研究者詳細 - 田中　哲人

論文 - 田中　哲人

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Clinical implications of cerebral microbleeds in patients who undergo transcatheter aortic valve replacement 査読有り

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

Cardiovascular Revascularization Medicine 2025年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Cardiovascular 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

Feasibility and efficacy of real-time ultrasound-guided venous closure with suture-mediated vascular closure device 査読有り国際誌

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

Heart Rhythm 21 巻 ( 10 ) 頁： 2028 - 2036 2024年10月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：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

Predictability of noninvasive liver fibrosis score for cardiac events in patients with nonalcoholic fatty liver disease 査読有り国際誌

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 34 巻 ( 9 ) 頁： 2115 - 2123 2024年9月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：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

Clinical Impacts of Urinary Neutrophil Gelatinase-Associated Lipocalin in Patients With Chronic Kidney Disease Undergoing Percutaneous Coronary Intervention 査読有り国際誌

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

Circulation Journal 88 巻 ( 6 ) 頁： 944 - 950 2024年5月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本循環器学会

Background: 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. Methods and Results: We enrolled 124 patients with non-dialysis CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2) 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. Conclusions: Urinary NGAL could be a novel and informative biomarker for predicting subsequent renal and cardiovascular events in patients with CKD undergoing elective PCI.

DOI： 10.1253/circj.cj-24-0060

Scopus

PubMed

CiNii Research

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 査読有り国際誌

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

Journal of Cardiology Cases 2024年

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：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

Clinical features, future cardiac events, and prognostic factors following percutaneous coronary intervention in young female patients 査読有り国際誌

Tatami Y., Tanaka A., Ohashi T., Kubota R., Kaneko S., Shinoda M., Uemura Y., Takagi K., Tanaka M., Umemoto N., Tashiro H., Shibata N., Yoshioka N., Watarai M., Morishima I., Takada Y., Shimizu K., Ishii H., Murohara T.

Heart and Vessels 2024年

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Heart and Vessels

Background: The proportion of young females among the patients who undergo percutaneous coronary intervention (PCI) is relatively small, and information on their clinical characteristics is limited. This study investigated the clinical characteristics and prognostic factors for future cardiac events in young females who underwent PCI. Methods: This multicenter observational study included 187 consecutive female patients aged < 60 years who underwent PCI in seven hospitals. The primary composite endpoint was the incidence of cardiac death, nonfatal myocardial infarction, and target vessel revascularization. Results: The mean patient age was 52.1 ± 6.1 years and 89 (47.6%) had diabetes, and renal dysfunction (an estimated glomerular filtration rate < 60 mL/min/1.73 m2) was observed in 38 (20.3%). During a median follow-up of 3.3 years, the primary endpoint occurred in 28 patients. The Cox proportional hazards models showed that renal dysfunction was an independent predictor for the primary endpoint (hazard ratio 3.04, 95% confidence interval 1.25–7.40, p = 0.01), as well as multivessel disease (hazard ratio 2.79, 95% confidence interval 1.12–6.93, p = 0.03). Patients with renal dysfunction had a significantly higher risk for the primary endpoint than those without renal dysfunction. Conclusions: Renal dysfunction was strongly associated with future cardiac events in young females who underwent PCI.

DOI： 10.1007/s00380-024-02369-7

Scopus

PubMed

Long-term clinical outcomes following percutaneous coronary intervention in patients aged 90 years and older 査読有り国際誌

Tokuda K., Tanaka A., Uemura Y., Shibata N., Iwama M., Sakaguchi T., Yoshida R., Negishi Y., Tashiro H., Tanaka M., Tatami Y., Yamaguchi S., Yoshioka N., Umemoto N., Ohashi T., Takada Y., Asano H., Yoshida Y., Tanaka T., Noda T., Morishima I., Ishii H., Murohara T.

Journal of Cardiology 2024年

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiology

Background: In an aging society, percutaneous coronary intervention (PCI) for super-elderly patients is commonly performed in clinical practice. However, data are scarce regarding the clinical features and outcomes of this population. Methods: This multicenter observational study enrolled patients aged over 90 years who underwent PCI across 10 hospitals between 2011 and 2020. The study included patients presenting with acute coronary syndrome (ACS) and chronic coronary syndrome (CCS). The occurrence of all-cause and cardiac deaths during hospitalization and after discharge was investigated. Results: In total, 402 patients (91.9 ± 2.0 years, 48.3 % male) participated in the study, of whom 77.9 % presented with ACS. The rate of in-hospital death was significantly higher in patients with ACS compared to patients with CCS (15.3 % vs. 2.2 %, p < 0.001). The estimated cumulative incidence rates of all-cause death were 24.3 %, 39.5 %, and 60.4 % at 1, 3, and 5 years, respectively. No significant difference was observed in the occurrence of all-cause death between patients with ACS and CCS. Regarding causes of death after discharge, non-cardiac deaths accounted for just over half of the cases. Conclusion: This study highlights the clinical features and long-term clinical course of patients aged over 90 years who underwent PCI in a real-world setting. Patients presenting with ACS exhibited a higher rate of in-hospital mortality compared to those with CCS. Following discharge, both ACS and CCS patients experienced comparable and substantial increases in the incidence rates of both cardiac and non-cardiac mortality over time, and a more holistic management approach is warranted.

DOI： 10.1016/j.jjcc.2024.07.004

Scopus

The incidence and influencing factors of in-hospital frailty progression following transcatheter aortic valve implantation 査読有り

Miyazaki Tatsuya, Tanaka Akihito, Tokuda Yoshiyuki, Shirai Yoshinori, Mizutani Koji, Furusawa Kenji, Akita Sho, Ozeki Takahiro, Kobayashi Kiyonori, Ishii Hideki, Mutsuga Masato, Murohara Toyoaki

Internal Medicine advpub 巻 ( 0 ) 2024年

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：The Japanese Society of Internal Medicine

Objective Patients undergoing transcatheter aortic valve implantation (TAVI) are generally older and frailty is therefore an important clinical issue. The baseline degree of frailty is associated with the prognosis in patients undergoing TAVI; however, the incidence of in-hospital frailty progression and its influencing factors have not yet been elucidated. Methods This observational, single-center study retrospectively evaluated 281 patients who underwent TAVI. The degree of frailty at baseline and discharge was evaluated using the Clinical Frailty Scale (CFS). In-hospital frailty progression was defined as an increase of at least one level in the CFS score at discharge from baseline, and predictors of frailty progression were assessed. Results The median baseline CFS score was 4.0 (interquartile range: 3.0-4.0). In-hospital frailty progression was observed in 49 patients (17.4%). No significant differences were observed in age, sex, comorbidities, or surgical risk scores between patients with and without frailty progression. Patients with frailty progression experienced stroke more frequently during hospitalization than those without (12.2% vs. 1.3%, p = 0.001). A multivariable logistic analysis showed that in-hospital stroke was a significant predictor of frailty progression (odds ratio, 10.7; 95% confidence interval: 2.34-49.2, p = 0.002). Patients with frailty progression had a longer hospital stay than those without frailty progression [7.0 (4.0-17.0) vs. 4.0 (4.0-8.0) days, p = 0.001]. Conclusions In-hospital frailty progression was not uncommon in patients undergoing TAVI. Stroke incidence was a significant influencing factor in frailty progression, whereas baseline comorbidities and surgical risks were not.

DOI： 10.2169/internalmedicine.3146-23

PubMed

CiNii Research

Reply to the Editor —Additional value of venous flow pattern for ultrasound-guided venous closure with suture-mediated vascular closure device 招待有り査読有り国際誌

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

Heart Rhythm 2024年

Can a new biomarker complement the current diagnostic gap in the management of patients with suspected acute coronary syndrome? 招待有り査読有り国際誌

Tanaka A., Ishii H.

International Journal of Cardiology 393 巻頁： 131390 2023年12月

Impact of proteinuria on long-term prognosis in patients with coronary artery disease 査読有り国際誌

Funakubo H., Tanaka A., Tobe A., Kunieda T., Kubota Y., Yoshioka N., Otsuka S., Kudo N., Shirai Y., Furusawa K., Ishii H., Murohara T.

Journal of Cardiovascular Medicine 24 巻 ( 12 ) 頁： 900 - 905 2023年12月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiovascular Medicine

BackgroundThis study aimed to investigate the association between proteinuria and long-term prognosis in patients with coronary artery disease.MethodsThis was a single-center observational study. A total of 1351 patients were identified who underwent percutaneous coronary intervention, and whose urine data were available. Patients were divided into two groups according to the presence (n = 245) or absence (n = 1106) of proteinuria. All-cause and cardiovascular deaths were primarily evaluated.ResultsThe prevalence rates of hypertension and diabetes were significantly higher, and the baseline estimated glomerular filtration rate (eGFR) was lower in patients with proteinuria than in those without proteinuria. During the median follow-up of 4.1 years (interquartile range, 1.7-6.8 years), the occurrences of all-cause and cardiovascular deaths were significantly higher in patients with proteinuria. Multivariable Cox regression analysis indicated that the presence of proteinuria was a significant predictor of cardiovascular death as well as age, BMI, reduced eGFR, and left ventricular ejection fraction. When stratified into four groups based on eGFR category (eGFR <60 or ≥60 ml/min/1.73 m2) and absence or presence of proteinuria, the incidence rates of all-cause and cardiovascular deaths were highest in patients with proteinuria and eGFR less than 60 ml/min/1.73 m2. Furthermore, the incidence rates of all-cause and cardiovascular deaths were significantly higher in patients with proteinuria among both diabetic and nondiabetic patients.ConclusionProteinuria is associated with the long-term prognosis, and all-cause and cardiovascular deaths in patients with coronary artery disease, regardless of eGFR and the presence or absence of diabetes mellitus.

DOI： 10.2459/JCM.0000000000001573

Scopus

PubMed

Lethal ventricular arrhythmia due to entrectinib-induced Brugada syndrome: a case report and literature review 査読有り

Futamura Keisuke, Hase Tetsunari, Tanaka Akihito, Sakai Yoshinori, Okachi Shotaro, Shibata Hirofumi, Ushijima Futoshi, Hashimoto Takahiko, Nakashima Kuniya, Ito Katsuki, Yamamoto Takanori, Numaguchi Atsushi, Inden Yasuya, Ishii Makoto

INTERNATIONAL CANCER CONFERENCE JOURNAL 12 巻 ( 4 ) 頁： 299 - 304 2023年10月

Author's reply.

Iwama M, Noda T, Takagi K, Tanaka A, Murohara T

Journal of cardiology 2023年9月

特集血行再建の適応を見直そう診る4b 血行再建適応を考えるb.急性冠症候群招待有り

田中哲人

Heart View 27 巻 ( 7 ) 頁： 640 - 644 2023年7月

Acute Coronary Syndrome in the Japan Resuscitation Council Guidelines for Resuscitation 2020 査読有り

Kikuchi Migaku, Tahara Yoshio, Yamaguchi Junichi, Nakashima Takahiro, Nomura Osamu, Tanaka Akihito, Kojima Sunao, Hashiba Katsutaka, Nakayama Naoki, Hanada Hiroyuki, Mano Toshiaki, Yamamoto Takeshi, Matsuo Kunihiro, Takeuchi Ichiro, Matoba Tetsuya, Nonogi Hiroshi

日本循環器病學 87 巻 ( 6 ) 頁： 866 - 878 2023年5月

Ischemic and Bleeding Outcomes in Patients Who Underwent Percutaneous Coronary Intervention With Chronic Kidney Disease or Dialysis (from a Japanese Nationwide Registry) 査読有り国際誌

Tobe A., Sawano M., Kohsaka S., Ishii H., Tanaka A., Numasawa Y., Amano T., Nakamura M., Ikari Y., Murohara T.

American Journal of Cardiology 195 巻頁： 37 - 44 2023年5月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：American Journal of Cardiology

The relation between chronic kidney disease (CKD) and outcomes in patients receiving percutaneous coronary intervention (PCI) is thought to be bidirectional; these patients are at a higher risk of ischemic and bleeding events. From a Japanese nationwide PCI registry, ischemic (cardiovascular death, nonfatal myocardial infarction, or nonfatal ischemic stroke) and bleeding events (fatal or nonfatal major bleeding) 1 year after discharge among patients who had second- or newer-generation drug-eluting stent implantation were analyzed. Patients on oral anticoagulants were excluded. Patients were stratified according to their preprocedural renal function: CKD stages 1 to 2 (estimated glomerular filtration rate [eGFR] ≥60 ml/min/1.73 m2), 3 (eGFR 30 to 59), or 4 to 5 (eGFR <30), or those receiving dialysis. Overall, 23,349 patients, including 2,798 patients with CKD 3 to 5 (12.0%) and 1,464 patients on dialysis (6.3%), were investigated. One-year ischemic events were observed in 1.5%, 5.2%, 9.7%, and 5.3% in the CKD stages 1-to-2, 3, 4-to-5, and dialysis groups, respectively; patients with CKD stages 3 or 4 to 5 and those receiving dialysis were associated with higher risks of ischemic events after adjustment of covariates than were patients without CKD. Compared with ischemic events, 1-year bleeding events were low, with incidence rates of 1.5%, 2.0%, 3.4%, and 2.3%, respectively. Furthermore, the presence of CKD or dialysis was not associated with a higher risk of bleeding events after adjustment of covariates. In conclusion, in the contemporary nationwide PCI registry, the presence of CKD and dialysis was independently associated with a higher risk of ischemic events but not with bleeding events, and this suggests a need to alter the models of care delivery in these patients.

DOI： 10.1016/j.amjcard.2023.02.027

Scopus

PubMed

Clinical implications of the cardio-ankle vascular index before and after transcatheter aortic valve implantation. 査読有り

Miki Y, Tanaka A, Tokuda Y, Tobe A, Shirai Y, Yuhara S, Akita S, Furusawa K, Ishii H, Mutsuga M, Murohara T

Journal of cardiovascular medicine (Hagerstown, Md.) 24 巻 ( 5 ) 頁： 302 - 307 2023年5月

Relationship between the volume of cases and in-hospital mortality in patients with cardiogenic shock receiving short-term mechanical circulatory support. 査読有り国際誌

Araki T, Kondo T, Imaizumi T, Sumita Y, Nakai M, Tanaka A, Okumura T, Yang M, Butt JH, Petrie MC, Murohara T

American heart journal 2023年4月

Impact of right coronary artery dominance on the long-term mortality in the patients with acute Total/ subtotal occlusion of unprotected left Main coronary artery. 査読有り

Iwama M, Noda T, Takagi K, Tanaka A, Uemura Y, Umemoto N, Shibata N, Negishi Y, Ohashi T, Tanaka M, Yoshida R, Shimizu K, Tashiro H, Yoshioka N, Morishima I, Watarai M, Tanaka T, Tatami Y, Takada Y, Ishii H, Murohara T, N-registry investigators

Journal of cardiology 2023年4月

JCS/CVIT/JCC 2023 Guideline Focused Update on Diagnosis and Treatment of Vasospastic Angina (Coronary Spastic Angina) and Coronary Microvascular Dysfunction.

Hokimoto S, Kaikita K, Yasuda S, Tsujita K, Ishihara M, Matoba T, Matsuzawa Y, Mitsutake Y, Mitani Y, Murohara T, Noda T, Node K, Noguchi T, Suzuki H, Takahashi J, Tanabe Y, Tanaka A, Tanaka N, Teragawa H, Yasu T, Yoshimura M, Asaumi Y, Godo S, Ikenaga H, Imanaka T, Ishibashi K, Ishii M, Ishihara T, Matsuura Y, Miura H, Nakano Y, Ogawa T, Shiroto T, Soejima H, Takagi R, Tanaka A, Tanaka A, Taruya A, Tsuda E, Wakabayashi K, Yokoi K, Minamino T, Nakagawa Y, Sueda S, Shimokawa H, Ogawa H, Japanese Circulation Society and Japanese Association of Cardiovascular Intervention and Therapeutics and Japanese College of Cardiology Joint Working Group

日本循環器病學 advpub 巻 ( 0 ) 2023年3月

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