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論文 - 田中　哲人

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Impact of Diabetes Mellitus on the Aortic Wall Changes as Atherosclerosis Progresses: Aortic Dilatation and Calcification 査読有り

Iwakawa Naoki, Tanaka Akihito, Ishii Hideki, Kataoka Takashi, Niwa Kiyoshi, Hitora Yusuke, Tashiro Hiroshi, Mitsuda Takayuki, Kojima Hiroki, Hirayama Kenshi, Furusawa Kenji, Yoshida Ruka, Suzuki Susumu, Murohara Toyoaki

JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS 27 巻 ( 6 ) 頁： 509 - 515 2020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：一般社団法人日本動脈硬化学会

Aim: An inverse association between diabetes mellitus (DM) and aortic dilatation has recently been reported. However, little is known about the association between DM and the progression of aortic dilatation/calcification as atherosclerosis progresses. Methods: We identified 216 patients who had undergone percutaneous coronary intervention (PCI) and abdominal computed tomography (CT) during the PCI and follow-up phases. The patients were classified into two groups: those with DM (DM+ group; n=107) and those without DM (DM− group; n=109). The infrarenal aortic diameter and aortic calcification index (ACI) were measured, and annual changes were calculated using measurement results obtained during the PCI and follow-up phases. Results: Infrarenal aortic diameters were significantly shorter in the DM+ group than in the DM-group during the PCI phase, and no significant ACI differences were observed between the DM+ and DM− groups. The median duration between the PCI and follow-up phase CT was 3.0 years. The growth rate of the infrarenal aor-tic dilatation from the PCI phase in the DM+ group was similar to that in the DM− group. Annual ACI changes were significantly larger in the DM+ group than in the DM− group. Multivariate logistic regression analysis indi-cated that the prevalence of DM was an independent predictor of rapid aortic calcification progression (odds ratio: 2.51; 95% confidence interval: 1.23–5.14; p =0.01). Conclusion: Our findings suggest that DM negatively affects aortic dilatation during an earlier phase of atherosclerosis progression and positively affects the progression of aortic calcification in a later phase.

DOI： 10.5551/jat.50930

Reduced exercise capacity and clinical outcomes following acute myocardial infarction

Tashiro H., Tanaka A., Ishii H., Motomura N., Arai K., Adachi T., Okajima T., Hitora Y., Hayashi M., Furusawa K., Imai H., Ogawa Y., Kawaguchi K., Murohara T.

EUROPEAN HEART JOURNAL 40 巻頁： 2813 - 2813 2019年10月

Accumulative impact of poor nutrition and frailty on 1-year mortality among acute decompensated heart failure patients

Sumi T., Oguri M., Takahara K., Umemoto N., Shimizu K., Tanaka A., Ishii H., Murohara T.

EUROPEAN HEART JOURNAL 40 巻頁： 1490 - 1490 2019年10月

Accuracy and Safety of Newly Developed Optical-based FFR Device Compared to Conventional FFR Device

Suzuki Akihiro, Takashima Hiroaki, Saka Yuki, Waseda Katsuhisa, Ando Hirohiko, Nakano Yusuke, Sakurai Shinichiro, Fujimoto Masanobu, Ohashi Hirofumi, Tanaka Akihito, Ishii Hideki, Amano Tetsuya

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 73 巻 ( 15 ) 頁： S68 - S68 2019年4月

Saphenous Vein Graft Aneurysm 10 Years After Paclitaxel-Eluting Stent Implantation. 査読有り

Tanaka A, Jabbour RJ, Giannini F, Latib A, Colombo A

The Journal of invasive cardiology 29 巻 ( 5 ) 頁： E63 2017年5月

A Comparison Between First-Generation and Second-Generation Transcatheter Aortic Valve Implantation (TAVI) Devices: A Propensity-Matched Single-Center Experience. 査読有り国際誌

Ruparelia N, Latib A, Kawamoto H, Buzzatti N, Giannini F, Figini F, Mangieri A, Regazzoli D, Stella S, Sticchi A, Tanaka A, Ancona M, Agricola E, Monaco F, Spagnolo P, Chieffo A, Montorfano M, Alfieri O, Colombo A

The Journal of invasive cardiology 28 巻 ( 5 ) 頁： 210 - 6 2016年5月

Influence of the false lumen status on acute type A aortic dissection without urgent surgical repair

Tanaka A., Ishii H., Suzuki S., Ota T., Oshima H., Usui A., Murohara T.

EUROPEAN HEART JOURNAL 36 巻頁： 1161 - 1161 2015年8月

Association of Estimated Glomerular Filtration Rate and Proteinuria With Lipid-Rich Plaque in Coronary Artery Disease 査読有り

Shimbo Yusaku, Suzuki Susumu, Ishii Hideki, Shibata Yohei, Tatami Yosuke, Harata Shingo, Osugi Naohiro, Ota Tomoyuki, Tanaka Akihito, Shibata Kanako, Mizukoshi Toshihiro, Yasuda Yoshinari, Maruyama Shoichi, Murohara Toyoaki

日本循環器學誌 79 巻 ( 10 ) 頁： 2263 - 2270 2015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：一般社団法人日本循環器学会

Background: Estimated glomerular filtration rate (eGFR) and proteinuria are both important determinants of the risk of cardiovascular disease and mortality. The aim of the present study was to investigate the independent and combined effects of eGFR and proteinuria on tissue characterization of the coronary plaques of culprit lesions. Methods and Results: Conventional intravascular ultrasound and 3-D integrated backscatter intravascular ultrasound (IB-IVUS) were performed in 555 patients undergoing elective percutaneous coronary intervention. They were divided into 2 groups according to the absence or presence of proteinuria (dipstick result ≥1+). Patients with proteinuria had coronary plaque with significantly greater percentage lipid volume compared with those without (43.6±14.8% vs. 48.6±16.1%, P=0.005). Combined analysis was done using eGFR and absence or presence of proteinuria. Subjects with eGFR 45–59 ml/min/1.73 m2 and proteinuria were significantly more likely to have higher percent lipid volume compared with those with eGFR >60 ml/min/1.73 m2 without proteinuria. After multivariate adjustment for confounders, the presence of proteinuria proved to be an independent predictor for lipid-rich plaque (OR, 1.85; 95% CI: 1.12–3.06, P=0.016). Conclusions: The addition of proteinuria to eGFR level may be of value in the risk stratification of patients with coronary artery disease.

DOI： 10.1253/circj.CJ-15-0460

Impact of Airflow Limitation on Carotid Atherosclerosis in Coronary Artery Disease Patients 査読有り

Hamrah Mohammad Shoaib, Suzuki Susumu, Ishii Hideki, Shibata Yohei, Tatami Yosuke, Osugi Naohiro, Ota Tomoyuki, Kawamura Yoshihiro, Tanaka Akihito, Aso Hiromichi, Takeshita Kyosuke, Sakamoto Junichi, Hasegawa Yoshinori, Murohara Toyoaki

RESPIRATION 89 巻 ( 4 ) 頁： 322 - 328 2015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：Respiration

Background: Both airflow limitation and smoking are established cardiovascular risk factors. However, their interaction as risk factors for the development of atherosclerosis in coronary artery disease patients remains unclear. Objectives: To evaluate the effect of the interaction between airflow limitation and smoking status on the severity of carotid atherosclerosis. Methods: We categorized the 234 enrolled patients with coronary artery disease into four groups: never-smokers with normal pulmonary function (group A), never-smokers with airflow limitation (group B), ever-smokers with normal pulmonary function (group C), and ever-smokers with airflow limitation (group D). Results: The prevalence of airflow limitation in the enrolled patients was 23.1% (ever-smokers: 15.8%, never-smokers: 7.3%). The prevalence of severe carotid atherosclerosis was 28.2, 29.4, 41.3, and 45.9%, respectively, in the four groups (group D vs. group A, p = 0.035). Even after multivariate adjusting for confounding factors, ever-smokers with airflow limitation were independently associated with severe carotid atherosclerosis (odds ratio 2.89, 95% confidence interval, 1.19-7.00, p = 0.019). Conclusions: Ever-smokers with airflow limitation were significantly associated with severe carotid atherosclerosis among patients with coronary artery disease. These findings also provide additional insight into the correlation between airflow limitation and poor cardiovascular clinical outcomes.

DOI： 10.1159/000375313

Assessment of In-Stent Restenosis Using High-Definition Computed Tomography With a New Gemstone Detector 査読有り国際誌

Tsuda Takuma, Ishii Hideki, Ichimiya Satoshi, Kanashiro Masaaki, Watanabe Jyunji, Takefuji Mikito, Aoyama Toru, Suzuki Susumu, Tanaka Akihito, Matsubara Tatsuaki, Murohara Toyoaki

Circulation Journal 79 巻 ( 7 ) 頁： 1542 - 1548 2015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：The Japanese Circulation Society

Background:Until now, there have been few reports on the accuracy of in-stent restenosis (ISR) detection using high-definition computed tomography (HDCT). The purpose of this study was to assess ISR using HDCT with a new gemstone detector and to examine the diagnostic accuracy compared with invasive coronary angiography.Methods and Results:We evaluated 162 consecutive patients with 316 stents and the image quality (IQ) scores used to assess ISR, and analyzed whether stent strut thickness and diameter affected IQ score and assessability. In the 316 stents, 278 were diagnosed as assessable with HDCT (88.0%). IQ score for stent diameter ≥3 mm was significantly higher than that for stent diameter <3 mm, for stents with both thick struts ≥140 μm in thickness (mean IQ: 2.04±0.97 vs. 2.83±1.06, P<0.001) and thin struts <140 μm (mean IQ: 1.92±0.87 vs. 2.64±0.96, P=0.01). Assessability for stent diameter ≥3 mm was significantly higher than that for stent diameter <3 mm only for stents with thick struts (92.8% vs. 76.1%, P<0.001). Stent strut thickness, however, was not statistically significantly associated with either IQ score or assessability.Conclusions:In-stent lumens have high HDCT assessability, and HDCT is useful to evaluate thick-strut stents with diameter <3 mm.

DOI： 10.1253/circj.CJ-14-1344

Inverse association between diabetes and aortic dilatation in patients with advanced coronary artery disease 査読有り

Tanaka Akihito, Ishii Hideki, Oshima Hideki, Narita Yuji, Kodama Akio, Suzuki Susumu, Komori Kimihiro, Usui Akihiko, Murohara Toyoaki

ATHEROSCLEROSIS 242 巻 ( 1 ) 頁： 123 - 127 2015年

担当区分：筆頭著者,　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：Atherosclerosis

Background: A negative association between diabetes and abdominal aortic aneurysm has recently been reported. The purpose of this study was to assess the relationship between diabetes and aortic diameter, including non-aneurysmal aortic diameter, in patients with advanced coronary artery disease. Methods: We identified 351 consecutive patients who had undergone coronary artery bypass graft surgery. The patients were divided into two groups: those with diabetes mellitus (DM) (DM+ group; n=180), and those without DM (DM- group; n=171). Infrarenal and ascending aortic diameters were measured by preoperative computed tomography and corrected for body surface area. Results: Infrarenal and ascending aortic diameters were significantly shorter in the DM+ group than in the DM- group (21.3±5.0mm vs. 24.7±9.8mm, p<0.001 and 36.0±4.4mm vs. 37.8±5.5mm, p=0.001, respectively). The rates of infrarenal aortic diameter ≥30mm and ascending aortic diameter ≥40mm were significantly lower in the DM+ group than in the DM- group (3.5% vs. 13.3%, p=0.003 and 14.2% vs. 24.1%, p=0.025, respectively). Multivariate models demonstrated diabetes to be an independent predictor of both infrarenal and ascending aortic diameters even after correction for body surface area. Conclusion: Our findings indicated an inverse association between diabetes and aortic dilatation of both the infrarenal and ascending aorta in patients with advanced coronary artery disease.

DOI： 10.1016/j.atherosclerosis.2015.07.016

Impact of low-grade albuminuria on left ventricular diastolic dysfunction 査読有り

Nagai H., Suzuki S., Ishii H., Shibata Y., Harata S., Takayama Y., Tatami Y., Shimbo Y., Osugi N., Ota T., Kawamura Y., Tanaka A., Takeshita K., Murohara T.

IJC Metabolic and Endocrine 6 巻頁： 13 - 16 2015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：IJC Metabolic and Endocrine

Background: Albuminuria is an established risk factor for mortality and cardiovascular events in high-risk populations. However, few studies have evaluated the relationship between normoalbuminuria and left ventricular (LV) diastolic function. The present study evaluated the impact of the low-grade albuminuria on LV diastolic function in patients with coronary artery disease (CAD). Methods: A cross-sectional study was conducted in 202 chronic CAD patients with normal urinary albumin levels. Subjects were divided into 3 tertiles according to sex-specific urinary albumin-to-creatinine concentration ratio (UACR) cut-off points. Subjects in the upper tertile were classified as having low-grade albuminuria. To evaluate the LV function, all subjects underwent echocardiography. LV diastolic dysfunction was defined as E/e'>15 or 8<E/e'<15, with an E/A<0.5, a deceleration time>280ms, and a LV mass index>122g/m2 for women or >149g/m2 for men. Results: Among the 202 patients, 76 patients (37.6%) had LV diastolic dysfunction. The prevalence of LV diastolic dysfunction in the upper tertile was significantly greater than that in the middle and lower tertiles (49.3%, 32.3% and 29.2%, respectively; p for trend. =. 0.029). Adjusting for confounding factors, the presence of low-grade albuminuria independently associated with LV diastolic dysfunction (odds ratio 2.22, 95% confidence interval: 1.05-4.71, p. =. 0.037). Conclusions: A high UACR level that is still below the current microalbuminuria threshold is significantly associated with an increased prevalence of LV diastolic dysfunction in CAD patients. Our data suggest that low-grade albuminuria in high-risk populations may provide greater cardiovascular risk stratification.

DOI： 10.1016/j.ijcme.2015.01.006

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Relation of airflow limitation and smoking status to carotid atherosclerosis in patients with coronary artery disease

Suzuki S., Ishii H., Shibata Y., Tatami Y., Osugi N., Ota T., Kawamura Y., Tanaka A., Murohara T.

EUROPEAN HEART JOURNAL 35 巻頁： 902 - 902 2014年9月

Impact of albuminuria on the incidence of peri-procedural myocardial injury in patients undergoing elective stent implantation

Suzuki S., Ishii H., Shibata Y., Tatami Y., Osugi N., Ota T., Kawamura Y., Tanaka A., Murohara T.

EUROPEAN HEART JOURNAL 35 巻頁： 130 - 130 2014年9月

Impact of Albuminuria on the Incidence of Periprocedural Myocardial Injury in Patients Undergoing Elective Coronary Stent Implantation 査読有り

Osugi Naohiro, Suzuki Susumu, Ishii Hideki, Yasuda Yoshinari, Shibata Yohei, Tatami Yosuke, Ota Tomoyuki, Kawamura Yoshihiro, Okumura Satoshi, Tanaka Akihito, Inoue Yosuke, Matsuo Seiichi, Murohara Toyoaki

AMERICAN JOURNAL OF CARDIOLOGY 114 巻 ( 1 ) 頁： 42 - 46 2014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：American Journal of Cardiology

Albuminuria has traditionally been associated with an elevated risk of cardiovascular events. However, few studies have examined the potential relation between albuminuria and periprocedural risk in percutaneous coronary intervention (PCI). The aim of this study was to evaluate the impact of albuminuria on the incidence of periprocedural myocardial injury (PMI) in patients who underwent PCI. The study included 252 consecutive patients who underwent PCI. The incidence of PMI was significantly higher in patients with albuminuria than in those with normoalbuminuria (31.9% vs 43.3%, respectively, p = 0.014). Even after adjustment for confounders, the presence of albuminuria predicted PMI (odds ratio 2.07, 95% confidence interval 1.08 to 3.97, p = 0.029). Furthermore, patients with albuminuria and preserved estimated glomerular filtration rate had a 4.2-fold higher risk for PMI than did patients with normoalbuminuria and preserved estimated glomerular filtration rate. In conclusion, albuminuria was a strong predictor of PMI in patients who underwent PCI. © 2014 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.amjcard.2014.03.058

Impact of chronic obstructive pulmonary disease on composition of left main coronary artery plaque with intermediate stenosis 査読有り

Kumagai Soichiro, Ishii Hideki, Takashima Hiroaki, Waseda Katsuhisa, Kurita Akiyoshi, Ando Hirohiko, Gosho Masahiko, Yoshikawa Daiji, Suzuki Susumu, Tanaka Akihito, Matsubara Tatsuaki, Murohara Toyoaki, Amano Tetsuya

INTERNATIONAL JOURNAL OF CARDIOLOGY 174 巻 ( 3 ) 頁： 865 - 866 2014年

Influence of the false lumen status on clinical outcomes in patients with acute type B aortic dissection 査読有り国際誌

Tanaka Akihito, Sakakibara Masaki, Ishii Hideki, Hayashida Ryo, Jinno Yasushi, Okumura Satoshi, Okada Koji, Murohara Toyoaki

JOURNAL OF VASCULAR SURGERY 59 巻 ( 2 ) 頁： 321 - 326 2014年

担当区分：筆頭著者,　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 Vascular Surgery

Objective Clinical outcomes in acute type B aortic dissection patients with partial thrombosis of the false lumen have not been clearly elucidated. The purpose of this study was to investigate long-term mortality and incidence of surgical treatment by focusing on the status of the false lumen including partial thrombosis. Methods One hundred three patients (69 males, mean age 67 ± 13 years) with acute type B aortic dissection were enrolled. Patients were divided into three groups according to the status of the false lumen on enhanced computed tomography image (complete thrombosis, n = 55; partial thrombosis, n = 25; patent, n = 23). Results Requirement of surgical (open or endovascular) treatment during initial hospitalization was significantly less frequent in patients with complete thrombosis (0% in complete thrombosis, 16% in partial thrombosis, and 26% in patent). The long-term mortality (mean follow-up term, 1143 ± 933 days) did not differ among the three groups. Long-term surgical treatment-free rate was significantly lower in patients with patent false lumen. Cox regression analysis revealed that age (P <.01) and male sex (P =.013) were significant predictive factors of long-term mortality. Conclusions In acute type B aortic dissection, the incidence of surgical treatment was higher in patients with patent false lumen during long-term follow-up, whereas status of the false lumen did not influence long-term mortality. © 2014 by the Society for Vascular Surgery.

DOI： 10.1016/j.jvs.2013.08.031

Accelerated decline in renal function after acute myocardial infarction in patients with high low-density lipoprotein-cholesterol to high-density lipoprotein-cholesterol ratio 査読有り国際誌

Okumura Satoshi, Sakakibara Masaki, Hayashida Ryo, Jinno Yasushi, Tanaka Akihito, Okada Koji, Hayashi Mutsuharu, Ishii Hideki, Murohara Toyoaki

HEART AND VESSELS 29 巻 ( 1 ) 頁： 7 - 14 2014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：Heart and Vessels

High low-density lipoprotein-cholesterol to high-density lipoprotein-cholesterol (L/H) ratio is associated with progressions of coronary arteriosclerosis and chronic kidney disease. On the other hand, renal function markedly declined after acute myocardial infarction (AMI). The aims of the present study were (1) to identify what type of patients with AMI would have high L/H ratio at follow-up and (2) to evaluate whether decline in renal function after AMI had accelerated or not in patients with high L/H ratio. The 190 eligible AMI patients who underwent primary percutaneous coronary intervention (PCI) and received atorvastatin (10 mg) were divided into one of two groups according to the L/H ratio at 6-month follow-up: L/H >2 group (n = 81) or L/H ≤2 group (n = 109). The characteristics on admission in the two groups were examined. Furthermore, changes in serum creatinine (sCr) and estimated glomerular filtration rate (eGFR) during 1- and 6-month follow-up were compared between the two groups. L/H >2 group were significantly younger and had greater body mass index (BMI) and worse lipid profile on admission compared with L/H ≤2 group. Percentage increase in sCr and percentage decrease in eGFR during 1-month follow-up in L/H >2 group tended to be greater than in L/H ≤2 group, and those during 6-month follow-up were significantly greater (16.5 ± 2.77 vs. 9.79 ± 2.23%, p = 0.03 and 11.8 ± 1.93 vs. 2.75 ± 3.85%, p = 0.04, respectively). In AMI patients undergoing primary PCI, those who were young and had large BMI and poor lipid profile on admission were likely to have a high L/H ratio at follow-up despite statin therapy. In addition, the decline in renal function after AMI had significantly accelerated in patients with high L/H ratio. © Springer 2013.

DOI： 10.1007/s00380-012-0321-y

Impact of serum bilirubin levels on carotid atherosclerosis in patients with coronary artery disease 査読有り

Tatami Y., Suzuki S., Ishii H., Shibata Y., Osugi N., Ota T., Kawamura Y., Tanaka A., Takeshita K., Murohara T.

IJC Metabolic and Endocrine 5 巻頁： 24 - 27 2014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：IJC Metabolic and Endocrine

Background/objectives: Bilirubin protects against oxidative stress-mediated diseases, especially atherosclerotic diseases. On the other hand, subjects with carotid atherosclerosis have a high incidence of adverse cardiovascular events. The aim of this study was to evaluate the possible relationship between serum bilirubin levels and carotid atherosclerosis in patients with coronary artery disease (CAD). Methods: We evaluated a total of 394 patients with chronic CAD, defined as stable angina pectoris or a previous myocardial infarction. They were divided into four groups according to serum bilirubin level. Carotid intima-media thickness and plaque score (PS) in the common carotid artery were measured using an ultrasound system. Severe carotid atherosclerosis was defined as PS >. 10. Results: With increasing quartiles of serum bilirubin levels, the prevalence of severe carotid atherosclerosis significantly decreased (48.2%, 39.6%, 30.3%, and 27.0%, respectively, p for trend = 0.007). After adjusting for other risk factors, low serum bilirubin levels were independently correlated with severe carotid atherosclerosis in CAD patients (odds ratio 0.89, 95% confidence interval, 0.81-0.99, p = 0.027). Conclusion: We demonstrated that low serum bilirubin levels were associated with severe carotid atherosclerosis in CAD patients. Our data suggest that serum bilirubin levels might be an independent, useful, and cost-effective tool for evaluating atherosclerotic status in CAD patients.

DOI： 10.1016/j.ijcme.2014.08.006

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Elevated Fasting Glucose is an Important Risk Factor for Contrast-Induced Nephropathy in Non-Diabetic Patients with Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Okumura Satoshi, Sakakibara Masaki, Havashida Ryo, Tanaka Akihito, Jinno Yasushi, Okada Koji, Murohara Toyoaki

CIRCULATION 126 巻 ( 21 ) 2012年11月

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