Updated on 2025/06/15

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写真a

 
Naohiro Komura
 
Organization
Yokohama City University Hospital CCU Lecturer
Title
Lecturer
Homepage
http://www.yokohama-medicine.org/
Profile

 

 

日本内科学会認定医/専門医、日本循環器学会専門医、心血管インターベンション治療学会認定医。

2004年：横浜市立大学医学部卒業。

2010年：同大学院博士課程卒業。虚血性心疾患の病態解明に関する臨床研究（Circ J. 2010 Jan;74(1):142-7）。

2013年～2015年：熊本大学附属病院循環器内科医員（国内留学）。血管内皮機能と循環器疾患に関する臨床研究。(J Am Heart Assoc. 2016 Jun 17;5(6).)

2015年４月～：横浜市立大学循環器・腎臓・高血圧内科学助教。

2023年7月～：横浜市立大学循環器内科学助教。

2024年4月～診療講師。

External link

Degree

  • 医学博士 ( 横浜市立大学 )

Research Interests

  • 血管内超音波

  • 虚血性心疾患

  • 血管内皮機能

  • 慢性血栓塞栓性肺高血圧症

Research Areas

  • Life Science / Cardiology

Research History

  • Yokohama City University School of Medicine, department of Cardiology   Assistant Professor

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Papers

  • Effect of balloon pulmonary angioplasty on chronic thromboembolic pulmonary hypertension: an assessment of the learning curve in a Japanese university hospital.

    Naohiro Komura, Teruyasu Sugano, Fumiaki Ono, Mina Nakayama, Toru Suzuki, Noriyuki Kawaura, Junya Hosoda, Masaaki Konishi, Noriaki Iwahashi, Tomoaki Ishigami, Makoto Mo, Kiyoshi Hibi

    Cardiovascular intervention and therapeutics   2024.12

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    Balloon pulmonary angioplasty (BPA) is an innovative treatment for chronic thromboembolic pulmonary hypertension (CTEPH). We retrospectively examined the clinical outcomes and complications of BPA at Yokohama City University Hospital (YCUH) between 2012 and 2018. In 2012, we began to conduct BPA sessions in 46 patients with inoperable CTEPH; 34 completed the BPA scheme and the follow-up plan. A longitudinal sub-analysis was performed with cohorts 1 and 2 receiving BPA before and after April 2015. Significant improvements in the mean pulmonary arterial pressure, pulmonary vascular resistance, and other parameters were detected after BPA. The total rate of thoracic complications was 25%. Specifically, the increase in SaO2 and home oxygen therapy discontinuation rate, and oral riociguat discontinuation rate was significantly higher in cohort 2 (+ 7.7, 75, and 59%) compared to cohort 1 (+ 3.1, 27, and 10%) (P < 0.05). Moreover, the need for non-invasive positive pressure ventilation was significantly lower: 0% (cohort 2) vs. 7% (cohort 1) (P < 0.05). The BPA sessions conducted at the YCUH resulted in significant improvements in patients with CTEPH. This study demonstrates a clear learning curve regarding the effectiveness of BPA both in normalizing SaO2 and facilitating the cessation of home oxygen therapy, as well as in reducing the incidence of severe complications.

    DOI： 10.1007/s12928-024-01076-4

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  • Onco-Hypertensionにおけるエビデンス構築の試み CQの設定とSystematic Reviewによるエビデンス構築

    浅井 真成, 所 卓見, 堀米 旭, 服部 京子, 石井 怜, 花島 陽平, 岡崎 善則, 小村 直弘, 峯岸 慎太郎, 石上 友章, 日比 潔

    日本高血圧学会総会プログラム・抄録集   46回   326 - 326   2024.10

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    Language：Japanese   Publisher：(NPO)日本高血圧学会  

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  • 腫瘍関連 腫瘍循環器としての肺高血圧症の検討

    鈴木 徹, 岩橋 徳明, 相澤 広太郎, 峯岸 慎太郎, 小村 直弘, 川浦 範之, 小西 正紹, 石上 友章, 菅野 晃靖, 日比 潔

    日本肺高血圧・肺循環学会学術集会抄録集   9回   124 - 124   2024.8

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    Language：Japanese   Publisher：日本肺高血圧・肺循環学会  

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  • Adult-onset idiopathic peripheral pulmonary artery stenosis. International journal

    Yudai Tamura, Yuichi Tamura, Ayako Shigeta, Kazuya Hosokawa, Yu Taniguchi, Takumi Inami, Shiro Adachi, Ichizo Tsujino, Naohiko Nakanishi, Kimi Sato, Jiro Sakamoto, Nobuhiro Tanabe, Noriaki Takama, Kazuto Nakamura, Kayoko Kubota, Naohiro Komura, Shigehiko Kato, Jun Yamashita, Makoto Takei, Shuji Joho, Shunsuke Ishii, Ryo Takemura, Koichiro Sugimura, Koichiro Tatsumi

    The European respiratory journal   62 ( 6 )   2023.12

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    BACKGROUND: Peripheral pulmonary artery stenosis (PPS) refers to stenosis of the pulmonary artery from the trunk to the peripheral arteries. Although paediatric PPS is well described, the clinical characteristics of adult-onset idiopathic PPS have not been established. Our objectives in this study were to characterise the disease profile of adult-onset PPS. METHODS: We collected data in Japanese centres. This cohort included patients who underwent pulmonary angiography (PAG) and excluded patients with chronic thromboembolic pulmonary hypertension or Takayasu arteritis. Patient backgrounds, right heart catheterisation (RHC) findings, imaging findings and treatment profiles were collected. RESULTS: 44 patients (median (interquartile range) age 39 (29-57) years; 29 females (65.9%)) with PPS were enrolled from 20 centres. In PAG, stenosis of segmental and peripheral pulmonary arteries was observed in 41 (93.2%) and 36 patients (81.8%), respectively. 35 patients (79.5%) received medications approved for pulmonary arterial hypertension (PAH) and 22 patients (50.0%) received combination therapy. 25 patients (56.8%) underwent transcatheter pulmonary angioplasty. RHC data showed improvements in both mean pulmonary arterial pressure (44 versus 40 mmHg; p<0.001) and pulmonary vascular resistance (760 versus 514 dyn·s·cm-5; p<0.001) from baseline to final follow-up. The 3-, 5- and 10-year survival rates of patients with PPS were 97.5% (95% CI 83.5-99.6%), 89.0% (95% CI 68.9-96.4%) and 67.0% (95% CI 41.4-83.3%), respectively. CONCLUSIONS: In this study, patients with adult-onset idiopathic PPS presented with segmental and peripheral pulmonary artery stenosis. Although patients had severe pulmonary hypertension at baseline, they showed a favourable treatment response to PAH drugs combined with transcatheter pulmonary angioplasty.

    DOI： 10.1183/13993003.00763-2023

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  • Dramatic Improvement of Pulmonary Tumor Thrombotic Microangiopathy in a Breast Cancer Patient Treated With Bevacizumab. International journal

    Aki Kimura, Akimitsu Yamada, Masanori Oshi, Mina Nakayama, Naohiro Komura, Teruyasu Sugano, Shinya Yamamoto, Kazutaka Narui, Itaru Endo

    World journal of oncology   14 ( 6 )   575 - 579   2023.12

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    A 47-year-old woman diagnosed with stage IV left-sided breast cancer (T3N3aM1; OSS, HEP, LYM) 6 months back presented with respiratory distress. On admission, she developed respiratory failure, requiring 4 L of oxygen support. Pulmonary embolism was ruled out because computed tomography revealed no obvious pulmonary artery thrombus. Transthoracic echocardiography revealed a significant enlargement of the right ventricle and atrium. Pulmonary hypertension was confirmed via right heart catheterization. Pulmonary artery wedge aspiration cytology revealed adenocarcinoma cells. Based on these findings, we diagnosed the patient with pulmonary tumor thrombotic microangiopathy (PTTM) caused by breast cancer. Immediate chemotherapy (paclitaxel and bevacizumab) for breast cancer and concurrent treatment for pulmonary hypertension and disseminated intravascular coagulation were initiated. We could successfully control her condition with paclitaxel and bevacizumab for a year, and the patient survived for 1 year and 8 months. PTTM is a rare disease characterized by pulmonary hypertension and hypoxemia arising due to tumor embolization of the peripheral pulmonary arteries. PTTM is a rapidly progressing condition with no established treatment guidelines; its pathogenesis involves vascular endothelial growth factor (VEGF). This report highlighted the potential of bevacizumab, known for its anti-VEGF effect, in improving the pathological condition of patients with PTTM caused by breast cancer.

    DOI： 10.14740/wjon1691

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  • Association between sarcopenia and exercise capacity in patients with pulmonary hypertension without left heart disease. International journal

    Mina Nakayama, Masaaki Konishi, Teruyasu Sugano, Masatsugu Okamura, Masaomi Gohbara, Kiwamu Iwata, Naoki Nakayama, Eiichi Akiyama, Naohiro Komura, Manabu Nitta, Noriyuki Kawaura, Tomoaki Ishigami, Kiyoshi Hibi, Toshiyuki Ishikawa, Takeshi Nakamura, Kouichi Tamura, Kazuo Kimura

    International journal of cardiology   387   131115 - 131115   2023.9

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    BACKGROUND: Pulmonary hypertension (PH) has recently been described as a complex clinical syndrome affecting multiple organ systems, including the heart, lungs, and skeletal muscle, each of which plays an important role in exercise capacity. However, the relationship between exercise capacity and skeletal muscle abnormalities in patients with PH has not been fully elucidated. METHODS: We retrospectively analysed the exercise capacity and measures of skeletal muscle of 107 patients with PH without left heart disease (mean age 63 ± 15 years, 32.7% males, n = 30/6/66/5 in the clinical classification Group 1/3/4/5). RESULTS: Sarcopenia, low appendicular skeletal muscle mass index, low grip strength, and slow gait speed, determined by international criteria, were found in 15 (14.0%), 16 (15.0%), 62 (57.9%), and 41 (38.3%) patients, respectively. The mean 6-min walk distance of all patients was 436 ± 134 m and was independently associated with sarcopenia (standardised β = -0.292, p < 0.001). All patients with sarcopenia showed reduced exercise capacity defined as 6-min walk distance <440 m. Multivariable logistic regression analysis showed that each of the components of sarcopenia was associated with reduced exercise capacity (adjusted odds ratio and 95% confidence interval of appendicular skeletal muscle mass index: 0.39 [0.24-0.63] per 1 kg/m2, p = 0.006, grip strength: 0.83 [0.74-0.94] per 1 kg, p = 0.003, and gait speed: 0.31 [0.18-0.51] per 0.1 m/s, p < 0.001). CONCLUSIONS: Sarcopenia and its components are associated with reduced exercise capacity in patients with PH. A multifaceted evaluation may be important in the management of reduced exercise capacity in patients with PH.

    DOI： 10.1016/j.ijcard.2023.06.006

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  • 先天性横隔膜ヘルニア術後の若年女性に発症した肺高血圧症の1例

    相澤 広太郎, 日比 潔, 石上 友章, 岩橋 徳明, 小西 正昭, 細田 順也, 川浦 範之, 小村 直弘, 峯岸 慎太郎, 鈴木 徹

    日本内科学会関東地方会   689回   30 - 30   2023.9

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    Language：Japanese   Publisher：日本内科学会-関東地方会  

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  • 右冠動脈の高度屈曲石灰化病変へのPCI中にDiamondBackが断裂し、回収に成功した一例

    小村 直弘, 菅野 晃靖, 鈴木 徹, 岩田 究, 川浦 範之, 小西 正紹, 日比 潔, 有川 雅也, 櫛田 俊一

    日本心血管インターベンション治療学会抄録集   31回   MP68 - 2   2023.8

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  • Impact of grip strength and gait speed on exercise tolerance in patients with pulmonary hypertension without left heart disease.

    Masatsugu Okamura, Masaaki Konishi, Yusuke Saigusa, Shuji Ando, Mina Nakayama, Naohiro Komura, Teruyasu Sugano, Kouichi Tamura, Takeshi Nakamura

    Heart and vessels   37 ( 11 )   1928 - 1936   2022.11

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    Patients with pulmonary hypertension (PH) suffer from poor exercise tolerance due to impaired oxygenation and/or reduced cardiac output. However, the relationship between exercise tolerance and physical function remains unclear. The purpose of this study was to investigate the relationship between exercise tolerance and physical function in patients with PH. A total of 94 patients without left heart disease (61.3 ± 14.7 years old, 69.1% females, 22/8/60/4 patients with Group 1/3/4/5 PH) were retrospectively analysed. Physical function was measured using muscle strength (grip strength, knee extension muscle strength), balance function (one-leg standing time), and gait speed within 7 days of cardiac catheterization. Exercise tolerance was measured using the 6-min walking distance (6-MWD). A total of 194 6-MWD measurements and the corresponding physical function were evaluated in 94 patients. Multivariable linear regression analysis using adaptive-LASSO methods indicated that the World Health Organization functional classification, pulmonary vascular resistance, mixed venous oxygen saturation, grip strength, and gait speed were independently associated with the 6-MWD. Low grip strength (< 28 kg for males and < 18 kg for females; adjusted odds ratio and 95% confidence interval: 2.06 [1.30-3.26], p = 0.002), and slow gait speed (< 1.0 m/s for both sexes; 13.33 [3.61-49.19], p < 0.001) were independent predictors of poor exercise tolerance (6-MWD < 440 m) in a logistic regression analysis. Grip strength and gait speed as measures of physical function, pulmonary vascular resistance, and mixed venous oxygen saturation were associated with exercise tolerance in patients with PH without left heart disease.

    DOI： 10.1007/s00380-022-02091-2

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  • Randomized controlled trial of landiolol, a short-acting beta-1 adrenergic receptor blocker, illustrating changes in high-molecular weight adiponectin levels after elective percutaneous coronary intervention.

    Masayoshi Kiyokuni, Masaaki Konishi, Yusuke Saigusa, Kiwamu Iwata, Naoki Nakayama, Naohiro Komura, Teruyasu Sugano, Tomoaki Ishigami, Toshiyuki Ishikawa, Takeharu Yamanaka, Kouichi Tamura, Kazuo Kimura

    Heart and vessels   35 ( 11 )   1510 - 1517   2020.11

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    Adiponectin (APN) has cardioprotective properties and bisoprolol has been reported to increase myocardial APN expression and reduce myocardial damage. Administration of landiolol, which has a higher cardio-selectivity and shorter half-life than bisoprolol, during the percutaneous coronary intervention (PCI) may increase serum APN and high-molecular weight (HMW)-APN, an active form of APN, in patients with stable angina pectoris (SAP). We recruited 70 patients with SAP and randomized them to intravenous landiolol during PCI (N = 35) or control group (N = 35). The primary endpoint was serum APN and HMW-APN level 3 days after PCI. There was no difference in the primary endpoint between the landiolol and control groups (8.93 ± 5.24 vs. 10.18 ± 5.81 μg/mL, p = 0.35 and 3.36 ± 2.75 vs. 4.28 ± 3.13 μg/mL, p = 0.20) for APN and HMW-APN levels, respectively. APN and HMW-APN level were significantly decreased 1 day after PCI [-0.55 ± 0.92 μg/mL (9.87-9.32 μg/mL), p < 0.001 and -0.20 ± 0.45 μg/mL (3.89-3.69 μg/mL), p < 0.001, respectively]. Additionally, the absolute change in HMW-APN was significantly smaller in the landiolol group compared to the control group (-0.08 ± 0.27 vs. -0.31 ± 0.55 μg/mL, p = 0.031). Multiple linear regression analysis showed that use of landiolol was an independent predictor of change in HMW-APN (β = 0.276, p = 0.014). Serum APN and HMW-APN level 3 days after PCI were similar between patients treated with and without landiolol. APN and HMW-APN decreased 1 day after PCI in the SAP and landiolol mitigated decrease in HMW-APN.

    DOI： 10.1007/s00380-020-01637-6

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  • Impact of serum lipoprotein (a) level on coronary plaque progression and cardiovascular events in statin-treated patients with acute coronary syndrome: a yokohama-acs substudy. International journal

    Kensuke Matsushita, Kiyoshi Hibi, Naohiro Komura, Yuichiro Kimura, Yasushi Matsuzawa, Masaaki Konishi, Nobuhiko Maejima, Noriaki Iwahashi, Masami Kosuge, Toshiaki Ebina, Kouichi Tamura, Kazuo Kimura

    Journal of cardiology   76 ( 1 )   66 - 72   2020.7

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    BACKGROUND: Lipoprotein (a) [Lp(a)] has been reported to be a residual risk factor in patients who have achieved target lipid levels. The aim of the present study was to investigate the associations of Lp(a) with plaque progression and major cardiovascular events in patients with acute coronary syndromes (ACS). METHODS: The Yokohama-ACS study included 102 patients with ACS who underwent intravascular ultrasound (IVUS) at baseline and at 10-month follow-up after percutaneous coronary intervention (PCI). The patients were randomly assigned to receive either moderate- or low-intensity statin therapy. IVUS was performed to measure the plaque volume at non-culprit lesions. We enrolled 76 patients for whom Lp(a) levels at 10-month follow-up were available. RESULTS: The patients were divided into 2 groups according whether their Lp(a) levels were ≤20 mg/dl [low Lp(a) group; n = 49] or >20 mg/dl [high Lp(a) group; n = 27]. Baseline characteristics and low-density lipoprotein cholesterol levels at 10-month follow-up were similar in the low Lp(a) group and high Lp(a) group (87 ± 29 mg/dl vs. 93 ± 27 mg/dl, p = 0.42). The low Lp(a) group had significant plaque regression, whereas the high Lp(a) group showed slight plaque progression (-6.8% vs. 2.5%, p = 0.02). Ninety-five percent of the prognostic data were obtained 5 years after PCI. The cumulative event-free survival rate was significantly lower in the high Lp(a) group (p = 0.02; log-rank test). CONCLUSIONS: Lp(a) levels may be an alternative predictor of further plaque regression and the likelihood of major adverse cardiovascular events in statin-treated ACS patients.

    DOI： 10.1016/j.jjcc.2020.01.005

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  • Is crossability of the classic crown with the glide assist superior to the micro crown in the Diamondback 360® coronary orbital atherectomy system? Reviewed

    Gohbara M, Sugano T, Matsumoto Y, Nakayama M, Iwata K, Komura N, Konishi M, Shigenaga A, Ishikawa T, Tamura K, Kimura K

    Cardiovascular intervention and therapeutics   35 ( 4 )   361 - 370   2020.1

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    The Diamondback 360® coronary orbital atherectomy system (OAS) can safely debulk calcified lesions by pullback of the crown, if the crown is advanced to the distal of the lesion. The aim of this study was to compare crossability with two types of crown in OAS. Thirty-six consecutive severely calcified lesions in 33 patients who underwent percutaneous coronary intervention with the coronary OAS were included. The micro crown was used in 18 consecutive lesions from April 2018 to February 2019, and the classic crown with the glide assist was used in 18 consecutive lesions from March 2019 to August 2019. Good crossability was defined as the ability to cross the lesion before orbital atherectomy or to cross the lesion with a first session of orbital atherectomy. We also tried to elucidate whether the crown could cross the lesion without using the glide assist in 13 consecutive lesions at the end of the classic crown cases. Good crossability was more often observed in cases with the classic crown (17 of 18 lesions, 94%) than the micro crown (6 of 18 lesions, 33%) (P < 0.001). In 13 consecutive lesions at the end of the classic crown cases, the crown could cross the lesion in 4 lesions (31%) without use of the glide assist or orbital atherectomy, and in 11 lesions (85%) with only use of the glide assist (P = 0.005). The classic crown with the glide assist is superior to the micro crown in terms of crossability for severely calcified lesions.

    DOI： 10.1007/s12928-020-00640-y

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  • 機械弁置換後の狭小僧帽弁に対する治療方針決定に難渋している症例(A Treatment Strategy for Mitral Stenosis Associated with Patient-Prosthesis-Mismatch After Mitral Valve Replacement: a Case Report)

    鍵本 美奈子, 仁田 学, 木野 旅人, 松本 祐介, 寺中 紗絵, 岩田 究, 清國 雅義, 小村 直弘, 上村 大輔, 重永 豊一郎, 細田 順也, 松本 克己, 菅野 晃靖, 石上 友章, 石川 利之, 町田 大輔, 益田 宗孝, 田村 功一

    日本成人先天性心疾患学会雑誌   8 ( 1 )   141 - 141   2019.1

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  • Outcome of current and history of cancer on the risk of cardiovascular events following percutaneous coronary intervention: A Kumamoto University Malignancy and Atherosclerosis (KUMA) study

    Noriaki Tabata, Daisuke Sueta, Eiichiro Yamamoto, Seiji Takashio, Yuichiro Arima, Satoshi Araki, Kenshi Yamanaga, Masanobu Ishii, Kenji Sakamoto, Hisanori Kanazawa, Koichiro Fujisue, Shinsuke Hanatani, Hirofumi Soejima, Seiji Hokimoto, Yasuhiro Izumiya, Sunao Kojima, Hiroshige Yamabe, Koichi Kaikita, Kenichi Tsujita, Tomoko Tanaka, Megumi Yamamuro, Koichi Sugamura, Naohiro Komura, Takashi Miyazaki, Tomonori Akasaka, Yoshiro Onoue, Hisao Ogawa

    European Heart Journal - Quality of Care and Clinical Outcomes   4 ( 4 )   290 - 300   2018.10

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    © The Author 2017. Aims With the advancement in successfully treating different types of cancers, there is an immediate and increased need to focus on the risk and complexity of treating cardiovascular events in cancer survivors. This has led to the emergence of onco-cardiology/cardio-oncology field. We examined the varying incidence of cardiovascular events after percutaneous coronary intervention (PCI) in patients with or without cancer. Methods and results Participants were divided into a non-malignant group and a malignant group, consisting of patients who were receiving or had ever received cancer treatment. The primary endpoint was target lesion revascularization (TLR) within 1 year of PCI. In the patient groups studied, we showed that the malignant group had a significantly higher probability of TLR than the non-malignant group (P = 0.002). Moreover, proportional hazards analyses identified malignancy as an independent predictor of TLR [hazard ratio (HR) 2.28, 95% confidential interval (CI) 1.3-4.0; P = 0.004]. Combining malignancy status with high-sensitivity C-reactive protein levels further increased the HR for TLR (HR 3.01, 95% CI 1.57-5.76; P = 0.001), and the net reclassification improvement was significant (15.2%, 95% CI 4.3-26%; P = 0.02). Time since completion of cancer treatment had an impact on the rate of TLR, with those patients with a current or recent cancer history having more TLR events within 1 year. Conclusion We demonstrated a significant association between the recent history of cancer and the risk of recurrent coronary atherosclerosis in patients undergoing PCI and showed that malignancy status can predict the likelihood of cardiovascular events following this procedure.

    DOI： 10.1093/ehjqcco/qcx047

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  • ファロー四徴症/両大血管右室起始症術後遠隔期における右室リモデリングと血漿BNP値との関連

    仁田 学, 野田 光里, 木野 旅人, 松本 祐介, 鍵本 美奈子, 田口 有香, 岩田 究, 清國 雅義, 小村 直弘, 重永 豊一郎, 細田 順也, 松本 克己, 菅野 晃靖, 石上 友章, 石川 利之, 田村 功一

    日本心臓病学会学術集会抄録   66回   O - 018   2018.9

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    Language：Japanese   Publisher：(一社)日本心臓病学会  

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  • Impact of Chronic Kidney Disease on Outcomes After Percutaneous Coronary Intervention for Chronic Total Occlusions (from the Japanese Multicenter Registry). Reviewed International journal

    Naganuma T, Tsujita K, Mitomo S, Ishiguro H, Basavarajaiah S, Sato K, Kobayashi T, Obata J, Nagamatsu S, Yamanaga K, Komura N, Sakamoto K, Yamamoto E, Izumiya Y, Kojima S, Kaikita K, Ogawa H, Nakamura S

    The American journal of cardiology   121 ( 12 )   1519 - 1523   2018.3

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    The impact of chronic kidney disease (CKD) and potential pharmacologic intervention on clinical outcomes after percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) remains unknown. A total of 1,463 patients underwent successful CTO-PCI between August 2004 and December 2014. Major adverse cardiovascular events (MACE) defined as the composite of all-cause death, myocardial infarction and target lesion revascularization, cardiac death, and stent thrombosis were compared between patients with and without CKD (555 and 908 patients, respectively). The results demonstrated higher risks of MACE (log-rank p = 0.015), all-cause death (log-rank p <0.001), and cardiac death (log-rank p <0.001) in the CKD group compared with the non-CKD group. Multivariable analyses demonstrated that CKD was an independent predictor for MACE (hazard ratio 1.23, 95% confidence interval 1.02 to 1.47, p = 0.03). With regard to pharmacotherapy, statin use was associated with significantly lower rates of MACE in the CKD group (log-rank p = 0.003). In conclusion, the presence of CKD would be an important predictor of long-term clinical outcomes in patients who underwent CTO-PCI, and use of statin may influence in reducing the adverse clinical outcomes.

    DOI： 10.1016/j.amjcard.2018.02.032

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  • The AB Portable Driver Generates Higher Drive-Line Pressures Possibly Leading to Accelerated Hemolysis. International journal

    Motohiko Goda, Naoto Yabu, Norihisa Tominaga, Daisuke Machida, Yukihisa Isomatsu, Shinichi Suzuki, Manabu Nitta, Naohiro Komura, Naoki Nakayama, Masayoshi Kiyokuni, Teruyasu Sugano, Munetaka Masuda

    Artificial organs   42 ( 2 )   235 - 239   2018.2

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    The AB5000 Circulatory Support System is paracorporeal pulsatile ventricular assist device. The AB Portable Driver is a portable console for this system. We experienced two cases with accelerated hemolysis while receiving support by the AB Portable Driver. The purpose of this study was to clarify the mechanical differences associated with the hemolysis between the AB5000 console and the AB Portable Driver. The mock circulatory system modeled by an AB5000 ventricle and a blood sampling bag of vinyl chloride was run with an AB5000 console or AB Portable Driver. The peak drive-line pressure, the mean arterial cannula pressure and the pumping rate of the VAD were recorded. The AB5000 console generated a peak drive-line pressure of 280-300 mm Hg in LVAD mode and 210-220 mm Hg in RVAD mode, approximately 100 mm Hg lower than officially documented. In contrast, the AB Portable Driver generated pressures of 310-330 mm Hg in LVAD mode and 230-250 mm Hg in RVAD mode, 65-95 mm Hg higher than officially documented. The AB Portable Driver console generates higher drive-line pressures than the AB5000 console, possibly explaining the accelerated hemolysis.

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  • Relationship between sleep-disordered breathing and renal dysfunction in acute coronary syndrome. Reviewed International journal

    Masayoshi Kiyokuni, Chika Kawashima, Masaaki Konishi, Kentaro Sakamaki, Kiwamu Iwata, Naoki Nakayama, Naohiro Komura, Masami Kosuge, Teruyasu Sugano, Tomoaki Ishigami, Tsutomu Endo, Toshiyuki Ishikawa, Takeharu Yamanaka, Kazuo Kimura, Kouichi Tamura

    Journal of cardiology   71 ( 2 )   168 - 173   2018.2

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    BACKGROUND: Sleep-disordered breathing (SDB) is associated with cardiovascular complications. However, the effect of SDB on renal function in patients with acute coronary syndrome (ACS) treated by percutaneous coronary intervention (PCI) remains unclear. METHODS: We enrolled 154 consecutive ACS patients without heart failure. A sleep study was performed immediately after PCI. RESULTS: The mean apnea-hypopnea index (AHI) was 16.4±13.1, and 33 patients (21%) had severe SDB, defined as AHI≥25. Estimated glomerular filtration rate (eGFR) values on admission (60±12mL/min/1.73m2 vs. 67±17mL/min/1.73m2, p=0.046) and at discharge (54±15mL/min/1.73m2 vs. 63±15mL/min/1.73m2, p=0.002) were lower in patients with severe SDB than in those patients without severe SDB. Multiple linear regression analysis showed that AHIs were significantly correlated with absolute changes in eGFR values from admission to discharge (β=0.201, p=0.004). Median 24-h urinary noradrenaline excretion measured on the same day of the sleep study was higher [297 (interquartile range {IQR}: 232-472) vs. 174 (IQR: 107-318)μg/day, p=0.021] in patients with severe SDB. On multivariate logistic regression analysis, the presence of severe SDB was a significant predictor (adjusted odds ratio 3.76, 95% confidence interval 1.06-13.9, p=0.047) for eGFR of less than 45mL/min/1.73m2 at discharge. This association was independent of age, eGFR on admission, and a presentation of ST-segment elevation myocardial infarction. CONCLUSION: In patients with ACS who undergo PCI, severe SDB is associated with impaired renal function on admission and its deterioration during hospitalization. Further studies will be needed to conclude that SDB would be a therapeutic target in ACS.

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  • Beneficial effect of early infusion of landiolol, a very short-acting beta-1 adrenergic receptor blocker, on reperfusion status in acute myocardial infarction. Reviewed International journal

    Masayoshi Kiyokuni, Masaaki Konishi, Kentaro Sakamaki, Chika Kawashima, Masatoshi Narikawa, Hiroshi Doi, Kiwamu Iwata, Sakie Tomari, Naoki Nakayama, Naohiro Komura, Takayuki Mitsuhashi, Hideto Yano, Teruyasu Sugano, Tomoaki Ishigami, Tsutomu Endo, Toshiyuki Ishikawa, Takeharu Yamanaka, Kazuo Kimura

    International journal of cardiology   221   321 - 6   2016.10

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    BACKGROUND: An early IV beta blocker during primary percutaneous coronary intervention (PCI) has been shown to reduce infarct size in ST-segment elevation acute myocardial infarction (STEMI), although the underlying mechanism is unknown. The aim of this study was to investigate the efficacy of early infusion of landiolol, the short-acting beta-1 adrenergic receptor blocker, on the reperfusion status in a STEMI. METHODS: We conducted a prospective, single-group trial of landiolol during the primary PCI for a STEMI. Landiolol was started intravenously just before reperfusion. The reperfusion status and outcomes in 55 treated patients were compared with those in 60 historical controls treated without landiolol. The optimal reperfusion was assessed by an ST-segment resolution (STR), coronary flow, and myocardial brush grade (MBG) after reperfusion. RESULTS: Patients in the landiolol group achieved a higher rate of an STR (64% vs. 42%, p=0.023) and MBG 2/3 (64% vs. 45%, p=0.045), whereas coronary flow was comparable between the two groups. A multivariate analysis showed that landiolol use was an independent predictor of an STR (odds ratio 2.99, 95% confidence interval 1.25-7.16, p=0.014). The incidence of non-sustained ventricular tachycardia (27% vs. 50%, p=0.014), hypotension (15% vs. 32%, p=0.046), and progression to Killip class grade III or IV (0% vs. 10%, p=0.028) were lower in the landiolol group. CONCLUSION: Early infusion of landiolol during the primary PCI was associated with optimal reperfusion and a lower incidence of adverse events in comparison with the control group.

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  • Clinical and morphological presentations of acute coronary syndrome without coronary plaque rupture - An intravascular ultrasound study Reviewed International journal

    Kenichi Tsujita, Kenshi Yamanaga, Naohiro Komura, Kenji Sakamoto, Takashi Miyazaki, Yu Oimatsu, Masanobu Ishii, Noriaki Tabata, Tomonori Akasaka, Daisuke Sueta, Eiichiro Yamamoto, Megumi Yamamuro, Yasuhiro Izumiya, Sunao Kojima, Sunao Nakamura, Koichi Kaikita, Seiji Hokimoto, Hisao Ogawa

    INTERNATIONAL JOURNAL OF CARDIOLOGY   220   112 - 115   2016.10

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    Background: Although acute coronary syndrome (ACS) mainly arises from plaque ruptures (PR), precise mechanisms underlying ACS without PR are unknown. We sought to examine clinical, angiographic and intravascular ultrasound (IVUS) characteristics of ACS without PR.
    Methods and results: Culprit lesions of 161 ACS patients were categorized by the presence or absence of PR (PR group: n = 57, Non-PR group: n = 104). Lower abdominal circumference (86 +/- 10 cm vs 90 +/- 9 cm, p = 0.02), lower prevalence of myocardial infarction (53% vs 82%, p = 0.0002), and higher prevalence of definite vasospasm (15% vs 2%, p = 0.006) were found in Non-PR group. Morphologically, Non-PR group was associated with simpler Ambrose classification (36% vs 14%, p = 0.004), less hypoechoic plaque (45% vs 65%, p = 0.04) and lower incidence of IVUS-detected thrombus (21% vs 54%, p &lt; 0.0001), compared with PR group. On quantitative IVUS, although minimum lumen area (MLA) was similar between the groups, vessel (14.2 +/- 5.4 mm(2) vs 17.5 +/- 5.1 mm(2), p = 0.0002) and plaque (11.6 +/- 5.0 mm(2) vs 14.9 +/- 4.9 mm(2), p &lt; 0.0001) areas were significantly smaller at MLA site in Non-PR group than in PR group. On multivariate analysis, average plaque area was only an independent IVUS-predictor of non-rupture ACS (odds ratio: 0.85, p = 0.01).
    Conclusion: Compared to ACS with PR, non-rupture ACS arise from more hyperechoic (allegedly "stable") plaque with smaller vessel and plaque area, leading to lower incidence of thrombotic occlusion. Coronary vasospasm might be a possible pathogenic mechanism underlying non-rupture ACS. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

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  • The Timing of Conversion to Ventricular Assist Device (VAD) in Fulminant Myocarditis-Consideration From an Unsuccessful Case Using Bi-VAD

    Kiwamu Iwata, Teruyasu Sugano, Masayoshi Kiyokuni, Naoki Nakayama, Naohiro Komura, Manabu Nitta, Tomoaki Ishigami, Kazuo Kimura, Toshiyuki Ishikawa

    JOURNAL OF CARDIAC FAILURE   22 ( 9 )   S223 - S223   2016.9

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  • Synergistic effect of ezetimibe addition on coronary atheroma regression in patients with prior statin therapy: Subanalysis of PRECISE-IVUS trial. Reviewed International journal

    Tsujita K, Yamanaga K, Komura N, Sakamoto K, Sugiyama S, Sumida H, Shimomura H, Yamashita T, Oka H, Nakao K, Nakamura S, Ishihara M, Matsui K, Sakaino N, Nakamura N, Yamamoto N, Koide S, Matsumura T, Fujimoto K, Tsunoda R, Morikami Y, Matsuyama K, Oshima S, Kaikita K, Hokimoto S, Ogawa H, PRECISE-IVUS Investigators

    European journal of preventive cardiology   23 ( 14 )   1524 - 1528   2016.9

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    BACKGROUND: The IMPROVE-IT trial showed that the clinical benefit of statin/ezetimibe combination appeared to be pronounced in patients with prior statin therapy. We hypothesized that the antiatherosclerotic effect of atorvastatin/ezetimibe combination was pronounced in patients with statin pretreatment. METHODS: In the prospective, randomized, controlled, multicenter PRECISE-IVUS trial, 246 patients undergoing intravascular ultrasound-guided percutaneous coronary intervention were randomized to atorvastatin/ezetimibe combination or atorvastatin alone. The dosage of atorvastatin was uptitrated with a treatment goal of lowering low-density lipoprotein cholesterol to below 70 mg/dl in both groups. Serial volumetric intravascular ultrasound was performed at baseline and 9-12 month follow-up to quantify the coronary plaque response in 202 patients. We compared the intravascular ultrasound endpoints in all subjects, stratified by the presence or absence of statin pretreatment. RESULTS: The baseline low-density lipoprotein cholesterol level (100.7 ± 23.1 mg/dl vs. 116.4 ± 25.9 mg/dl, p < 0.001) and lathosterol (55 (38 to 87)) µg/100 mg total cholesterol vs. 97 (57 to 149) µg/100 mg total cholesterol, p < 0.001) was significantly lower, and campesterol/lathosterol ratio (3.9 (2.4 to 7.4) vs. 2.6 (1.5 to 4.1), p < 0.001) was significantly increased in patients with statin pretreatment. Contrary to the patients without statin pretreatment (-1.3 (-3.1 to -0.1)% vs. -0.9 (-2.3 to 0.9)%, p = 0.12), the atorvastatin/ezetimibe combination showed a significantly stronger reduction in delta percent atheroma volume, compared with atorvastatin alone, in patients with statin pretreatment (-1.8 (-3.6 to -0.3)% vs. -0.1 (-1.6 to 0.8)%, p = 0.002). CONCLUSION: Compensatory increase in cholesterol absorption observed in statin-treated patients might attenuate the inhibitory effects of statins on coronary plaque progression. A low-dose statin/ezetimibe combination might be a promising option in statin-hyporesponder.

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  • Lipid profile associated with coronary plaque regression in patients with acute coronary syndrome: Subanalysis of PRECISE-IVUS trial. Reviewed International journal

    Tsujita K, Yamanaga K, Komura N, Sakamoto K, Sugiyama S, Sumida H, Shimomura H, Yamashita T, Oka H, Nakao K, Nakamura S, Ishihara M, Matsui K, Sakaino N, Nakamura N, Yamamoto N, Koide S, Matsumura T, Fujimoto K, Tsunoda R, Morikami Y, Matsuyama K, Oshima S, Kaikita K, Hokimoto S, Ogawa H, PRECISE-IVUS Investigators

    Atherosclerosis   251   367 - 372   2016.8

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    BACKGROUND AND AIMS: Although dual low-density lipoprotein cholesterol (LDL-C)-lowering therapy (DLLT) with statin-ezetimibe combination showed clinical benefit in patients with acute coronary syndrome (ACS) confirming "the lower, the better," the underlying mechanisms of DLLT are still unknown. METHODS: PRECISE-IVUS trial evaluated the effects of DLLT on IVUS-derived coronary atherosclerosis and lipid profile, compared with atorvastatin monotherapy, quantifying the coronary plaque response in 100 ACS patients. We explored the potential predictors of plaque regression. RESULTS: Lower total cholesterol, LDL-C, triglyceride, remnant-like particles cholesterol, and stronger reduction of small dense LDL-C and cholesterol absorption markers were observed in patients with plaque regression compared to those with progression. Multivariate analysis revealed that achieved LDL-C was the strongest predictor for coronary plaque regression (95% CI: 0.944-1.000, p = 0.05), followed by age (95% CI: 0.994-1.096, p = 0.09). CONCLUSIONS: Incremental LDL-C lowering by DLLT was associated with stronger coronary plaque regression, reconfirming that lowering LDL-C to levels below previous targets provided additional clinical benefit.

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  • Effects of 4 Statins on Regression of Coronary Plaque in Acute Coronary Syndrome Reviewed

    Kensuke Matsushita, Kiyoshi Hibi, Naohiro Komura, Eiichi Akiyama, Nobuhiko Maejima, Noriaki Iwahashi, Kengo Tsukahara, Masami Kosuge, Toshiaki Ebina, Shinichi Sumita, Satoshi Umemura, Kazuo Kimura

    CIRCULATION JOURNAL   80 ( 7 )   1634 - +   2016.7

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    Background: There is no information on differences in the effects of moderate-and low-intensity statins on coronary plaque in patients with acute coronary syndrome (ACS). The aim of this study was to compare the effects of 4 different statins in patients with ACS, using intravascular ultrasound (IVUS).
    Methods and Results: A total of 118 patients with ACS who underwent IVUS before percutaneous coronary intervention and who were found to have mild to moderate non-culprit coronary plaques were randomly assigned to receive either 20 mg/day atorvastatin or 4 mg/day pitavastatin (moderate-intensity statin therapy), or 10 mg/day pravastatin or 30 mg/day fluvastatin (low-intensity statin therapy). IVUS at baseline and at end of 10-month treatment was available in 102 patients. Mean percentage change in plaque volume (PV) was -11.1 +/- 12.8%, -8.1 +/- 16.9%, 0.4 +/- 16.0%, and 3.1 +/- 20.0% in the atorvastatin, pitavastatin, pravastatin, and fluvastatin groups, respectively (P=0.007, ANOVA). Moderate-intensity statin therapy induced regression of PV, whereas low-intensity statin therapy produced insignificant progression (-9.6% vs. 1.8%, P&lt;0.001). On multivariate linear regression analysis, moderate-intensity statin therapy (P=0.02) and uric acid at baseline (P=0.02) were significant determinants of large percent PV reduction. LDL-C at follow-up did not correlate with percent PV change.
    Conclusions: Moderate-intensity statin therapy induced regression of coronary PV, whereas low-intensity statin therapy resulted in slight progression of coronary PV in patients with ACS.

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  • Impaired Peripheral Endothelial Function Assessed by Digital Reactive Hyperemia Peripheral Arterial Tonometry and Risk of In-Stent Restenosis. Reviewed International journal

    Komura N, Tsujita K, Yamanaga K, Sakamoto K, Kaikita K, Hokimoto S, Iwashita S, Miyazaki T, Akasaka T, Arima Y, Yamamoto E, Izumiya Y, Yamamuro M, Kojima S, Tayama S, Sugiyama S, Matsui K, Nakamura S, Hibi K, Kimura K, Umemura S, Ogawa H

    Journal of the American Heart Association   5 ( 6 )   2016.6

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    BACKGROUND: Drug-eluting stents are replacing bare-metal stents, but in-stent restenosis (ISR) remains a problem. Reactive hyperemia index (RHI) assessed by peripheral arterial tonometry evaluates endothelial function noninvasively. We prospectively assessed the prognostic value of RHI in predicting ISR after percutaneous coronary intervention. METHODS AND RESULTS: RHI was measured before percutaneous coronary intervention and at follow-up (F/U) angiography (F/U RHI; 6 and 9 months post bare-metal stents- and drug-eluting stents- percutaneous coronary intervention, respectively) in 249 consecutive patients. At F/U, ISR (stenosis >50% of diameter) was seen in 68 patients (27.3%). F/U natural logarithm (RHI) was significantly lower in patients with ISR than in those without (0.52±0.23 versus 0.65±0.27, P<0.01); no between-group difference in initial natural logarithm (RHI) (0.60±0.26 versus 0.62±0.25, P=0.56) was seen. By multivariate logistic regression analysis, even after adjusting for other significant parameters in univariate analysis, F/U natural logarithm (RHI) independently predicted ISR (odds ratio: 0.13; 95% CI: 0.04-0.48; P=0.002). In receiver operating-characteristic analysis, F/U RHI was the strongest predictor of ISR (area under the curve: 0.67; 95% CI: 0.60-0.75; P<0.01; RHI <1.73 had 67.6% sensitivity, 64.1% specificity); area under the curve significantly improved from 0.62 to 0.70 when RHI was added to traditional ISR risk factors (P=0.02). Net reclassification index was significant after addition of RHI (26.5%, P=0.002). CONCLUSIONS: Impaired RHI at F/U angiography independently correlated with ISR, adding incremental prognostic value to the ISR-risk stratification following percutaneous coronary intervention. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov/. Unique identifier: NCT02131935.

    DOI： 10.1161/JAHA.116.003202

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  • Clinical characteristics and intravascular ultrasound findings of culprit lesions in elderly patients with acute coronary syndrome Reviewed

    Yuji Ogura, Kenichi Tsujita, Hideki Shimomura, Kenshi Yamanaga, Naohiro Komura, Takashi Miyazaki, Masanobu Ishii, Noriaki Tabata, Tomonori Akasaka, Yuichiro Arima, Kenji Sakamoto, Sunao Kojima, Sunao Nakamura, Koichi Kaikita, Seiji Hokimoto, Hisao Ogawa

    HEART AND VESSELS   31 ( 3 )   341 - 350   2016.3

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    Acute coronary syndrome (ACS) is one of the main causes of cardiovascular death. According to rapid aging of society, the peak age of ACS onset has grown older globally. Despite growing recognition of the necessity to build the ACS prevention strategy in the elderly, patients background and culprit lesion morphology of these elderly ACS patients have not been well studied. We sought to assess the clinical characteristics and intravascular ultrasound (IVUS) findings of the culprit lesions in elderly ACS patients. One-hundred and fifty-eight consecutive ACS patients whose culprit lesions imaged by pre-intervention IVUS were divided into two groups based on the age of onset: elderly [E] group (a parts per thousand yen75 years, n = 65) and non-elderly [NE] group (&lt; 75 years, n = 93). As compared with NE group, hemoglobin (12.7 +/- A 2.0 g/dL vs. 13.7 +/- A 1.6 g/dL, p = 0.001), estimated glomerular filtration rate (62.5 +/- A 22.5 mL/min/1.73 m(2) vs. 75.5 +/- A 20.5 mL/min/1.73 m(2), p = 0.0001), and body mass index (22.9 +/- A 3.4 kg/m(2) vs. 24.5 +/- A 3.4 kg/m(2), p = 0.003) were significantly lower, and comorbid malignancy was more common (20.0 vs 6.5 %, p = 0.01) in E group. Although whole culprit segment was not positively remodeled (mean vessel area was 15.2 +/- A 5.6 mm(3)/mm vs. 16.2 +/- A 5.1 mm(3)/mm, p = 0.16) in E group, at maximum external elastic membrane site of the culprit lesion, lumen area was smaller (5.5 +/- A 3.2 mm(2) vs. 6.7 +/- A 3.5 mm(2), p = 0.04), and plaque burden tended to be more abundant (70 +/- A 13 vs. 66 +/- A 13 %, p = 0.08). Interestingly, echo attenuation arc of culprit attenuated plaque was significantly greater in E group than in NE group (157 +/- A 83A degrees vs. 118 +/- A 60A degrees, p = 0.01). In conclusion, extracardiac comorbidity was more common in elderly ACS patients, and their culprit coronary lesions were still rupture prone, and "vulnerable.".

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  • Impact of left ventricular hypertrophy on impaired coronary microvascular dysfunction. Reviewed International journal

    Tsujita K, Yamanaga K, Komura N, Sakamoto K, Miyazaki T, Ishii M, Tabata N, Akasaka T, Sueta D, Arima Y, Kojima S, Yamamoto E, Yamamuro M, Tanaka T, Izumiya Y, Tayama S, Nakamura S, Kaikita K, Hokimoto S, Ogawa H

    International journal of cardiology   187 ( 1 )   411 - 413   2015.5

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  • The Impact of Peripheral Artery Disease Assessed by Ankle-Brachial Index on Endothelial Dysfunction and Risk of In-Stent Restenosis After Percutaneous Coronary Intervention Reviewed

    Naohiro Komura, Kenichi Tsujita, Kenshi Yamanaga, Kenji Sakamoto, Takashi Miyazaki, Noriaki Tabata, Masanobu Ishii, Tomonori Akasaka, Yuichiro Arima, Takamichi Ono, Sunao Kojima, Shinji Tayama, Koichi Kaikita, Seiji Hokimoto, Kiyoshi Hibi, Kazuo Kimura, Satoshi Umemura, Hisao Ogawa

    CIRCULATION   130   2014.11

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  • Relation between hyperinsulinemia and nonculprit plaque characteristics in nondiabetic patients with acute coronary syndromes Reviewed International journal

    T. Mitsuhashi, K. Hibi, M. Kosuge, S. Morita, N. Komura, I. Kusama, F. Otsuka, M. Endo, N. Iwahashi, J. Okuda, K. Tsukahara, T. Ebina, S. Umemura, K. Kimura

    JACC: Cardiovascular Imaging   4 ( 4 )   392 - 401   2011

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    OBJECTIVES: We sought to assess whether hyperinsulinemia is associated with percentage lipid and coronary plaque burden in nondiabetic patients with acute coronary syndromes (ACS). BACKGROUND: Hyperinsulinemia carries an increased risk of cardiovascular disease even in pre-diabetic patients, but the precise mechanisms of its effects remain unclear. METHODS: Nonculprit coronary lesions associated with mild-to-moderate stenosis in 82 nondiabetic patients with ACS were examined by integrated backscatter intravascular ultrasound (IB-IVUS), using a 40-MHz intravascular catheter. Conventional IVUS and IB-IVUS measurements from the worst 10-mm segment (1-mm intervals) were calculated. All patients underwent a 75-g oral glucose tolerance test (OGTT) to calculate the area under the insulin concentration-time curve (AUC insulin) from 0 to 120 min. RESULTS: Patients in the high tertile of AUC insulin had a significantly greater percentage lipid area and absolute lipid volume than did patients in the intermediate and low tertiles (tertile 3 vs. tertile 2 vs. tertile 1; 37.6 ± 16.6% vs. 25.8 ± 11.9% vs. 27.5 ± 14.7%, p < 0.01 by analysis of variance [ANOVA], and 29.9 ± 22.6 mm(3) vs. 15.3 ± 12.6 mm(3) vs. 17.7 ± 12.7 mm(3), p < 0.01 by ANOVA, respectively) and a smaller percentage fibrosis area (55.0 ± 11.5% vs. 61.7 ± 9.4% vs. 60.7 ± 9.4%, p = 0.03 by ANOVA). Multiple regression analysis showed that the high tertile of AUC insulin was independently associated with an increased percentage lipid area (p < 0.05). On conventional IVUS analysis, external elastic membrane cross-sectional area was significantly increased with greater plaque volume in patients in the high tertile of AUC insulin (both p < 0.05 by ANOVA). CONCLUSIONS: Hyperinsulinemia is associated with an increased lipid content and a greater plaque volume of nonculprit intermediate lesions in nondiabetic patients with ACS, suggesting that plaque vulnerability is increased in this subgroup of patients.

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  • Impact of ultrasound attenuation and plaque rupture as detected by intravascular ultrasound on the incidence of no-reflow phenomenon after percutaneous coronary intervention in ST-segment elevation myocardial infarction. Reviewed International journal

    Endo M, Hibi K, Shimizu T, Komura N, Kusama I, Otsuka F, Mitsuhashi T, Iwahashi N, Okuda J, Tsukahara K, Kosuge M, Ebina T, Umemura S, Kimura K

    JACC. Cardiovascular interventions   3 ( 5 )   540 - 549   2010.5

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    OBJECTIVES: The aim of this study was to assess whether ultrasound attenuation and plaque rupture as detected by intravascular ultrasound (IVUS) are associated with the incidence of no-reflow phenomenon after percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). BACKGROUND: No-reflow phenomenon is associated with worse long-term outcomes after STEMI. Therefore, reliable and feasible intravascular imaging techniques are needed to identify patient subgroups that would be at high risk for no-reflow phenomenon. METHODS: One hundred seventy consecutive patients with STEMI who underwent PCI within 12 h after symptom onset were enrolled. The IVUS interrogation was performed before PCI. RESULTS: No-reflow phenomenon occurred in 30 patients (18%), who had a higher incidence of no ST-segment resolution (50% vs. 9%; p < 0.001), a higher peak creatine kinase level (4,090 IU/l vs. 2,823 IU/l; p < 0.001), and a lower left ventricular ejection fraction in the chronic phase (51% vs. 59%; p < 0.01). Multivariate logistic regression analysis revealed that ultrasound attenuation with a longitudinal length of > or =5 mm, plaque rupture, and reperfusion time correlated with no-reflow phenomenon (all p < 0.05). In patients with both ultrasound attenuation > or =5 mm and plaque rupture, the incidence of no-reflow phenomenon was 88%, and the risk of decreased coronary reflow was higher than that predicted by either factor alone (p = 0.004 for interaction). CONCLUSIONS: In patients with STEMI, a longer ultrasound attenuation and plaque rupture on IVUS are associated with an increased incidence of no-reflow phenomenon, suggesting that this subset of patients might be at high risk for distal embolism.

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  • Plaque location in the left anterior descending coronary artery and tissue characteristics in angina pectoris: an integrated backscatter intravascular ultrasound study. Reviewed

    Komura N, Hibi K, Kusama I, Otsuka F, Mitsuhashi T, Endo M, Iwahashi N, Okuda J, Tsukahara K, Kosuge M, Ebina T, Umemura S, Kimura K

    Circulation journal : official journal of the Japanese Circulation Society   74 ( 1 )   142 - 147   2010.1

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    BACKGROUND: Ruptured plaque and culprit lesions associated with anterior acute myocardial infarction cluster mainly in the proximal segment of the left anterior descending coronary artery (LAD). This study investigated whether the tissue characteristics of plaque in the proximal LAD differs from that of plaque in the distal LAD as assessed by integrated backscatter (IB)-intravascular ultrasound (IVUS). METHODS AND RESULTS: IVUS interrogation was used to study 107 non-culprit intermediate plaques in 68 patients with angina pectoris who underwent percutaneous coronary interventions. Proximal and distal segments were defined as <30 mm and > or =30 mm from the ostium, respectively. IB-IVUS images were recorded, and the average percentage values of each plaque component (lipid, fibrosis, dense fibrosis, and calcification) were compared between segments. Plaques in the proximal segment (n=51) had a higher %lipid content (36 vs 19%, P<0.01) and a lower %fibrosis content (57 vs 64%, P<0.01) than did plaques in the distal segment (n=56). Multiple linear regression analysis showed that proximal plaques had a higher %lipid content, independently of other coronary risk factors and plaque burden (P<0.01). CONCLUSIONS: The %lipid and %fibrosis contents differ significantly between plaques in the proximal segment and those in the distal segment of the LAD. (Circ J 2010; 74: 142 - 147).

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  • Effects of Pretreatment With Statins on Infarct Size in Patients With Acute Myocardial Infarction Who Receive Fibrinolytic Therapy Reviewed

    Masayoshi Kiyokuni, Masami Kosuge, Toshiaki Ebina, Kiyoshi Hibi, Kengo Tsukahara, Jun Okuda, Noriaki Iwahashi, Nobuhiko Maejima, Ikuyoshi Kusama, Naohiro Komura, Naoki Nakayama, Satoshi Umemura, Kazuo Kimura

    CIRCULATION JOURNAL   73 ( 2 )   330 - 335   2009.2

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    Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPANESE CIRCULATION SOC  

    Background Experimental studies suggest that statins promote vascular fibrinolysis, so statin treatment before the onset of acute myocardial infarction (AMI) may result in a smaller infarct size.
    Methods and Results The study group comprised 3 10 patients with AMI who received fibrinolysis within 12 h after symptom onset: 39 had received statin pretreatment (statin group) and 27 1 had not (non-statin group). Initial Thrombolysis In Myocardial Infarction (TIMI) flow grade did not differ between groups. Among 120 patients with initial TIMI flow grade 0/1, achievement of TIMI flow grade &gt;= 2 after passing the guidewire through the culprit lesion was more frequent in the statin group (70% vs 35%, P=0.03). The final rate of TIMI flow grade 3 was higher in the statin group (95% vs 86%, P=0.11). Area under the curve (AUC) for creatine kinase (CK) was lower in the statin group (55,972 +/- 45,934 vs 84,195 +/- 84,276 IU.L(-1).h(-1), P=0.04). Multivariate analysis revealed statin pretreatment as an independent negative predictor of larger infarct size as defined by the upper tertile of AUC for CK (odds ratio 0.25, 95% confidence interval 0.07-0.91, P=0.035).
    Conclusion Stalin pretreatment may enhance fibrinolysis and reduce infarct size inpatients with AMI. (Circ J 2009; 73: 330-335)

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  • Early, accurate, non-invasive predictors of left main or 3-vessel disease in patients with non-ST-segment elevation acute coronary syndrome Reviewed

    M. Kosuge, T. Ebina, K. Hibi, S. Morita, N. Komura, K. Hashiba, M. Kiyokuni, N. Nakayama, S. Umemura, K. Kimura

    Circulation Journal   73 ( 6 )   1105 - 1110   2009

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    BACKGROUND: In patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS), identification of left main and/or 3-vessel disease (LM/3VD) is crucial for deciding whether to initiate early treatment with clopidogrel, which can increase the risk of surgical bleeding. METHODS AND RESULTS: On admission, the clinical factors of 501 patients with NSTE-ACS, who underwent coronary angiography, were evaluated. ST-segment shifts and the widest QRS duration were measured on an admission 12-lead electrocardiogram. Ninety-six patients had LM/3VD. Univariate analysis indicated that many factors were related to LM/3VD. On multivariate analysis, QRS duration (odds ratio (OR) 9.04, P<0.01), the degree of ST-segment elevation in lead aVR (OR 7.10, P<0.01), and positive-troponin T (OR 1.52, P<0.05) were independent predictors of LM/3VD. A QRS duration of >90 ms and a ST-segment elevation in lead aVR of >or=0.5 mm best identified LM/3VD. A QRS duration of >90 ms, a ST-segment elevation in lead aVR of >or=0.5 mm, and a positive-troponin T identified LM/3VD with sensitivities of 88%, 76%, and 54% (P<0.01), and specificities of 88%, 86%, and 71% (P<0.01), respectively. CONCLUSIONS: A prolonged QRS duration, ST-segment elevation in lead aVR, and a positive-troponin T on admission are useful predictors of LM/3VD in patients with NSTE-ACS. In particular, a maximal QRS duration of >90 ms was the most sensitive predictor of LM/3VD.

    DOI： 10.1253/circj.CJ-08-1009

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  • ST-segment elevation resolution in lead aVR: a strong predictor of adverse outcomes in patients with non-ST-segment elevation acute coronary syndrome.

    Masami Kosuge, Toshiaki Ebina, Kiyoshi Hibi, Mitsuaki Endo, Naohiro Komura, Katsutaka Hashiba, Masayoshi Kiyokuni, Naoki Nakayama, Satoshi Umemura, Kazuo Kimura

    Circulation journal : official journal of the Japanese Circulation Society   72 ( 7 )   1047 - 53   2008.7

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    BACKGROUND: The impact of ST-segment elevation resolution in lead aVR on outcomes in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) is unclear. METHODS AND RESULTS: Electrocardigrams (ECGs) were recorded on admission and 6 h later in 367 patients with NSTE-ACS. ST-segment deviation >or=0.5 mm was considered significant: 92 patients had ST-segment elevation in lead aVR on admission ECG (ST upward arrowaVR), and 275 did not. Among patients with ST upward arrowaVR, 50 had ST resolution, defined as a reduction >50% in the degree of ST-segment elevation in lead aVR from admission to 6 h later, and 42 did not. ST upward arrowaVR without ST resolution was associated with older age, greater ST-segment depression in other leads on admission and 6 h later, higher rates of positive troponin T, left main and/or 3-vessel coronary disease, and adverse events such as death, (re)infarction, or urgent revascularization within 30 days after admission. Multivariate analysis showed that ST upward arrowaVR without ST resolution was the strongest independent predictor of death or (re)infarction within 30 days after admission (hazard ratio 5.62, p=0.018). CONCLUSIONS: ST upward arrowaVR without ST resolution is a strong predictor of 30-day adverse outcomes and correlates with the extent and severity of coronary artery disease in patients with NSTE-ACS.

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  • Clinical implications of serial changes in ST-segment elevation after reperfusion in patients with anterior acute myocardial infarction. Reviewed

    Okuda J, Kosuge M, Ebina T, Hibi K, Tsukahara K, Iwahashi N, Endo M, Nakachi T, Mitsuhashi T, Otsuka F, Kusama I, Hashiba K, Komura N, Umemura S, Kimura K

    Circulation journal : official journal of the Japanese Circulation Society   72 ( 3 )   409 - 414   2008.3

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    BACKGROUND: In patients with acute myocardial infarction (AMI), the relationship of serial changes in ST-segment elevation after reperfusion to left ventricular (LV) function remains unclear. METHODS AND RESULTS: The study group comprised 164 patients with reperfused anterior AMI within 6 h of symptom onset. The sum of ST-segment deviation was calculated on admission (SigmaST-admission), and 1 h (SigmaST-1 h) and 24 h (SigmaST-24 h) after reperfusion. ST resolution was defined as a reduction in SigmaST-1 h of > or =50% as compared with SigmaST-admission. Patients were classified into 3 groups: group A, 82 patients with ST resolution in whom SigmaST-1 h > or = SigmaST-24 h; group B, 37 patients with ST resolution in whom SigmaST-1 h < SigmaST-24 h; group C, 45 patients without ST resolution. Peak creatine kinase were higher in groups B and C than in group A (4,578+/-2,176, 4,236+/-2,638, 2,222+/-1,926 mU/ml, p<0.01). At 6 months follow-up, the LV ejection fraction were lower in groups B and C than in group A (53+/-8, 54+/-12, 62+/-9%, p<0.01). CONCLUSIONS: An increase in ST-segment elevation 1-24 h after reperfusion, despite ST resolution, is associated with a larger infarction and poorer LV function in patients with reperfused anterior AMI.

    DOI： 10.1253/circj.72.409

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  • Does tissue characteristics differ between proximal and distal segment of left anterior descending coronary artery in angina pectoris? An integrated backscatter intravascular ultrasound (IB-IVUS) study

    Naohiro Komura, Kiyoshi Hibi, Ikuyoshi Kusama, Fumiyuki Ootsuka, Takayuk Mitsuhashi, Mitsuaki Endou, Satoshi Umemura, Kazuo Kimura

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   51 ( 10 )   A290 - A290   2008.3

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  • Electrocardiographic differentiation between acute pulmonary embolism and acute coronary syndromes on the basis of negative T waves Reviewed International journal

    Masami Kosuge, Kazuo Kimura, Toshiyuki Ishikawa, Toshiaki Ebina, Kiyoshi Hibi, Ikuyoshi Kusama, Tatuya Nakachi, Mitsuaki Endo, Naohiro Komura, Satoshi Umemura

    AMERICAN JOURNAL OF CARDIOLOGY   99 ( 6 )   817 - 821   2007.3

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    Negative T waves in precordial leads are often seen in patients with acute coronary syndrome (ACS), but also occur in those with acute pulmonary embolism (APE). However, little attention has been given to differences in negative T waves between patients with these 2 diseases. The present study examines the value of electrocardiograms for discriminating between 40 patients with APE and 87 patients with ACS who had negative T waves in the precordial leads (V-1 to V-4) on the admission electrocardiogram. In 77 patients (89%) with ACS, the culprit lesion was confirmed angiographically to be located in the left anterior descending coronary artery. Pulmonary P waves, S1S2S3 pattern, S(1)Q(3)T(3) Pattern, low voltage, and clockwise rotation were specific for APE, but sensitivities of these findings were very low. In patients with APE, negative T waves were commonly present in leads 11, 111, aVF, V-1, and V-2, but were less frequent in leads 1, aVL, and V-3 to V-6 (P &lt; 0.05)Negative T,waves in leads III and V-1 were observed in only 1% of patients with ACS compared with 88% of patients with APE (p &lt; 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of this finding for the diagnosis of APE were 88%, 99%, 97%, and 95%, respectively. In conclusion, the presence of negative T waves in both leads III and V-1 allows APE to be differentiated simply but accurately from ACS in patients with negative T waves in the precordial leads. (c) 2007 Elsevier Inc. All rights reserved.

    DOI： 10.1016/j.amjcard.2006.10.043

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  • バルーン肺動脈形成術(BPA)施行も救命できなかったAcute on chronic PTEによる心肺停止の一例

    小村 直弘, 菅野 晃靖, 鈴木 徹, 川浦 範之, 小西 正紹, 岩橋 徳明, 日比 潔

    日本心血管インターベンション治療学会抄録集   32回   MO41 - 5   2024.7

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  • 運動負荷肺高血圧症の除外診断における下肢挙上法の有用性(Legs Elevation Method may be Useful for Diagnosis of Exclusion for Exercised Pulmonary Hypertension)

    鈴木 徹, 相澤 広太郎, 峯岸 慎太郎, 小村 直弘, 川浦 範之, 小西 正紹, 岩橋 徳明, 石上 友章, 菅野 晃靖, 日比 潔

    日本循環器学会学術集会抄録集   88回   PJ062 - 3   2024.3

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  • バルサルバ洞動脈瘤が塞栓源と考えられた若年発症の血栓性急性心筋梗塞の1例

    山内健輔, 鈴木徹, 石井怜, 乙竹泰, 相澤広太郎, 阿部茉莉愛, 菅原拓哉, 中島理恵, 小村直弘, 川浦範之, 小西正紹, 岩橋徳明, 石上友章, 山口由衣, 日比潔

    日本心臓病学会学術集会(Web)   72nd   2024

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  • がん治療におけるレニン・アンジオテンシン系阻害薬の役割

    石井怜, 花島陽平, 峯岸慎太郎, 堀米旭, 服部京子, 所卓見, 浅井真成, 岡崎善則, 小村直弘, 石上友章, 日比潔, 日比潔, 矢野裕一朗, 西山成

    日本腫瘍循環器学会学術集会抄録集(Web)   7th   2024

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  • 成人のがんサバイバーにおける高血圧と固形がん再発リスク:系統的レビューとメタアナリシス

    岡崎善則, 小村直弘, 峯岸慎太郎, 堀米旭, 石井怜, 所卓見, 服部京子, 浅井真成, 花島陽平, 石上友章, 日比潔, 日比潔, 矢野裕一朗, 西山成

    日本腫瘍循環器学会学術集会抄録集(Web)   7th   2024

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  • 血行再建を伴わないCTEPHに対する肺血管拡張薬の効果を再考する:当院でのSelexipagとRiociguatの肺血行動態への効果の比較検討

    小村直弘, 菅野晃靖, 鈴木徹, 小西正紹, 岩橋徳明, 石上友章, 日比潔

    日本心臓病学会学術集会(Web)   72nd   2024

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  • 先天性横隔膜ヘルニア術後の若年女性に発症した肺高血圧症の1例

    相澤 広太郎, 日比 潔, 石上 友章, 岩橋 徳明, 小西 正昭, 細田 順也, 川浦 範之, 小村 直弘, 峯岸 慎太郎, 鈴木 徹

    日本内科学会関東地方会   689回   30 - 30   2023.9

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  • 肺高血圧診断基準変更の意義 肺高血圧症の新基準は早期薬物介入の可能性を高める

    岩橋 徳明, 小村 直弘, 鈴木 徹, 川浦 範之, 堀井 睦夫, 菅野 晃靖, 石上 友章, 田村 功一, 日比 潔

    日本心臓病学会学術集会抄録   71回   S6 - 6   2023.9

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  • STEMIのprimary PCIにおける若年術者と上級術者の長期予後比較

    郷原 正臣, 桐ヶ谷 仁, 桐ヶ谷 英邦, 菊地 進之介, 中橋 秀文, 南本 祐吾, 岩田 究, 小村 直弘, 岡田 興造, 松澤 泰志, 小西 正紹, 川浦 範之, 岩橋 徳明, 菅野 晃靖, 海老名 俊明, 日比 潔

    日本心血管インターベンション治療学会抄録集   31回   MP57 - 1   2023.8

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  • 右冠動脈の高度屈曲石灰化病変へのPCI中にDiamondBackが断裂し、回収に成功した一例

    小村 直弘, 菅野 晃靖, 鈴木 徹, 岩田 究, 川浦 範之, 小西 正紹, 日比 潔, 有川 雅也, 櫛田 俊一

    日本心血管インターベンション治療学会抄録集   31回   MP68 - 2   2023.8

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  • 大量腹水によりEpoprostenolからTreprostinilへ変更したIPAH症例

    小村 直弘, 菅野 晃靖, 鈴木 徹, 小野 文明, 日比 潔

    日本肺高血圧・肺循環学会学術集会抄録集   8回   118 - 118   2023.6

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  • 強皮症関連肺動脈性肺高血圧症に対するセレキシパグ単剤治療

    鈴木 徹, 松村 賢治, 岩田 究, 小村 直弘, 川浦 範之, 小西 正紹, 石上 友章, 菅野 晃靖, 日比 潔

    日本肺高血圧・肺循環学会学術集会抄録集   8回   107 - 107   2023.6

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  • トシリズマブが有効であった全身型若年性関節炎によるPAHの一例

    小村 直弘, 菅野 晃靖, 鈴木 徹, 小野 文明, 日比 潔

    日本肺高血圧・肺循環学会学術集会抄録集   8回   86 - 86   2023.6

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  • 肺高血圧症患者の運動耐容能に対するサルコペニアの影響

    中山 未奈, 小西 正紹, 中島 理恵, 郷原 正臣, 岩田 究, 小村 直弘, 仁田 学, 川浦 範之, 石上 友章, 菅野 晃靖

    日本肺高血圧・肺循環学会学術集会・日本小児肺循環研究会プログラム・抄録集   7回・28回   143 - 143   2022.7

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  • BPA手技に有用なPCIのテクニック

    小村 直弘, 菅野 晃靖, 中山 未奈, 郷原 正臣, 岩田 究, 川浦 範之, 小西 正紹, 木村 一雄, 田村 功一

    日本心血管インターベンション治療学会抄録集   30回   [MO268] - [MO268]   2022.7

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  • Diamondback 360 coronary orbital atherectomy systemは分岐部病変、入口部病変で安全に使用できるか?

    郷原 正臣, 岩田 究, 小村 直弘, 川浦 範之, 菅野 晃靖

    日本心血管インターベンション治療学会抄録集   30回   [MO547] - [MO547]   2022.7

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  • BPA施行も救命できなかったAcute on chronic PTEによるCPAの一例

    小村 直弘, 中山 美奈, 菅野 晃靖, 田村 功一

    日本肺高血圧・肺循環学会学術集会・日本小児肺循環研究会プログラム・抄録集   7回・28回   112 - 112   2022.7

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  • CTEPH診療の進歩 CVIT仕込みBPAでここまでやれる! BPAへの各種PCIテクニックの応用

    小村 直弘, 菅野 晃靖, 中山 未奈, 田村 功一

    日本肺高血圧・肺循環学会学術集会・日本小児肺循環研究会プログラム・抄録集   7回・28回   74 - 74   2022.7

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  • 慢性血栓塞栓性肺高血圧症(CTEPH)の診断・治療の最前線—Current diagnostic and therapeutic strategies for chronic thromboembolic pulmonary hypertension (CTEPH)—特集 循環器・腎臓内科医が知りたい循環器・腎臓・高血圧治療のupdate

    小村 直弘

    循環器内科 = Cardioangiology / 循環器内科編集委員会 編   91 ( 5 )   574 - 580   2022.5

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    researchmap

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  • Current diagnostic and therapeutic strategies for chronic thromboembolic pulmonary hypertension (CTEPH).

    小村直弘

    循環器内科   91 ( 5 )   2022

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  • 肺高血圧症患者の運動耐容能における骨格筋・栄養状態の重要性

    中山 未奈, 小村 直弘, 小西 正紹, 郷原 正臣, 岩田 究, 川浦 範之, 菅野 晃靖, 石上 友章, 石川 利之, 木村 一雄

    日本肺高血圧・肺循環学会学術集会・日本小児肺循環研究会プログラム・抄録集   6回・27回   40 - 40   2021.5

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  • 早期診断・治療が功を奏した肺腫瘍血栓性微小血管症(PTTM)の一例

    所 卓見, 小村 直弘, 山田 顕光, 中山 未奈, 木村 安希, 三宅 暁夫, 菅野 晃靖, 石川 利之, 遠藤 格, 田村 功一

    日本肺高血圧・肺循環学会学術集会・日本小児肺循環研究会プログラム・抄録集   6回・27回   31 - 31   2021.5

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  • 肺高血圧症患者の運動能に対する骨格筋の量および機能の影響(Impact of Skeletal Muscle Mass and Function on Exercise Capacity in Patients with Pulmonary Hypertension)

    中山 未奈, 小西 正紹, 小村 直弘, 郷原 正臣, 岩田 究, 川浦 範之, 菅野 晃靖, 石上 友章, 石川 利之, 田村 功一, 木村 一雄

    日本循環器学会学術集会抄録集   85回   OJ83 - 2   2021.3

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  • Diamondback 360 Coronary Orbital Atherectomy Systemにおける安全な方法としてのクラウンのFirst Pullback Motion(First Pullback Motion of the Crown as a Safe Method in Diamondback 360 Coronary Orbital Atherectomy System)

    郷原 正臣, 菅野 晃靖, 中山 未奈, 岩田 究, 小村 直弘, 小西 正紹, 川浦 範之, 石川 利之, 田村 功一, 木村 一雄

    日本循環器学会学術集会抄録集   85回   OJ39 - 4   2021.3

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  • Diamondback 360 coronary orbital atherectomy systemは分岐部病変、入口部病変で安全に使用できるか?

    郷原 正臣, 菅野 晃靖, 松本 祐介, 中山 未奈, 岩田 究, 小村 直弘, 小西 正紹, 重永 豊一郎, 木村 一雄

    日本心血管インターベンション治療学会抄録集   29回   1019 - 1019   2021.2

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  • 安全かつ確実な側枝保護であるJailed Corsair Techniqueの有効性を実感した複雑病変症例

    重永 豊一郎, 菅野 晃靖, 松本 祐介, 中山 未奈, 郷原 正臣, 岩田 究, 小村 直弘, 石川 利之

    日本心血管インターベンション治療学会抄録集   29回   728 - 728   2021.2

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  • Focus on CHIP(Complex High-Risk Indicated Procedure/Patients) intervention 2020 Diamondback 360 coronary atherectomy systemにおける初回pullback motionの安全性(First pullback motion of the crown as a safe method in Diamondback 360 coronary atherectomy system)

    郷原 正臣, 菅野 晃靖, 松本 祐介, 中山 未奈, 岩田 究, 小村 直弘, 小西 正紹, 重永 豊一郎, 木村 一雄

    日本心血管インターベンション治療学会抄録集   29回   362 - 362   2021.2

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  • 成人大動脈縮窄症に対する血管内治療前後の大動脈内視鏡による観察

    松本 祐介, 仁田 学, 重永 豊一郎, 中山 未奈, 郷原 正臣, 岩田 究, 小村 直弘, 菅野 晃靖

    日本心血管インターベンション治療学会抄録集   29回   1003 - 1003   2021.2

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  • バルーン肺動脈拡張術が慢性血栓塞栓性肺高血圧症患者の腎機能に与える影響

    中山 未奈, 小村 直弘, 菅野 晃靖, 松本 祐介, 郷原 正臣, 岩田 究, 重永 豊一郎, 木村 一雄

    日本心血管インターベンション治療学会抄録集   29回   809 - 809   2021.2

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  • 肺高血圧疾患に対する治療戦略 慢性肺血栓塞栓症治療の現状 肺動脈血栓内膜摘除術

    孟 真, 橋山 直樹, 益田 宗孝, 菅野 晃靖, 小村 直弘

    静脈学   31 ( 2 )   120 - 120   2020.9

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  • 肺高血圧症患者の運動能力に対し骨格筋量および機能が及ぼす影響(Impact of Skeletal Muscle Mass and Function on Exercise Capacity in Patients with Pulmonary Hypertension)

    小西 正紹, 中山 未奈, 小村 直弘, 岩田 究, 郷原 正臣, 仁田 学, 石上 友章, 石川 利之, 菅野 晃靖, 田村 功一, 木村 一雄

    日本循環器学会学術集会抄録集   84回   PJ28 - 8   2020.7

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  • 部分肺静脈還流異常症に合併した肺がんに対する治療戦略 治療の優先順位は?

    仁田 学, 中島 理恵, 木野 旅人, 松本 祐介, 成川 雅俊, 中山 未奈, 田口 有香, 郷原 正臣, 岩田 究, 清國 雅義, 小村 直弘, 小西 正紹, 細田 順也, 重永 豊一郎, 上村 大輔, 松本 克己, 菅野 晃靖, 石上 友章, 石川 利之, 石川 善啓, 町田 大輔, 益田 宗孝, 田村 功一, 木村 一雄

    日本成人先天性心疾患学会雑誌   9 ( 1 )   193 - 193   2020.1

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  • 欠損孔の同定が困難なpre-tricuspid shunt もう一つの鑑別診断

    中島 理恵, 仁田 学, 木野 旅人, 松本 祐介, 成川 雅俊, 中山 未奈, 田口 有香, 郷原 正臣, 岩田 究, 清國 雅義, 小村 直弘, 小西 正紹, 細田 順也, 重永 豊一郎, 上村 大輔, 松本 克己, 菅野 晃靖, 石上 友章, 石川 利之, 田村 功一, 木村 一雄

    日本成人先天性心疾患学会雑誌   9 ( 1 )   289 - 289   2020.1

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  • 慢性肺血栓塞栓症治療の現状:肺動脈血栓内膜摘除術

    孟真, 孟真, 橋山直樹, 益田宗孝, 菅野晃靖, 小村直弘

    静脈学(Web)   31 ( 2 )   2020

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  • 横浜における成人先天性心疾患診療の現状 小児科からの移行医療を進める以前の問題

    仁田 学, 中島 理恵, 田口 有香, 郷原 正臣, 岩田 究, 清國 雅義, 小村 直弘, 小西 正紹, 細田 順也, 重永 豊一郎, 松本 克己, 菅野 晃靖, 石上 友章, 石川 利之, 田村 功一

    日本心臓病学会学術集会抄録   67回   O - 212   2019.9

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  • 肺高血圧症の最新治療 横浜市立大学における慢性血栓塞栓性肺高血圧症(CTEPH)に対するバルーン肺動脈形成術(BPA)の効果とLearning Curveの検討

    小村 直弘, 菅野 晃靖, 小野 文明, 野田 光里, 中島 理恵, 石川 利之, 田村 功一, 木村 一雄

    日本心臓病学会学術集会抄録   67回   S12 - 1   2019.9

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  • 血管内視鏡による特異な形態をした浅大腿動脈の石灰化結節の観察

    重永 豊一郎, 菅野 晃靖, 松本 祐介, 中山 未奈, 郷原 正臣, 岩田 究, 小村 直弘, 石川 利之, 木村 一雄

    日本心血管インターベンション治療学会抄録集   28回   [MO39 - 001]   2019.9

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  • 川崎病による冠動脈病変に対してOASを用いて治療した一例

    松本 祐介, 菅野 晃靖, 中山 未奈, 郷原 正臣, 岩田 究, 小村 直弘, 小西 正紹, 重永 豊一郎, 木村 一雄

    日本心血管インターベンション治療学会抄録集   28回   [MO14 - 004]   2019.9

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  • 冠動脈石灰化病変に対する治療戦略2 Diamondback 360 coronary orbital atherectomy systemにおけるMicro crownとClassic crownのcrossabilityの違い

    郷原 正臣, 松本 祐介, 中山 未奈, 岩田 究, 小村 直弘, 小西 正紹, 重永 豊一郎, 菅野 晃靖, 木村 一雄

    日本心血管インターベンション治療学会抄録集   28回   [S44 - 6]   2019.9

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  • 冠動脈石灰化病変に対する治療戦略2 Diamondback 360 coronary orbital atherectomy systemにおけるClassic crownの高速回転時の切削効果

    郷原 正臣, 松本 祐介, 中山 未奈, 岩田 究, 小村 直弘, 小西 正紹, 重永 豊一郎, 菅野 晃靖, 木村 一雄

    日本心血管インターベンション治療学会抄録集   28回   [S44 - 4]   2019.9

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  • BPAにおける逆行性アプローチの有用性

    小村 直弘, 菅野 晃靖, 中山 未奈, 小野 文明, 郷原 正臣, 岩田 究, 重永 豊一郎, 石川 利之, 田村 功一, 木村 一雄

    日本心血管インターベンション治療学会抄録集   28回   [MO162 - 003]   2019.9

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  • クランク状の石灰化病変に対して新しいDiamondback 360 Coronary Orbital Atherectomy Systemが有効だった一例

    重永 豊一郎, 菅野 晃靖, 松本 祐介, 中山 未奈, 郷原 正臣, 岩田 究, 小村 直弘, 石川 利之, 木村 一雄

    日本心血管インターベンション治療学会抄録集   28回   [MP33 - 001]   2019.9

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  • 肺高血圧症の難渋症例から学ぶ診療のキーポイント 治療方針・薬剤選択/使用量に難渋した、重症右心不全・低心拍出による透析困難・失神を合併した透析関連5群肺高血圧症の一例

    小村 直弘, 菅野 晃靖, 小野 文明, 野田 光里, 中島 理恵, 石川 利之, 田村 功一, 木村 一雄

    日本心臓病学会学術集会抄録   67回   S - 4   2019.9

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  • 肺高血圧症患者の運動耐容能に影響を与える因子の検討

    岡村 正嗣, 岩田 究, 中島 理恵, 小村 直弘, 上杉 上, 金森 裕一, 菅野 晃靖, 田村 功一, 中村 健

    日本循環器学会学術集会抄録集   83回   CP07 - 2   2019.3

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  • 心臓外科治療だけでは成人先天性心疾患患者の運動耐容能を十分改善しない(Only Surgical Treatment of Cardiac Impairment is Insufficient for Improvement of Exercise Tolerance in Patients with Adult Congenital Heart Disease)

    岩田 究, 仁田 学, 岡村 正嗣, 木野 旅人, 松本 祐介, 寺中 紗絵, 鍵本 美奈子, 清國 雅義, 小村 直弘, 細田 順也, 重永 豊一郎, 上村 大輔, 松本 克己, 菅野 晃靖, 石上 友章, 石川 利之, 町田 大輔, 益田 宗孝, 中村 健, 田村 功一

    日本成人先天性心疾患学会雑誌   8 ( 1 )   178 - 178   2019.1

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  • ファロー四徴症心内修復術後遠隔期に肺動脈弁置換術と冠血行再建を行った1例(Coronary Artery Bypass Grafting Concomitant with Pulmonary Valve Replacement for a Patient with Repaired Tetralogy of Fallot)

    寺中 紗絵, 仁田 学, 野田 光里, 木野 旅人, 松本 祐介, 鍵本 美奈子, 中島 理恵, 岩田 究, 清國 雅義, 小村 直弘, 上村 大輔, 重永 豊一郎, 細田 順也, 松本 克己, 菅野 晃靖, 石上 友章, 石川 利之, 町田 大輔, 益田 宗孝, 田村 功一

    日本成人先天性心疾患学会雑誌   8 ( 1 )   142 - 142   2019.1

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  • 右室二腔症に合併した心室頻拍に対してカテーテルアブレーションで根治に成功した一例(Successful Radiofrequency Catheter Ablation for Ventricular Tachycardia in a Patient with Double-chambered Right Ventricle)

    木野 旅人, 鍵本 美奈子, 仁田 学, 松本 祐介, 寺中 紗絵, 田口 有香, 岩田 究, 清國 雅義, 小村 直弘, 細田 順也, 重永 豊一郎, 上村 大輔, 松本 克己, 菅野 晃靖, 石上 友章, 石川 利之, 町田 大輔, 益田 宗孝, 田村 功一

    日本成人先天性心疾患学会雑誌   8 ( 1 )   146 - 146   2019.1

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  • 著明な収縮期雑音により、心疾患を疑われた一例(A suspected case of cardiac anomaly because of a marked systolic ejection murmur)

    松本 祐介, 仁田 学, 木野 旅人, 寺中 紗絵, 鍵本 美奈子, 岩田 究, 清國 雅義, 小村 直弘, 細田 順也, 重永 豊一郎, 上村 大輔, 松本 克己, 菅野 晃靖, 石上 友章, 石川 利之, 町田 大輔, 益田 宗孝, 田村 功一

    日本成人先天性心疾患学会雑誌   8 ( 1 )   143 - 143   2019.1

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  • Discrete Type Subaortic StenosisとS字状心室中隔とによって引き起こされた左室流出路狭窄(Left Ventricular Outflow Tract Obstruction Induced by Sigmoid Septum in Addition to Discrete Type Subvalvular Aortic Stenosis)

    野田 光里, 仁田 学, 木野 旅人, 松本 祐介, 寺中 紗絵, 鍵本 美奈子, 岩田 究, 清國 雅義, 小村 直弘, 細田 順也, 重永 豊一郎, 上村 大輔, 松本 克己, 菅野 晃靖, 石上 友章, 石川 利之, 町田 大輔, 益田 宗孝, 田村 功一

    日本成人先天性心疾患学会雑誌   8 ( 1 )   169 - 169   2019.1

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  • Scimitar症候群亜型に対する低侵襲外科治療の経験(Minimally Invasive Cardiac Surgery for a Patient with Scimitar Syndrome)

    仁田 学, 木野 旅人, 松本 祐介, 寺中 紗絵, 鍵本 美奈子, 岩田 究, 清國 雅義, 小村 直弘, 細田 順也, 重永 豊一郎, 上村 大輔, 松本 克己, 菅野 晃靖, 石上 友章, 石川 利之, 石川 善啓, 町田 大輔, 益田 宗孝, 田村 功一

    日本成人先天性心疾患学会雑誌   8 ( 1 )   168 - 168   2019.1

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  • 急性肺血栓塞栓症が引き起こした一過性左室中部閉塞

    野田光里, 仁田学, 寺中紗絵, 松本祐介, 中島理恵, 岩田究, 清國雅義, 小村直弘, 重永豊一郎, 細田順也, 松本克己, 菅野晃靖, 石上友章, 石川利之, 町田大輔, 郷田素彦, 鈴木伸一, 孟真, 益田宗孝, 田村功一

    日本循環器学会関東甲信越地方会(Web)   251st   2019

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  • 心筋梗塞後のoozing型左室自由壁破裂は修復術後であっても仮性瘤を形成する可能性がある。

    香西祐樹, 仁田学, 野田光里, 小村直弘, 寺中紗絵, 木野旅人, 松本祐介, 鍵本美奈子, 郷原正臣, 岩田究, 清國雅義, 重永豊一郎, 上村大輔, 菅野晃靖, 石上友章, 石川利之, 町田大輔, 郷田素彦, 鈴木伸一, 益田宗孝, 田村功一

    日本循環器学会関東甲信越地方会(Web)   251st   2019

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  • 成人先天性心疾患患者の三尖弁位,劣化生体弁に対する経皮的バルーン拡張治療

    仁田学, 菅野晃靖, 野田光里, 木野旅人, 松本祐介, 寺中紗絵, 鍵本美奈子, 中島理恵, 田口有香, 岩田究, 清國雅義, 小村直弘, 細田順也, 重永豊一郎, 上村大輔, 荒川健太郎, 松本克己, 石上友章, 石川利之, 田村功一

    日本Pediatric Interventional Cardiology学会学術集会プログラム抄録集   30th   2019

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  • Combined pre-and postcapillary Pulmonary Hypertensionを合併したAnomalous Mitral Arcade

    野田 光里, 仁田 学, 松本 祐介, 中島 理恵, 岩田 究, 小村 直弘, 重永 豊一郎, 菅野 晃靖, 石上 友章, 田村 功一

    日本心臓病学会学術集会抄録   66回   EP - 244   2018.9

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  • LAD入口部の石灰化結節病変にエキシマレーザーを用いてステントレスで治療した一例

    重永 豊一郎, 菅野 晃靖, 野田 光里, 松本 祐介, 岩田 究, 小村 直弘, 仁田 学, 石川 利之, 田村 功一

    日本心血管インターベンション治療学会抄録集   27回   MP268 - MP268   2018.8

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  • PADと血管内皮機能障害がDES Failureに与える影響

    小村 直弘, 辻田 賢一, 菅野 晃靖, 石川 利之, 田村 功一

    日本心血管インターベンション治療学会抄録集   27回   MO316 - MO316   2018.8

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  • CTEPHに対する包括的管理 横浜市立大学におけるCTEPHに対するBPAの効果と合併症の検討

    小村 直弘, 菅野 晃靖, 野田 光里, 松本 祐介, 岩田 究, 重永 豊一郎, 石川 利之, 田村 功一

    日本心血管インターベンション治療学会抄録集   27回   SY17 - 3   2018.8

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  • CTEPHの診断、治療におけるピットフォールとこつ

    小村 直弘, 菅野 晃靖, 石川 利之, 小野 文明, 田村 功一

    日本心血管インターベンション治療学会抄録集   27回   MO262 - MO262   2018.8

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  • 高度石灰化病変に対するPCI中にロータブレーターによる冠動脈穿孔・ワイヤー断裂、大動脈解離を一度に生じた一例

    小村 直弘, 菅野 晃靖, 石川 利之, 田村 功一

    日本心血管インターベンション治療学会抄録集   27回   CC1 - 4   2018.8

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  • 左浅大腿動脈にViabahn留置3ヵ月後の血管内視鏡所見

    松本 祐介, 重永 豊一郎, 菅野 晃靖, 野田 光里, 岩田 究, 小村 直弘, 仁田 学, 石川 利行, 田村 功一

    日本心血管インターベンション治療学会抄録集   27回   MP228 - MP228   2018.8

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  • 経カテーテル的血栓溶解療法を繰り返し、および持続的に行い治療しえた大量血栓を伴う急性下肢虚血の一例

    岩田 究, 菅野 晃靖, 野田 光里, 松本 祐介, 小村 直弘, 重永 豊一郎, 石川 利之, 木村 一雄

    日本心血管インターベンション治療学会抄録集   27回   MP129 - MP129   2018.8

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  • PADと血管内皮機能障害がDES Failureに与える影響

    小村 直弘, 辻田 賢一, 菅野 晃靖, 石川 利之, 田村 功一

    日本心血管インターベンション治療学会抄録集   27回   MO316 - MO316   2018.8

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  • 高齢期に三尖弁置換手術を行った修正大血管転位症の一例

    仁田 学, 菅野 晃靖, 重永 豊一郎, 小村 直弘, 岩田 究, 中島 理恵, 松本 祐介, 寺中 紗絵, 野田 光里, 石上 友章, 石川 利之

    日本小児循環器学会雑誌   34 ( Suppl.1 )   s1 - 379   2018.7

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  • ファロー四徴症/両大血管右室起始症遠隔期における、右室機能障害と血漿BNP値との関連

    仁田 学, 菅野 晃靖, 重永 豊一郎, 小村 直弘, 岩田 究, 中島 理恵, 松本 祐介, 寺中 紗絵, 野田 光里, 石上 友章, 石川 利之, 落合 亮太, 田村 功一

    日本成人先天性心疾患学会雑誌   7 ( 1 )   185 - 185   2018.1

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  • 感染性心内膜炎に仮性左室瘤を合併した僧帽弁逸脱症の1例

    松岡勇樹, 松下広興, 田口有香, 中島理恵, 野田光里, 松本祐介, 寺中紗絵, 岩田究, 清國雅義, 小村直弘, 仁田学, 井口公平, 荒川健太郎, 重永豊一郎, 細田順也, 松本克己, 菅野晃靖, 石上友章, 石川利之, 田村功一

    日本循環器学会関東甲信越地方会(Web)   248th   2018

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  • 自己免疫性溶血性貧血(AIHA)を合併した末梢動脈疾患(PAD)の1例

    秀川智春, 石上友章, 野田光里, 岩田究, 清國雅義, 小村直弘, 仁田学, 中島理恵, 寺中紗絵, 木野旅人, 菅野晃靖, 石川利之, 松本祐介, 田村功一

    日本循環器学会関東甲信越地方会(Web)   247th   2018

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  • 大動脈弁置換術後に生体弁が急速に劣化した両大血管右室起始症心内修復術後の成人例

    仁田 学, 菅野 晃靖, 野田 光里, 松本 祐介, 岩田 究, 清國 雅義, 小村 直弘, 重永 豊一郎, 石上 友章, 石川 利之, 田村 功一

    日本心臓病学会学術集会抄録   65回   P - 300   2017.9

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  • 右室二腔症を合併したNoonan症候群 2例

    山田 なお, 仁田 学, 菅野 晃靖, 重永 豊一郎, 小村 直弘, 清國 雅義, 岩田 究, 中島 理恵, 松本 祐介, 野田 光里, 石上 友章, 石川 利之, 落合 亮太, 田村 功一

    日本心臓病学会学術集会抄録   65回   P - 125   2017.9

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  • 横浜市立大学附属病院における慢性血栓塞栓性肺高血圧症に対するバルーン肺動脈形成術の治療成績と合併症の考察

    小村 直弘, 菅野 晃靖, 鍵本 美奈子, 中山 尚貴, 野田 光里, 松本 祐介, 中島 理恵, 岩田 究, 重永 豊一郎, 小野 文明, 戸田 憲孝, 石川 利之, 木村 一雄, 田村 功一

    日本心臓病学会学術集会抄録   65回   P - 289   2017.9

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  • 心タンポナーデの解除は急性肺塞栓症を引き起こす契機となるか?

    高野 桂子, 仁田 学, 野田 光里, 松本 祐介, 岩田 究, 清國 雅義, 小村 直弘, 重永 豊一郎, 菅野 晃靖, 石上 友章, 石川 利之, 田村 功一

    日本心臓病学会学術集会抄録   65回   P - 257   2017.9

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  • 成人で症候化した右肺動脈閉鎖症の一例

    仁田 学, 菅野 晃靖, 小村 直弘, 清國 雅義, 中山 尚貴, 岩田 究, 高野 桂子, 山田 なお, 石上 友章, 田村 功一

    日本小児循環器学会雑誌   33 ( Suppl.1 )   s1 - 399   2017.7

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  • 本邦におけるCTEPHに対する最新の治療戦略 横浜市立大学における慢性血栓塞栓性肺高血圧症に対するバルーン肺動脈形成術の効果と合併症の検討

    小村 直弘, 菅野 晃靖, 鍵本 美奈子, 岩田 究, 中山 尚貴, 清國 雅義, 小野 文明, 石川 利之, 木村 一雄, 田村 功一

    日本心血管インターベンション治療学会抄録集   26回   S21 - 5   2017.7

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  • 右室二腔症を合併したNoonan症候群 2例

    山田 なお, 仁田 学, 菅野 晃靖, 小村 直弘, 清國 雅義, 中山 尚貴, 岩田 究, 高野 桂子, 石上 友章, 石川 利之, 落合 亮太, 田村 功一

    日本成人先天性心疾患学会雑誌   6 ( 1 )   173 - 173   2017.1

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  • 横浜における成人先天性心疾患診療体制の発足

    仁田 学, 菅野 晃靖, 小村 直弘, 清國 雅義, 中山 尚貴, 岩田 究, 高野 桂子, 山田 なお, 石上 友章, 石川 利之, 落合 亮太, 田村 功一

    日本成人先天性心疾患学会雑誌   6 ( 1 )   119 - 119   2017.1

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  • 収縮性心膜炎診断のTips 多脾症候群、複雑心奇形心内修復術後の症例を通じて

    高野 桂子, 仁田 学, 菅野 晃靖, 小村 直弘, 清國 雅義, 中山 尚貴, 岩田 究, 山田 なお, 石上 友章, 石川 利之, 落合 亮太, 田村 功一

    日本成人先天性心疾患学会雑誌   6 ( 1 )   186 - 186   2017.1

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  • 長期にわたって包括的薬物治療管理を行っている全身性動脈硬化症合併の腎血管性高血圧の1例

    藤野洋平, 中島理恵, 野田光里, 松本祐介, 小林竜, 畝田一司, 小村直弘, 石上友章, 石川利之, 戸谷義幸, 菅野晃靖, 田村功一

    日本循環器学会関東甲信越地方会(Web)   246th   2017

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  • 横浜市立大学附属病院における慢性血栓塞栓性肺高血圧症に対するバルーン肺動脈形成術の効果の検討

    小村 直弘, 菅野 晃靖, 鍵本 美奈子, 木野 旅人, 土肥 宏志, 岩田 究, 中山 尚貴, 清國 雅義, 矢野 英人, 石川 利之, 木村 一雄, 梅村 敏

    日本心血管インターベンション治療学会抄録集   25回   MO370 - MO370   2016.7

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  • 穿刺困難症例における血管内超音波カテーテルの臨床的有用性

    矢野 英人, 菅野 晃靖, 清國 雅義, 小村 直弘, 中山 尚貴, 岩田 究, 土肥 宏志, 戸田 憲孝, 日比 潔, 木村 一雄

    日本心血管インターベンション治療学会抄録集   25回   MO446 - MO446   2016.7

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  • DUAL LIPID-LOWERING WITH EZETIMIBE/STATIN AS A PROMISING ANTI-ATHEROSCLEROTIC STRATEGY

    Kenichi Tsujita, Kenshi Yamanaga, Naohiro Komura, Hideki Shimomura, Masaharu Ishihara, Koichi Kaikita, Seiji Hokimoto, Hisao Ogawa

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   67 ( 13 )   2132 - 2132   2016.4

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  • 劇症型心筋炎に対しBiVADを装着した一例

    井上綾佳, 岩田究, 土肥宏志, 清國雅義, 中山尚貴, 小村直弘, 矢野英人, 菅野晃靖, 石上友章, 石川利之, 木村一雄, 梅村敏

    日本循環器学会関東甲信越地方会(Web)   239th   2016

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  • Physiological basis of discordance between coronary flow velocity reserve and hyperemic microvascular resistance for evaluating coronary microvascular dysfunction in patients without atherosclerotic obstruction International journal

    Kenshi Yamanaga, Kenichi Tsujita, Naohiro Komura, Koichi Kaikita, Kenji Sakamoto, Takashi Miyazaki, Michiyo Saito, Masanobu Ishii, Noriaki Tabata, Tomonori Akasaka, Yuichiro Arima, Eiichiro Yamamoto, Megumi Yamamuro, Yasuhiro Izumiya, Sunao Kojima, Shinji Tayama, Sunao Nakamura, Seiji Hokimoto, Hisao Ogawa

    INTERNATIONAL JOURNAL OF CARDIOLOGY   201   535 - 537   2015.12

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    DOI： 10.1016/j.ijcard.2015.08.102

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  • The Impact of Statin-Ezetimibe Combination Therapy in Patients With Decreased Cholesterol Absorption Ability

    Kenshi Yamanaga, Kenichi Tsujita, Seigo Sugiyama, Hitoshi Sumida, Hideki Shimomura, Takuro Yamashita, Naohiro Komura, Kenji Sakamoto, Hideki Oka, Koichi Nakao, Sunao Nakamura, Masaharu Ishihara, Kunihiko Matsui, Naritsugu Skaino, Natsuki Nakamura, Nobuyasu Yamamoto, Shunichi Koide, Toshiyuki Matsumura, Kazuteru Fujimoto, Ryusuke Tsunoda, Yasuhiro Morikami, Koushi Matsuyama, Shuichi Oshima, Koichi Kaikita, Seiji Hokimoto, Hisao Ogawa

    CIRCULATION   132   2015.11

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  • The Impact of Peripheral Artery Disease Assessed by Ankle-Brachial Index on Endothelial Dysfunction and Risk of In-Stent Restenosis After Percutaneous Coronary Intervention

    Naohiro Komura, Kenichi Tsujita, Kenshi Yamanaga, Kenji Sakamoto, Satomi Iwashita, Sunao Kojima, Koichi Kaikita, Seiji Hokimoto, Kiyoshi Hibi, Teruyasu Sugano, Kazuo Kimura, Satoshi Umemura, Hisao Ogawa

    CIRCULATION   132   2015.11

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  • 放射線治療後の右鎖骨下動脈狭窄に対し、バルーン治療を施行したが翌日に再閉塞を生じ、ステント留置にて良好な結果を得た一例

    小村 直弘, 中山 尚貴, 土肥 宏志, 岩田 究, 清國 雅義, 矢野 英人, 菅野 晃靖, 木村 一雄, 梅村 敏

    日本心臓病学会学術集会抄録   63回   76 - 76   2015.9

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  • Plaque REgression with Cholesterol absorption Inhibitor or Synthesis inhibitor Evaluated by IntraVascular UltraSound (PRECISE-IVUS Trial): Study protocol for a randomized controlled trial International journal

    Kenichi Tsujita, Seigo Sugiyama, Hitoshi Sumida, Hideki Shimomura, Takuro Yamashita, Kenshi Yamanaga, Naohiro Komura, Kenji Sakamoto, Takamichi Ono, Hideki Oka, Koichi Nakao, Sunao Nakamura, Masaharu Ishihara, Kunihiko Matsui, Naritsugu Sakaino, Natsuki Nakamura, Nobuyasu Yamamoto, Shunichi Koide, Toshiyuki Matsumura, Kazuteru Fujimoto, Ryusuke Tsunoda, Yasuhiro Morikami, Koushi Matsuyama, Shuichi Oshima, Koichi Kaikita, Seiji Hokimoto, Hisao Ogawa

    JOURNAL OF CARDIOLOGY   66 ( 3-4 )   353 - 358   2015.9

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    Background: Although the positive association between achieved low-density lipoprotein cholesterol (LDL-C) level and the risk of coronary artery disease (CAD) has been confirmed by randomized studies with statins, many patients remain at high residual risk of events suggesting the necessity of novel pharmacologic strategies. The combination of ezetimibe/statin produces greater reductions in LDL-C compared to statin monotherapy.
    Purpose: The Plaque REgression with Cholesterol absorption Inhibitor or Synthesis inhibitor Evaluated by IntraVascular UltraSound (PRECISE-IVUS) trial was aimed at evaluating the effects of ezetimibe addition to atorvastatin, compared with atorvastatin monotherapy, on coronary plaque regression and change in lipid profile in patients with CAD.
    Methods: The study is a prospective, randomized, controlled, multicenter study. The eligible patients undergoing IVUS-guided percutaneous coronary intervention will be randomly assigned to receive either atorvastatin alone or atorvastatin plus ezetimibe (10 mg) daily using a web-based randomization software. The dosage of atorvastatin will be increased by titration within the usual dose range with a treatment goal of lowering LDL-C below 70 mg/dL based on consecutive measures of LDL-C at follow-up visits. IVUS will be performed at baseline and 9-12 months follow-up time point at participating cardiovascular centers. The primary endpoint will be the nominal change in percent coronary atheroma volume measured by volumetric IVUS analysis.
    Conclusion: PRECISE-IVUS will assess whether the efficacy of combination of ezetimibe/atorvastatin is noninferior to atorvastatin monotherapy for coronary plaque reduction, and will translate into increased clinical benefit of dual lipid-lowering strategy in a Japanese population. (C) 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

    DOI： 10.1016/j.jjcc.2014.12.011

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  • 冠動脈血管攣縮性狭心症患者における心外膜と冠動脈微小血管の血管運動機能の生理学的評価(Physiological Evaluation of Epicardial and Microvascular Coronary Vasomotor Function in Patients With Coronary Vasospastic Angina)

    辻田 賢一, 山永 健之, 小村 直弘, 坂本 憲治, 小島 淳, 海北 幸一, 掃本 誠治, 小川 久雄

    日本心臓病学会学術集会抄録   63回   410 - 410   2015.9

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  • Impact of Dual Lipid-Lowering Strategy With Ezetimibe and Atorvastatin on Coronary Plaque Regression in Patients With Percutaneous Coronary Intervention The Multicenter Randomized Controlled PRECISE-IVUS Trial International journal

    Kenichi Tsujita, Seigo Sugiyama, Hitoshi Sumida, Hideki Shimomura, Takuro Yamashita, Kenshi Yamanaga, Naohiro Komura, Kenji Sakamoto, Hideki Oka, Koichi Nakao, Sunao Nakamura, Masaharu Ishihara, Kunihiko Matsui, Naritsugu Sakaino, Natsuki Nakamura, Nobuyasu Yamamoto, Shunichi Koide, Toshiyuki Matsumura, Kazuteru Fujimoto, Ryusuke Tsunoda, Yasuhiro Morikami, Koushi Matsuyama, Shuichi Oshima, Koichi Kaikita, Seiji Hokimoto, Hisao Ogawa

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   66 ( 5 )   495 - 507   2015.8

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    BACKGROUND Despite standard statin therapy, a majority of patients retain a high "residual risk" of cardiovascular events.
    OBJECTIVES The aim of this study was to evaluate the effects of ezetimibe plus atorvastatin versus atorvastatin monotherapy on the lipid profile and coronary atherosclerosis in Japanese patients who underwent percutaneous coronary intervention (PCI).
    METHODS This trial was a prospective, randomized, controlled, multicenter study. Eligible patients who underwent PCI were randomly assigned to atorvastatin alone or atorvastatin plus ezetimibe (10 mg) daily. Atorvastatin was uptitrated with a treatment goal of low-density lipoprotein cholesterol (LDL-C) &lt;70 mg/dl. Serial volumetric intravascular ultrasound was performed at baseline and again at 9 to 12 months to quantify the coronary plaque response in 202 patients.
    RESULTS The combination of atorvastatin/ezetimibe resulted in lower levels of LDL-C than atorvastatin monotherapy (63.2 +/- 16.3 mg/dl vs. 73.3 +/- 20.3 mg/dl; p &lt; 0.001). For the absolute change in percent atheroma volume (PAV), the mean difference between the 2 groups (-1.538%; 95% confidence interval [CI]: -3.079% to 0.003%) did not exceed the pre-defined noninferiority margin of 3%, but the absolute change in PAV did show superiority for the dual lipid-lowering strategy (-1.4%; 95% CI: -3.4% to -0.1% vs. -0.3%; 95% CI: -1.9% to 0.9% with atorvastatin alone; p = 0.001). For PAV, a significantly greater percentage of patients who received atorvastatin/ezetimibe showed coronary plaque regression (78% vs. 58%; p = 0.004). Both strategies had acceptable side effect profiles, with a low incidence of laboratory abnormalities and cardiovascular events.
    CONCLUSIONS Compared with standard statin monotherapy, the combination of statin plus ezetimibe showed greater coronary plaque regression, which might be attributed to cholesterol absorption inhibition-induced aggressive lipid lowering. (Plaque Regression With Cholesterol Absorption Inhibitor or Synthesis Inhibitor Evaluated by Intravascular Ultrasound [PRECISE-IVUS]; NCT01043380) (C) 2015 by the American College of Cardiology Foundation.

    DOI： 10.1016/j.jacc.2015.05.065

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  • ST-segment elevation myocardial infarction in a patient with anomalous origin of left circumflex coronary artery

    Masahiro Yamamoto, Kenichi Tsujita, Kenshi Yamanaga, Naohiro Komura, Kenji Sakamoto, Sunao Kojima, Eiichiro Yamamoto, Tomoko Tanaka, Megumi Yamamuro, Yasuhiro Izumiya, Sunao Nakamura, Koichi Kaikita, Seiji Hokimoto, Hisao Ogawa

    Journal of Cardiology Cases   11 ( 4 )   120 - 123   2015.4

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    We present a case of ST-segment elevation myocardial infarction in the territory of an anomalous left circumflex coronary artery running through the retroaortic region. In vivo coronary imaging with intravascular ultrasound visualized the usual atherosclerotic change and subsequent plaque rupture and thrombus formation at the culprit lesion. The clarification of pathologic mechanisms underlying the myocardial infarction case could provide information about pathophysiology of atherosclerotic development in anomalous left circumflex coronary artery, and could help in decision-making regarding the management strategy.&lt
    . Learning objective: Intravascular ultrasound (IVUS) imaging indicated that ordinary atherosclerosis could develop at retroaortic anomalous course of left circumflex coronary artery (LCX) despite absence of mechanical cause of ischemia. IVUS screening could provide significant information about pathophysiology of atherosclerotic development in anomalous LCX, and could help in decision-making regarding the management strategy. The images and discussion have high educational value for clinical cardiologists alike.&gt
    .

    DOI： 10.1016/j.jccase.2015.01.002

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  • IMPACT OF AGING ON INTRAVASCULAR ULTRASOUND MORPHOLOGY OF CULPRIT LESIONS AND CLINICAL CHARACTERISTICS IN PATIENTS WITH ACUTE CORONARY SYNDROME

    Kenichi Tsujita, Kenshi Yamanaga, Naohiro Komura, Kenji Sakamoto, Sunao Kojima, Koichi Kaikita, Seiji Hokimoto, Sunao Nakamura, Hisao Ogawa

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   65 ( 10 )   A79 - A79   2015.3

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    DOI： 10.1016/S0735-1097(15)60079-1

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  • Single-wire pressure and flow velocity measurement for quantifying microvascular dysfunction in patients with coronary vasospastic angina International journal

    Kenshi Yamanaga, Kenichi Tsujita, Naohiro Komura, Koichi Kaikita, Kenji Sakamoto, Takashi Miyazaki, Michiyo Saito, Masanobu Ishii, Noriaki Tabata, Tomonori Akasaka, Koji Sato, Yuichiro Arima, Sunao Kojima, Shinji Tayama, Sunao Nakamura, Seiji Hokimoto, Hisao Ogawa

    AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY   308 ( 5 )   H478 - H484   2015.3

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    Endothelial and vascular smooth muscle dysfunction of epicardial coronary arteries play a pivotal role in the pathogenesis of vasospastic angina (VSA). However, coronary microvascular (MV) function in patients with VSA is not fully understood. In the present study, subjects without coronary obstruction were divided into two groups according to the acetylcholine provocation test: VSA group (n = 29) and non-VSA group (n = 21). Hyperemic MV resistance (hMR) was measured using a dual-sensor (Doppler velocity and pressure)-equipped guidewire, and guidewire-derived hemodynamic parameters were compared. There were no between-group differences in clinical demographics, including potential factors affecting MV function (e.g., diabetes). Although coronary flow velocity reserve was similar between the two groups [2.4 +/- 1.0 (VSA group) vs. 2.4 +/- 0.9 (non-VSA group); P = 0.8], coronary vessel resistance and hMR were significantly elevated in the VSA group compared with the non-VSA group (2.6 +/- 3.1 vs. 1.2 +/- 0.8, P = 0.04; 1.9 +/- 0.6 vs. 1.6 +/- 0.5, P = 0.03, respectively). Coronary vasospasm, older age, E/e', and estimated glomerular filtration rate were significantly associated with MV dysfunction [defined as &gt;= median value of hMR (1.6)] in univariate analysis. Coronary vasospasm most strongly predicted higher hMR in multivariate logistic regression analysis (odds ratio, 4.61; 95% confidence interval, 0.98-21.60; P = 0.053). In conclusion, coronary MV resistance is impaired in patients with VSA compared with non-VSA patients, whereas coronary flow velocity reserve is maintained at normal levels in both groups. In vivo assessment of hMR might be a promising index of coronary MV dysfunction in patients with VSA.

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  • 長期透析患者における急性細菌性心筋炎の一例

    宮川秀一, 鍵本美奈子, 矢野英人, 小村直弘, 清國雅義, 中山尚貴, 岩田究, 土肥宏志, 菅野晃靖, 石上友章, 石川利之, 戸田憲孝, 梅村敏, 木村一雄

    日本循環器学会関東甲信越地方会(Web)   238th   2015

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  • 脂質低下薬二剤併用療法の有用性PRECISE‐IVUS研究からの知見

    辻田賢一, 山永健之, 小村直弘, 海北幸一, 掃本誠治, 中尾浩一, 小川久雄

    日本冠疾患学会雑誌   ( Suppplement )   110 - 110   2015

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  • Impact of Left Ventricular Hypertrophy on Impaired Coronary Microvascular Dysfunction Determined by Direct Single-Wire Pressure and Flow Velocity Measurement

    Kenichi Tsujita, Kenshi Yamanaga, Naohiro Komura, Kenji Sakamoto, Takashi Miyazaki, Masanobu Ishii, Noriaki Tabata, Tomonori Akasaka, Tomonori Akasaka, Yuichiro Arima, Takamichi Ono, Sunao Kojima, Shinji Tayama, Koichi Kaikita, Seiji Hokimoto, Hiroshige Yamabe, Sunao Nakamura, Hisao Ogawa

    CIRCULATION   130   2014.11

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  • A Case of Severe Myocardial Bridging: Usefulness of Diastolic Fractional Flow Reserve

    Tatsuro Mitsuse, Kenji Sakamoto, Kenichi Tsujita, Naohiro Komura, Kenshi Yamanaga, Tomonori Akasaka, Takashi Miyazaki, Noriaki Tabata, Masanobu Ishii, Yuichiro Arima, Sunao Kojima, Koichi Kaikita, Sunao Nakamura, Seiji Hokimoto, Hisao Ogawa

    CIRCULATION   130   2014.11

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  • Physiological Basis of Discordance Between Coronary Flow Reserve and Hyperemic Microvascular Resistance to Evaluate Coronary Microvascular Dysfunction in Patients Without Atherosclerotic Obstruction

    Kenshi Yamanaga, Kenichi Tsujita, Naohiro Komura, Kenji Sakamoto, Masanobu Ishii, Noriaki Tabata, Takashi Miyazaki, Tomonori Akasaka, Yuichiro Arima, Takamichi Ono, Sunao Kojima, Shinji Tayama, Koichi Kaikita, Seiji Hokimoto, Sunao Nakamura, Hisao Ogawa

    CIRCULATION   130   2014.11

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  • Impact of Obesity on Outcomes After Percutaneous Coronary Intervention in Japanese Population: Obesity Paradox with High Waist Circumference but Not High BMI

    Kenji Sakamoto, Seiji Hokimoto, Shuichi Oshima, Koichi Nakao, Kazuteru Fujimoto, Yuji Miyao, Hideki Shimomura, Ryusuke Tsunoda, Hideki Maruyama, Toyoki Hirose, Kenichi Tsujita, Yuichiro Arima, Tomonori Akasaka, Noriaki Tabata, Naohiro Komura, Kenshi Yamanaga, Takashi Miyazaki, Masanobu Ishii, Sunao Kojima, Koichi Kaikita, Sunao Nakamura, Hisao Ogawa

    CIRCULATION   130   2014.11

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  • Comprehensive Hemodynamic Analysis of Coronary Arterial Responses to Acetylcholine Provocation Test in Patients With Coronary Vasospastic Angina

    Kenshi Yamanaga, Kenichi Tsujita, Naohiro Komura, Kenji Sakamoto, Masanobu Ishii, Noriaki Tabata, Takashi Miyazaki, Tomonori Akasaka, Yuichiro Arima, Takamichi Ono, Sunao Kojima, Shinji Tayama, Koichi Kaikita, Seiji Hokimoto, Sunao Nakamura, Hisao Ogawa

    CIRCULATION   130   2014.11

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  • RH‐PATを用いて測定した末梢血管内皮障害とステント再狭窄の関係

    小村直弘, 辻田賢一, 山永健之, 坂本憲治, 海北幸一, 掃本誠治, 岩下さとみ, 有馬勇一郎, 小島淳, 田山信至, 杉山正悟, 日比潔, 木村一雄, 梅村敏, 小川久雄

    日本心臓病学会学術集会抄録(CD-ROM)   62nd   ROMBUNNO.S2-5 - 5   2014.9

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  • 冠動脈ステント留置後の再狭窄におけるメタボリックシンドロームの関与とObesity Paradox

    坂本憲治, 小村直弘, 辻田賢一, 山永健之, 赤坂朋紀, 宮崎貴志, 有馬勇一郎, 田山信至, 小島淳, 海北幸一, 中村淳, 掃本誠治, 小川久雄

    日本心臓病学会学術集会抄録(CD-ROM)   62nd   ROMBUNNO.O-235 - 235   2014.9

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  • 高齢発症急性冠症候群の臨床背景および責任病変血管内超音波所見の検討

    辻田賢一, 山永健之, 小村直弘, 坂本憲治, 赤坂朋紀, 宮崎貴志, 石井正将, 田畑範明, 小島淳, 海北幸一, 掃本誠治, 中村淳, 小川久雄

    日本心臓病学会学術集会抄録(CD-ROM)   62nd   ROMBUNNO.O-072 - 072   2014.9

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  • Combo wireを使用した冠攣縮性狭心症患者における冠微小循環障害の評価

    山永健之, 辻田賢一, 小村直弘, 海北幸一, 掃本誠治, 宮崎貴志, 赤坂朋紀, 佐藤幸治, 有馬勇一郎, 坂本憲治, 小島淳, 田山信至, 中村淳, 小川久雄

    日本心臓病学会学術集会抄録(CD-ROM)   62nd   ROMBUNNO.S1-5 - 5   2014.9

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  • 高齢発症急性冠症候群の臨床背景および責任病変血管内超音波所見の検討

    辻田賢一, 山永健之, 小村直弘, 坂本憲治, 田山信至, 海北幸一, 山本英一郎, 安田修, 掃本誠治, 小川久雄

    日本老年医学会雑誌   51 ( 3 )   299 - 299   2014.5

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  • TISSUE DOPPLAR-DERIVED E/E' RATIO AT STENT IMPLANTATION IS A POWERFUL PREDICTOR OF INSTENT RESTENOSIS IN PATIENTS WITH CORONARY ARTERY DISEASE

    Naohiro Komura, Kenichi Tsujita, Kenshi Yamanaga, Kenji Sakamoto, Sunao Kojima, Shinji Tayama, Koichi Kaikita, Seiji Hokimoto, Kiyoshi Hibi, Kazuo Kimura, Satoshi Umemura, Hisao Ogawa

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   63 ( 12 )   A1182 - A1182   2014.4

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  • IMPAIRED PERIPHERAL ENDOTHELIAL FUNCTION AS ASSESSED BY DIGITAL REACTIVE HYPEREMIA PERIPHERAL ARTERIAL TONOMETRY AND RISK OF IN-STENT RESTENOSIS

    Naohiro Komura, Kenichi Tsujita, Kenshi Yamanaga, Kenji Sakamoto, Sunao Kojima, Shinji Tayama, Koichi Kaikita, Seiji Hokimoto, Kiyoshi Hibi, Kazuo Kimura, Satoshi Umemura, Hisao Ogawa

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   63 ( 12 )   A2070 - A2070   2014.4

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  • Comprehensive analysis of intravascular ultrasound and angiographic morphology of culprit lesions between ST-segment elevation myocardial infarction and non-ST-segment elevation acute coronary syndrome. International journal

    Naoko Takaoka, Kenichi Tsujita, Koichi Kaikita, Seiji Hokimoto, Michio Mizobe, Masahide Nagano, Eiji Horio, Koji Sato, Naoki Nakayama, Hiromi Yoshimura, Kenshi Yamanaga, Naohiro Komura, Sunao Kojima, Shinji Tayama, Sunao Nakamura, Hisao Ogawa

    International journal of cardiology   171 ( 3 )   423 - 430   2014

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    BACKGROUND: Some plaques lead to ST-segment elevation myocardial infarction (STEMI), whereas others cause non-ST-segment elevation acute coronary syndrome (NSTEACS). We used angiography and intravascular ultrasound (IVUS) to investigate the difference of culprit lesion morphologies in ACS. METHODS: Consecutive 158 ACS patients whose culprit lesions were imaged by preintervention IVUS were enrolled (STEMI=81; NSTEACS=77). IVUS and angiographic findings of the culprit lesions, and clinical characteristics were compared between the groups. RESULTS: There were no significant differences in patients' characteristics except for lower rate of statin use in patients with STEMI (20% vs 44%, p=0.001). Although angiographic complex culprit morphology (Ambrose classification) and thrombus were more common in STEMI than in NSTEACS (84% vs 62%, p=0.002; 51% vs 5%, p<0.0001, respectively), SYNTAX score was lower in STEMI (8.6 ± 5.4 vs 11.5 ± 7.1, p=0.01). In patients with STEMI, culprit echogenicity was more hypoechoic (64% vs 40%, p=0.01), and the incidence of plaque rupture, attenuation and "microcalcification" were significantly higher (56% vs 17%, p<0.0001; 85% vs 69%, p=0.01; 77% vs 61%, p=0.04, respectively). Furthermore, the maximum area of ruptured cavity, echolucent zone and arc of microcalcification were significantly greater in STEMI compared with NSTEACS (1.80 ± 0.99 mm(2) vs 1.13 ± 0.86 mm(2), p=0.006; 1.52 ± 0.74 mm(2) vs 1.21 ± 0.81 mm(2), p=0.004; 99.9 ± 54.6° vs 77.4 ± 51.2°, p=0.01, respectively). Quantitative IVUS analysis showed that vessel and plaque area were significantly larger at minimum lumen area site (16.6 ± 5.4 mm(2) vs 14.2 ± 5.5 mm(2), p=0.003; 13.9 ± 5.1 mm(2) vs 11.6 ± 5.2 mm(2), p=0.003, respectively). CONCLUSION: Morphological feature (outward vessel remodeling, plaque buildup and IVUS vulnerability of culprit lesions) might relate to clinical presentation in patients with ACS.

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  • Intravascular ultrasound morphology of culprit lesions and clinical demographics in patients with acute coronary syndrome in relation to low-density lipoprotein cholesterol levels at onset.

    Naoko Takaoka, Kenichi Tsujita, Koichi Kaikita, Seiji Hokimoto, Kenshi Yamanaga, Naohiro Komura, Tadasuke Chitose, Takamichi Ono, Michio Mizobe, Eiji Horio, Koji Sato, Naoki Nakayama, Michiyo Saito, Satomi Iwashita, Sunao Kojima, Shinji Tayama, Seigo Sugiyama, Sunao Nakamura, Hisao Ogawa

    Heart and vessels   29 ( 5 )   584 - 959   2014

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    Despite current standards of care aimed at achieving targets for low-density lipoprotein cholesterol (LDL-C), many patients remain at high residual risk of cardiovascular events. We sought to assess the LDL-C-dependent differences in culprit intravascular ultrasound (IVUS) morphologies and clinical characteristics in patients with acute coronary syndrome (ACS). Eighty-six consecutive ACS patients whose culprit lesions imaged by preintervention IVUS were divided into two groups based on the fasting LDL-C level on admission: a low-LDL-C group (LDL-C <2.6 mmol/l, n = 45) and a high-LDL-C group (LDL-C ≥2.6 mmol/l, n = 41). Patients with stable angina with LDL-C <2.6 mmol/l (n = 30) were also enrolled as an age- and gender-matched control. The low-LDL-C ACS group was significantly older (72 ± 12 vs 64 ± 14 years, P = 0.007) and more diabetic (47 % vs 15 %, P = 0.001). Importantly, IVUS morphologies were comparable between low- and high-LDL-C ACS groups (all P not significant), whereas culprit plaque was more hypoechoic and less calcified in the low-LDL-C ACS group than in the low-LDL-C stable angina group. Furthermore, compared with the low-LDL-C ACS nondiabetic group, the low-LDL-C ACS diabetic group was more obese, more triglyceride rich (1.3 ± 0.6 vs 0.9 ± 0.4 mmol/l, P = 0.003), and more endothelially injured, but no different for the culprit IVUS morphologies. In multivariate analysis, diabetes was independently associated with a low LDL-C level on admission in patients with ACS. There was no relationship between the LDL-C level at onset and culprit-plaque IVUS morphologies in ACS patients, although culprit plaque in the low-LDL-C ACS group was more vulnerable than in the low-LDL-C stable angina group. In patients with low-LDL-C levels, diabetes with atherogenic dyslipidemia might be the key residual risk.

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  • Serial intravascular ultrasound assessment of very late stent thrombosis after sirolimus-eluting stent placement. International journal

    Kenshi Yamanaga, Kenichi Tsujita, Hideki Shimomura, Yoshinori Nakamura, Yuji Ogura, Yoshiro Onoue, Naomi Chazono, Takeshi Nagata, Shogo Morisaki, Takashi Kudo, Yoshihiro Yamada, Naohiro Komura, Takashi Miyazaki, Tomonori Akasaka, Eiji Horio, Koji Sato, Yuichiro Arima, Sunao Kojima, Koichi Kaikita, Shinji Tayama, Seiji Hokimoto, Hisao Ogawa

    Journal of cardiology   64 ( 4 )   279 - 284   2014

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    PURPOSE: In-stent restenosis has been decreasing through the introduction of drug-eluting stents (DES). On the other hand, adverse events such as very late stent thrombosis (VLST) and late catch-up phenomenon can occur especially with sirolimus-eluting stents (SES, first-generation DES) in long-term follow-up. However, the precise mechanisms underlying VLST have not been well investigated in vivo. METHODS AND RESULTS: From 2004 to 2010, 2034 SES were implanted in 1656 patients and caused eight VLST (0.48% per patient) at Fukuoka Tokushukai Medical Center. Of these, serial intravascular ultrasound (IVUS) images (post-stent implantation and at the time of VLST onset) were obtained from three patients with VLST. Comparing them with eight control patients with SES implanted, the vascular reactivity of VLST patients was analyzed. Eight VLST happened 50 ± 15 months after stent implantation and three of the eight patients with VLST had not taken aspirin daily. There were no differences in minimum stent area, maximum external elastic membrane (EEM) area, and stent edge (distal and proximal) EEM area in post-procedural IVUS images. Compared with the control group patients, ΔEEM area (10.6 ± 3.4mm(2) vs. 1.7 ± 1.9 mm(2), p=0.01) and vessel expansion ratio (185.6 ± 40.3% vs. 112.0 ± 12.1%, p=0.01) were significantly greater in the VLST group based on the greater peri-stent plaque expansion (262.1 ± 72.8% vs. 118.7 ± 21.2%, p=0.01). CONCLUSION: Our serial IVUS study showed that the vascular positive remodeling after SES implantation is one of the most probable morphological mechanisms for VLST development.

    DOI： 10.1016/j.jjcc.2014.02.008

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  • 末梢血管内皮機能障害はステント内再狭窄を予測する

    小村直弘, 辻田賢一, 山永健之, 坂本憲治, 海北幸一, 掃本誠治, 岩下さとみ, 宮崎貴志, 赤坂朋紀, 田畑範明, 石井正将, 有馬勇一郎, 小島淳, 田山信至, 杉山正悟, 日比潔, 木村一雄, 梅村敏, 小川久雄

    日本循環器学会九州地方会(Web)   117th   KYUSHU117,YIA1 (WEB ONLY)   2014

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  • Percutaneous coronary intervention strategy for acute coronary syndrome caused by spontaneous coronary artery dissection for relieving ongoing ischemia-Case series and literature review.

    Kenshi Yamanaga, Kenichi Tsujita, Hideki Shimomura, Yuji Ogura, Yuri Matsumuro, Yoshiro Onoue, Naomi Chazono, Shogo Morisaki, Naohiro Komura, Kenji Sakamoto, Koichi Kaikita, Shinji Tayama, Seiji Hokimoto, Hisao Ogawa

    Journal of cardiology cases   10 ( 5 )   184 - 187   2014

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    Although spontaneous coronary artery dissection (SCAD) is one of the causes of acute coronary syndrome (ACS) or sudden cardiac death, its standard management, especially primary percutaneous coronary intervention (PCI) in ACS patients with ongoing ischemia, has not been established. We experienced three ACS patients with SCAD who were treated with a different strategy of primary PCI. Each PCI strategy led to different clinical and procedural results. We describe here such PCI strategies and results, and also discuss the literature regarding primary PCI strategies for SCAD-induced ACS patients with ongoing ischemia. <Learning objective: SCAD is a cause of ACS. However, the treatment strategy of primary PCI for SCAD has not been fully investigated. We used different PCI strategies for three SCAD patients with ongoing ischemia. Our case series suggested that plain old balloon angioplasty is an acceptable option to avoid coronary stenting because the majority of patients were young menstruating women. Coronary vasospasm might be associated with SCAD. Treatment with vasodilators could be a potential pharmacological option for avoiding recurrence of SCAD.>.

    DOI： 10.1016/j.jccase.2014.07.006

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  • Combo wireを使用した冠攣縮性狭心症患者における冠微小循環障害の評価

    山永健之, 辻田賢一, 小村直弘, 海北幸一, 掃本誠治, 宮崎貴志, 赤坂朋紀, 佐藤幸治, 堀尾英治, 有馬勇一郎, 小島淳, 田山信至, 中村淳, 小川久雄

    日本冠疾患学会雑誌   19 ( Supplement )   121 - 121   2013.12

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  • Impaired Peripheral Endothelial Function as Assessed by Digital Reactive Hyperemia Peripheral Arterial Tonometry and Risk of In- Stent Restenosis

    Naohiro Komura, Kenichi Tsujita, Kenshi Yamanaga, Koichi Kaikita, Seiji Hokimoto, Satomi Iwashita, Takashi Miyazaki, Tomonori Akasaka, Koji Sato, Eiji Horio, Hiromi Yoshimura, Yuichiro Arima, Sunao Kojima, Shinji Tayama, Sunao Nakamura, Seigo Sugiyama, Kiyoshi Hibi, Kazuo Kimura, Satoshi Umemura, Hisao Ogawa

    CIRCULATION   128 ( 22 )   2013.11

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  • cypher stent留置後のvery late stent thrombosis発症例のIVUS上の特徴について

    山永健之, 仲村佳典, 下村英紀, 小村直弘, 辻田賢一, 小椋裕司, 尾上喜郎, 堀尾英二, 佐藤幸治, 宮崎貴志, 赤坂朋紀, 小島淳, 田山信至, 海北幸一, 掃本誠治, 小川久雄

    日本心臓病学会誌   8 ( Supplement 1 )   523 - 523   2013.9

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  • 冠動脈ステント留置後の配置部位の組織成分に及ぼす糖尿病の影響(Impact of Diabetes on Tissue Components of Stented Segment after Coronary Stent Placement)

    辻田 賢一, 小村 直弘, 山永 健之, 赤坂 朋紀, 堀尾 英治, 佐藤 幸治, 宮崎 貴志, 小島 淳, 田山 信至, 海北 幸一, 掃本 誠治, 中村 淳, 小川 久雄

    日本心臓病学会誌   8 ( Suppl.I )   516 - 516   2013.9

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  • 急性心不全・発熱を初発症状とした大動脈炎症候群の1例

    井上 満穂, 瀬川 知, 久慈 正太郎, 武藤 和弘, 小村 直弘, 奥田 純, 日隈 菊比児, 梅村 敏

    日本内科学会関東地方会   593回   39 - 39   2012.12

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  • RELATION BETWEEN HYPERINSULINEMIA AND TISSUE CHARACTERISTICS OF NON-CULPRIT PLAQUE IN NON-DIABETIC PATIENTS WITH ACUTE CORONARY SYNDROMES

    Takayuki Mitsuhashi, Kiyoshi Hibi, Masami Kosuge, Sakano Tomokazu, Naohiro Komura, Ikuyoshi Kusama, Fumiyuki Otsuka, Mitsuaki Endo, Noriyuki Iwahashi, Jun Okuda, Kengo Tsukahara, Toshiaki Ebina, Satoshi Umemura, Kazuo Kimura

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   57 ( 14 )   E1471 - E1471   2011.4

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  • マラソン中心室細動が惹起された若年者心停止蘇生例-心房頻拍,頻脈依存性J波増強とQT延長の関与-

    本田洵也, 金城貴士, 吉田健太郎, 小村直弘, 関口幸夫, 夛田浩, 奥田純, 青沼和隆

    日本循環器学会関東甲信越地方会(Web)   221st   2011

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  • 食物アレルギーによる全身膨隆疹出現後に亜急性ステント血栓症を発症した不安定狭心症の1例

    中橋 秀文, 奥田 純, 小村 直弘, 岩田 究, 檜佐 彰男, 日隈 菊比児

    日本内科学会関東地方会   577回   50 - 50   2010.12

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  • Assessment of Morphological Features of Non-culprit Plaques in Patients With Acute Coronary Syndrome Using Optical Coherence Tomography

    Nobuhiko Maejima, Kiyoshi Hibi, Masayoshi Kiyokuni, Naoki Nakayama, Kazutoshi Minami, Naohiro Komura, Yasushi Matsuzawa, Katsutaka Hashiba, Kenichiro Sake, Fumiyuki Otsuka, Tatsuya Nakachi, Nodaki Iwahashi, Jun Okuda, Kengo Tsukahara, Yoshio Tahara, Masami Kosuge, Toshiaki Ebina, Satoshi Umemura, Kazuo Kimura

    CIRCULATION   120 ( 18 )   S921 - S922   2009.11

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  • 急性冠症候群非責任病変におけるプラークの組織学的特徴 OCTを用いた検討

    前島 信彦, 日比 潔, 中山 尚貴, 小村 直弘, 坂 賢一郎, 大塚 文之, 岩橋 徳明, 奥田 純, 塚原 健吾, 小菅 雅美, 海老名 俊明, 木村 一雄

    日本冠疾患学会雑誌   15 ( 4 )   376 - 376   2009.11

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  • Impact of Drug-eluting Stents on the Peristent Tissue Compositions: A Serial Volumetric Analysis Using Quantitative Integrated Backscatter Intravascular Ultrasound

    Kiyoshi Hibi, Mitsuaki Endo, Nobuhiko Maejima, Naoki Nakayama, Naohiro Komura, Fumiyuki Otsuka, Noriaki Iwahashi, Jun Okuda, Kengo Tsukahara, Masami Kosuge, Toshiaki Ebina, Satoshi Umemura, Kazuo Kimura

    AMERICAN JOURNAL OF CARDIOLOGY   104 ( 6A )   17D - 18D   2009.9

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  • 右室組織ドプラー法の初回ST上昇型急性心筋梗塞の評価における活用法に関する検討

    岩橋 徳明, 小菅 雅美, 南 一敏, 中山 尚貴, 小村 直弘, 羽柴 克孝, 大塚 文之, 仲地 達哉, 前島 信彦, 奥田 純, 塚原 健吾, 田原 良雄, 日比 潔, 海老名 俊明, 梅村 敏, 木村 一雄

    日本心臓病学会誌   4 ( Suppl.I )   357 - 357   2009.8

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  • 急性下壁梗塞におけるV4R誘導のST上昇による右室虚血診断の問題点

    小菅 雅美, 海老名 俊明, 日比 潔, 奥田 純, 岩橋 徳明, 塚原 健吾, 大塚 文之, 前島 信彦, 羽柴 克孝, 清國 雅義, 南 一敏, 仲地 達哉, 中山 尚貴, 小村 直弘, 木村 一雄, 梅村 敏

    日本心臓病学会誌   4 ( Suppl.I )   205 - 205   2009.8

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  • 急性冠症候群非責任病変におけるプラークの組織学的特徴 OCTを用いた検討

    前島 信彦, 日比 潔, 中山 尚貴, 小村 直弘, 羽柴 克孝, 坂 賢一郎, 大塚 文之, 仲地 達哉, 岩橋 徳明, 奥田 純, 塚原 健吾, 田原 良雄, 小菅 雅美, 海老名 俊明, 梅村 敏, 木村 一雄

    日本心臓病学会誌   4 ( Suppl.I )   245 - 245   2009.8

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  • 非糖尿病の急性心筋梗塞症例における耐糖能障害と冠動脈リモデリングとの関連

    大塚 文之, 日比 潔, 小菅 雅美, 小村 直弘, 前島 信彦, 仲地 達哉, 羽柴 克孝, 岩橋 徳明, 奥田 純, 塚原 健吾, 田原 良雄, 海老名 俊明, 梅村 敏, 木村 一雄

    日本心臓病学会誌   4 ( Suppl.I )   234 - 234   2009.8

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  • 急性冠症候群患者におけるスタチン投与によるLDLコレステロール/HDLコレステロール比の変化とプラーク体積の変化の検討

    小村 直弘, 日比 潔, 中山 尚貴, 清國 雅義, 南 一敏, 羽柴 克孝, 大塚 文之, 仲地 達哉, 前島 信彦, 岩橋 徳明, 奥田 純, 塚原 健吾, 小菅 雅美, 海老名 俊明, 梅村 敏, 木村 一雄

    日本心臓病学会誌   4 ( Suppl.I )   282 - 282   2009.8

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  • 初回ST上昇型急性心筋梗塞における心臓超音波諸指標とBNPの関係

    岩橋 徳明, 小菅 雅美, 中山 尚貴, 清國 雅義, 小村 直弘, 羽柴 克孝, 大塚 文之, 仲地 達哉, 前島 信彦, 奥田 純, 塚原 健吾, 田原 良雄, 日比 潔, 海老名 俊明, 梅村 敏, 木村 一雄

    日本心臓病学会誌   4 ( Suppl.I )   398 - 398   2009.8

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  • 初回ST上昇型急性心筋梗塞における組織ドプラー法諸指標の有用性に関する検討

    岩橋 徳明, 小菅 雅美, 小村 直弘, 中山 尚貴, 南 一敏, 羽柴 克孝, 大塚 文之, 仲地 達哉, 前島 信彦, 奥田 純, 塚原 健吾, 田原 良雄, 日比 潔, 海老名 俊明, 梅村 敏, 木村 一雄

    日本心臓病学会誌   4 ( Suppl.I )   396 - 396   2009.8

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  • 急性冠症候群責任病変における血管内超音波で認める超音波減衰性プラークのOCTによる組織学的特徴

    前島 信彦, 日比 潔, 中山 尚貴, 小村 直弘, 羽柴 克孝, 坂 賢一郎, 大塚 文之, 仲地 達哉, 岩橋 徳明, 奥田 純, 塚原 健吾, 田原 良雄, 小菅 雅美, 海老名 俊明, 梅村 敏, 木村 一雄

    日本心臓病学会誌   4 ( Suppl.I )   303 - 303   2009.8

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  • 狭心症責任病変プラーク組織性状は血清HDL-C値とCRP値と関連する integrated backscatter intravascular ultrasound(IB-IVUS)での検討

    中山 尚貴, 日比 潔, 清國 雅義, 南 一敏, 小村 直弘, 羽柴 克孝, 大塚 文之, 仲地 達哉, 前島 信彦, 岩橋 徳明, 奥田 純, 塚原 健吾, 小菅 雅美, 海老名 俊明, 梅村 敏, 木村 一雄

    日本心臓病学会誌   4 ( Suppl.I )   282 - 282   2009.8

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  • E/e'を含む組織ドプラー法指標は初回急性前壁梗塞において強力な予後規定因子である

    岩橋 徳明, 小菅 雅美, 清國 雅義, 南 一敏, 小村 直弘, 羽柴 克孝, 大塚 文之, 仲地 達哉, 前島 信彦, 奥田 純, 塚原 健吾, 田原 良雄, 日比 潔, 海老名 俊明

    日本心臓病学会誌   4 ( Suppl.I )   312 - 312   2009.8

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  • 急性心筋梗塞血栓溶解療法施行例で急性期高血糖は梗塞前狭心症による梗塞サイズ縮小効果を減弱させる

    清國 雅義, 小菅 雅美, 海老名 俊明, 日比 潔, 塚原 健吾, 奥田 純, 岩橋 徳明, 前島 信彦, 仲地 達哉, 大塚 文之, 羽柴 克孝, 小村 直弘, 南 一敏, 中山 尚貴, 木村 一雄, 梅村 敏

    日本心臓病学会誌   4 ( Suppl.I )   311 - 311   2009.8

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  • 急性心筋梗塞発症前のスタチン内服は造影剤腎症の発症リスクを低下させる

    清國 雅義, 小菅 雅美, 海老名 俊明, 日比 潔, 塚原 健吾, 奥田 純, 岩橋 徳明, 前島 信彦, 仲地 達哉, 大塚 文之, 羽柴 克孝, 小村 直弘, 南 一敏, 中山 尚貴, 木村 一雄, 梅村 敏

    日本心臓病学会誌   4 ( Suppl.I )   390 - 390   2009.8

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  • Different Influence of Insulin Resistance and Low-Density Lipoprotein Cholesterol on the Tissue Components of Culprit and Nonculprit Plaques in Patients With Unstable Angina

    Takayuki Mitsuhashi, Kiyoshi Hibi, Naoki Nakayama, Naohiro Komura, Fumiyuki Otsuka, Nobuhiko Maejima, Masayoshi Kiyokuni, Kazutoshi Minami, Katsutaka Hashiba, Tatsuya Nakachi, Noriaki Iwahashi, Jun Okuda, Kengo Tsukahara, Yoshio Tahara, Masami Kosuge, Toshiaki Ebina, Shinichi Sumita, Satoshi Umemura, Kazuo Kimura

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   53 ( 10 )   A423 - A423   2009.3

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  • Impact of Drug-Eluting Stents on the Peristent Plaque Compositions: A Serial Volumetric Analysis Using Quantitative Integrated Backscatter Intravascular Ultrasound

    Mitsuaki Endo, Kiyoshi Hibi, Naohiro Komura, Fumiyuki Otsuka, Takayuki Mitsuhashi, Noriaki Iwahashi, Naoki Nozawa, Jun Okuda, Kengo Tsukahara, Masami Kosuge, Toshiaki Ebina, Tsutomu Endo, Satoshi Umemura, Kazuo Kimura

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   53 ( 10 )   A13 - A13   2009.3

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  • Intensive and Moderate Lipid Lowering Therapy to Prevent Progression of Coronary Atherosclerosis in Patients With Acute Coronary Syndrome in Japan: A Serial Intravascular Ultrasound Study

    Naohiro Komura, Kiyoshi Hibi, Fumiyuki Otsuka, Takayuki Mitsuhashi, Noriaki Iwahashi, Jun Okuda, Kenngo Tsukahara, Masami Kosuge, Toshiaki Ebina, Satoshi Umemura, Kazuo Kimura

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   53 ( 10 )   A204 - A204   2009.3

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  • インスリン分泌能とインスリン抵抗性の冠動脈プラーク組織性状への影響 IB-IVUSを用いた検討

    三橋 孝之, 日比 潔, 中山 尚貴, 小村 直弘, 大塚 文之, 前島 信彦, 岩橋 徳明, 奥田 純, 塚原 健吾, 小菅 雅美, 海老名 俊明, 木村 一雄

    日本冠疾患学会雑誌   14 ( 4 )   367 - 367   2008.11

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  • Impaired Glucose Tolerance is Associated With Positive Coronary Artery Remodeling in Non-diabetic Patients with ST-elevation Acute Myocardial Infarction

    Fumiyuki Otsuka, Kiyoshi Hibi, Ikuyoshi Kusama, Mitsuaki Endo, Masami Kosuge, Takayuki Mitsuhashi, Naohiro Komura, Noriaki Iwahashi, Jun Okuda, Kengo Tsukahara, Yoshio Tahara, Toshiaki Ebina, Satoshi Umemura, Kazuo Kimura

    CIRCULATION   118 ( 18 )   S1113 - S1113   2008.10

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  • Impact of Long-Term Statin Pretreatment on the Incidence of Plaque Rupture and Infarct Size in ST-Elevation Acute Myocardial Infarction

    Fumiyuki Otsuka, Kiyoshi Hibi, Ikuyoshi Kusama, Mitsuaki Endo, Masami Kosuge, Takayuki Mitsuhashi, Naohiro Komura, Noriaki Iwahashi, Jun Okuda, Kengo Tsukahara, Yoshio Tahara, Toshiaki Ebina, Satoshi Umemura, Kazuo Kimura

    CIRCULATION   118 ( 18 )   S584 - S584   2008.10

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  • ST上昇型急性冠症候群における再灌流療法後のIschemic Diastolic Stunningの評価にTSI法を用いたストレインレート法は有効である

    岩橋 徳明, 小菅 雅美, 中山 尚貴, 小村 直弘, 羽柴 克孝, 大塚 文之, 仲地 達哉, 三橋 孝之, 奥田 純, 塚原 健吾, 日比 潔, 田原 良雄, 海老名 俊明, 梅村 敏, 木村 一雄

    日本心臓病学会誌   2 ( Suppl.I )   458 - 458   2008.8

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  • 急性心筋梗塞症におけるPCI後のNo-reflowと梗塞サイズ、心機能との関連、およびIVUSでのNo-reflowの予測因子についての検討

    遠藤 光明, 日比 潔, 海老名 俊明, 小菅 雅美, 塚原 健吾, 奥田 純, 岩橋 徳明, 三橋 孝之, 大塚 文之, 草間 郁好, 小村 直弘, 清国 雅義, 清水 智明, 猿渡 力, 梅村 敏, 木村 一雄

    日本心臓病学会誌   2 ( Suppl.I )   259 - 259   2008.8

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  • ST上昇型急性心筋梗塞症における冠動脈プラーク破裂とHDLコレステロール値及び喫煙との関連

    大塚 文之, 日比 潔, 草間 郁好, 遠藤 光明, 三橋 孝之, 小村 直弘, 小菅 雅美, 岩橋 徳明, 奥田 純, 塚原 健吾, 田原 良雄, 海老名 俊明, 梅村 敏, 木村 一雄

    日本心臓病学会誌   2 ( Suppl.I )   363 - 363   2008.8

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  • 非糖尿病耐糖能異常患者におけるインスリン抵抗性とintegrated backscatter IVUS(IB-IVUS)を用いた冠動脈プラーク組織性状との関係

    三橋 孝之, 日比 潔, 小村 直弘, 大塚 文之, 南 一敏, 羽柴 克孝, 仲地 達哉, 岩橋 徳明, 前島 信彦, 奥田 純, 塚原 健吾, 田原 良雄, 小菅 雅美, 海老名 俊明, 梅村 敏, 木村 一雄

    日本心臓病学会誌   2 ( Suppl.I )   279 - 279   2008.8

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  • 早期再灌流療法に成功した初回ST上昇型急性冠症候群の拡張期弛緩能に関する検討 Tissue Strain Imagingでの検討

    岩橋 徳明, 羽柴 克孝, 奥田 純, 海老名 俊明, 三橋 孝之, 小菅 雅美, 小村 直弘, 大塚 文之, 南 一敏, 仲地 達哉, 塚原 健吾, 田原 良雄, 日比 潔, 梅村 敏, 木村 一雄

    日本心臓病学会誌   2 ( Suppl.I )   457 - 457   2008.8

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  • 薬物溶出性ステント留置例における血小板凝集能と予後

    塚原 健吾, 木村 一雄, 海老名 俊明, 小菅 雅美, 日比 潔, 奥田 純, 岩橋 徳明, 仲地 達哉, 三橋 孝之, 大塚 文之, 小村 直弘, 羽柴 克孝, 中山 尚貴, 梅村 敏

    日本心臓病学会誌   2 ( Suppl.I )   439 - 439   2008.8

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  • 心肺停止に対するPCPS使用例の予後

    田原 良雄, 鈴木 範行, 小菅 宇之, 南 一敏, 清國 雅義, 中山 尚貴, 小村 直弘, 羽柴 克孝, 大塚 文之, 三橋 孝之, 仲地 達也, 岩橋 徳明, 奥田 純, 塚原 健吾, 日比 潔, 小菅 雅美, 海老名 俊明, 住田 晋一, 木村 一雄, 梅村 敏

    循環制御   29 ( Suppl. )   79 - 79   2008.5

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  • Impact of hyperinsulinemia on tissue characteristics of non-culprit plaque in non-diabetic patients with acute coronary syndrome

    Takayuki Mitsuhashi, Kiyoshi Hibi, Masami Kosuge, Toshialki Ebina, Shingo Tsukahara, Jun Okuda, Noriaki Iwahashi, Mitsuaki Endo, Fumiyuki Otsuka, Lkuyoshi Kusama, Naohiro Komura, Satoshi Umemura, Kazuo Kimura

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   51 ( 10 )   A332 - A332   2008.3

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  • Relation of high-density lipoprotein cholesterol and cigarette smoking to the incidence of plaque rupture detected by intravascular ultrasound in ST-elevation acute myocardial infarction

    Fumiyuki Otsuka, Kiyoshi Hibi, Ikuyoshi Kusama, Mitsuaki Endou, Takayuki Mitsuhashi, Naohiro Komura, Masami Kosuge, Noriaki Iwahashi, Jyun Okuda, Kengo Tsukahara, Yoshio Tahara, Toshiaki Ebina, Kazuo Kimura, Satoshi Umemura

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   51 ( 10 )   A366 - A366   2008.3

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  • Impact of chronic statin treatment before the onset of ST-elevation acute myocardial infarction on the incidence of plaque rupture detected by intravascular ultrasound

    Fumiyuki Otsuka, Kiyoshi Hibi, Ikuyoshi Kusama, Mitsuaki Endou, Takayuki Mitsuhashi, Naohiro Komura, Masami Kosuge, Noriaki Iwahashi, Jyun Okuda, Kengo Tsukahara, Yoshio Tahara, Toshiaki Ebina, Kazuo Kimura, Satoshi Umemura

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   51 ( 10 )   A351 - A351   2008.3

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  • 急性冠症候群おける明らかな石灰化によらない超音波減衰と冠インターベンション後の造影遅延との関係

    遠藤 光明, 日比 潔, 小村 直弘, 大塚 文之, 三橋 孝之, 岩橋 徳明, 奥田 純, 塚原 健吾, 小菅 雅美, 海老名 俊明, 木村 一雄, 梅村 敏

    日本冠疾患学会雑誌   13 ( 4 )   350 - 350   2007.11

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  • 非糖尿病患者におけるインスリン抵抗性とIB-IVUSを用いた冠動脈プラーク組織性状との関係

    三橋 孝之, 日比 潔, 小菅 雅美, 海老名 俊明, 塚原 健吾, 奥田 純, 岩橋 徳明, 遠藤 光明, 大塚 文之, 仲地 達哉, 草間 郁好, 小村 直弘, 清國 雅義, 木村 一雄, 梅村 敏

    日本冠疾患学会雑誌   13 ( 4 )   348 - 348   2007.11

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  • Impact of insulin resistance on tissue characteristics of non-culprit plaque in non-diabetic patients with acute coronary syndrome

    Takayuki Mitsuhashi, KJiyoshi Hibi, Naohiro Komura, Ikuyoshi Kusama, Fumiyuki Otsuka, Mitsuaki Endou, Noriaki Iwahashi, Jun Okuda, Kengo Tsukahara, Masami Kosuge, Toshiaki Ebina, Satoshi Umemura, Kazuo Kimura

    CIRCULATION   116 ( 16 )   796 - 796   2007.10

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  • Deep ultrasound attenuation and plaque rupture detected by intravascular ultrasound impacts quantitative coronary flow during percutaneous coronary intervention in acute myocardial infarction

    Mitsuaki Endo, Kiyoshi Hibi, Tomoaki Shimizu, Naohiro Komura, Ikuyoshi Kusama, Fumiyuki Otsuka, Takayuki Mitsuhashi, Norialki Iwahashi, Jun Okuda, Kengo Tsukahara, Masami Kosuge, Toshiaki Ebina, Kazuo Kimura, Satoshi Umemura

    CIRCULATION   116 ( 16 )   628 - 629   2007.10

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  • 冠動脈近位部と遠位部でプラーク組織性状は異なるか? Integrated backscatter intravascular ultrasound(IB-IVUS)を用いた検討

    小村 直弘, 日比 潔, 清国 雅義, 南 一敏, 羽柴 克孝, 草間 郁好, 大塚 文之, 三橋 孝之, 仲地 達哉, 遠藤 光明, 岩橋 徳明, 奥田 純, 塚原 健吾, 小菅 雅美, 住田 晋一, 海老名 俊明, 木村 一雄, 梅村 敏

    Journal of Cardiology   50 ( Suppl.I )   555 - 555   2007.8

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  • 急性心筋梗塞に対する救急隊による院外12誘導心電図記録・伝送の効果

    中山 尚貴, 田原 良雄, 木村 一雄, 小菅 雅美, 海老名 俊明, 住田 晋一, 日比 潔, 塚原 健吾, 奥田 純, 遠藤 光明, 岩橋 徳明, 仲地 達哉, 三橋 孝之, 大塚 文之, 草間 郁好, 羽柴 克孝, 小村 直弘, 清国 雅義, 南 一敏, 梅村 敏

    Journal of Cardiology   50 ( Suppl.I )   256 - 256   2007.8

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  • 非糖尿病患者におけるインスリン抵抗性とIntegrated Backscatter IVUS(IB-IVUS)を用いた冠動脈プラーク組織性状との関係

    三橋 孝之, 日比 潔, 小菅 雅美, 住田 晋一, 海老名 俊明, 田原 良雄, 塚原 健吾, 奥田 純, 岩橋 徳明, 遠藤 光明, 仲地 達哉, 大塚 文之, 草間 郁好, 羽柴 克孝, 小村 直弘, 南 一敏, 清国 雅義, 中山 尚貴, 木村 一雄, 梅村 敏

    Journal of Cardiology   50 ( Suppl.I )   271 - 271   2007.8

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  • 早期再灌流療法に成功したST上昇型急性冠症候群における局所ストレインに関する検討

    岩橋 徳明, 小村 直弘, 草間 郁好, 大塚 文之, 三橋 孝之, 仲地 達哉, 遠藤 光明, 奥田 純, 塚原 健吾, 田原 良雄, 日比 潔, 小菅 雅美, 海老名 俊明, 木村 一雄, 梅村 敏

    Journal of Cardiology   50 ( Suppl.I )   328 - 328   2007.8

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  • 血管内超音波によるSirolimus-eluting stent留置後の慢性期ステント圧着不良についての検討 Bare metal stentとの比較

    遠藤 光明, 日比 潔, 海老名 俊明, 小菅 雅美, 塚原 健吾, 奥田 純, 岩橋 徳明, 仲地 達哉, 三橋 孝之, 大塚 文之, 草間 郁好, 羽柴 克孝, 小村 直弘, 南 一敏, 清国 雅義, 梅村 敏, 木村 一雄

    Journal of Cardiology   50 ( Suppl.I )   313 - 313   2007.8

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  • トロポニン陰性の非ST上昇型急性冠症候群におけるD-dimer上昇の意義

    塚原 健吾, 木村 一雄, 海老名 俊明, 小菅 雅美, 日比 潔, 奥田 純, 岩橋 徳明, 遠藤 光明, 仲地 達哉, 三橋 孝之, 大塚 文之, 草間 郁好, 小村 直弘, 梅村 敏

    Journal of Cardiology   50 ( Suppl.I )   339 - 339   2007.8

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  • 角度補正組織ストレインドプラー法によるST上昇型急性冠症候群における局所心筋障害の評価 99mTc-MIBIとの対照研究

    岩橋 徳明, 木村 一雄, 遠藤 光明, 三橋 孝之, 小村 直弘, 草間 郁好, 大塚 文之, 仲地 達哉, 奥田 純, 小菅 雅美, 塚原 健吾, 田原 良雄, 日比 潔, 海老名 俊明, 梅村 敏, 望月 秀一, 石川 栄二

    Journal of Cardiology   50 ( Suppl.I )   328 - 328   2007.8

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  • Real time経胸壁3D心エコーによる急性大動脈解離の診断

    岩橋 徳明, 遠藤 光明, 奥田 純, 海老名 俊明, 三橋 孝之, 小菅 雅美, 小村 直弘, 草間 郁好, 大塚 文之, 仲地 達哉, 塚原 健吾, 田原 良雄, 日比 潔, 梅村 敏, 木村 一雄

    Journal of Cardiology   50 ( Suppl.I )   472 - 472   2007.8

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  • 前胸部誘導で陰性T波を認める急性肺塞栓と急性冠症候群の鑑別

    小菅 雅美, 海老名 俊明, 日比 潔, 奥田 純, 岩橋 徳明, 塚原 健吾, 遠藤 光明, 仲地 達哉, 大塚 文之, 小村 直弘, 木村 一雄, 梅村 敏

    Journal of Cardiology   50 ( Suppl.I )   406 - 406   2007.8

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  • 急性心筋梗塞前のスタチン内服は血栓溶解療法施行後の再疎通時間を向上させるか?

    清國 雅義, 奥田 純, 小菅 雅美, 住田 晋一, 海老名 俊明, 日比 潔, 田原 良雄, 塚原 健吾, 岩橋 徳明, 遠藤 光明, 仲地 達哉, 三橋 孝之, 大塚 文之, 羽柴 克孝, 草間 郁好, 小村 直弘, 南 一敏, 中山 尚貴, 木村 一雄, 梅村 敏

    Journal of Cardiology   50 ( Suppl.I )   475 - 475   2007.8

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  • 初回ST上昇型急性冠症候群においてE/e'は一年以内の再入院の予測因子である

    岩橋 徳明, 木村 一雄, 小村 直弘, 草間 郁好, 大塚 文之, 仲地 達哉, 三橋 孝之, 遠藤 光明, 奥田 純, 塚原 健吾, 日比 潔, 小菅 雅美, 田原 良雄, 海老名 俊明, 梅村 敏

    Journal of Cardiology   50 ( Suppl.I )   473 - 473   2007.8

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  • 待機的PCIにおける血小板凝集能の検討

    塚原 健吾, 木村 一雄, 海老名 俊明, 小菅 雅美, 日比 潔, 奥田 純, 岩橋 徳明, 遠藤 光明, 仲地 達哉, 三橋 孝之, 大塚 文之, 草間 郁好, 小村 直弘, 梅村 敏

    Journal of Cardiology   50 ( Suppl.I )   561 - 561   2007.8

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  • Effects of Angiotensin-II receptor blockers on coronary atherosclerosis in patients with acute myocardial infarction taking angiotensin-converting-enzyme inhibitors: Final results of captopril combined with valsartan in acute myocardial infarction study (CVAS)

    Hideto Yano, Kiyoshi Hibi, Hiroyuki Ozaki, Ikuyoshi Kusama, Mitsuaki Endou, Takayuki Mitsuhashi, Naohiro Komura, Toshiaki Ebina, Masami Kosuge, Kengo Tsukahara, Jun Okuda, Noriaki Iwahashi, Tatsuya Nakachi, Fumiyuki Otsuka, Satoshi Umemura, Kazuo Kimura

    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY   49 ( 9 )   316A - 316A   2007.3

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  • A full recovery case from sudden cardiac arresi with an automated external defibrillator placed in a sports center

    Nakayama Naoki, Ozaki Hiroyuki, Ebina Toshiaki, Kosuge Masami, Hibi Kiyoshi, Tsukahara Kengo, Okuda Jun, Iwahashi Noriaki, Yano Hideto, Nakachi Tatsuya, Endo Mitsuaki, Mitsuhashi Takayuki, Otsuka Fumiyuki, Kusama Ikuyoshi, Komura Naohiro, Kimura Kazuo, Hashiba Katsutaka, Tahara Yoshio, Kosuge Takayuki, Sugiyama Mitsugi

    Shinzo   39 ( Supplement3 )   54 - 57   2007

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    DOI： 10.11281/shinzo1969.39.supplement3_54

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  • 急性肺動脈血栓塞栓症のリスク層別における陰性T波の臨床的意義

    小菅 雅美, 海老名 俊明, 日比 潔, 塚原 健吾, 奥田 純, 岩橋 徳明, 仲地 達哉, 大塚 文之, 三橋 孝之, 小村 直弘, 田原 良雄, 矢野 英人, 尾崎 弘幸, 羽柴 克孝, 木村 一雄, 梅村 敏

    Journal of Cardiology   48 ( Suppl.I )   663 - 663   2006.9

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  • Plaque Ruptureの位置に冠リモデリングは影響するか? 血管内超音波を用いた検討

    草間 郁好, 日比 潔, 尾崎 弘幸, 矢野 英人, 海老名 俊明, 小菅 雅美, 塚原 健吾, 奥田 純, 岩橋 徳明, 遠藤 光明, 仲地 達哉, 三橋 孝之, 大塚 文之, 小村 直弘, 梅村 敏, 木村 一雄

    Journal of Cardiology   48 ( Suppl.I )   428 - 428   2006.9

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  • 急性心筋梗塞患者におけるメタボリック症候群の臨床像

    小菅 雅美, 海老名 俊明, 日比 潔, 塚原 健吾, 奥田 純, 岩橋 徳明, 遠藤 光明, 仲地 達哉, 大塚 文之, 三橋 孝之, 小村 直弘, 矢野 英人, 尾崎 弘幸, 草間 郁好, 木村 一雄, 梅村 敏

    Journal of Cardiology   48 ( Suppl.I )   705 - 705   2006.9

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  • 巨細胞性動脈炎の一例

    小村 直弘, 玉井 明子, 瀬沼 昭子, 中村 満行, 長岡 章平, 鈴木 敏彦, 河野 尚美

    共済医報   54 ( 3 )   266 - 266   2005.8

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  • The transformation behavior induced by water for Y-TZP containing transition metal oxides.

    平尾一之, 曽我直弘, 小村浩史, 岡本剛, 田中征二郎, 川上辰男

    材料   39 ( 439 )   1990

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