐rater reliability and 0.88 for test–retest reliability. In total, 103 patients (97%) and all caregivers responded that the tool was easy to understand. One hundred (94%) patients and 89 (94%) caregivers felt that the tool would improve the quality of care, and 102 (96%) patients and 91 (96%) caregivers indicated that the discussions using this tool allowed them to confide in all their burdens and care needs. All healthcare providers expressed that this tool is helpful in understanding the burden and care needs of both patients and caregivers comprehensively.

Conclusions

The NAT: PD‐HF is a reliable and valid tool for Japanese patients with HF and their caregivers. This tool was very well accepted by patients, caregivers and healthcare providers to identify burdens and care needs.

Chronic Active Myocarditis After Transapical Transcatheter Aortic Valve Implantation.
Yuta Kobayashi, Toshiyuki Nagai, Kiwamu Kamiya, Satonori Tsuneta, Yasushige Shingu, Kento Wakabayashi, Kohsuke Kudo, Yoshihiro Matsuno, Satoru Wakasa, Toshihisa Anzai
Circulation journal : official journal of the Japanese Circulation Society, 88, 6, 1008, 1008, 2024年05月24日, ［国内誌］
英語, 研究論文（学術雑誌）

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, ［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.

Prognostic Value of Combined Assessments of Late Gadolinium Enhancement and Fluorodeoxyglucose Uptake in Cardiac Sarcoidosis.
Sho Kazui, Sakae Takenaka, Toshiyuki Nagai, Satonori Tsuneta, Kenji Hirata, Yoshiya Kato, Hirokazu Komoriyama, Yuta Kobayashi, Akinori Takahashi, Kiwamu Kamiya, Taro Temma, Takuma Sato, Atsushi Tada, Yutaro Yasui, Michikazu Nakai, Takahiro Sato, Ichizo Tsujino, Kohsuke Kudo, Satoshi Konno, Toshihisa Anzai
JACC. Cardiovascular imaging, 2024年03月11日, ［国際誌］
英語

Exercise Capacity and Clinical Outcomes in Chronic Heart Failure Patients with Mild Tricuspid Regurgitation.
Kosuke Nakamura, Suguru Ishizaka, Kazunori Omote, Yutaro Yasui, Yoshifumi Mizuguchi, Sakae Takenaka, Yui Shimono, Ko Motoi, Hiroyuki Aoyagi, Yoji Tamaki, Sho Kazui, Yuki Takahashi, Kohei Saiin, Seiichiro Naito, Atsushi Tada, Yuta Kobayashi, Takuma Sato, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai
Journal of clinical medicine, 12, 23, 2023年12月01日, ［国際誌］
英語, 研究論文（学術雑誌）, AIM: The present study aimed to investigate the impact of mild tricuspid regurgitation (TR) on the exercise capacity or clinical outcomes in patients with chronic heart failure (CHF). METHODS AND RESULTS: The study enrolled 511 patients with CHF who underwent cardiopulmonary exercise testing (CPET) between 2013 and 2018. The primary outcome was a composite of heart failure hospitalization and death. Patients with mild TR (n = 324) or significant TR (moderate or greater; n = 60) displayed worse NHYA class and reduced exercise capacity on CPET than those with non-TR (n = 127), but these were more severely impaired in patients with significant TR. A total of 90 patients experienced events over a median follow-up period of 3.3 (interquartile range 0.8-5.5) years. Patients with significant TR displayed a higher risk of events, while patients with mild TR had a 3.0-fold higher risk of events than patients with non-TR (hazard ratio (HR) 3.01; 95% confidence interval (CI), 1.50-6.07). Multivariate Cox regression analysis showed that, compared with non-TR, mild TR was associated with increased adverse events, even after adjustment for co-variates (HR 2.97; 95% CI, 1.35-6.55). CONCLUSIONS: TR severity was associated with worse symptoms, reduced exercise capacity, and poor clinical outcomes. Even patients with mild TR had worse clinical characteristics than those with non-TR.

Differences in blood flow dynamics between balloon- and self-expandable valves in patients with aortic stenosis undergoing transcatheter aortic valve replacement.
Yuki Takahashi, Kiwamu Kamiya, Toshiyuki Nagai, Satonori Tsuneta, Noriko Oyama-Manabe, Takeshi Hamaya, Sho Kazui, Yutaro Yasui, Kohei Saiin, Seiichiro Naito, Yoshifumi Mizuguchi, Sakae Takenaka, Atsushi Tada, Suguru Ishizaka, Yuta Kobayashi, Kazunori Omote, Takuma Sato, Yasushige Shingu, Kohsuke Kudo, Satoru Wakasa, Toshihisa Anzai
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 25, 1, 60, 60, 2023年10月26日, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: The differences in pre- and early post-procedural blood flow dynamics between the two major types of bioprosthetic valves, the balloon-expandable valve (BEV) and self-expandable valve (SEV), in patients with aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR), have not been investigated. We aimed to investigate the differences in blood flow dynamics between the BEV and SEV using four-dimensional flow cardiovascular magnetic resonance (4D flow CMR). METHODS: We prospectively examined 98 consecutive patients with severe AS who underwent TAVR between May 2018 and November 2021 (58 BEV and 40 SEV) after excluding those without CMR because of a contraindication, inadequate imaging from the analyses, or patients' refusal. CMR was performed in all participants before (median interval, 22 [interquartile range (IQR) 4-39] days) and after (median interval, 6 [IQR 3-6] days) TAVR. We compared the changes in blood flow patterns, wall shear stress (WSS), and energy loss (EL) in the ascending aorta (AAo) between the BEV and SEV using 4D flow CMR. RESULTS: The absolute reductions in helical flow and flow eccentricity were significantly higher in the SEV group compared in the BEV group after TAVR (BEV: - 0.22 ± 0.86 vs. SEV: - 0.85 ± 0.80, P < 0.001 and BEV: - 0.11 ± 0.79 vs. SEV: - 0.50 ± 0.88, P = 0.037, respectively); there were no significant differences in vortical flow between the groups. The absolute reduction of average WSS was significantly higher in the SEV group compared to the BEV group after TAVR (BEV: - 0.6 [- 2.1 to 0.5] Pa vs. SEV: - 1.8 [- 3.5 to - 0.8] Pa, P = 0.006). The systolic EL in the AAo significantly decreased after TAVR in both the groups, while the absolute reduction was comparable between the groups. CONCLUSIONS: Helical flow, flow eccentricity, and average WSS in the AAo were significantly decreased after SEV implantation compared to BEV implantation, providing functional insights for valve selection in patients with AS undergoing TAVR. Our findings offer valuable insights into blood flow dynamics, aiding in the selection of valves for patients with AS undergoing TAVR. Further larger-scale studies are warranted to confirm the prognostic significance of hemodynamic changes in these patients.

心臓サルコイドーシス患者の免疫抑制療法開始後における心筋トロポニン値経時的評価の予後的意義　　　　　　　　　　　　　　　
數井 翔, 竹中 秀, 永井 利幸, 加藤 喜哉, 小森山 弘和, 小林 雄太, 高橋 昌寛, 神谷 究, 佐藤 琢真, 多田 篤司, 安井 悠太郎, 中井 陸運, 佐藤 隆博, 辻野 一三, 今野 哲, 安斉 俊久
日本サルコイドーシス/肉芽腫性疾患学会雑誌, 43, サプリメント号, 64, 64, 日本サルコイドーシス, 2023年10月
日本語

心臓サルコイドーシス患者におけるガドリニウム遅延造影心臓MRIとFDG-PETを用いた複合的画像評価の予後的意義　　　　　　　　　　　　　　　
數井 翔, 竹中 秀, 永井 利幸, 常田 慧徳, 加藤 喜哉, 小森山 弘和, 小林 雄太, 高橋 昌寛, 神谷 究, 天満 太郎, 佐藤 琢真, 多田 篤司, 安井 悠太郎, 中井 陸運, 佐藤 隆博, 辻野 一三, 工藤 與亮, 今野 哲, 安斉 俊久
日本サルコイドーシス/肉芽腫性疾患学会雑誌, 43, サプリメント号, 65, 65, 日本サルコイドーシス, 2023年10月
日本語

心臓サルコイドーシス患者の免疫抑制療法開始後における心筋トロポニン値経時的評価の予後的意義　　　　　　　　　　　　　　　
數井 翔, 竹中 秀, 永井 利幸, 加藤 喜哉, 小森山 弘和, 小林 雄太, 高橋 昌寛, 神谷 究, 佐藤 琢真, 多田 篤司, 安井 悠太郎, 中井 陸運, 佐藤 隆博, 辻野 一三, 今野 哲, 安斉 俊久
日本サルコイドーシス/肉芽腫性疾患学会雑誌, 43, サプリメント号, 64, 64, 日本サルコイドーシス, 2023年10月
日本語

心臓サルコイドーシス患者におけるガドリニウム遅延造影心臓MRIとFDG-PETを用いた複合的画像評価の予後的意義　　　　　　　　　　　　　　　
數井 翔, 竹中 秀, 永井 利幸, 常田 慧徳, 加藤 喜哉, 小森山 弘和, 小林 雄太, 高橋 昌寛, 神谷 究, 天満 太郎, 佐藤 琢真, 多田 篤司, 安井 悠太郎, 中井 陸運, 佐藤 隆博, 辻野 一三, 工藤 與亮, 今野 哲, 安斉 俊久
日本サルコイドーシス/肉芽腫性疾患学会雑誌, 43, サプリメント号, 65, 65, 日本サルコイドーシス, 2023年10月
日本語

Impact of Cardiac Power Output on Exercise Capacity and Clinical Outcome in Patients With Chronic Heart Failure.
Yui Shimono, Suguru Ishizaka, Kazunori Omote, Kosuke Nakamura, Yutaro Yasui, Yoshifumi Mizuguchi, Sakae Takenaka, Hiroyuki Aoyagi, Yoji Tamaki, Takuma Sato, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai
The American journal of cardiology, 206, 4, 11, 2023年09月05日, ［国際誌］
英語, 研究論文（学術雑誌）, Less data are available regarding the impact of cardiac power output on exercise capacity or clinical outcome in patients with chronic heart failure (CHF). The study enrolled 280 consecutive patients with CHF referred for cardiopulmonary exercise testing and right-sided heart catheterization between 2013 and 2018. The primary outcome was composite of heart failure hospitalization or death. Cardiac power output was calculated as (mean arterial pressure × CO) ÷ 451. Patients with low cardiac power output (<0.53 W, n = 99) were older and had a higher brain natriuretic peptide level than patients with high cardiac power output (≥0.53W, n = 181). Cardiac power output was correlated with peak oxygen consumption (peak V̇O2), peak workload achievement, and ventilatory efficiency (V̇E/V̇CO2 slope) in cardiopulmonary exercise testing, whereas each of cardiac output or mean arterial pressure was not. There were 48 patients with events over a median follow-up period of 3.5 (interquartile range 1.0 to 6.0) years. Patients with low cardiac power output had about a 2-fold higher risk of events than those with a high cardiac power output (hazard ratio 1.97, 95% confidence interval 1.12 to 3.48). In the multivariable Cox regression, a 0.1-W decrease in cardiac power output was associated with 19% increased adverse events (hazard ratio 0.81, 95% confidence interval 0.67 to 0.99). In conclusion, cardiac power output was associated with reduced exercise capacity and poor clinical outcome, suggesting that cardiac power output is useful for risk stratification in patients with CHF. Further study is required to identify therapies targeting cardiac power output to improve the exercise capacity or clinical outcome in patients with CHF.

Association of longitudinal cardiac troponin trajectory with adverse events in patients with cardiac sarcoidosis.
Sho Kazui, Sakae Takenaka, Toshiyuki Nagai, Yoshiya Kato, Hirokazu Komoriyama, Yuta Kobayashi, Akinori Takahashi, Kiwamu Kamiya, Takuma Sato, Atsushi Tada, Yutaro Yasui, Michikazu Nakai, Takahiro Sato, Ichizo Tsujino, Satoshi Konno, Toshihisa Anzai
International journal of cardiology, 389, 131268, 131268, 2023年08月15日, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Although high-sensitivity cardiac troponins may be sensitive and easily repeatable markers of disease activity in patients with cardiac sarcoidosis (CS), the association between longitudinal cardiac troponin trajectory and adverse events remains unclear. This study aimed to clarify whether longitudinal cardiac troponin levels were associated with adverse events in patients with CS. METHODS: We examined 63 consecutive CS-initiated prednisolone (PSL) patients with available longitudinal high-sensitivity cardiac troponin T (cTnT) data between December 2013 and March 2023. The area under the cTnT trajectory, which reflected cumulative cTnT release, was calculated to assess the association between longitudinal cTnT levels and adverse events. Patients were divided into two groups according to the median area under the cTnT trajectory per month. The primary outcome was a composite of sustained ventricular tachycardia or fibrillation, worsening heart failure, and sudden cardiac death (SCD). RESULTS: In total, 463 cTnT measurements were collected over a median follow-up period of 30.4 (interquartile range [IQR] 15.6-34.2) months. The primary outcome was observed in 12 (19%) patients. A higher area under the cTnT trajectory was significantly associated with an increased incidence of the primary outcome (P = 0.027), while cTnT levels before and one month after initiation of PSL, and these changes were not related to adverse events (P = 0.179, 0.096, and 0.95, respectively). CONCLUSIONS: Longitudinal cTnT trajectory following PSL initiation was associated with adverse cardiac events in patients with CS, suggesting that longitudinal measurement of cTnT would be useful for the early identification of high-risk patients.

Association between Non-Lipid Residual Risk Factors and Cardiovascular Events in Patients with Stable Coronary Artery Disease Treated with Pitavastatin: An Observation from the REAL-CAD Study.
Kiwamu Kamiya, Makoto Takei, Toshiyuki Nagai, Toru Miyoshi, Hiroshi Ito, Yoshihiro Fukumoto, Hitoshi Obara, Tatsuyuki Kakuma, Ichiro Sakuma, Hiroyuki Daida, Satoshi Iimuro, Hiroaki Shimokawa, Takeshi Kimura, Ryozo Nagai, Toshihisa Anzai
Journal of atherosclerosis and thrombosis, 2023年08月11日, ［国内誌］
英語, 研究論文（学術雑誌）, AIMS: We aimed to investigate the association between non-lipid residual risk factors and cardiovascular events in patients with stable coronary artery disease (CAD) who achieved low-density lipoprotein cholesterol (LDL-C) ＜100 mg/dL from the Randomized Evaluation of Aggressive or Moderate Lipid Lowering Therapy with Pitavastatin in Coronary Artery Disease (REAL-CAD) study. METHODS: The REAL-CAD study was a prospective, multicenter, open-label trial. As a sub-study, we examined the prognostic impact of non-lipid residual risk factors, including blood pressure, glucose level, and renal function, in patients who achieved LDL-C ＜100 mg/dL at 6 months after pitavastatin therapy. Each risk factor was classified according to severity. The primary outcome was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal ischemic stroke, and unstable angina requiring emergency hospitalization. RESULTS: Among 8,743 patients, the mean age was 68±8.2 years, and the mean LDL-C level was 84.4±18 mg/dL. After adjusting for the effects of confounders, an estimated glomerular filtration rate (eGFR) ≤ 60 mL/min/1.73 m2 showed the highest risk of the primary outcome (hazard ratio [HR] 1.92; 95% confidence interval [CI] 1.45-2.53). The combination of eGFR ≤ 60 and hemoglobin A1c (HbA1c) ≥ 6.0% also showed the highest risk of all-cause death (HR, 2.42; 95% CI, 1.72-3.41). CONCLUSIONS: In patients with stable CAD treated with pitavastatin and who achieved guidelines-directed levels of LDL-C, eGFR and HbA1c were independently associated with adverse events, suggesting that renal function and glycemic control could be residual non-lipid therapeutic targets after statin therapy.

Prognostic Value of Liver Fibrotic Markers in Patients With Heart Failure.
Atsushi Tada, Toshiyuki Nagai, Yoshiya Kato, Noriko Oyama-Manabe, Satonori Tsuneta, Michikazu Nakai, Yutaro Yasui, Sho Kazui, Yuki Takahashi, Kohei Saiin, Seiichiro Naito, Sakae Takenaka, Yoshifumi Mizuguchi, Yuta Kobayashi, Suguru Ishizaka, Kazunori Omote, Takuma Sato, Takao Konishi, Kiwamu Kamiya, Kohsuke Kudo, Toshihisa Anzai
The American journal of cardiology, 200, 115, 123, 2023年06月10日, ［国際誌］
英語, 研究論文（学術雑誌）, Several liver fibrotic markers are associated with prognosis in patients with heart failure (HF). However, the optimal markers for outcome prediction remain unclear. This study aimed to simultaneously investigate the prognostic value of liver fibrotic markers and the associations between these markers and clinical parameters in patients with HF without organic liver disease. We prospectively examined 211 consecutive patients with chronic HF between April 2018 and August 2021, excluding those with organic liver disease, using liver magnetic resonance imaging and ultrasound. A total of 7 representative liver fibrotic markers were measured in all patients. The primary outcome of interest was the composite of all-cause death and hospitalization for worsening HF. During a median follow-up period of 747 (interquartile range 465 to 1,042) days, the primary outcome occurred in 45 patients. Patients with higher hyaluronic acid and type III procollagen N-terminal peptide (P-III-P) levels showed a significantly higher incidence of the primary outcome than those without (p <0.001 and p = 0.005, respectively). The multivariable Cox regression analysis revealed that hyaluronic acid and P-III-P levels were independently associated with the risk of adverse events (hazard ratio 1.84, 95% confidence interval 1.18 to 2.87 and hazard ratio 2.89, 95% confidence interval 1.32 to 6.34, respectively) even after adjustment for a mortality prediction model, whereas the other 5 markers were not associated with the primary outcome. In conclusion, among the representative liver fibrotic markers, hyaluronic acid and P-III-P might be the optimal markers for outcome prediction in patients with HF.

Application of an echocardiographic scoring system of left ventricular filling pressure to diagnose acute heart failure in patients complaining dyspnea.
Yoji Tamaki, Hiroyuki Iwano, Michito Murayama, Suguru Ishizaka, Ko Motoi, Hiroyuki Aoyagi, Kosuke Nakamura, Mana Goto, Yukino Suzuki, Shinobu Yokoyama, Hisao Nishino, Masahiro Nakabachi, Sanae Kaga, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai
Journal of cardiology, 82, 1, 62, 68, 2023年04月27日, ［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.

Multimodal Imaging of Constrictive Pericarditis Induced by Long-term Pergolide Treatment for Parkinson's Disease.
Hiroyuki Aoyagi, Shingo Tsujinaga, Yuki Takahashi, Seiichiro Naito, Takuma Sato, Takuya Otsuka, Yoji Tamaki, Ko Motoi, Suguru Ishizaka, Yasuyuki Chiba, Kiwamu Kamiya, Hiroyuki Iwano, Toshiyuki Nagai, Satoru Wakasa, Toshihisa Anzai
Internal medicine (Tokyo, Japan), 2023年03月31日, ［国内誌］
英語, 研究論文（学術雑誌）, We herein report the first case of constrictive pericarditis (CP) induced by long-term pergolide treatment for Parkinson's disease that was assessed using multimodal imaging in a 72-year-old patient with leg edema and dyspnea. The patient was correctly diagnosed with CP using multimodal imaging and successfully treated with pericardiectomy. The treatment history of Parkinson's disease and pathological findings of the removed pericardium suggested that long-term pergolide was the cause of CP. Properly recognizing pergolide as the cause of CP and accurately diagnosing CP using multimodal imaging may contribute to the early detection and treatment of pergolide-induced CP.

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, (一社)日本循環器学会, 2023年03月
英語

Impact of right ventricular reserve on exercise capacity and quality of life in patients with left ventricular assist device.
Sakae Takenaka, Takuma Sato, Toshiyuki Nagai, Kazunori Omote, Yuta Kobayashi, Kiwamu Kamiya, Takao Konishi, Atsushi Tada, Yoshifumi Mizuguchi, Yuki Takahashi, Seiichiro Naito, Kohei Saiin, Suguru Ishizaka, Satoru Wakasa, Toshihisa Anzai
American journal of physiology. Heart and circulatory physiology, 324, 3, H355-H363, 2023年03月01日, ［国際誌］
英語, 研究論文（学術雑誌）, Although measuring right ventricular (RV) function during exercise is more informative than assessing it at rest, the relationship between RV reserve function, exercise capacity, and health-related quality of life (HRQoL) in patients with left ventricular assist devices (LVAD) remains unresolved. We aimed to investigate whether RV reserve assessed by the change in RV stroke work index (RVSWI) during exercise is correlated with exercise capacity and HRQoL in patients with LVAD. We prospectively assessed 24 consecutive patients with LVAD who underwent invasive right heart catheterization in the supine position. Exercise capacity and HRQoL were assessed using the 6-min walk distance (6 MWD) and peak oxygen consumption (V̇o2) in cardiopulmonary exercise testing, and the EuroQol visual analog scale (EQ-VAS), respectively. The patients were divided into two groups according to the median ΔRVSWI (change from rest to peak exercise). Patients with lower ΔRVSWI had significantly lower changes in cardiac index and absolute value of RV dP/dt than those with higher ΔRVSWI. The ΔRVSWI was positively correlated with 6 MWD (r = 0.59, P = 0.003) and peak V̇o2 (r = 0.56, P = 0.006). In addition, ΔRVSWI was positively correlated with the EQ-VAS (r = 0.44, P = 0.030). In contrast, there was no significant correlation between RVSWI at rest and 6 MWD (r = -0.34, P = 0.88), peak V̇o2 (r = 0.074, P = 0.74), or EQ-VAS (r = 0.127, P = 0.56). Our findings suggest that the assessment of RV reserve function is useful for risk stratification in patients with LVAD.NEW & NOTEWORTHY The change in right ventricular stroke work index (RVSWI) during exercise, not RVSWI at rest, was associated with exercise capacity and HRQoL. Our findings suggest that the assessment of change in RVSWI during exercise as a surrogate of RV reserve function may aid in risk stratification of patients with LVAD.

Prognostic Significance of Peak Workload-to-Weight Ratio by Cardiopulmonary Exercise Testing in Chronic Heart Failure.
Yutaro Yasui, Kosuke Nakamura, Kazunori Omote, Suguru Ishizaka, Sakae Takenaka, Yoshifumi Mizuguchi, Yui Shimono, Sho Kazui, Yuki Takahashi, Kohei Saiin, Seiichiro Naito, Atsushi Tada, Yuta Kobayashi, Takuma Sato, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai
The American journal of cardiology, 193, 37, 43, 2023年03月01日, ［国際誌］
英語, 研究論文（学術雑誌）, The prognostic impact of peak workload-to-weight ratio (PWR) during cardiopulmonary exercise testing (CPET) and its determinants in patients with chronic heart failure (CHF) are not well understood. Consecutive 514 patients with CHF referred for CPET at the Hokkaido University Hospital between 2013 and 2018 were identified. The primary outcome was a composite of hospitalization because of worsening heart failure and death. PWR was calculated as peak workload normalized to body weight (W/kg) by CPET. Patients with low PWR (cut-off median 1.38 [W/kg], n = 257) were older and more anemic than those with high PWR (n = 257). In CPET, patients with low PWR displayed reduced peak oxygen consumption and impaired ventilatory efficiency compared with those with high PWR, whereas the peak respiratory exchange ratio was not significantly different between the 2 groups. There were 89 patients with events over a median follow-up period of 3.3 (interquartile range 0.8 to 5.5) years. The incidence of composite events was significantly higher in patients with low PWR than in those with high PWR (log-rank p <0.0001). In the multivariable Cox regression, lower PWR was associated with adverse events (hazard ratio 0.31, 95% confidence interval 0.13 to 0.73, p = 0.008). Low hemoglobin concentration was strongly related to impaired PWR (β coefficient = 0.43, per 1 g/100 ml increased, p <0.0001). In conclusion, PWR was associated with worse clinical outcomes, where blood hemoglobin was strongly related to PWR. Further study is required to identify therapies targeting peak workload achievements in exercise stress tests to improve the outcome in patients with CHF.

Association of coronary plaque morphology with inflammatory biomarkers and target lesion revascularization in patients with chronic coronary syndrome: an optical coherence tomography study.
Kohei Saiin, Takao Konishi, Sho Kazui, Yutaro Yasui, Yuki Takahashi, Seiichiro Naito, Sakae Takenaka, Yoshifumi Mizuguchi, Atsushi Tada, Yuta Kobayashi, Yoshiya Kato, Kazunori Omote, Takuma Sato, Kiwamu Kamiya, Toshiyuki Nagai, Shinya Tanaka, Toshihisa Anzai
American journal of cardiovascular disease, 13, 5, 309, 319, 2023年, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: The characteristics of high-risk coronary atherosclerosis evaluated using optical coherence tomography (OCT) can have a prognostic role. Inflammatory biomarkers may be related to the severity of coronary artery disease. This study investigated the association of high-risk morphological features of coronary plaques on OCT with circulating levels of inflammatory biomarkers and target lesion revascularization (TLR). MATERIALS AND METHODS: We prospectively analyzed the data of 30 consecutive patients with chronic coronary syndrome who underwent percutaneous coronary intervention (PCI) using OCT. The levels of interleukin-6, tumor necrosis factor-alpha, high-sensitivity C-reactive protein, pentraxin 3, vascular endothelial growth factor, and monocyte chemoattractant protein-1 (MCP-1) were measured in plasma samples. Coronary plaque characteristics were scored quantitatively in the form of coronary plaque risk score (CPRS). The estimated high-risk plaque characteristics for TLR were plaque rupture, plaque erosion, calcified nodule, lipid-rich plaque, thin-cap fibroatheroma, cholesterol crystals, macrophage infiltration, microchannels, calcification angle >90°, and microcalcifications. Each high-risk feature carries 1 point. Patients were defined as having a low CPRS (CPRS ≤3) or a high CPRS (CPRS ≥4). RESULTS: The primary outcome was TLR. TLR occurred in 6 (20%) patients within 15 months of PCI. High CPRS on OCT was directly correlated with TLR (P=0.029). In logistic regression analysis, CPRS was associated with TLR (odds ratio, 10.0; 95% confidence interval, 1.34-74.5). Serum MCP-1 level was significantly correlated with the CPRS (P=0.020). CONCLUSIONS: In patients with chronic coronary syndrome, CPRS may be a surrogate predictor of TLR. Serum MCP-1 may aid in the detection of high-risk coronary atherosclerosis.

Closed VSDを合併した右室二腔症の手術症例　　　　　　　　　　　　　　　
齋藤 翔太, 石坂 傑, 下野 裕依, 甲谷 太郎, 神谷 究, 阿部 慎司, 加藤 伸康, 永井 利幸, 若狭 哲, 安斉 俊久
日本成人先天性心疾患学会雑誌, 12, 1, 200, 200, (一社)日本成人先天性心疾患学会, 2023年01月
日本語

Associations of right ventricular pulsatile load and cardiac power output to clinical outcomes in heart failure: Difference from systemic circulation.
Yasuyuki Chiba, Hiroyuki Iwano, Hiroyuki Aoyagi, Yoji Tamaki, Ko Motoi, Suguru Ishizaka, Michito Murayama, Shinobu Yokoyama, Masahiro Nakabachi, Hisao Nishino, Sanae Kaga, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai
Journal of cardiology, 81, 4, 404, 412, 2022年12月08日, ［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.

Liver stiffness assessed by magnetic resonance elastography predicts clinical outcomes in patients with heart failure and without chronic liver disease.
Atsushi Tada, Toshiyuki Nagai, Yoshiya Kato, Kazunori Omote, Noriko Oyama-Manabe, Satonori Tsuneta, Yusuke Kudo, Mutsumi Nishida, Michikazu Nakai, Yuki Takahashi, Kohei Saiin, Seiichiro Naito, Yuta Kobayashi, Sakae Takenaka, Yoshifumi Mizuguchi, Kiwamu Kamiya, Takao Konishi, Takuma Sato, Kohsuke Kudo, Toshihisa Anzai
European radiology, 33, 3, 2062, 2074, 2022年11月03日, ［国際誌］
英語, 研究論文（学術雑誌）, OBJECTIVES: Evaluation of liver stiffness (LS) by magnetic resonance elastography (MRE) is useful for estimating right atrial pressure (RAP) in patients with heart failure (HF). However, its prognostic implications are unclear. We sought to investigate whether LS measured by MRE (LS-MRE) could predict clinical outcomes in patients with HF. METHODS: We prospectively examined 207 consecutive HF patients between April 2018 and May 2021 after excluding those with organic liver disease. All patients underwent 3.0-T MRE. The primary outcome of interest was the composite of all-cause death and hospitalisation for HF. RESULTS: During a median follow-up period of 720 (interquartile range [IQR] 434-1013) days, the primary outcome occurred in 44 patients (21%), including 15 (7%) all-cause deaths and 29 (14%) hospitalisations for HF. The patients were divided into two groups according to median LS-MRE of 2.54 (IQR 2.34-2.82) kPa. Patients with higher LS-MRE showed a higher incidence of the primary outcome compared to those with lower LS-MRE (p < 0.001). Multivariable Cox regression analyses revealed that LS-MRE value was independently associated with the risk of adverse events (hazard ratio 2.49, 95% confidence interval 1.46-4.24). In multivariable linear regression, RAP showed a stronger correlation with LS-MRE (β coefficient = 0.31, p < 0.001) compared to markers related to liver fibrosis. CONCLUSIONS: In patients without chronic liver disease and presenting with HF, elevated LS-MRE was independently associated with worse clinical outcomes. Elevated LS-MRE may be useful for risk stratification in patients with HF and without chronic liver disease. KEY POINTS: • Magnetic resonance elastography (MRE) is an emerging non-invasive imaging technique for evaluating liver stiffness (LS) which can estimate right atrial pressure. • Elevated LS-MRE, which mainly reflects liver congestion, was independently associated with worse clinical outcomes in patients with heart failure. • The assessment of LS-MRE would be useful for stratifying the risk of adverse events in heart failure patients without chronic liver disease.

日本人心臓サルコイドーシス患者におけるAHA/ACC/HRSガイドライン植込型除細動器適応の外的妥当性　　　　　　　　　　　　　　　
竹中 秀, 小林 雄太, 永井 利幸, 加藤 喜哉, 小森山 弘和, 永野 伸卓, 神谷 究, 小西 崇夫, 佐藤 琢真, 表 和徳, 多田 篤司, 水口 賢史, 草野 研吾, 植田 初江, 安斉 俊久
日本サルコイドーシス/肉芽腫性疾患学会雑誌, 42, サプリメント号, 64, 64, 日本サルコイドーシス, 2022年10月
日本語

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, 2022年09月16日, ［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, Springer Science and Business Media LLC, 2022年07月16日
研究論文（学術雑誌）

MitraClip実施後にたこつぼ症候群を呈した1例　　　　　　　　　　　　　　　
甲谷 次郎, 神谷 究, 立田 大志郎, 西野 広太郎, 高橋 勇樹, 斎院 康平, 内藤 正一郎, 竹中 秀, 多田 篤司, 水口 賢史, 石坂 傑, 小林 雄太, 佐藤 琢真, 永井 利幸, 安斉 俊久
日本心血管インターベンション治療学会抄録集, 30回, [YIA4, 2], (一社)日本心血管インターベンション治療学会, 2022年07月
英語

Clinical Utility of Superior Vena Cava Flow Velocity Waveform Measured from the Subcostal Window for Estimating Right Atrial Pressure.
Michito Murayama, Sanae Kaga, Kazunori Okada, Hiroyuki Iwano, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Shingo Tsujinaga, Yasuyuki Chiba, Suguru Ishizaka, Ko Motoi, Kiwamu Kamiya, Mutsumi Nishida, Toshiyuki Nagai, Toshihisa Anzai
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 35, 7, 727, 737, 2022年02月09日, ［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.

Determinants of altered left ventricular suction in pre-capillary pulmonary hypertension.
Yasuyuki Chiba, Hiroyuki Iwano, Satonori Tsuneta, Shingo Tsujinaga, Brett Meyers, Pavlos Vlachos, Suguru Ishizaka, Ko Motoi, Hiroyuki Aoyagi, Yoji Tamaki, Asuka Tanemura, Michito Murayama, Shinobu Yokoyama, Masahiro Nakabachi, Hisao Nishino, Sanae Kaga, Kiwamu Kamiya, Hiroshi Ohira, Ichizo Tsujino, Toshihisa Anzai
European heart journal. Cardiovascular Imaging, 23, 10, 1399, 1406, 2022年01月10日, ［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.

Neoatherosclerosis with silent plaque rupture in a saphenous vein graft causing no re-flow phenomenon assessed by optical coherence tomography and histopathology.
Takao Konishi, Yuki Takahashi, Sho Kazui, Yutaro Yasui, Kohei Saiin, Seiichiro Naito, Sakae Takenaka, Yoshifumi Mizuguchi, Atsushi Tada, Yuta Kobayashi, Kazunori Omote, Takuma Sato, Kiwamu Kamiya, Toshiyuki Nagai, Shinya Tanaka, Toshihisa Anzai
Cardiology journal, 29, 4, 718, 719, 2022年, ［国際誌］
英語, 研究論文（学術雑誌）

Vulnerable plaque derived from aspirated thrombi in recurrent acute coronary syndrome with familial hypercholesterolemia despite intensive lipid-lowering statin therapy.
Hiroyuki Natsui, Takao Konishi, Kohei Saiin, Youji Tamaki, Tomoya Sato, Sakae Takenaka, Atsushi Tada, Yoshifumi Mizuguchi, Yuta Kobayashi, Takuma Sato, Rui Kamada, Kiwamu Kamiya, Toshiyuki Nagai, Shinya Tanaka, Toshihisa Anzai
Cardiology journal, 29, 2, 362, 363, 2022年, ［国際誌］
英語, 研究論文（学術雑誌）

Paravalvular leak vanishing at end-diastole during transcatheter aortic valve replacement.
Yoji Tamaki, Shingo Tsujinaga, Hiroyuki Iwano, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai
Journal of echocardiography, 21, 2, 81, 82, 2021年10月06日, ［国内誌］
英語, 研究論文（学術雑誌）

Association of high serum soluble interleukin 2 receptor levels with risk of adverse events in cardiac sarcoidosis.
Yuta Kobayashi, Takuma Sato, Toshiyuki Nagai, Kenji Hirata, Satonori Tsuneta, Yoshiya Kato, Hirokazu Komoriyama, Kiwamu Kamiya, Takao Konishi, Kazunori Omote, Hiroshi Ohira, Kohsuke Kudo, Satoshi Konno, Toshihisa Anzai
ESC heart failure, 8, 6, 5282, 5292, 2021年09月12日, ［国際誌］
英語, 研究論文（学術雑誌）, AIMS: Although soluble interleukin 2 receptor (sIL-2R) is a potentially useful biomarker in the diagnosis and evaluation of disease severity in patients with sarcoidosis, its prognostic implication in patients with cardiac sarcoidosis (CS) is unclear. We sought to investigate whether sIL-2R was associated with clinical outcomes and to clarify the relationship between sIL-2R levels and disease activity in patients with CS. METHODS AND RESULTS: We examined 83 consecutive patients with CS in our hospital who had available serum sIL-2R data between May 2003 and February 2020. The primary outcome was a composite of advanced atrioventricular block, ventricular tachycardia or ventricular fibrillation, heart failure hospitalization, and all-cause death. Inflammatory activity in the myocardium and lymph nodes was assessed by 18 F-fluorideoxyglucose positron emission tomography/computed tomography. During a median follow-up period of 2.96 (IQR 2.24-4.27) years, the primary outcome occurred in 24 patients (29%). Higher serum sIL-2R levels (>538 U/mL, the median) were significantly related to increased incidence of primary outcome (P = 0.037). Multivariable Cox regression analysis showed that a higher sIL-2R was independently associated with an increased subsequent risk of adverse events (HR 3.71, 95% CI 1.63-8.44, P = 0.002), even after adjustment for significant covariates. sIL-2R levels were significantly correlated to inflammatory activity in lymph nodes (r = 0.346, P = 0.003) but not the myocardium (r = 0.131, P = 0.27). CONCLUSIONS: Increased sIL-2R is associated with worse long-term clinical outcomes accompanied by increased systemic inflammatory activity in CS patients.

MitraClipを用いた経皮的僧帽弁接合修復術により強心薬を離脱できた重症心不全の一例　　　　　　　　　　　　　　　
高橋 昌寛, 辻永 真吾, 高橋 勇樹, 佐藤 琢真, 内藤 正一郎, 青柳 裕之, 小林 雄太, 神谷 究, 岩野 弘幸, 永井 利幸, 安斉 俊久
日本心臓病学会学術集会抄録, 69回, O, 267, (一社)日本心臓病学会, 2021年09月
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, 本居 昂, 石坂 傑, 辻永 真吾, 村山 迪史, 横山 しのぶ, 中鉢 雅大, 西野 久雄, 岡田 一範, 加賀 早苗, 神谷 究, 永井 利幸, 安斉 俊久
日本心臓病学会学術集会抄録, 69回, O, 029, (一社)日本心臓病学会, 2021年09月
日本語

Performance of the H2FPEF and the HFA-PEFF scores for the diagnosis of heart failure with preserved ejection fraction in Japanese patients: A report from the Japanese multicenter registry.
Atsushi Tada, Toshiyuki Nagai, Kazunori Omote, Hiroyuki Iwano, Shingo Tsujinaga, Kiwamu Kamiya, Takao Konishi, Takuma Sato, Hirokazu Komoriyama, Yuta Kobayashi, Sakae Takenaka, Yoshifumi Mizuguchi, Tomoya Sato, Kazuhiro Yamamoto, Tsutomu Yoshikawa, Yoshihiko Saito, Toshihisa Anzai
International journal of cardiology, 342, 43, 48, 2021年08月05日, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Diagnosing heart failure with preserved ejection fraction (HFpEF) is challenging. Although the H2FPEF score and HFA-PEFF algorithm have been proposed for diagnosing HFpEF, previous validation studies were conducted in stable chronic heart failure (HF). Moreover, information on their applicability in the Asian population is limited. We sought to investigate these scores' diagnostic performance for HFpEF in Japanese patients recently hospitalized due to acute decompensated HF. METHODS: We examined patients with HFpEF recently hospitalized with acute decompensated HF from a nationwide HFpEF-specific multicenter registry (HFpEF group) and control patients who underwent echocardiography to investigate the cause of dyspnea in our hospital (Non-HFpEF group). RESULTS: The studied population included 372 patients (194 HFpEF group and 178 Non-HFpEF group; HFpEF prevalence, 52%). A high H2FPEF score (6-9 points) could diagnose HFpEF with a high specificity of 97% and a positive predictive value (PPV) of 94%, and a low H2FPEF score (0-1 point) could rule out HFpEF with a high sensitivity of 97% and a negative predictive value (NPV) of 93%. HFpEF could be diagnosed with a high HFA-PEFF score (5-6 points) (specificity, 84%; PPV, 82%) or ruled out with a low HFA-PEFF score (0-1 point) (sensitivity, 99%; NPV, 89%). The H2FPEF score was significantly superior to the HFA-PEFF score in diagnostic accuracy (area under the curve: 0.89 vs. 0.82, respectively, p = 0.004). CONCLUSIONS: The H2FPEF and the HFA-PEFF scores had acceptable diagnostic accuracy in diagnosing HFpEF in Japanese patients.

Long-Term Prognostic Significance of Ventricular Repolarization Dispersion in Patients with Cardiac Sarcoidosis.
Yuta Kobayashi, Toshiyuki Nagai, Sakae Takenaka, Yoshiya Kato, Hirokazu Komoriyama, Nobutaka Nagano, Kiwamu Kamiya, Takao Konishi, Takuma Sato, Kazunori Omote, Shingo Tsujinaga, Hiroyuki Iwano, Kengo Kusano, Satoshi Yasuda, Hisao Ogawa, Hatsue Ishibashi-Ueda, Toshihisa Anzai
The American journal of cardiology, 152, 125, 131, 2021年08月01日, ［国際誌］
英語, 研究論文（学術雑誌）, Cardiac sarcoidosis (CS) is frequently complicated by fatal ventricular arrhythmias. T-peak to T-end interval to QT interval ratio (TpTe/QT) on electrocardiograms (ECG) was proposed as a marker of ventricular repolarization dispersion. Although this ratio could be associated with the incidence of ventricular arrhythmias in cardiovascular diseases, its prognostic implication in patients with CS is unclear. We sought to investigate whether TpTe/QT was associated with long-term clinical outcomes in patients with CS. Ninety consecutive patients with CS in 2 tertiary hospitals who had ECG data before initiation of immunosuppressive therapy between November 1995 and March 2019 were examined. The primary outcome was a composite of advanced atrioventricular block, ventricular tachycardia or ventricular fibrillation (VT/VF), heart failure hospitalization, and all-cause death. During a median follow-up period of 4.70 (interquartile range 2.06-7.23) years, the primary outcome occurred in 21 patients (23.3%). Survival analyses revealed that the primary outcome (p < 0.001), especially VT/VF or sudden cardiac death (p = 0.002), occurred more frequently in patients with higher TpTe/QT (≥ 0.242, the median) than in those with lower TpTe/QT. Multivariable Cox regression analysis showed that a higher TpTe/QT was independently associated with increased subsequent risk of adverse events (hazard ratio1.11, 95% confidence interval 1.03-1.20, p = 0.008) even after adjustment for the significant covariates. In conclusion, a higher TpTe/QT was associated with worse long-term clinical outcomes, especially fatal ventricular arrhythmic events, in patients with cardiac sarcoidosis, suggesting the importance of assessing TpTe/QT as a surrogate for risk stratification in these patients.

Fulminant cardiac and renal sarcoidosis revealed by electron microscope: challenging aspect of diagnosis
Seiichiro Naito, Shingo Tsujinaga, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai
European Heart Journal - Case Reports, 5, 11, ytab298, Oxford University Press (OUP), 2021年07月28日, ［国際誌］
英語, 研究論文（学術雑誌）

Blood flow dynamics with four-dimensional flow cardiovascular magnetic resonance in patients with aortic stenosis before and after transcatheter aortic valve replacement.
Hirokazu Komoriyama, Kiwamu Kamiya, Toshiyuki Nagai, Noriko Oyama-Manabe, Satonori Tsuneta, Yuta Kobayashi, Yoshiya Kato, Miwa Sarashina, Kazunori Omote, Takao Konishi, Takuma Sato, Shingo Tsujinaga, Hiroyuki Iwano, Yasushige Shingu, Satoru Wakasa, Toshihisa Anzai
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, 23, 1, 81, 81, 2021年06月28日, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Pre- and post-procedural hemodynamic changes which could affect adverse outcomes in aortic stenosis (AS) patients who undergo transcatheter aortic valve replacement (TAVR) have not been well investigated. Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) enables accurate analysis of blood flow dynamics such as flow velocity, flow pattern, wall shear stress (WSS), and energy loss (EL). We sought to examine the changes in blood flow dynamics of patients with severe AS who underwent TAVR. METHODS: We examined 32 consecutive severe AS patients who underwent TAVR between May 2018 and June 2019 (17 men, 82 ± 5 years, median left ventricular ejection fraction 61%, 6 self-expanding valve), after excluding those without CMR because of a contraindication or inadequate imaging from the analyses. We analyzed blood flow patterns, WSS and EL in the ascending aorta (AAo), and those changes before and after TAVR using 4D flow CMR. RESULTS: After TAVR, semi-quantified helical flow in the AAo was significantly decreased (1.4 ± 0.6 vs. 1.9 ± 0.8, P = 0.002), whereas vortical flow and eccentricity showed no significant changes. WSS along the ascending aortic circumference was significantly decreased in the left (P = 0.038) and left anterior (P = 0.033) wall at the basal level, right posterior (P = 0.011) and left (P = 0.010) wall at the middle level, and right (P = 0.012), left posterior (P = 0.019) and left anterior (P = 0.028) wall at the upper level. EL in the AAo was significantly decreased (15.6 [10.8-25.1 vs. 25.8 [18.6-36.2]] mW, P = 0.012). Furthermore, a significant negative correlation was observed between EL and effective orifice area index after TAVR (r = - 0.38, P = 0.034). CONCLUSIONS: In severe AS patients undergoing TAVR, 4D flow CMR demonstrates that TAVR improves blood flow dynamics, especially when a larger effective orifice area index is obtained.

Takotsubo Syndrome After Transcatheter Mitral Valve Repair.
Takahide Kadosaka, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai
Circulation journal : official journal of the Japanese Circulation Society, 85, 7, 1100, 1100, 2021年06月25日, ［国内誌］
英語, 研究論文（学術雑誌）

Applicability of the AHA/ACC/HRS Guideline for Implantable Cardioverter Defibrillator Implantation in Japanese Patients With Cardiac Sarcoidosis.
Sakae Takenaka, Yuta Kobayashi, Toshiyuki Nagai, Yoshiya Kato, Hirokazu Komoriyama, Nobutaka Nagano, Kiwamu Kamiya, Takao Konishi, Takuma Sato, Kazunori Omote, Yoshifumi Mizuguchi, Atsushi Tada, Tomoya Sato, Hiroyuki Iwano, Kengo Kusano, Hatsue Ishibashi-Ueda, Toshihisa Anzai
JACC. Clinical electrophysiology, 7, 11, 1410, 1418, 2021年06月22日, ［国際誌］
英語, 研究論文（学術雑誌）, OBJECTIVES: This study aimed to assess, among Japanese patients with cardiac sarcoidosis (CS), the implantable cardioverter-defibrillator (ICD) recommendations from the 2017 American Heart Association/American College of Cardiology/Heart Rhythm Society (AHA/ACC/HRS) guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death (SCD). BACKGROUND: Although ICDs are used to prevent SCD from ventricular tachycardia or ventricular fibrillation (VT/VF) in patients with CS, the generalizability of the AHA/ACC/HRS guidelines for Japanese patients with CS remains unclear. METHODS: This study examined 188 consecutive patients with CS in 2 tertiary hospitals between 1979 and 2020. Patients were followed for a primary outcome of VT/VF or SCD. RESULTS: During a median follow-up of 5.68 years, the primary outcome occurred in 44 patients (23%). Patients with a class I recommendation for ICD implantation showed the highest incidence of the primary outcome among patients in whom the guideline recommendations for ICD implantation were used (log-rank test; p = 0.03). However, compared with patients with left ventricular ejection fractions (LVEFs) ≤35%, there was no significant difference in the incidence of the primary outcome among patients with LVEFs >35% and those who required a permanent pacemaker (p = 0.31); similar results were observed in those with LVEFs >35% and late gadolinium enhancement during cardiovascular magnetic resonance imaging (p = 0.22). CONCLUSIONS: The American guideline recommendations for ICD implantation might be applicable to Japanese patients with CS. Implantation of an ICD may need to be considered in these patients if they require a permanent pacemaker or have late gadolinium enhancement, regardless of LVEF.

4-Dimensional Flow Cardiovascular Magnetic Resonance Imaging of Changes in Blood Flow Dynamics After Surgery for Discrete Subaortic Stenosis.
Hirokazu Komoriyama, Kiwamu Kamiya, Yuta Kobayashi, Satonori Tsuneta, Takao Konishi, Takuma Sato, Hiroyuki Iwano, Toshiyuki Nagai, Satoru Wakasa, Kohsuke Kudo, Toshihisa Anzai
Circulation journal : official journal of the Japanese Circulation Society, 85, 6, 954, 954, 2021年05月25日, ［国内誌］
英語, 研究論文（学術雑誌）

Influence of left ventricular systolic dysfunction on occurrence of pulsus tardus in patients with aortic stenosis.
Suguru Ishizaka, Hiroyuki Iwano, Ko Motoi, Yasuyuki Chiba, Shingo Tsujinaga, Asuka Tanemura, Michito Murayama, Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Kazunori Okada, Sanae Kaga, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai
Journal of cardiology, 78, 4, 322, 327, 2021年05月13日, ［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, 2021年03月03日, ［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.

Prognostic value of admission serum magnesium in acute myocardial infarction complicated by malignant ventricular arrhythmias.
Yoshifumi Mizuguchi, Takao Konishi, Toshiyuki Nagai, Tomoya Sato, Sakae Takenaka, Atsushi Tada, Yuta Kobayashi, Hirokazu Komoriyama, Yoshiya Kato, Kazunori Omote, Takuma Sato, Kiwamu Kamiya, Shingo Tsujinaga, Hiroyuki Iwano, Kenjiro Kikuchi, Shinya Tanaka, Toshihisa Anzai
The American journal of emergency medicine, 44, 100, 105, 2021年02月05日, ［国際誌］
英語, 研究論文（学術雑誌）, OBJECTIVES: Although electrolyte abnormalities are related to worse clinical outcomes in patients with acute myocardial infarction (AMI), little is known about the association between admission serum magnesium level and adverse events in AMI patients complicated by out-of-hospital cardiac arrest presenting with malignant ventricular arrhythmias (OHCA-MVA). We investigated the prognostic value of serum magnesium level on admission in these patients. METHODS: We retrospectively analyzed the data of 165 consecutive reperfused AMI patients complicated with OHCA-MVA between April 2007 and February 2020 in our university hospital. Serum magnesium concentration was measured on admission. The primary outcome was in-hospital death. RESULTS: Fifty-four patients (33%) died during hospitalization. Higher serum magnesium level was significantly related to in-hospital death (Fine & Gray's test; p < 0.001). In multivariable logistic regression analyses, serum magnesium level on admission was independently associated with in-hospital death (hazard ratio 2.68, 95% confidence interval 1.24-5.80) even after adjustment for covariates. Furthermore, the incidences of cardiogenic shock necessitating an intra-aortic balloon pump (p = 0.005) or extracorporeal membrane oxygenation (p < 0.001), tracheal intubation (p < 0.001) and persistent vegetative state (p = 0.002) were significantly higher in patients with higher serum magnesium level than in those with lower serum magnesium level. CONCLUSIONS: In reperfused AMI patients complicated by OHCA-MVA, admission serum magnesium level might be a potential surrogate marker for predicting in-hospital death.

High-Density Lipoprotein Cholesterol and Cardiovascular Events in Patients with Stable Coronary Artery Disease Treated with Statins: An Observation from the REAL-CAD Study.
Kazunori Omote, Isao Yokota, Toshiyuki Nagai, Ichiro Sakuma, Yoshihisa Nakagawa, Kiwamu Kamiya, Hiroshi Iwata, Katsumi Miyauchi, Yukio Ozaki, Kiyoshi Hibi, Takafumi Hiro, Yoshihiro Fukumoto, Hiroyoshi Mori, Seiji Hokimoto, Yasuo Ohashi, Hiroshi Ohtsu, Hisao Ogawa, Hiroyuki Daida, Satoshi Iimuro, Hiroaki Shimokawa, Yasushi Saito, Takeshi Kimura, Masunori Matsuzaki, Ryozo Nagai, Toshihisa Anzai
Journal of atherosclerosis and thrombosis, 29, 1, 50, 68, 2021年01月09日, ［国内誌］
英語, 研究論文（学術雑誌）, AIM: The association between high-density lipoprotein cholesterol (HDL-C) level after statin therapy and cardiovascular events in patients with stable coronary artery disease (CAD) remains unclear. Thus, in this study, we sought to determine how HDL-C level after statin therapy is associated with cardiovascular events in stable CAD patients. METHODS: From the REAL-CAD study which had shown the favorable prognostic effect of high-dose pitavastatin in stable CAD patients with low-density lipoprotein cholesterol (LDL-C) ＜120 mg/dL, 9,221 patients with HDL-C data at baseline and 6 months, no occurrence of primary outcome at 6 months, and reported non-adherence for pitavastatin, were examined. The primary outcome was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal ischemic stroke, or unstable angina requiring emergent admission after 6 months of randomization. Absolute difference and ratio of HDL-C levels were defined as (those at 6 months-at baseline) and (absolute difference/baseline)×100, respectively. RESULTS: During a median follow-up period of 4.0 (IQR 3.2-4.7) years, the primary outcome occurred in 417 (4.5%) patients. The adjusted risk of all HDL-C-related variables (baseline value, 6-month value, absolute, and relative changes) for the primary outcome was not significant (hazard ratio [HR] 0.99, 95% confidence interval [CI] 0.91-1.08, HR 1.03, 95% CI 0.94-1.12, HR 1.05, 95% CI 0.98-1.12, and HR 1.08, 95% CI 0.94-1.24, respectively). Furthermore, adjusted HRs of all HDL-C-related variables remained non-significant for the primary outcome regardless of on-treatment LDL-C level at 6 months. CONCLUSIONS: After statin therapy with modestly controlled LDL-C, HDL-C level has little prognostic value in patients with stable CAD.

Influence of advanced pulmonary vascular remodeling on accuracy of echocardiographic parameters of left ventricular filling pressure
Yasuyuki Chiba, Hiroyuki Iwano, Sanae Kaga, Mio Shinkawa, Michito Murayama, Hiroshi Ohira, Suguru Ishizaka, Miwa Sarashina, Shingo Tsujinaga, Shinobu Yokoyama, Masahiro Nakabachi, Hisao Nishino, Kazunori Okada, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai
Pulmonary Circulation, 11, 1, 204589402098372, 204589402098372, SAGE Publications, 2021年01月
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.

Acute Myocardial Infarction of the Left Main Coronary Artery Presenting with Cardiogenic Shock and Pulmonary Edema during Noncardiac Surgery.
Sakae Takenaka, Takao Konishi, Tomoya Sato, Atsushi Tada, Takuya Koizumi, Yoshifumi Mizuguchi, Takahide Kadosaka, Ko Motoi, Yuta Kobayashi, Hirokazu Komoriyama, Yoshiya Kato, Miwa Sarashina, Kazunori Omote, Shingo Tsujinaga, Takuma Sato, Rui Kamada, Kiwamu Kamiya, Hiroyuki Iwano, Toshiyuki Nagai, Tatsuya Orimo, Hirofumi Kamachi, Akinobu Taketomi, Toshihisa Anzai
Case reports in cardiology, 2021, 5460816, 5460816, 2021年, ［国際誌］
英語, Acute myocardial infarction (AMI) caused by severe stenosis of left main coronary artery (LMCA) presenting with cardiogenic shock and pulmonary edema during noncardiac surgery is uncommon, but a catastrophic event. A 77-year-old male with cholangiocarcinoma underwent hepatectomy. During the surgery, he presented with cardiogenic shock, which did not respond to infusion administration or vasopressor. A transesophageal echocardiogram revealed anterior, septal, and lateral severe hypokinesia and impaired left ventricular function. Emergent coronary angiogram showed severe stenosis of LMCA. The patient underwent primary percutaneous coronary intervention (PCI) under the support of intra-aortic balloon pump, followed by extracorporeal membrane oxygenation. The chest roentgenogram showed pulmonary edema. Two days after PCI, he successfully underwent hepatectomy and bile duct resection. Early identification of the cause of hemodynamic instability during noncardiac surgery and invasive strategy are important for minimizing the myocardial injury and improving clinical outcomes in AMI of LMCA.

The effectiveness of drug-coated balloons for two dissimilar calcific lesions assessed by near-infrared spectroscopy intravascular ultrasound and optical coherence tomography.
Takao Konishi, Kohei Saiin, Youji Tamaki, Hiroyuki Natsui, Tomoya Sato, Sakae Takenaka, Atsushi Tada, Yoshifumi Mizuguchi, Yuta Kobayashi, Hirokazu Komoriyama, Yoshiya Kato, Takuma Sato, Rui Kamada, Kiwamu Kamiya, Toshiyuki Nagai, Shinya Tanaka, Toshihisa Anzai
Cardiology journal, 28, 5, 794, 795, 2021年, ［国際誌］
英語, 研究論文（学術雑誌）

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, 2020年12月28日, ［国際誌］
英語, 研究論文（学術雑誌）

Lower left ventricular ejection fraction and higher serum angiotensin-converting enzyme activity are associated with histopathological diagnosis by endomyocardial biopsy in patients with cardiac sarcoidosis.
Hirokazu Komoriyama, Kazunori Omote, Toshiyuki Nagai, Yoshiya Kato, Nobutaka Nagano, Kazuhiro Koyanagawa, Kiwamu Kamiya, Takao Konishi, Takuma Sato, Yuta Kobayashi, Shingo Tsujinaga, Hiroyuki Iwano, Kengo Kusano, Satoshi Yasuda, Hisao Ogawa, Hatsue Ishibashi-Ueda, Toshihisa Anzai
International journal of cardiology, 321, 113, 117, 2020年12月15日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: The histopathological diagnosis of cardiac sarcoidosis (CS) is challenging because of sampling error in endomyocardial biopsy (EMB) and the determinants of positive EMB are unclear. Reduced left ventricular ejection fraction (LVEF) is a simple parameter of the extent of myocardial damage, and higher serum angiotensin-converting enzyme (ACE) activity would indicate the spread of disease activity in CS patients. Thus, we sought to examine whether these parameters are related to the histopathological diagnosis of CS by EMB. METHODS: A total of 94 consecutive clinically diagnosed CS patients between August 1986 and March 2019 who were admitted to two academic hospitals were examined. We determined EMB as positive if non-caseating epithelioid granulomas were confirmed in the myocardial tissue. Patients were divided into two groups according to positive (n = 37) and negative (n = 57) EMB. We assessed the relationship between LVEF, serum ACE activity and positive EMB. RESULTS: Multivariable analysis revealed that both LVEF and serum ACE were independently associated with positive EMB (OR 0.83, 95% CI 0.70-0.99; OR 1.39, 95% CI 1.02-1.90, respectively). Moreover, patients with both lower LVEF (<37%, median) and higher ACE activity (≥13.5 IU/L, median) had the highest frequency of positive EMB (p = .003). The combination of lower LVEF and higher serum ACE showed better specificity (91.2%) and positive predictive value (73.7%) than either LVEF or serum ACE alone for positive EMB. CONCLUSIONS: Lower LVEF and higher serum ACE activity were associated with positive EMB, suggesting that these parameters might be useful for predicting positive EMB in CS patients.

経カテーテル的大動脈弁置換術による左室機能の変化と左室外的仕事量との関連　　　　　　　　　　　　　　　
辻永 真吾, 岩野 弘幸, 石坂 傑, 千葉 泰之, 更科 美羽, 中鉢 雅大, 神谷 究, 永井 利幸, 安斉 俊久
超音波医学, 47, Suppl., S208, S208, (公社)日本超音波医学会, 2020年11月
日本語

心臓サルコイドーシス患者における左室駆出率低値と血清ACE活性高値は組織診断陽性と関連する
小森山 弘和, 表 和徳, 永井 利幸, 加藤 喜哉, 永野 伸卓, 神谷 究, 小西 崇夫, 草野 研吾, 植田 初江, 安斉 俊久
日本サルコイドーシス/肉芽腫性疾患学会雑誌, 40, サプリメント号, 52, 52, 日本サルコイドーシス, 2020年10月
日本語

心臓サルコイドーシス患者におけるステロイド開始前心室再分極過程のばらつきは長期心事故発生と関連する
小林 雄太, 永井 利幸, 神谷 究, 小西 崇夫, 佐藤 琢真, 加藤 喜哉, 小森山 弘和, 草野 研吾, 植田 初江, 安斉 俊久
日本サルコイドーシス/肉芽腫性疾患学会雑誌, 40, サプリメント号, 56, 56, 日本サルコイドーシス, 2020年10月
日本語

心臓サルコイドーシス患者におけるステロイド開始前心室再分極過程のばらつきは長期心事故発生と関連する
小林 雄太, 永井 利幸, 神谷 究, 小西 崇夫, 佐藤 琢真, 加藤 喜哉, 小森山 弘和, 草野 研吾, 植田 初江, 安斉 俊久
日本サルコイドーシス/肉芽腫性疾患学会雑誌, 40, サプリメント号, 56, 56, 日本サルコイドーシス, 2020年10月
日本語

心臓サルコイドーシス患者における左室駆出率低値と血清ACE活性高値は組織診断陽性と関連する
小森山 弘和, 表 和徳, 永井 利幸, 加藤 喜哉, 永野 伸卓, 神谷 究, 小西 崇夫, 草野 研吾, 植田 初江, 安斉 俊久
日本サルコイドーシス/肉芽腫性疾患学会雑誌, 40, サプリメント号, 52, 52, 日本サルコイドーシス, 2020年10月
日本語

Cardiac involvement with anti-mitochondrial antibody-positive myositis mimicking cardiac sarcoidosis.
Takahide Kadosaka, Shingo Tsujinaga, Hiroyuki Iwano, Kiwamu Kamiya, Azusa Nagai, Yoshifumi Mizuguchi, Ko Motoi, Kazunori Omote, Toshiyuki Nagai, Ichiro Yabe, Toshihisa Anzai
ESC heart failure, 2020年09月11日, ［査読有り］, ［国際誌］
英語, Anti-mitochondrial antibody (AMA)-positive myositis is an atypical inflammatory myopathy characterized by chronic progressive respiratory muscle weakness, muscular atrophy, and cardiac involvement. Arrhythmias, cardiomyopathy, and myocarditis have been reported as cardiac manifestations. Herein, we present the first report of a patient diagnosed with having AMA-positive myositis with cardiac involvement mimicking cardiac sarcoidosis.

Usefulness of Liver Magnetic Resonance Elastography for Estimating Right-Atrial Pressure in Heart Failure Patients.
Yoshiya Kato, Toshiyuki Nagai, Noriko Oyama-Manabe, Satonori Tsuneta, Michikazu Nakai, Yuta Kobayashi, Hirokazu Komoriyama, Kazunori Omote, Shingo Tsujinaga, Takuma Sato, Takao Konishi, Kiwamu Kamiya, Hiroyuki Iwano, Toshihisa Anzai
JACC. Cardiovascular imaging, 13, 9, 2050, 2052, 2020年09月, ［査読有り］, ［国際誌］
英語

Reversible Cancer Therapeutics-related Cardiac Dysfunction Complicating Intra-cardiac Thrombi.
Shingo Tsujinaga, Hiroyuki Iwano, Tomohiro Oshino, Takahide Kadosaka, Yoshifumi Mizuguchi, Ko Motoi, Yasuyuki Chiba, Taro Koya, Taro Temma, Kiwamu Kamiya, Arata Fukushima, Takuya Koizumi, Tomoya Sato, Sakae Takenaka, Atsushi Tada, Suguru Ishizaka, Miwa Sarashina, Kazunori Omote, Rui Kamada, Takao Konishi, Takuma Sato, Toshiyuki Nagai, Hiroko Yamashita, Toshihisa Anzai
Internal medicine (Tokyo, Japan), 59, 17, 2155, 2160, 2020年09月01日, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, Epirubicin-based chemotherapy carries a risk of inducing heart failure, although the frequency is rare. Bevacizumab, an anti-vascular endothelial growth factor monoclonal antibody, has recently been widely used in patients with recurrent breast cancer as a first-line chemotherapeutic agent. Heart failure or arterial thromboembolism has been reported as a rare cardiovascular complication of bevacizumab. We herein report a breast cancer patient with reversible cancer therapeutics-related cardiac dysfunction associated with bevacizumab and epirubicin complicating intracardiac thrombi in the left atrium and left ventricle. This case underscores the importance of tailored medical planning according to the individual status in patients receiving anti-cancer therapies.

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, 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.

Refractory Right Ventricular Failure in a Patient with Emery-Dreifuss Muscular Dystrophy.
Yasuyuki Chiba, Arata Fukushima, Motoki Nakao, Yuta Kobayashi, Takahiro Ishigaki, Taro Tenma, Kiwamu Kamiya, Yasushige Shingu, Tomonori Ooka, Yoshiro Matsui, Toshihisa Anzai
Internal medicine (Tokyo, Japan), 59, 10, 1277, 1281, 2020年05月15日, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, A 23-year-old man had progressive muscle weakness and Emery-Dreifuss muscular dystrophy (EDMD) due to a LMNA (lamin A/C) mutation. Congestive heart failure diagnosed at 19 years of age. Maximal drug treatment/cardiac resynchronization failed to improve the cardiac function. He was therefore hospitalized due to heart failure. Despite extracorporeal membrane oxygenation, he developed severe right heart dysfunction and died (multiple organ failure). A cardiac lesion's presence determines the prognosis of EDMD. While there are many arrhythmia reports, few reports on heart failure (particularly severe heart failure requiring cardiac transplantation) have been published. Right heart function monitoring and early ventricular-assist device use plus right heart support considering heart transplantation are important.

Procedural Volume and Outcomes After Percutaneous Coronary Intervention for Unprotected Left Main Coronary Artery Disease-Report From the National Clinical Data (J-PCI Registry).
Tadao Aikawa, Kyohei Yamaji, Toshiyuki Nagai, Shun Kohsaka, Kiwamu Kamiya, Kazunori Omote, Taku Inohara, Yohei Numasawa, Kenichi Tsujita, Tetsuya Amano, Yuji Ikari, Toshihisa Anzai
Journal of the American Heart Association, 9, 9, e015404, 2020年05月05日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, Background There is a limited evidence base to support the volume-outcome relationship in patients undergoing percutaneous coronary intervention (PCI) for unprotected left main coronary artery disease (UPLMD). This study aimed to evaluate the relationship between institutional and operator volume and in-hospital outcomes in patients undergoing PCI for unprotected left main coronary artery disease. Methods and Results We analyzed characteristics and clinical outcomes of 24 320 patients undergoing PCI for unprotected left main coronary artery disease at 1102 hospitals by 7244 operators using data from the Japanese nationwide J-PCI Registry (National PCI Data Registry) between January 2014 and December 2017. We classified institutions and operators into quartiles based on the mean annual volume of PCI. A generalized linear mixed-effects model was used to evaluate the association between institutional and operator PCI volume and in-hospital outcomes. Among the 24 320 patients, 4027 (16.6%), 6147 (25.3%), and 14 146 (58.2%) presented with ST-segment-elevation myocardial infarction, non-ST-segment-elevation acute coronary syndrome, and stable ischemic heart disease; their crude in-hospital mortality was 15%, 3.1%, and 0.3%, respectively. Compared with patients in the lowest quartile of institutional volume (1-216 PCIs/y), the adjusted odds ratio of in-hospital death in patients in the second (217-323 PCIs/y), third (324-487 PCIs/y), and fourth (488-3015 PCIs/y) quartile of institutional volume was 0.75 (95% CI, 0.51-1.10; P=0.14), 0.87 (95% CI, 0.57-1.34; P=0.54), and 0.51 (95% CI, 0.30-0.86; P=0.01), respectively. These findings were consistent in rates of in-hospital death or any complication. Conversely, operator PCI volume was not significantly associated with in-hospital outcomes. Conclusions Institutional rather than operator-based PCI volume was associated with better in-hospital outcomes in patients undergoing PCI for unprotected left main coronary artery disease.

Prognostic Value of Serum Uric Acid in Hospitalized Heart Failure Patients With Preserved Ejection Fraction (from the Japanese Nationwide Multicenter Registry).
Yuta Kobayashi, Kazunori Omote, Toshiyuki Nagai, Kiwamu Kamiya, Takao Konishi, Takuma Sato, Yoshiya Kato, Hirokazu Komoriyama, Shingo Tsujinaga, Hiroyuki Iwano, Kazuhiro Yamamoto, Tsutomu Yoshikawa, Yoshihiko Saito, Toshihisa Anzai
The American journal of cardiology, 125, 5, 772, 776, 2020年03月01日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, Elevated serum uric acid (UA) is associated with an increased risk of cardiovascular disease and worse clinical outcome in patients with cardiovascular disease. Nevertheless, the prognostic value of serum UA level in hospitalized heart failure patients with preserved ejection fraction (HFpEF) has not been fully elucidated. The aim of this study was to investigate whether serum UA level on admission could be associated with subsequent mortality in hospitalized patients with HFpEF. We examined 516 consecutive hospitalized HFpEF (left ventricular ejection fraction ≥50%) patients with decompensated heart failure from our HFpEF-specific multicenter registry who had serum UA data on admission. The primary outcome of interest was all-cause death. During a median follow-up period of 749 (interquartile range 540 to 831) days, 90 (17%) patients died. Higher serum UA level was significantly related to increased incidence of all-cause death (p = 0.016). In addition, patients with higher serum UA (≥6.6 mg/dl, median) and plasma B-type natriuretic peptide (≥401.2 pg/ml, median) levels had the highest incidence of all-cause death in the groups (p = 0.002). In multivariable Cox regression analysis, serum UA was an independent determinant of mortality (hazards ratio 1.23, 95% confidence interval 1.10 to 1.39) even after adjustment for prespecified confounders, renal function and the use of diuretics before admission. In conclusions, higher admission serum UA was an independent determinant of mortality in hospitalized HFpEF patients. Our findings indicate the importance of assessing admission serum UA level for further risk stratification in hospitalized patients with HFpEF.

Differential Prognostic Impact of Atrial Fibrillation in Hospitalized Heart Failure Patients With Preserved Ejection Fraction According to Coronary Artery Disease Status - Report From the Japanese Nationwide Multicenter Registry.
Taro Temma, Toshiyuki Nagai, Masaya Watanabe, Rui Kamada, Yumi Takahashi, Hikaru Hagiwara, Taro Koya, Motoki Nakao, Kazunori Omote, Kiwamu Kamiya, Hiroyuki Iwano, Kazuhiro Yamamoto, Tsutomu Yoshikawa, Yoshihiko Saito, Toshihisa Anzai
Circulation journal : official journal of the Japanese Circulation Society, 84, 3, 397, 403, 2020年02月25日, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Atrial fibrillation (AF) is an important prognostic determinant in heart failure (HF) with preserved ejection fraction (HFpEF). However, it is unclear which HFpEF phenotypes are affected by AF in terms of long-term clinical outcomes because HFpEF is a heterogeneous syndrome with comorbidities such as coronary artery disease (CAD). In this study we determined the differential prognostic significance of AF in HFpEF patients according to CAD status.Methods and Results:Data for 408 hospitalized HFpEF patients enrolled in the Japanese Heart Failure Syndrome with Preserved Ejection Fraction Nationwide Multicenter Registry were analyzed. Patients were divided into 4 groups according to the presence of AF and CAD. The primary outcome was the composite of all-cause death and HF rehospitalization. The incidence of adverse events was higher in the AF-non-CAD than non-AF-non-CAD group (P=0.004). On multivariable Cox regression analysis with prespecified confounders, AF-non-CAD was significantly associated with an increased risk of adverse events than non-AF-non-CAD (adjusted HR, 1.91; 95% CI: 1.02-3.92) regardless of the type of AF. In contrast, risk was comparable between the AF-CAD and non-AF-CAD groups (adjusted HR, 1.24; 95% CI: 0.64-2.47). CONCLUSIONS: In HFpEF patients without CAD, AF was independently related to adverse events, indicating that intensive management of AF would have more beneficial effects particularly in HFpEF patients without CAD.

Left ventricular outflow tract velocity time integral in hospitalized heart failure with preserved ejection fraction.
Kazunori Omote, Toshiyuki Nagai, Hiroyuki Iwano, Shingo Tsujinaga, Kiwamu Kamiya, Tadao Aikawa, Takao Konishi, Takuma Sato, Yoshiya Kato, Hirokazu Komoriyama, Yuta Kobayashi, Kazuhiro Yamamoto, Tsutomu Yoshikawa, Yoshihiko Saito, Toshihisa Anzai
ESC heart failure, 7, 1, 167, 175, 2020年02月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, AIMS: The prognostic implication of left ventricular outflow tract velocity time integral (LVOT-VTI) on admission in hospitalized heart failure with preserved ejection fraction (HFpEF) patients has not been determined. We sought to investigate whether LVOT-VTI on admission is associated with worse clinical outcomes in hospitalized patients with HFpEF. METHODS AND RESULTS: We studied consecutive 214 hospitalized HFpEF patients who had accessible LVOT-VTI data on admission, from a prospective HFpEF-specific multicentre registry. The primary outcome of interest was the composite of all-cause death and readmission due to heart failure. During a median follow-up period of 688 (interquartile range 162-810) days, the primary outcome occurred in 83 patients (39%). The optimal cut-off value of LVOT-VTI for the primary outcome estimated by receiver operating characteristic analysis was 15.8 cm. Lower LVOT-VTI was significantly associated with the primary outcome compared with higher LVOT-VTI (P = 0.005). Multivariable Cox regression analyses revealed that lower LVOT-VTI was an independent determinant of the primary outcome (hazard ratio 0.94, 95% confidence interval 0.91-0.98). In multivariable linear regression, haemoglobin level was the strongest independent determinant of LVOT-VTI among clinical parameters (β coefficient = -0.61, P = 0.007). Furthermore, patients with lower LVOT-VTI and anaemia had the worst clinical outcomes among the groups (P < 0.001). CONCLUSIONS: Lower admission LVOT-VTI was an independent determinant of worse clinical outcomes in hospitalized HFpEF patients, indicating that LVOT-VTI on admission might be useful for categorizing a low-flow HFpEF phenotype and risk stratification in hospitalized HFpEF patients.

Emery-Dreifuss muscular dystrophy as a possible cause of coronary embolism.
Atsushi Tada, Takao Konishi, Takuma Sato, Tomoya Sato, Takuya Koizumi, Sakae Takenaka, Yoshifumi Mizuguchi, Takahide Kadosaka, Ko Motoi, Yuta Kobayashi, Hirokazu Komoriyama, Yoshiya Kato, Kazunori Omote, Shingo Tsujinaga, Rui Kamada, Kiwamu Kamiya, Hiroyuki Iwano, Toshiyuki Nagai, Nanase Okazaki, Yoshihiro Matsuno, Toshihisa Anzai
Cardiology journal, 27, 4, 443, 444, 2020年, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）

Histopathologically confirmed very late stent thrombosis associated with stent fracture after implantation of first-generation drug eluting stent.
Takao Konishi, Naohiro Funayama, Tadashi Yamamoto, Daisuke Hotta, Yuta Kobayashi, Hirokazu Komoriyama, Yoshiya Kato, Kazunori Omote, Takuma Sato, Kiwamu Kamiya, Toshiyuki Nagai, Shinya Tanaka, Toshihisa Anzai
Cardiology journal, 27, 2, 204, 205, 2020年, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）

Four-dimensional flow magnetic resonance imaging visualizes significant changes in flow pattern and wall shear stress in the ascending aorta after transcatheter aortic valve implantation in a patient with severe aortic stenosis.
Hirokazu Komoriyama, Satonori Tsuneta, Noriko Oyama-Manabe, Kiwamu Kamiya, Toshiyuki Nagai
European heart journal cardiovascular Imaging, 21, 1, 21, 21, 2020年01月01日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）

収縮機能維持の心不全入院患者における入院時の三尖弁逆流圧較差の長期予後的意義 多施設レジストリーからの報告 TRPGとHFpEFにおける長期転帰(Long-term prognostic significance of admission tricuspid regurgitation pressure gradient in hospitalized heart failure patients with preserved ejection fraction: a report from the Japanese real-world multicenter registry: TRPG and long-term outcomes in HFpEF)
Omote Kazunori, Nagai Toshiyuki, Kamiya Kiwamu, Aikawa Tadao, Tsujinaga Shingo, Kato Yoshiya, Komoriyama Hirokazu, Iwano Hiroyuki, Yamamoto Kazuhiro, Yoshikawa Tsutomu, Saito Yoshihiko, Anzai Toshihisa
福田記念医療技術振興財団情報, 32, 41, 54, (公財)福田記念医療技術振興財団, 2019年12月
英語, 収縮機能維持心不全(HFpEF)多施設レジストリーにて、入院時に三尖弁逆流圧較差(TRPG)を測定した非代償性HFpEF患者(左室駆出分画≧50%)469名(女232名、平均78.3歳)を対象として、入院TRPGの予後的意義を検討した。主要評価項目は総死亡率とした。その結果、入院時TRPGは推定肺毛細血管楔入圧(PCWP)および左房径(LAD)と有意に相関した。追跡期間中央値の748日までに患者83名が死亡した。TRPG高値患者はTRPG低値患者に比べて有意に死亡率が高かった。多変量解析では、TRPG上昇が事前指定の交絡因子と腎機能による調整後の死亡率の独立決定因子であった。以上より、入院TRPG上昇はHFpEF入院患者の死亡率の独立決定因子であり、入院時のTRPGは有用なリスク分類の指標になると考えられた。

Long-term Prognostic Significance of Admission Tricuspid Regurgitation Pressure Gradient in Hospitalized Patients With Heart Failure With Preserved Ejection Fraction: A Report From the Japanese Real-World Multicenter Registry.
Kazunori Omote, Toshiyuki Nagai, Kiwamu Kamiya, Tadao Aikawa, Shingo Tsujinaga, Yoshiya Kato, Hirokazu Komoriyama, Hiroyuki Iwano, Kazuhiro Yamamoto, Tsutomu Yoshikawa, Yoshihiko Saito, Toshihisa Anzai
Journal of cardiac failure, 25, 12, 978, 985, 2019年12月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Doppler-estimated peak systolic tricuspid regurgitation pressure gradient (TRPG) is a representative noninvasive parameter for evaluating pulmonary artery systolic pressure, which can be a determinant of adverse outcomes in chronic heart failure with preserved ejection fraction (HFpEF). However, the prognostic implications of TRPG at admission for hospitalized patients with HFpEF are undetermined. METHODS AND RESULTS: We examined 469 consecutive hospitalized patients with decompensated HFpEF (left ventricular ejection fraction ≥ 50%) who underwent TRPG measurement at admission in our HFpEF multicenter registry. The primary outcome of interest was all-cause death. Admission TRPG was significantly correlated with estimated pulmonary capillary wedge pressure and left atrial dimension (r = 0.24, P < 0.001 and r = 0.21, P < 0.001, respectively). During a median follow-up period of 748 (IQR 540-820) days, 83 patients died. Higher TRPG was significantly associated with higher mortality compared to lower TRPG (log-rank; P = 0.007). Multivariable analysis revealed that elevated TRPG was an independent determinant of mortality (HR 1.02, 95% CI 1.01-1.04, P = 0.008) after adjustment for prespecified confounders and renal function. CONCLUSIONS: Elevated TRPG at admission was an independent determinant of mortality in hospitalized patients with HFpEF, indicating that TRPG at admission could be a useful marker for risk stratification in these patients.

心不全における肺動脈圧波形上のv波出現の意義に関する検討　　　　　　　　　　　　　　　
岩野 弘幸, 横山 しのぶ, 石坂 傑, 千葉 泰之, 更科 美羽, 辻永 真吾, 中鉢 雅大, 加賀 早苗, 神谷 究, 永井 利幸, 安斉 俊久
日本心臓病学会学術集会抄録, 67回, O, 281, (一社)日本心臓病学会, 2019年09月
日本語

心筋梗塞後偽性仮性左室瘤に収縮性心膜炎の合併が考えられた1例　　　　　　　　　　　　　　　
甲谷 太郎, 神谷 究, 千葉 泰之, 岩野 弘幸, 納谷 昌直, 永井 利幸, 松居 喜郎, 安斉 俊久
日本心臓病学会学術集会抄録, 67回, P, 180, (一社)日本心臓病学会, 2019年09月
日本語

エイコサペンタエン酸治療と冠動脈プラーク安定性の関連性についての検討 光干渉断層診断法を用いた検討　　　　　　　　　　　　　　　
小西 崇夫, 小林 雄太, 小森山 弘和, 加藤 喜哉, 表 和徳, 相川 忠夫, 佐藤 琢真, 神谷 究, 永井 利幸, 須永 大介, 舟山 直宏, 山本 匡, 堀田 大介, 安斉 俊久
日本心血管インターベンション治療学会抄録集, 28回, [MO6, 001], (一社)日本心血管インターベンション治療学会, 2019年09月
英語

心電図同期SPECTが虚血領域評価に有用であった冠動脈バイパス術後の1例　　　　　　　　　　　　　　　
小林 雄太, 相川 忠夫, 永井 利幸, 神谷 究, 小西 崇夫, 佐藤 琢真, 表 和徳, 加藤 喜哉, 小森山 弘和, 安斉 俊久
日本心血管インターベンション治療学会抄録集, 28回, [MP15, 003], (一社)日本心血管インターベンション治療学会, 2019年09月
英語

Abnormal FDG uptake predicting the instability of thoracic aortic aneurysms.
Yasuyuki Chiba, Kiwamu Kamiya, Tadao Aikawa, Hiroyuki Iwano, Toshiyuki Nagai, Takahiro Ishigaki, Yasushige Shingu, Ai Shimizu, Yoshiro Matsui, Toshihisa Anzai
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 27, 5, 1841, 1843, 2019年08月27日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）

Early therapeutic effects of adaptive servo-ventilation on cardiac sympathetic nervous function in patients with heart failure evaluated using a combination of 11C-HED PET and 123I-MIBG SPECT.
Yusuke Tokuda, Mamoru Sakakibara, Keiichiro Yoshinaga, Shiro Yamada, Kiwamu Kamiya, Naoya Asakawa, Takashi Yoshitani, Keiji Noguchi, Osamu Manabe, Nagara Tamaki, Hiroyuki Tsutsui
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 26, 4, 1079, 1089, 2019年08月, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, RATIONALE: Adaptive servo-ventilation (ASV), a novel respiratory support therapy for sleep disorders, may improve cardiac function in heart failure (HF). However, the reasons that ASV improves cardiac function have not been fully studied especially in sympathetic nervous function (SNF). The purpose of the present study was to investigate the effects of ASV therapy on cardiac SNF in patients with HF. METHODS: We evaluated ASV therapeutic effects before and 6 months after ASV therapy in 9 HF patients [57.3 ± 17.3 years old, left ventricular ejection fraction (LVEF) 36.1 ± 16.7%]. We performed echocardiography, polysomnography, biomarkers, 11C-hydroxyephedrine (HED) PET as a presynaptic function marker and planar 123I-metaiodobenzylguanidine (MIBG) to evaluate washout rate. RESULTS: ASV therapy reduced apnea-hypopnea index (AHI) and improved plasma brain natriuretic peptide (BNP) concentration. In 123I-MIBG imaging, the early heart/mediastinum (H/M) ratio increased after ASV therapy (2.19 ± 0.58 to 2.40 ± 0.67; P = 0.045). Washout rate did not change (23.8 ± 7.3% to 23.8 ± 8.8%; P = 0.122). Global 11C-HED retention index (RI) improved from 0.068 ± 0.033/s to 0.075 ± 0.034/s (P = 0.029). CONCLUSIONS: ASV reduced AHI and improved BNP. ASV might initially improve presynaptic cardiac sympathetic nervous function in HF patients after 6 months of treatment.

Impact of admission liver stiffness on long-term clinical outcomes in patients with acute decompensated heart failure.
Kazunori Omote, Toshiyuki Nagai, Naoya Asakawa, Kiwamu Kamiya, Yusuke Tokuda, Tadao Aikawa, Arata Fukushima, Keiji Noguchi, Yoshiya Kato, Hirokazu Komoriyama, Mutsumi Nishida, Yusuke Kudo, Hiroyuki Iwano, Takashi Yokota, Toshihisa Anzai
Heart and vessels, 34, 6, 984, 991, 2019年06月, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, Liver stiffness (LS) has been reported to be a marker of liver congestion caused by elevated central venous pressure in heart failure (HF) patients. Recent studies demonstrated that LS could be non-invasively measured by virtual touch quantification (VTQ). However, its prognostic implication in patients with acute decompensated heart failure (ADHF) is unclear. This study sought to determine whether LS measured by VTQ could be a determinant of subsequent adverse events in ADHF patients. We prospectively recruited 70 ADHF patients who underwent LS measurement by VTQ on admission in our university hospital between June 2016 and April 2018. The primary outcome of interest was the composite of all-cause mortality and worsening HF. During a median follow-up period of 272 (interquartile range 122-578) days, there were 26 (37%) events, including 5 (7%) deaths and 21 (30%) cases of worsening HF. The c-index of LS for predicting the composite of adverse events was 0.77 (95% CI 0.66-0.88), and the optimal cut-off value of LS was 1.50 m/s. Adverse events were more frequently observed in patients with high LS (≥ 1.50 m/s) compared to those with low LS (< 1.50 m/s). Multivariable Cox regression analyzes revealed that higher LS was independently associated with increased subsequent risk of adverse events after adjustment for confounders. In conclusion, high admission LS was an independent determinant of worse clinical outcomes in patients with ADHF. This finding suggests that LS on admission is useful for risk stratification of patients with ADHF.

Endomyocardial fibrosis presenting as apical calcification and infective endocarditis.
Tadao Aikawa, Kiwamu Kamiya, Tomoko Mitsuhashi, Toshihisa Anzai
European heart journal, 40, 12, 1016, 1016, 2019年03月21日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）

心不全患者におけるMRエラストグラフィで評価した肝硬度の増加は右心房圧の上昇を予測する(Increased Liver Stiffness Assessed by Magnetic Resonance Elastography Predicts Elevated Right Atrial Pressure in Patients with Heart Failure)　　　　　　　　　　　　　　　
加藤 喜哉, 永井 利幸, 小森山 弘和, 表 和徳, 相川 忠夫, 神谷 究, 常田 慧徳, 真鍋 徳子[大山], 安斉 俊久
日本循環器学会学術集会抄録集, 83回, PJ096, 6, (一社)日本循環器学会, 2019年03月, ［査読有り］
英語

18F-FDG uptake of the right ventricle is an important predictor of histopathologic diagnosis by endomyocardial biopsy in patients with cardiac sarcoidosis.
Kazunori Omote, Masanao Naya, Kazuhiro Koyanagawa, Tadao Aikawa, Osamu Manabe, Toshiyuki Nagai, Kiwamu Kamiya, Yoshiya Kato, Hirokazu Komoriyama, Masato Kuzume, Nagara Tamaki, Toshihisa Anzai
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 27, 6, 2135, 2143, 2019年01月04日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: The aim of this study was to determine whether right ventricle (RV) 18F-fluorodeoxyglucose (FDG) uptake can predict positive findings of endomyocardial biopsy (EMB) in patients with cardiac sarcoidosis (CS). METHODS: 70 consecutive patients with clinically diagnosed CS who had undergone FDG PET were registered in the present study. Patients without EMB (n = 42) were excluded. Ultimately, 28 patients were studied. EMB samples were obtained from the RV septum. We evaluated the FDG uptake on six segments (RV, left ventricle anterior, septal, lateral, inferior, and apex). RESULTS: Positive EMB was found in six patients (21%). Patients were divided into two groups according to positive (n = 12 [43%]) or negative (n = 16 [57%]) RV FDG uptake. Patients with positive RV FDG uptake had a significantly higher frequency of positive EMB than those without (42% vs. 6%, P = 0.024). On the other hand, there was no EMB-predictive value for the FDG uptakes in the other five segments, the cardiac metabolic volume, total lesion glycolysis, left ventricular ejection fraction, or any electrocardiogram findings. CONCLUSIONS: FDG uptake of the RV but no other heart segment was associated with positive EMB in CS patients. The presence of RV FDG uptake could improve the rate of positive EMB up to 42% in patients with CS.

A case of medical management of tricuspid regurgitation related to atrial fibrillation with constrictive pericarditis-like hemodynamics.
Yoshiya Kato, Arata Fukushima, Hiroyuki Iwano, Kiwamu Kamiya, Toshiyuki Nagai, Toshihisa Anzai
Journal of cardiology cases, 18, 5, 175, 179, 2018年11月, ［査読有り］, ［国内誌］
英語, Severe tricuspid regurgitation (TR) is reported to represent a hemodynamic pattern similar to that of constrictive pericarditis (CP), which should be clearly differentiated for appropriate management. We report the case of a patient with severe TR due to atrial fibrillation (AF) in whom hemodynamic monitoring played a role in the selection of the management strategy. An 81-year-old Japanese man with chronic AF was admitted due to worsening heart failure. Echocardiography showed the dilation of bilateral atria and a right ventricle with severe TR. The right heart catheterization demonstrated the elevation and equalization of diastolic pressures of four cardiac chambers with impaired diastolic filling pattern, which are hallmarks of pericardial constriction due to CP. Of note, the CP-like hemodynamics were completely normalized by 10 days of medical therapies including diuretics and carperitide. After his discharge and over a 1-year follow-up, he has never experienced worsening heart failure and remained NYHA class II with moderate TR. Medical management targeted at volume reduction and vasodilation can be a therapeutic option for CP-like hemodynamics in isolated severe TR related to AF. Repeated hemodynamic assessment is an appropriate tool to help our understanding of the CP-like physiology caused by severe TR based on chronic AF. .

心房細動に伴う心房拡大と高度三尖弁逆流によって収縮性心膜炎様の血行動態を呈した収縮能の保たれた心不全の一例　　　　　　　　　　　　　　　
加藤 喜哉, 福島 新, 表 和徳, 木村 銀河, 浅川 直也, 徳田 裕輔, 神谷 究, 岩野 弘幸
日本心臓病学会学術集会抄録, 65回, P, 219, (一社)日本心臓病学会, 2017年09月, ［査読有り］
日本語

Successful Percutaneous Transluminal Renal Angioplasty for Renal Artery Stenosis Due to Fibromuscular Dysplasia in Bilateral Renal Artery at Hilum
Kazunori Omote, Kiwamu Kamiya
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 69, 16, S341, S342, ELSEVIER SCIENCE INC, 2017年04月, ［査読有り］
英語

Utility of Intracardiac Echocardiography in Antegrade Balloon Aortic Valvuloplasty for Severe Aortic Stenosis
Kiwamu Kamiya
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 69, 16, S87, S88, ELSEVIER SCIENCE INC, 2017年04月, ［査読有り］
英語

Immunohistochemical identification of Propionibacterium acnes in granuloma and inflammatory cells of myocardial tissues obtained from cardiac sarcoidosis patients.
Naoya Asakawa, Keisuke Uchida, Mamoru Sakakibara, Kazunori Omote, Keiji Noguchi, Yusuke Tokuda, Kiwamu Kamiya, Kanako C Hatanaka, Yoshihiro Matsuno, Shiro Yamada, Kyoko Asakawa, Yuichiro Fukasawa, Toshiyuki Nagai, Toshihisa Anzai, Yoshihiko Ikeda, Hatsue Ishibashi-Ueda, Masanori Hirota, Makoto Orii, Takashi Akasaka, Kenta Uto, Yasushige Shingu, Yoshiro Matsui, Shin-Ichiro Morimoto, Hiroyuki Tsutsui, Yoshinobu Eishi
PloS one, 12, 7, e0179980, PUBLIC LIBRARY SCIENCE, 2017年, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Although rare, cardiac sarcoidosis (CS) is potentially fatal. Early diagnosis and intervention are essential, but histopathologic diagnosis is limited. We aimed to detect Propionibacterium acnes, a commonly implicated etiologic agent of sarcoidosis, in myocardial tissues obtained from CS patients. METHODS AND RESULTS: We examined formalin-fixed paraffin-embedded myocardial tissues obtained by surgery or autopsy and endomyocardial biopsy from patients with CS (n = 26; CS-group), myocarditis (n = 15; M-group), or other cardiomyopathies (n = 39; CM-group) using immunohistochemistry (IHC) with a P. acnes-specific monoclonal antibody. We found granulomas in 16 (62%) CS-group samples. Massive (≥14 inflammatory cells) and minimal (<14 inflammatory cells) inflammatory foci, respectively, were detected in 16 (62%) and 11 (42%) of the CS-group samples, 10 (67%) and 10 (67%) of the M-group samples, and 1 (3%) and 18 (46%) of the CM-group samples. P. acnes-positive reactivity in granulomas, massive inflammatory foci, and minimal inflammatory foci were detected in 10 (63%), 10 (63%), and 8 (73%) of the CS-group samples, respectively, and in none of the M-group and CM-group samples. CONCLUSIONS: Frequent identification of P. acnes in sarcoid granulomas of originally aseptic myocardial tissues suggests that this indigenous bacterium causes granuloma in many CS patients. IHC detection of P. acnes in massive or minimal inflammatory foci of myocardial biopsy samples without granulomas may be useful for differentiating sarcoidosis from myocarditis or other cardiomyopathies.

Successful Evaluation for Reversibility of Pulmonary Hypertension Using Inhaled Nitric Oxide Determining Candidate for Heart Transplantation
Kazunori Omote, Mamoru Sakakibara, Hideo Nanbu, Satoshi Maekawa, Naoya Asakawa, Keiji Noguchi, Yusuke Tokuda, Kiwamu Kamiya, Shintaro Kinugawa, Hiroyuki Tsutsui
JOURNAL OF CARDIAC FAILURE, 22, 9, S228, S229, CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS, 2016年09月, ［査読有り］
英語

Higher Hemoglobin A1c After Discharge Is an Independent Predictor of Adverse Outcomes in Patients With Acute Coronary Syndrome - Findings From the PACIFIC Registry.
Keiji Noguchi, Mamoru Sakakibara, Naoya Asakawa, Yusuke Tokuda, Kiwamu Kamiya, Takashi Yoshitani, Koji Oba, Katsumi Miyauchi, Yuji Nishizaki, Hisao Ogawa, Hiroyoshi Yokoi, Masayasu Matsumoto, Masafumi Kitakaze, Takeshi Kimura, Tetsuo Matsubara, Yuji Ikari, Kazuo Kimura, Hideki Origasa, Takaaki Isshiki, Yoshihiro Morino, Hiroyuki Daida, Hiroyuki Tsutsui
Circulation journal : official journal of the Japanese Circulation Society, 80, 7, 1607, 14, 2016年06月24日, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Optimal medical therapy (OMT) and the management of coronary risk factors are necessary for secondary prevention of major adverse cardiac and cerebrovascular events (MACCE) in post-acute coronary syndrome (ACS) patients. However, the effect of post-discharge patient adherence has not been investigated in Japanese patients. METHODS AND RESULTS: The Prevention of AtherothrombotiC Incidents Following Ischemic Coronary Attack (PACIFIC) registry was a multicenter, prospective observational study of 3,597 patients with ACS. Death or MACCE occurred in 229 patients between hospitalization and up to 1 year after discharge. Among 2,587 patients, the association between OMT adherence and risk factor control at 1 year and MACCE occurring between 1 and 2 years after discharge was assessed. OMT was defined as the use of antiplatelet agents, angiotensin-converting enzyme inhibitors, β-blockers, and statins. Risk factor targets were: low-density lipoprotein-cholesterol <100 mg/dl, HbA1c <7.0%, non-smoking status, blood pressure <130/80 mmHg, and 18.5≤body mass index≤24.9 kg/m(2). The incidence of MACCE was 1.8% and associated with female sex (P=0.020), age ≥75 years (P=0.004), HbA1c ≥7.0% (P=0.004), LV ejection fraction <35% (P<0.001), estimated glomerular filtration rate <60 ml/min (P=0.008), and history of cerebral infarction (P=0.003). In multivariate analysis, lower post-discharge HbA1c was strongly associated with a lower risk of MACCE after ACS (P=0.004). CONCLUSIONS: Hyperglycemia after discharge is a crucial target for the prevention of MACCE in post-ACS patients. (Circ J 2016; 80: 1607-1614).

Value of Virtual Touch Quantification Elastography for Assessing Liver Congestion in Patients With Heart Failure.
Takashi Yoshitani, Naoya Asakawa, Mamoru Sakakibara, Keiji Noguchi, Yusuke Tokuda, Kiwamu Kamiya, Hiroyuki Iwano, Satoshi Yamada, Yusuke Kudou, Mutsumi Nishida, Chikara Shimizu, Toraji Amano, Hiroyuki Tsutsui
Circulation journal : official journal of the Japanese Circulation Society, 80, 5, 1187, 95, JAPANESE CIRCULATION SOC, 2016年04月25日, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Heart failure (HF) causes organ congestion, which is thought to increase organ stiffness. The virtual touch quantification (VTQ) method can be used to assess liver stiffness in patients with chronic liver diseases. This study aimed to measure liver and kidney stiffness using VTQ and to determine its value for assessing organ congestion in patients with HF. METHODS AND RESULTS: This study included 10 normal subjects and 38 HF patients (age 52.3±16.7 years, left ventricular ejection fraction 27.0±9.4%, plasma B-type natriuretic peptide [BNP] 1,297.3±1,155.1 pg/ml). We investigated the relationships between clinical characteristics and hemodynamics and liver and kidney stiffness, and assessed the effects of medical treatment on these measurements. Liver stiffness was significantly higher in HF patients (1.17±0.13 m/s vs. 2.03±0.91 m/s, P=0.004) compared with normal subjects, but kidney stiffness was similar in both groups. Central venous pressure (CVP) (P=0.021) and BNP (P=0.025) were independent predictive factors for increased liver stiffness in HF patients. Liver stiffness decreased significantly from 2.37±1.09 to 1.27±0.33 m/s (P<0.001) after treatment. Changes in liver stiffness in HF patients significantly correlated with changes in CVP (R=0.636, P=0.014) and cardiac index (R=-0.557, P=0.039) according to univariate analysis, and with changes in CVP in multivariate analysis. CONCLUSIONS: Liver stiffness measured by noninvasive VTQ methods can be used to assess liver congestion and therapeutic effects in patients with HF. (Circ J 2016; 80: 1187-1195).

Adaptive Servo-Ventilation Has More Favorable Acute Effects on Hemodynamics Than Continuous Positive Airway Pressure in Patients With Heart Failure.
Naoya Asakawa, Mamoru Sakakibara, Keiji Noguchi, Kiwamu Kamiya, Shiro Yamada, Takashi Yoshitani, Kota Ono, Koji Oba, Hiroyuki Tsutsui
International heart journal, 56, 5, 527, 32, 2015年, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, Adaptive servo-ventilation (ASV) has been attracting attention as a novel respiratory support therapy for heart failure (HF). However, the acute hemodynamic effects have not been compared between ASV and continuous positive airway pressure (CPAP) in HF patients.We studied 12 consecutive patients with stable chronic HF. Hemodynamic measurement was performed by right heart catheterization before and after CPAP 5 cmH2O, CPAP 10 cmH2O, and ASV for 15 minutes each.Heart rate, blood pressure, pulmonary capillary wedge pressure (PCWP), and stroke volume index (SVI) were not changed by any intervention. Right atrial pressure significantly increased after CPAP 10 cmH2O (3.6 ± 3.3 to 6.7 ± 1.6 mmHg, P = 0.005) and ASV (4.1 ± 2.6 to 6.8 ± 1.5 mmHg, P = 0.026). Cardiac index was significantly decreased by CPAP 10 cmH2O (2.3 ± 0.4 to 1.9 ± 0.3 L/minute/m(2), P = 0.048), but was not changed by ASV (2.3 ± 0.4 to 2.0 ± 0.3 L/ minute/m(2), P = 0.299). There was a significant positive correlation between baseline PCWP and % of baseline SVI by CPAP 10 cmH2O (r = 0.705, P < 0.001) and ASV (r = 0.750, P < 0.001). ASV and CPAP 10 cmH2O had significantly greater slopes of this correlation than CPAP 5 cmH2O, suggesting that patients with higher PCWP had a greater increase in SVI by ASV and CPAP 10 cmH2O. The relationship between baseline PCWP and % of baseline SVI by ASV was shifted upwards compared to CPAP 10 cmH2O. Furthermore, based on the results of a questionnaire, patients accepted CPAP 5 cmH2O and ASV more favorably compared to CPAP 10 cmH2O.ASV had more beneficial effects on acute hemodynamics and acceptance than CPAP in HF patients.

Serum choline plasmalogens-those with oleic acid in sn-2-are biomarkers for coronary artery disease.
Megumi Nishimukai, Ryouta Maeba, Akiko Ikuta, Naoya Asakawa, Kiwamu Kamiya, Shiro Yamada, Takashi Yokota, Mamoru Sakakibara, Hiroyuki Tsutsui, Toshihiro Sakurai, Yuji Takahashi, Shu-Ping Hui, Hitoshi Chiba, Tomoki Okazaki, Hiroshi Hara
Clinica chimica acta; international journal of clinical chemistry, 437, 147, 54, ELSEVIER SCIENCE BV, 2014年11月01日, ［査読有り］, ［国際誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Identifying risk factors is crucial for preventing cardiovascular events, but there are no widely accepted predictive biomarkers. In our previous study of Japanese asymptomatic cohorts, we performed global analysis of serum ether glycerophospholipids (Egp) molecular profiles, and found that choline plasmalogens (PlsCho; 1-O-alk-1'-enyl-2-acyl-sn-glycero-3-phosphocholine), particularly those containing oleic acid (18:1) in the sn-2 position, were strongly associated with a wide range of risk factors for metabolic syndrome/atherosclerosis. METHODS: We determined serum concentrations of Egp molecular species of coronary artery disease patients (n=50; 31 males and 19 females) by LC/MS/MS, and plasmalogen (Pls; 1-O-alk-1'-enyl-2-acyl-sn-glycerophospholipids) contents in lipoprotein fractions by HPLC using radioactive iodine. RESULTS: We found that the serum concentrations of ether choline glycerophospholipids (EgpCho), particularly PlsCho, were not only significantly lower in males with significant coronary stenosis but also associated with atherosclerosis-related parameters, and their association was stronger than either high-density lipoprotein cholesterol or adiponectin. In addition, serum PlsCho containing 18:1 or linoleic acid (18:2) in sn-2 showed the highest correlations with a wide range of atherogenic parameters among PlsCho molecular species. CONCLUSION: These results verify our previous findings that serum PlsCho, particularly those containing 18:1 in sn-2, may serve as reliable biomarkers for atherosclerosis.

ADAPTIVE SERVO-VENTILATION IMPROVES CARDIAC SYMPATHETIC NERVE ACTIVITY IN PATIENTS WITH HEART FAILURE BY EVALUATION OF 11C-HYDROXYEPHEDRINE POSITRON EMISSION TOMOGRAPHY
Shiro Yamada, Mamoru Sakakibara, Kiwamu Kamiya, Naoya Asakawa, Takashi Yoshitani, Satoshi Yamada, Keiichiro Yoshinaga, Hiroyuki Tsutsui
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 63, 12, A1016, A1016, ELSEVIER SCIENCE INC, 2014年04月, ［査読有り］
英語

Cardiac magnetic resonance performs better in the detection of functionally significant coronary artery stenosis compared to single-photon emission computed tomography and dobutamine stress echocardiography.
Kiwamu Kamiya, Mamoru Sakakibara, Naoya Asakawa, Shiro Yamada, Takashi Yoshitani, Hiroyuki Iwano, Hiroshi Komatsu, Masanao Naya, Satoru Chiba, Satoshi Yamada, Osamu Manabe, Yasuka Kikuchi, Noriko Oyama-Manabe, Koji Oba, Hiroyuki Tsutsui
Circulation journal : official journal of the Japanese Circulation Society, 78, 10, 2468, 76, 2014年, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Fractional flow reserve (FFR) measured on catheterization is now widely used for the diagnosis of functional myocardial ischemia in patients with coronary artery disease (CAD). FFR, however, is invasive and carries potential procedural complications. Therefore, the aim of this study was to compare the diagnostic capability in functionally significant stenosis identified on FFR, between cardiac magnetic resonance myocardial perfusion imaging (CMR-MPI), single-photon emission computed tomography MPI (SPECT-MPI), and dobutamine stress echocardiography (DSE) in patients with CAD. METHODS AND RESULTS: A total of 25 patients who had at least 1 angiographic stenosis ≥50% on coronary angiography was studied. CMR-MPI, SPECT-MPI and DSE were done before FFR measurement. FFR was measured in all 3 major epicardial coronary arteries. Out of 71 vascular territories excluding 4 territories due to inadequate imaging, 29 (41%) had FFR <0.80. The sensitivity of CMR-MPI was significantly higher than that of SPECT-MPI and DSE (P=0.02 and P=0.001, respectively). The area under the receiver operating characteristic curve (AUC) for CMR-MPI (AUC, 0.92) was significantly greater than for SPECT-MPI (AUC, 0.73; P=0.006) and DSE (AUC, 0.69; P<0.001). CONCLUSIONS: CMR-MPI performed well in the detection of functionally significant stenosis defined according to FFR, and had the highest diagnostic sensitivity among the 3 modalities tested in patients with CAD.

慢性心不全患者に対するAdaptive Servo-Ventilation(ASV)導入時のクリニカルパスの有用性　　　　　　　　　　　　　　　
石川幸司, 榊原 守, 山田史郎, 神谷 究, 浅川直也, 高岡勇子, 筒井裕之
日本心臓病学会誌, 8, 2, 107, 117, 2013年04月, ［査読有り］

Acute hemodynamic effects of adaptive servo-ventilation in patients with heart failure.
Shiro Yamada, Mamoru Sakakibara, Takashi Yokota, Kiwamu Kamiya, Naoya Asakawa, Hiroyuki Iwano, Satoshi Yamada, Koji Oba, Hiroyuki Tsutsui
Circulation journal : official journal of the Japanese Circulation Society, 77, 5, 1214, 20, 2013年, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Adaptive servo-ventilation (ASV) improves cardiac function in patients with heart failure (HF). We compared the hemodynamics of control and HF patients, and identified the predictors for acute effects of ASV in HF. METHODS AND RESULTS: We performed baseline echocardiographic measurements and hemodynamic measurements at baseline and after 15 min of ASV during cardiac catheterization in 11 control and 34 HF patients. Heart rate and blood pressure did not change after ASV in either the control or HF group. Stroke volume index (SVI) decreased from 49.3±7.6 to 41.3±7.6 ml/m2 in controls (P<0.0001) but did not change in the HF patients (from 34.8±11.5 to 32.8±8.9 ml/m2, P=0.148). In the univariate analysis, pulmonary capillary wedge pressure (PCWP), mitral regurgitation (MR)/left atrial (LA) area, E/A, E/e', and the sphericity index defined by the ratio between the short-axis and long-axis dimensions of the left ventricle significantly correlated with % change of SVI from baseline during ASV. PCWP and MR/LA area were independent predictors by multivariate analysis. Moreover, responders (15 of 34 HF patients; 44%) categorized by an increase in SVI showed significantly higher PCWP, MR, and sphericity index. CONCLUSIONS: Left ventricular structure and MR, as well as PCWP, could predict acute favorable effects on hemodynamics by ASV therapy in HF patients.

Diffuse large B-cell lymphoma diagnosed by intracardiac echocardiography-guided cardiac tumor biopsy.
Kiwamu Kamiya, Mamoru Sakakibara, Shiro Yamada, Michinao Tan, Takaaki Furihata, Kanako Kubota, Hiroyuki Tsutsui
Internal medicine (Tokyo, Japan), 51, 9, 1043, 7, JAPAN SOC INTERNAL MEDICINE, 2012年, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, A 44-year-old man presented with exertional dyspnea. Transthoracic echocardiography (TTE) revealed a large tumor protruding into the right atrium and extending into the left ventricle. Cardiac magnetic resonance imaging and contrast enhanced computed tomography also confirmed the intracardiac tumor detected by TTE. An endomyocardial biopsy was performed under the intracardiac echocardiography (ICE) guidance, and he was diagnosed to have diffuse large B-cell lymphoma following the histological analysis. ICE-guided cardiac tumor biopsy is expected to be a useful diagnostic strategy that can minimize the risk of procedural complications.

Sleep-disordered breathing is an independent risk factor of aborted sudden cardiac arrest in patients with coronary artery spasm.
Mamoru Sakakibara, Shiro Yamada, Kiwamu Kamiya, Takashi Yokota, Koji Oba, Hiroyuki Tsutsui
Circulation journal : official journal of the Japanese Circulation Society, 76, 9, 2204, 10, 2012年, ［査読有り］, ［国内誌］
英語, 研究論文（学術雑誌）, BACKGROUND: Sleep-disordered breathing (SDB) is often associated with sudden cardiac arrest (SCA) during sleep. Coronary artery spasm (CS) also occurs during sleep and is rarely associated with SCA, but the role of SDB in the risk of SCA is unknown in CS patients. This study evaluated the breathing patterns during sleep in CS patients with a prior history of aborted SCA. METHODS AND RESULTS: This study enrolled 24 patients (age 61.6 ± 11.0 years, male/female 19/5) with CS proven by an acetylcholine provocation test. They were divided into 2 groups: prior history of aborted SCA due to fatal arrhythmia (SCA group; n=9) and no such history (no-SCA group; n=15). Patients underwent overnight polysomnography with ambulatory electrocardiography. The overall prevalence of SDB (apnea hypopnea index ≥15) was 45.8% in this cohort. SDB was more frequent in the SCA group than in the no-SCA group (88.9% vs. 20.0% P=0.001) and identified as a pivotal risk factor of aborted SCA (odds ratio: 38.9, 95% CI: 2.80-1,498.2, P=0.01). Very-low-frequency was significantly correlated with the apnea hypopnea index in patients with SCA (P=0.01, r=0.78) during sleep. CONCLUSIONS: SDB is a significant risk factor for SCA in CS patients and autonomic instability during sleep might be involved in this association.

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, 2023年

心臓サルコイドーシス患者における血清可溶性インターロイキン2レセプター高値は長期予後と関連する
小林雄太, 永井利幸, 平田健司, 常田慧徳, 加藤喜哉, 小森山弘和, 神谷究, 小西崇夫, 佐藤琢真, 表和徳, 工藤與亮, 今野哲, 安斉俊久, 日本サルコイドーシス/肉芽腫性疾患学会雑誌, 41, 2021年

慢性心不全における右室cardiac power outputの意義
千葉泰之, 岩野弘幸, 岩野弘幸, 本居昂, 石坂傑, 辻永真吾, 村山迪史, 横山しのぶ, 中鉢雅大, 西野久雄, 岡田一範, 加賀早苗, 神谷究, 永井利幸, 安斉俊久, 日本心臓病学会学術集会(Web), 69th, 2021年

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）

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）

VISUALIZATION OF PERIPROCEDUAL BLOOD FLOW DYNAMICS WITH FOUR-DIMENSIONAL FLOW MAGNETIC RESONANCE IMAGING IN PATIENTS WITH SEVERE AORTIC STENOSIS UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT
Hirokazu Komoriyama, Kiwamu Kamiya, Toshiyuki Nagai, Noriko Oyama-Manabe, Satonori Tsuneta, Yuta Kobayashi, Yoshiya Kato, Kazunori Omote, Takao Konishi, Takuma Sato, Shingo Tsujinaga, Hiroyuki Iwano, Yasushige Shingu, Satoru Wakasa, Toshihisa Anzai, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 75, 11, 1639, 1639, 2020年03月
ELSEVIER SCIENCE INC, 英語, 研究発表ペーパー・要旨（国際会議）

経カテーテル的大動脈弁置換術による左室機能の変化と左室外的仕事量との関連
辻永真吾, 岩野弘幸, 石坂傑, 千葉泰之, 更科美羽, 中鉢雅大, 神谷究, 永井利幸, 安斉俊久, 超音波医学 Supplement, 47, 2020年

Prognostic Value of Admission Serum Uric Acid in Hospitalized Heart Failure Patients With Preserved Ejection Fraction: A Report From the Japanese Real-world Multicenter Registry
Yuta Kobayashi, Kazunori Omote, Toshiyuki Nagai, Kiwamu Kamiya, Tadao Aikawa, Takao Konishi, Takuma Sato, Hiroyuki Iwano, Shingo Tsujinaga, Yoshiya Kato, Hirokazu Komoriyama, Kazuhiro Yamamoto, Tsutomu Yoshikawa, Yoshihiko Saito, 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）

Reduced Left Ventricular Ejection Fraction and Higher Angiotensin-Converting Enzyme Levels as Key Determinants of Histopathologic Diagnosis by Endomyocardial Biopsy in Patients With Cardiac Sarcoidosis
Hirokazu Komoriyama, Kazunori Omote, Toshiyuki Nagai, Yuta Kobayashi, Yoshiya Kato, Takuma Sato, Takao Konishi, Tadao Aikawa, Kiwamu Kamiya, Kazuhiro Koyanagawa, Shingo Tsujinaga, Hiroyuki Iwano, Hatsue Ueda, 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）

心不全患者におけるMagnetic Resonance Elastographyを用いた肝硬度測定による右房圧推定の有用性　　　　　　　　　　　　　　　
加藤 喜哉, 永井 利幸, 小林 雄太, 小森山 弘和, 表 和徳, 相川 忠夫, 佐藤 琢真, 小西 崇夫, 神谷 究, 安斉 俊久, 日本心臓病学会学術集会抄録, 67回, O, 315, 2019年09月
(一社)日本心臓病学会, 日本語

エイコサペンタエン酸治療と冠動脈プラーク安定性の関連性についての検討 光干渉断層診断法を用いた検討　　　　　　　　　　　　　　　
小西 崇夫, 小林 雄太, 小森山 弘和, 加藤 喜哉, 表 和徳, 相川 忠夫, 佐藤 琢真, 神谷 究, 永井 利幸, 須永 大介, 舟山 直宏, 山本 匡, 堀田 大介, 安斉 俊久, 日本心血管インターベンション治療学会抄録集, 28回, [MO6, 001], 2019年09月
(一社)日本心血管インターベンション治療学会, 英語

心電図同期SPECTが虚血領域評価に有用であった冠動脈バイパス術後の1例　　　　　　　　　　　　　　　
小林 雄太, 相川 忠夫, 永井 利幸, 神谷 究, 小西 崇夫, 佐藤 琢真, 表 和徳, 加藤 喜哉, 小森山 弘和, 安斉 俊久, 日本心血管インターベンション治療学会抄録集, 28回, [MP15, 003], 2019年09月
(一社)日本心血管インターベンション治療学会, 英語

心不全における肺動脈圧波形上のv波出現の意義に関する検討　　　　　　　　　　　　　　　
岩野 弘幸, 横山 しのぶ, 石坂 傑, 千葉 泰之, 更科 美羽, 辻永 真吾, 中鉢 雅大, 加賀 早苗, 神谷 究, 永井 利幸, 安斉 俊久, 日本心臓病学会学術集会抄録, 67回, O, 281, 2019年09月
(一社)日本心臓病学会, 日本語

心不全患者におけるMagnetic Resonance Elastographyを用いた肝硬度測定による右房圧推定の有用性　　　　　　　　　　　　　　　
加藤 喜哉, 永井 利幸, 小林 雄太, 小森山 弘和, 表 和徳, 相川 忠夫, 佐藤 琢真, 小西 崇夫, 神谷 究, 安斉 俊久, 日本心臓病学会学術集会抄録, 67回, O, 315, 2019年09月
(一社)日本心臓病学会, 日本語

心筋梗塞後偽性仮性左室瘤に収縮性心膜炎の合併が考えられた1例
甲谷 太郎, 神谷 究, 千葉 泰之, 岩野 弘幸, 納谷 昌直, 永井 利幸, 松居 喜郎, 安斉 俊久, 日本心臓病学会学術集会抄録, 67回, P, 180, 2019年09月
(一社)日本心臓病学会, 日本語

LONG-TERM PROGNOSTIC SIGNIFICANCE OF ADMISSION TRICUSPID REGURGITANT PRESSURE GRADIENT IN HOSPITALIZED HEART FAILURE PATIENTS WITH PRESERVED EJECTION FRACTION: A REPORT FROM JAPANESE REAL-WORLD MULTICENTER REGISTRY
Kazunori Omote, Toshiyuki Nagai, Kiwamu Kamiya, Tadao Aikawa, Yoshiya Kato, Hirokazu Komoriyama, Hiroyuki Iwano, Kazuhiro Yamamoto, Tsutomu Yoshikawa, Yoshihiko Saito, Toshihisa Anzai, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 73, 9, 807, 807, 2019年03月
ELSEVIER SCIENCE INC, 英語, 研究発表ペーパー・要旨（国際会議）

Increased Liver Stiffness Assessed by Magnetic Resonance Elastography Predicts Elevated Right Atrial Pressure in Patients with Heart Failure(和訳中)
加藤 喜哉, 永井 利幸, 小森山 弘和, 表 和徳, 相川 忠夫, 神谷 究, 常田 慧徳, 真鍋(大山) 徳子, 安斉 俊久, 日本循環器学会学術集会抄録集, 83回, PJ096, 6, 2019年03月
(一社)日本循環器学会, 英語

Serum Troponin T as a Determinant of Drug-Induced Heart Failure Development in Patients Treated With Cyclophosphamide
Kiwamu Kamiya, Toshiyuki Nagai, Hirokazu Komoriyama, Yoshiya Kato, Kazunori Omote, Tadao Aikawa, Keiji Noguchi, Yusuke Tokuda, Hiroyuki Iwano, 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）

18F-FDG Uptake of the Right Ventricle is an Important Predictor of Histopathologic Diagnosis by Endomyocardial Biopsy in Patients With Cardiac Sarcoidosis.
Kazunori Omote, Masanao Naya, Kazuhiro Koyanagawa, Tadao Aikawa, Osamu Manabe, Toshiyuki Nagai, Kiwamu Kamiya, Yoshiya Kato, Hirokazu Komoriyama, Masato Kuzume, Nagara Tamaki, 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）

心臓サルコイドーシスにおける18F-FDG PETでの右室自由壁集積は心内膜下心筋生検陽性率と関連する
表 和徳, 納谷 昌直, 小梁川 和宏, 相川 忠夫, 真鍋 治, 永井 利幸, 神谷 究, 加藤 喜哉, 小森山 弘和, 葛目 将人, 玉木 長良, 安斉 俊久, 日本サルコイドーシス/肉芽腫性疾患学会雑誌, 38, サプリメント号, 68, 68, 2018年10月
日本サルコイドーシス, 日本語

右冠動脈へのPCI中に生じた逆行性冠動脈大動脈解離に対してBail out stentingを行った一例　　　　　　　　　　　　　　　
加藤 喜哉, 永井 利幸, 小森山 弘和, 表 和徳, 相川 忠夫, 神谷 究, 安斉 俊久, 日本心臓病学会学術集会抄録, 66回, EP, 069, 2018年09月
(一社)日本心臓病学会, 日本語

右冠動脈へのPCI中に生じた逆行性冠動脈大動脈解離に対してBail out stentingを行った一例
加藤 喜哉, 永井 利幸, 小森山 弘和, 表 和徳, 相川 忠夫, 神谷 究, 安斉 俊久, 日本心臓病学会学術集会抄録, 66回, EP, 069, 2018年09月
(一社)日本心臓病学会, 日本語

地域医療における心血管インターベンションのあるべき姿とは 北海道地域における経皮的冠動脈インターベンション施設の現状と取り組み　　　　　　　　　　　　　　　
神谷 究, 永井 利幸, 表 和徳, 加藤 喜哉, 小森山 弘和, 安斉 俊久, 日本心血管インターベンション治療学会抄録集, 27回, SY6, 2, 2018年08月
(一社)日本心血管インターベンション治療学会, 英語

地域医療における心血管インターベンションのあるべき姿とは 北海道地域における経皮的冠動脈インターベンション施設の現状と取り組み　　　　　　　　　　　　　　　
神谷 究, 永井 利幸, 表 和徳, 加藤 喜哉, 小森山 弘和, 安斉 俊久, 日本心血管インターベンション治療学会抄録集, 27回, SY6, 2, 2018年08月
(一社)日本心血管インターベンション治療学会, 英語

経皮的冠動脈インターベンション後に生じた放射線皮膚障害の4例
須貝達朗, 菊地一博, 安藤貴代, 足立功一, 飯田憲治, 神谷究, 坂井英世, 高平真, 中村裕之, 市立釧路総合病院医学雑誌, 30, 1, 75‐80, 2018年03月
日本語

腎動脈狭窄に全身性ALアミロイドーシス心病変を合併した1例
小泉拓也, 高橋将成, 甲谷太郎, 神谷究, 坂井英世, 日本循環器学会北海道地方会(Web), 119th, 2018年

心房細動に伴う心房拡大と高度三尖弁逆流によって収縮性心膜炎様の血行動態を呈した収縮能の保たれた心不全の一例
加藤喜哉, 福島新, 表和徳, 木村銀河, 浅川直也, 徳田裕輔, 神谷究, 岩野弘幸, 日本心臓病学会学術集会(Web), 65th, ROMBUNNO.P‐219 (WEB ONLY), 219, 2017年09月
(一社)日本心臓病学会, 日本語

収縮性心膜炎様の血行動態を呈し心不全をきたした高度三尖弁逆流に対して手術を施行した1例
林大知, 岩野弘幸, 神谷究, 辻永真吾, 市川絢子, 阿部歩, 中鉢雅大, 横山しのぶ, 山田聡, 日本心エコー図学会学術集会プログラム・抄録集(Web), 28th, ROMBUNNO.MP10‐6 (WEB ONLY), 2017年
日本語

左房粘液腫摘出術9年後に血性心嚢液貯留による心不全を来した1例
甲谷太郎, 高橋将成, 小泉拓也, 神谷究, 坂井英世, 稗田哲也, 杉木孝司, 上久保康弘, 井上玲, 飯村泰昭, 守田玲菜, 日本循環器学会北海道地方会(Web), 118th, HOKKAIDO118,34 (WEB ONLY), 2017年
日本語

心房拡大と高度三尖弁逆流により収縮性心膜炎様の血行動態を呈した収縮能の保たれた心不全の一例
加藤喜哉, 福島新, 表和徳, 木村銀河, 浅川直也, 徳田裕輔, 神谷究, 岩野弘幸, 日本循環器学会北海道地方会(Web), 117th, HOKKAIDO117,24 (WEB ONLY), 2017年
日本語

Sudden Cardiac Death in a Patient With Severe Heart Failure Despite Undergoing Cardiac Resynchronization Therapy With Defibrillators (CRT-D)
Rui Kamada, Hirofumi Mitsuyama, Mamoru Sakakibara, Yusuke Tokuda, Kiwamu Kamiya, Taro Tenma, Masaya Watanabe, Hisashi Yokoshiki, Hiroyuki Tsutsui, JOURNAL OF CARDIAC FAILURE, 22, 9, S231, S231, 2016年09月
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS, 英語, 研究発表ペーパー・要旨（国際会議）

HeartMate IIから離脱し得た拡張型心筋症の一症例
表 和徳, 榊原 守, 高橋 雅之, 浅川 直也, 野口 圭士, 徳田 祐輔, 神谷 究, 松島 将士, 絹川 真太郎, 大岡 智学, 松居 喜郎, 筒井 裕之, 日本心臓病学会学術集会抄録, 64回, P, 431, 2016年09月
(一社)日本心臓病学会, 日本語

HeartMate IIから離脱し得た拡張型心筋症の一症例
表 和徳, 榊原 守, 高橋 雅之, 浅川 直也, 野口 圭士, 徳田 祐輔, 神谷 究, 松島 将士, 絹川 真太郎, 大岡 智学, 松居 喜郎, 筒井 裕之, 日本心臓病学会学術集会抄録, 64回, P, 431, 2016年09月
(一社)日本心臓病学会, 日本語

【冠動脈疾患と降圧療法】 各論(作用機序も含めて) β遮断薬　　　　　　　　　　　　　　　
神谷 究, 筒井 裕之, 血圧, 23, 7, 486, 490, 2016年07月
高血圧治療ガイドライン2014(JSH2014)では、冠動脈疾患の降圧目標は原則140/90mmHg未満とJSH2009よりも高い値に改定されたが、糖尿病、CKDや脂質異常症などの高リスク症例においては、可能であれば130/80mmHg未満と、より低い目標が設定されている。JSH2014より、β遮断薬は「とくに積極的適応がない高血圧患者」に対する第一選択薬から除かれたが、主要降圧薬であることに変わりはなく、冠動脈疾患(狭心症および心筋梗塞後)は、心不全、頻脈と並び積極的適応疾患となる。また冠動脈疾患においては、降圧以外にも、症状の改善、心臓リモデリング・心不全の予防、生命予後改善をおもな目的として、β遮断薬を使用する。(著者抄録), (株)先端医学社, 日本語

冠動脈疾患と降圧療法 各論(作用機序も含めて)2)β遮断薬
神谷究, 筒井裕之, 血圧, 23, 7, 486‐490, 2016年07月01日
日本語

体うっ血の評価 拡散強調核磁気共鳴画像法(DW‐MRI)を用いた心不全における体うっ血の定量的評価
神谷究, 榊原守, 筒井裕之, Fluid Management Renaissance, 6, 1, 48‐53, 53, 2016年02月05日
心機能低下と腎臓および肝臓機能障害は、互いに悪影響を及ぼしながら独立した予後危険因子であることは広く知られている。体うっ血による臓器うっ血は、臓器障害の大きな要因である。体うっ血を確実かつ定量的に評価することは、心不全患者の臓器障害の進行防止、予後改善のために非常に重要と考えられる。近年のMRIの撮像機器や技術の進歩は目覚ましく、従来の形態学的な情報のみならず血流や代謝などさまざまな機能的情報の取得も可能となっている。拡散強調(DW)-MRIは水分子の拡散運動を画像化するMRIの代表的な機能的評価方法であり、特に超急性期の脳梗塞の診断に対する有用性が確立されている。最近では撮像方法の改良により頭部以外の評価にも幅広く使用されており、本稿では心臓および体うっ血評価としてのDW-MRIについて概説する。(著者抄録), (株)メディカルレビュー社, 日本語

進行性右心不全を呈した抗ミトコンドリア抗体陽性関連心筋症の一例
菅原佑貴, 神谷究, 齋藤晶理, 高橋雅之, 前川聡, 表和徳, 南部秀雄, 浅川直也, 三山博史, 日本循環器学会北海道地方会(Web), 116th, HOKKAIDO116,42 (WEB ONLY), 2016年
日本語

収縮性心膜炎類似の血行動態を呈した重症三尖弁閉鎖不全症の一例
神谷究, 岩野弘幸, 表和徳, 野口圭士, 徳田裕輔, 浅川直也, 三山博史, 山田聡, 日本循環器学会北海道地方会(Web), 116th, HOKKAIDO116,45 (WEB ONLY), 2016年
日本語

拡散強調核磁気共鳴画像法(DW-MRI)を用いた心不全における体うっ血の定量的評価 (特集 体うっ血の評価)
神谷 究, 榊原 守, 筒井 裕之, Fluid management renaissance, 6, 1, 48, 53, 2016年01月
メディカルレビュー社, 日本語

Virtual Touch Tissue Quantification(VTQ)法による硬度測定を用いた心不全患者における臓器うっ血の評価　　　　　　　　　　　　　　　
吉谷 敬, 榊原 守, 浅川 直也, 神谷 究, 野口 圭士, 徳田 裕輔, 筒井 裕之, 日本心臓病学会学術集会抄録, 63回, 171, 171, 2015年09月
(一社)日本心臓病学会, 日本語

特異な左室壁形態を呈した肥大型心筋症の一例
相川 忠夫, 納谷 昌直, 神谷 究, 横田 卓, 松島 将士, 筒井 裕之, 日本心臓病学会学術集会抄録, 63回, 851, 851, 2015年09月
(一社)日本心臓病学会, 日本語

マルチモダリティによるCardiac Imaging2015 臨床編 II MRIのストラテジー&アウトカム 臨床施設からの報告―心臓MRIの臨床的有用性と技術進歩 3.最新MRI装置を用いた心筋MR perfusion
真鍋徳子, 神谷究, Innervision, 30, 5, 36, 38, 2015年04月25日
日本語

【マルチモダリティによるCardiac Imaging 2015[臨床編] 非侵襲的心臓画像診断の形態情報から機能評価への展開】 MRIのストラテジー&アウトカム 臨床施設からの報告 心臓MRIの臨床的有用性と技術進歩 最新MRI装置を用いた心筋MR perfusion　　　　　　　　　　　　　　　
真鍋 徳子, 神谷 究, INNERVISION, 30, 5, 36, 38, 2015年04月
(株)インナービジョン, 日本語

二次性心筋症 心サルコイドーシス
神谷究, 筒井裕之, 医学のあゆみ, 252, 10, 1093, 1100, 2015年03月07日
日本語

心サルコイドーシス (第1土曜特集 心筋症Update) -- (二次性心筋症)
神谷 究, 筒井 裕之, 医学のあゆみ, 252, 10, 1093, 1100, 2015年03月07日
医歯薬出版, 日本語

薬剤性過敏症症候群(DIHS:drug-induced hypersensitivity syndrome)に合併した急性心筋炎の一例
須野賢一郎, 高橋雅之, 表和徳, 白川亮介, 辻永真吾, 神谷究, 斎藤晶理, 三山博史, 筒井裕之, 日本循環器学会北海道地方会(Web), 114th, 2015年

抗精神病薬による薬剤過敏性症候群を発症した4か月後に薬剤過敏性症候群関連心筋炎を呈した1例
神谷究, 榊原守, 表和徳, 高橋雅之, 野口圭士, 浅川直也, 徳田裕輔, 吉谷敬, 三山博史, 筒井裕之, 日本血管生物医学会学術集会プログラム・抄録集, 23rd, 2015年

心サルコイドーシスにおけるP.acnes特異的モノクローナル抗体の陽性率に関する検討
浅川直也, 榊原守, 野口圭士, 徳田祐輔, 神谷究, 吉谷敬, 畑中佳奈子, 山田史郎, 浅川響子, 深澤雄一郎, 永井利幸, 池田善彦, 植田初江, 森本紳一郎, 廣田真規, 折居誠, 赤坂隆史, 内田佳介, 江石義信, 筒井裕之, 日本血管生物医学会学術集会プログラム・抄録集, 23rd, 182, 2015年
日本語

石灰化部位に感染性心内膜炎を生じた心内膜心筋線維症の一例
相川忠夫, 松島将士, 中島孝之, 笹井春江, 松谷健一, 神谷究, 横田卓, 真鍋治, 納谷昌直, 三橋智子, 松居喜郎, 筒井裕之, 日本血管生物医学会学術集会プログラム・抄録集, 23rd, 184, 2015年
日本語

エラストを臨床に活かす Virtual Touch Quantification(VTQ)法による腎硬度測定を用いた心不全患者における腎うっ血の評価　　　　　　　　　　　　　　　
吉谷 敬, 榊原 守, 野口 圭士, 浅川 直也, 神谷 究, 工藤 悠輔, 西田 睦, 作原 祐介, 清水 力, 筒井 裕之, 超音波医学, 42, 1, 83, 83, 2015年01月
(一社)日本超音波医学会, 日本語

シクロフォスファミドによる薬剤性心筋症における心不全発症の治療前予測因子の検討　　　　　　　　　　　　　　　
野口 圭士, 榊原 守, 山田 史郎, 神谷 究, 浅川 直也, 吉谷 敬, 村井 大輔, 林 大知, 山田 聡, 筒井 裕之, 日本心臓病学会学術集会抄録, 62回, O, 296, 2014年09月
(一社)日本心臓病学会, 日本語

シクロフォスファマイドによる急速に進行した心原性ショックに対して、機械的サポート併用により救命できた全身性強皮症の1例　　　　　　　　　　　　　　　
神谷 究, 榊原 守, 野口 圭士, 浅川 直也, 山田 史郎, 吉谷 敬, 筒井 裕之, 日本心臓病学会学術集会抄録, 62回, O, 446, 2014年09月
(一社)日本心臓病学会, 日本語

解離性総肝動脈瘤・脾動脈瘤を合併したStanford B型大動脈解離の一例
松谷健一, 片山貴史, 神谷究, 松島将士, 横田卓, 榊原守, 筒井裕之, 日本循環器学会北海道地方会(Web), 112th, 2014年

デバイス関連感染性心内膜炎に対しエキシマレーザーによる経静脈的リード抜去が奏効した一例
徳田裕輔, 鎌田塁, 神谷究, 松島将士, 横田卓, 榊原守, 四倉昭彦, 筒井裕之, 日本循環器学会北海道地方会(Web), 112th, 2014年

冠動脈攣縮を有する患者において, 睡眠呼吸障害は, 心臓突然死の独立した危険因子である
榊原 守, 山田 史郎, 神谷 究, 横田 卓, 筒井 裕之, 大庭 幸治, 北海道醫學雜誌 = Acta medica Hokkaidonensia, 88, 1, 32, 32, 2013年01月01日
日本語

6) 経皮的中隔心筋焼灼術が著効した閉塞性肥大型心筋症の1例(第98回日本循環器学会北海道地方会)
水島 航, 五十嵐 康己, 津田 正哉, 神谷 究, 正木 芳弘, 野澤 篤史, 岩切 直樹, 牧野 隆雄, 福田 洋之, 加藤 法喜, 横式 尚司, 筒井 裕之, Circulation journal : official journal of the Japanese Circulation Society, 72, 0, 902, 902, 2008年04月20日
社団法人日本循環器学会, 日本語

3)CABG後8年目に発症した心外膜膿瘍の1例(第96回日本循環器学会北海道地方会)
正木 芳宏, 神谷 究, 水島 航, 野澤 篤史, 岩切 直樹, 牧野 隆雄, 五十嵐 康己, 福田 洋之, 加藤 法喜, Circulation journal : official journal of the Japanese Circulation Society, 71, 0, 823, 823, 2007年04月20日
社団法人日本循環器学会, 日本語