Updated on 2025/03/20

写真a

 
TANAKA Akihito
 
Organization
Nagoya University Hospital Cardiology Assistant Professor
Graduate School
Graduate School of Medicine
Title
Assistant Professor
External link

Degree 1

  1. 医学博士 ( 2018.3   名古屋大学 ) 

Education 1

  1. Nagoya University   Faculty of Medicine

    - 2004.3

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    Country: Japan

 

Papers 211

  1. Clinical implications of cerebral microbleeds in patients who undergo transcatheter aortic valve replacement Reviewed

    Uemura Y., Tanaka A., Ozaki Y., Yamaguchi S., Okajima T., Mitsuda T., Ishikawa S., Takemoto K., Murohara T., Watarai M.

    Cardiovascular Revascularization Medicine     2025

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Cardiovascular Revascularization Medicine  

    Background: The prognostic implications of cerebral microbleeds (CMBs) in patients who undergo transcatheter aortic valve replacement (TAVR) have not been fully elucidated. Therefore, we aimed to investigate the association between the presence of CMBs and adverse outcomes post-TAVR. Methods: In this single-center retrospective study, we included 124 patients who underwent brain magnetic resonance imaging before TAVR. The outcomes of interest were the subsequent incidences of stroke and all-cause death or admission for heart failure. Results: CMBs were identified in 32.2 % of the included patients. The median follow-up duration was 954 (interquartile range, 553–1306) days. The incidence of stroke after TAVR was comparable between patients with and without CMBs. Conversely, all-cause death or admission for heart failure was significantly higher in patients with CMBs than in those without (log-rank P = 0.010). Multivariate Cox regression analysis revealed that the presence of CMBs was independently correlated with the occurrence of all-cause death or admission for heart failure after adjusting for other prognostic predictors (hazard ratio 4.016, 95 % confidence interval 1.572–10.259, P = 0.007). Conclusion: The presence of CMBs predicts the incidence of all-cause death or admission for heart failure in patients undergoing TAVR. Evaluating CMBs could provide useful information for post-TAVR management.

    DOI: 10.1016/j.carrev.2024.12.013

    Scopus

  2. Feasibility and efficacy of real-time ultrasound-guided venous closure with suture-mediated vascular closure device Reviewed International journal

    Tachi M., Tanaka A., Teraoka T., Furuta T., Matsushita E., Hayashi K., Shimojo M., Yanagisawa S., Inden Y., Murohara T.

    Heart Rhythm   Vol. 21 ( 10 ) page: 2028 - 2036   2024.10

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    Authorship:Corresponding author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:Heart Rhythm  

    Background: Venous vascular access complications are usually nonfatal but are the most common complications after transvenous catheter intervention. Vascular closure devices (VCDs) have recently become available for venous closure. Objective: This study aimed to evaluate the feasibility and efficacy of real-time ultrasound-guided venous closure with suture-mediated VCDs in patients who underwent catheter ablation. Methods: This single-center observational study enrolled 226 consecutive patients who underwent elective catheter ablation with femoral venipuncture. For hemostasis, vessel closure by VCD was performed with real-time ultrasound guidance after 2022 (n = 123) and without ultrasound guidance in 2021 (n = 103). The occurrence of venous access site–related complications (major, minor, or other) was compared. Results: The rate of device failure was significantly lower in patients with ultrasound guidance than in those without (1.6% vs 6.3%; P = .048). The occurrence of all venous access site–related complications was significantly lower in patients with ultrasound guidance than in those without (4.9% vs 18.4%; P = .001). Time to ambulation was shorter in patients with ultrasound guidance than in those without (2.0 ± 0.1 hours vs 2.2 ± 0.6 hours; P < .001). Conclusion: Real-time ultrasound guidance can reduce device failure, access site–related complications, and time to ambulation in performing venous closure with a VCD.

    DOI: 10.1016/j.hrthm.2024.04.041

    Scopus

  3. Predictability of noninvasive liver fibrosis score for cardiac events in patients with nonalcoholic fatty liver disease Reviewed International journal

    Shibata N., Ito T., Toyoda H., Tanaka A., Morita Y., Kanzaki Y., Watanabe N., Yoshioka N., Yasuda S., Morishima I.

    Nutrition, Metabolism and Cardiovascular Diseases   Vol. 34 ( 9 ) page: 2115 - 2123   2024.9

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:Nutrition, Metabolism and Cardiovascular Diseases  

    Background and aims: Patients with nonalcoholic fatty liver disease (NAFLD) have a higher risk of cardiac events. However, although the severity of liver fibrosis is related to worsening prognosis in patients with NAFLD, it is unclear whether the noninvasive liver fibrosis score has a predictive value for cardiac events. Methods and results: We evaluated 4071 patients with NAFLD diagnosed using ultrasonography. Liver fibrosis was assessed and divided into three groups based on the Fibrosis-4 (FIB4) index and NAFLD fibrosis score (NFS). The primary outcome of this study was major adverse cardiac events (MACE), including cardiac death, nonfatal myocardial infarction, and revascularization due to coronary artery disease. The median age of the evaluated patients was 61 (52–69) years, and 2201 (54.1%) were male. During the median follow-up period of 6.6 years, 179 (4.4%) patients experienced MACE. Kaplan–Meier survival analysis demonstrated that MACE increased progressively with the FIB4 index (log-rank, p < 0.001) and NFS (log-rank, p < 0.001). Multivariable analysis showed that the higher the FIB4 index, the higher the risk for MACE (low group as reference vs. intermediate group, hazard ratio [HR]: 1.860 [95% confidence interval (CI), 1.326–2.610; p < 0.001]; vs. high group, HR:3.325 [95% CI, 2.017–5.479; p < 0.001]), as well as NFS (low NFS group as reference vs. intermediate group, HR: 1.938 [95% CI, 1.391–2.699; p < 0.001]; vs. high group, HR: 3.492 [95% CI, 1.997–6.105; p < 0.001]). Conclusions: The FIB4 index and NFS are associated with the probability of MACE in patients with NAFLD. Clinical trials: The study design was approved by the ethics review board of Ogaki Municipal Hospital (approval number: 20221124–12, registration date: November 28th, 2022). https://www.ogaki-mh.jp/chiken/kenkyu.html.

    DOI: 10.1016/j.numecd.2024.03.025

    Scopus

  4. Clinical Impacts of Urinary Neutrophil Gelatinase-Associated Lipocalin in Patients With Chronic Kidney Disease Undergoing Percutaneous Coronary Intervention Reviewed International journal

    Ozaki Yuta, Uemura Yusuke, Tanaka Akihito, Yamaguchi Shogo, Okajima Takashi, Mitsuda Takayuki, Ishikawa Shinji, Takemoto Kenji, Murohara Toyoaki, Watarai Masato

    Circulation Journal   Vol. 88 ( 6 ) page: 944 - 950   2024.5

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:The Japanese Circulation Society  

    <p><b><i>Background:</i></b> Chronic kidney disease (CKD) is associated with poor prognosis in patients undergoing percutaneous coronary intervention (PCI). Urinary neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker for renal injury. However, the association between urinary NGAL concentrations and renal and cardiovascular events in patients with CKD undergoing PCI has not been elucidated. This study investigated the clinical impact of urinary NGAL concentrations on renal and cardiovascular outcomes in patients with non-dialysis CKD undergoing PCI.</p><p><b><i>Methods and Results:</i></b> We enrolled 124 patients with non-dialysis CKD (estimated glomerular filtration rate <60 mL/min/1.73 m<sup>2</sup>) undergoing elective PCI. Patients were divided into low and high NGAL groups based on the median urinary NGAL concentration measured the day before PCI. Patients were monitored for renal and cardiovascular events during the 2-year follow-up period. Kaplan-Meier analyses showed that the incidence of renal and cardiovascular events was higher in the high than low NGAL group (log-rank P<0.001 and P=0.032, respectively). Multivariate Cox proportional hazards analyses revealed that urinary NGAL was an independent risk factor for renal (hazard ratio [HR] 4.790; 95% confidence interval [CI] 1.537–14.924; P=0.007) and cardiovascular (HR 2.938; 95% CI 1.034–8.347; P=0.043) events.</p><p><b><i>Conclusions:</i></b> Urinary NGAL could be a novel and informative biomarker for predicting subsequent renal and cardiovascular events in patients with CKD undergoing elective PCI.</p>

    DOI: 10.1253/circj.cj-24-0060

    Scopus

    PubMed

    CiNii Research

  5. Refractory atrial tachycardia after transcatheter closure of an atrial septal defect, successfully treated by catheter ablation with transseptal approach via the side of the device Reviewed International journal

    Hiramatsu K., Tanaka A., Furusawa K., Inden Y., Murohara T.

    Journal of Cardiology Cases     2024

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    Authorship:Corresponding author   Language:English   Publishing type:Research paper (scientific journal)   Publisher:Journal of Cardiology Cases  

    Atrial tachyarrhythmias occurring after transcatheter atrial septal defect closure are not uncommon; however, those related to device stimulation are rare. Herein, a case involving a 24-year-old female, who developed drug-refractory atrial tachycardia during the early postoperative period, is reported. The results of electroanatomical mapping could eventually be obtained from both atria. They revealed a focal pattern, and the earliest site was located on the left atrial side of the superior atrial septum, between the left and right atrial discs of the device. An ablation catheter was inserted through the side of the device into the left atrial septum, and cauterization successfully achieved recovery of the sinus rhythm without device dislodgement. Learning objective: Atrial tachyarrhythmia related to mechanical stimulation with an atrial septal defect closure device in the early perioperative period is a rare complication. Catheter ablation with transseptal approach through the side of the device might be an option, although careful attention should be paid to the risk for device dislodgement.

    DOI: 10.1016/j.jccase.2024.02.007

    Scopus

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KAKENHI (Grants-in-Aid for Scientific Research) 4

  1. 冠動脈疾患進展の新規曝露危険因子と好中球を介した機序及び新規予防戦略の探索

    Grant number:22K16100  2022.4 - 2025.3

    科学研究費助成事業  若手研究

    田中 哲人

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    Authorship:Principal investigator 

    Grant amount:\4680000 ( Direct Cost: \3600000 、 Indirect Cost:\1080000 )

    心血管疾患に対する現行のアプローチによる一次、二次予防効果は近年頭打ちの状態であり、医療経済背景も考えた効果的な新たなアプローチが求められている。そのためには心血管疾患の残余リスクに対して、現存の介入方法に十分な上乗せ効果を得ることと同時に介入対象を正確に層別化していくことが重要であり、そのためには新たな視点が必要である。本研究では、新たな曝露危険因子となりうる PM2.5などの粒子状物質と体内炎症、心血管疾患との関連や、動脈硬化の進展に寄与する 血管内炎症を引き起こす好中球の活性化などに着目し、臨床的並びに基礎的検討の両面からその生体反応を追求する。

  2. Safe and Stable Transseptal Access for Trans-catheter Mitral Valve Replacement

    Grant number:22K08955  2022.4 - 2025.3

    Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

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    Authorship:Coinvestigator(s) 

  3. Medical Economics in Transcatheter Aortic Valve Implantation

    Grant number:19K08513  2019.4 - 2022.3

    Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

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    Authorship:Coinvestigator(s) 

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  4. 動脈硬化進展に伴う大動脈瘤発症のメカニズム並びに効果的な内科治療戦略の探索

    Grant number:19K17591  2019.4 - 2021.3

    科学研究費助成事業  若手研究

    田中 哲人

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    Authorship:Principal investigator 

    Grant amount:\4290000 ( Direct Cost: \3300000 、 Indirect Cost:\990000 )

    近年、糖尿病が大動脈径拡大に対して抑制的に働くというねじれの現象が観察され、糖尿病と大動脈瘤の負の相関関係が注目されている。糖尿病は、冠動脈疾患を始めとする動脈硬化性疾患の強力な危険因子であり、高血圧や脂質異常など動脈硬化のその他の危険因子を同時に有する事も多い。さらに冠動脈疾患や脳血管、末梢血管疾患の進行は大動脈瘤の有病率とも正の相関をすることがわかっている。それにもかかわらず、この負の相関関係が存在するが、その詳細なメカニズムは十分に明らかにされていない。本研究は、冠動脈疾患患者での糖尿病有無による大動脈径を比較検証することで、ねじれ現象の原因を詳細に解析し、そのメカニズムを探求する。
    近年、糖尿病が大動脈径拡大に対して抑制的に働くというねじれの現象が観察され、糖尿病と大動脈瘤の負の相関関係が注目されている。糖尿病は、冠動脈疾患を始めとする動脈硬化性疾患の強力な危険因子であり、高血圧や脂質異常など動脈硬化のその他の危険因子を同時に有する事も多い。さらに冠動脈疾患や脳血管、末梢血管疾患の進行は大動脈瘤の有病率とも正の相関をすることがわかっている。それにもかかわらず、この負の相関関係が存在するが、その詳細なメカニズムは十分に明らかにされていない。本研究においては、冠動脈疾患患者での糖尿病有無による大動脈径を比較検証することで、ねじれ現象を詳細に解析し、そのメカニズムを探求することを目的とした。
    今回カテーテル治療を受けた冠動脈疾患患者において、治療前後とその一年後以降の2点以上でCTを撮像した患者216名に関して、腹部大動脈径ならびに石灰化の程度、その時系列での変化を観察した。その結果、カテーテル治療前後の時点で、腹部大動脈径は糖尿病患者において有意に小さいことが確認されたが、石灰化の程度においては糖尿病の有無により有意な差を認めなかった。一方、その後の変化率においては、径の年次変化率については、糖尿病の有無により有意な差を認めなかったが、石灰化の進行については糖尿病患者において有意に大きかった。これらの結果から、糖尿病の血管壁に対する影響は、その血管の動脈硬化進展の過程の中で変化しうることが考えられた。これらの内容については、Journal of Atherosclerosis and Thrombosis誌に受理された。現在、さらに生理活性物質などを含めた検討を進めている。
    ここまでに、カテーテル治療を受けた冠動脈疾患患者において、治療前後とその一年後以降の2点以上でCTを撮像した患者216名に関して、腹部大動脈径ならびに石灰化の程度、その時系列での変化を観察した。その結果、カテーテル治療前後の時点で、腹部大動脈径は糖尿病患者において有意に小さいことが確認されたが、石灰化の程度においては糖尿病の有無により有意な差を認めなかった。一方、その後の変化率においては、径の年次変化率については、糖尿病の有無により有意な差を認めなかったが、石灰化の進行については糖尿病患者において有意に大きかった。これらの結果から、糖尿病の血管壁に対する影響は、その血管の動脈硬化進展の過程の中で変化しうることが考えられた。現在、さらに生理活性物質を含めた検討についても準備を進めている。
    糖尿病患者、非糖尿病患者において生理活性物質(大動脈壁の変性に関わると言われている物質など)と、大動脈径、石灰化、その経時変化などとの関わりを検討する。さらに糖尿病患者の中で、大動脈径などをエンドポイントとし、生理活性物質や薬剤などを含めた何がそれらと密接に関わっているかを検討する。

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