2025/07/01 更新

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写真a

スズキ トオル
鈴木 徹
Toru Suzuki
所属
附属病院 CCU 助教
職名
助教
外部リンク

学位

  • 医学博士 ( 2023年3月   横浜市立大学 )

研究キーワード

  • 肺高血圧症

  • 糖尿病性腎症

  • 心腎連関

研究分野

  • ライフサイエンス / 循環器内科学

  • ライフサイエンス / 腎臓内科学

学歴

  • 横浜市立大学大学院医学研究科

    2018年4月 - 2023年3月

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  • 横浜市立大学医学部医学科

    2006年4月 - 2012年3月

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経歴

  • 横浜市立大学附属病院   循環器内科

    2018年4月 - 現在

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  • 国際医療福祉大学熱海病院   循環器内科

    2017年4月 - 2018年3月

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  • 藤沢市民病院   循環器内科

    2014年4月 - 2017年3月

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  • 横浜市立大学附属市民総合医療センター   初期研修医

    2013年4月 - 2014年3月

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  • 藤沢市民病院   初期研修医

    2012年3月 - 2013年3月

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所属学協会

  • 日本肺高血圧・肺循環学会

    2023年5月 - 現在

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  • 日本心血管インターベンション治療学会

    2022年4月 - 現在

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  • 日本心臓リハビリテーション学会

    2017年7月 - 現在

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  • 日本循環器学会

    2015年4月 - 現在

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  • 日本内科学会

    2014年1月 - 現在

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委員歴

  • 日本循環器学会関東甲信越支部ダイバーシティ委員会 U-40部会  

    2022年12月 - 現在   

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論文

  • 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年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    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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  • Cigarette Smoking, Smoking Cessation, and Heart Failure Subtypes: Insights From the Jackson Heart Study. 国際誌

    Kamimura D, Yimer WK, Mentz RJ, Shah AM, White WB, Blaha MJ, Oshunbade A., Hamid A., Suzuki T., Clark DR, Fox ER, Correa A, Butler J, Hall ME

    Journal of the American Heart Association   e032921   2024年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Cigarette smoking has been associated with incident heart failure (HF). However, the association between cigarette smoking and smoking cessation with HF subtypes has not been well elucidated, particularly among Black people. METHODS AND RESULTS: We investigated 4189 (never smoker n=2934, former smoker n=761, current smoker n=464) Black participants (mean age 54 years, 64% women) without a history of HF or coronary heart disease at baseline in the Jackson Heart Study. We examined the association of cigarette smoking with incident HF hospitalization and HF subtypes (HF with preserved ejection fraction and HF with reduced ejection fraction). After adjustment for confounding factors, current smoking was associated with incident HF (both subtypes) compared with never smoking. Smoking intensity among those who identified as currently smoking and smoking burden among those who ever smoked were associated with higher incidence of HF with preserved ejection fraction compared with never smoking. Lung function evaluated by spirometry at baseline did not significantly influence these associations. The risk of developing HF decreased with more years after smoking cessation, and more than 20 years of smoking cessation were required to reach a risk comparable to that of never smoking. CONCLUSIONS: Smoking cigarettes was associated with developing both subtypes of HF and it was independent from the influences on baseline lung function. Long-term smoking cessation is necessary to prevent the onset of HF in people who smoke cigarettes.

    DOI: 10.1161/JAHA.123.032921

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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年8月

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    記述言語:日本語   出版者・発行元:日本肺高血圧・肺循環学会  

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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年7月

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    記述言語:英語   出版者・発行元:(一社)日本心血管インターベンション治療学会  

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  • Legs Elevation Method may be Useful for Diagnosis of Exclusion for Exercised Pulmonary Hypertension(タイトル和訳中)

    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年3月

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    記述言語:英語   出版者・発行元:(一社)日本循環器学会  

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  • Angiotensin II type 1 receptor-associated protein deletion combined with angiotensin II stimulation accelerates the development of diabetic kidney disease in mice on a C57BL/6 strain. 国際誌

    Shinya Taguchi, Kengo Azushima, Takahiro Yamaji, Toru Suzuki, Eriko Abe, Shohei Tanaka, Keigo Hirota, Shunichiro Tsukamoto, Ryutaro Morita, Ryu Kobayashi, Sho Kinguchi, Akio Yamashita, Hiromichi Wakui, Kouichi Tamura

    Hypertension research : official journal of the Japanese Society of Hypertension   2023年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The progress in the research field of diabetic kidney disease (DKD) has been disturbed by the lack of reliable animal models. Angiotensin II (Ang II) type 1 receptor (AT1R)-associated protein (ATRAP) promotes internalization of AT1R and selectively inhibits pathological AT1R signaling. In this study, we investigated whether overactivation of the renin-angiotensin system (RAS) through a combination of ATRAP deletion with Ang II stimulation developed a progressive DKD model in C57BL/6 mice, which are resistant to the development of kidney injury. Eight-week-old male systemic ATRAP-knockout mice on the C57BL/6 strain (KO) and their littermate wild-type mice (Ctrl) were divided into five groups: 1) Ctrl, 2) Ctrl-streptozotocin (STZ), 3) KO-STZ, 4) Ctrl-STZ-Ang II, and 5) KO-STZ-Ang II. Ang II was administered for 6 weeks from 4 weeks after STZ administration. At 10 weeks after STZ administration, mice were euthanized to evaluate kidney injuries. Neither ATRAP deletion alone nor Ang II stimulation alone developed a progressive DKD model in STZ-induced diabetic C57BL/6 mice. However, a combination of ATRAP deletion with Ang II stimulation accelerated the development of DKD as manifested by overt albuminuria, glomerular hypertrophy, podocyte loss, mesangial expansion, kidney interstitial fibrosis and functional insufficiency, concomitant with increased angiotensinogen and AT1R expression in the kidneys. In STZ-induced diabetic C57BL/6 mice that are resistant to the development of kidney injury, the combination of ATRAP deletion and Ang II stimulation accelerates the development of DKD, which may be associated with intrarenal RAS overactivation.

    DOI: 10.1038/s41440-023-01496-4

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  • Combination of sacubitril/valsartan and blockade of the PI3K pathway enhanced kidney protection in a mouse model of cardiorenal syndrome. 国際誌

    Shunichiro Tsukamoto, Hiromichi Wakui, Tatsuki Uehara, Yuka Shiba, Kengo Azushima, Eriko Abe, Shohei Tanaka, Shinya Taguchi, Keigo Hirota, Shingo Urate, Toru Suzuki, Takayuki Yamada, Sho Kinguchi, Akio Yamashita, Kouichi Tamura

    European heart journal open   3 ( 6 )   oead098   2023年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIMS: Angiotensin receptor-neprilysin inhibitor (ARNI) is an established treatment for heart failure. However, whether ARNI has renoprotective effects beyond renin-angiotensin system inhibitors alone in cardiorenal syndrome (CRS) has not been fully elucidated. Here, we examined the effects of ARNI on the heart and kidneys of CRS model mice with overt albuminuria and identified the mechanisms underlying ARNI-induced kidney protection. METHODS AND RESULTS: C57BL6 mice were subjected to chronic angiotensin II infusion, nephrectomy, and salt loading (ANS); they developed CRS phenotypes and were divided into the vehicle treatment (ANS-vehicle), sacubitril/valsartan treatment (ANS-ARNI), and two different doses of valsartan treatment (ANS-VAL M, ANS-VAL H) groups. Four weeks after treatment, the hearts and kidneys of each group were evaluated. The ANS-vehicle group showed cardiac fibrosis, cardiac dysfunction, overt albuminuria, and kidney fibrosis. The ANS-ARNI group showed a reduction in cardiac fibrosis and cardiac dysfunction compared with the valsartan treatment groups. However, regarding the renoprotective effects characterized by albuminuria and fibrosis, ARNI was less effective than valsartan. Kidney transcriptomic analysis showed that the ANS-ARNI group exhibited a significant enhancement in the phosphoinositide 3-kinase (PI3K)-AKT signalling pathway compared with the ANS-VAL M group. Adding PI3K inhibitor treatment to ARNI ameliorated kidney injury to levels comparable with those of ANS-VAL M while preserving the superior cardioprotective effect of ARNI. CONCLUSION: PI3K pathway activation has been identified as a key mechanism affecting remnant kidney injury under ARNI treatment in CRS pathology, and blockading the PI3K pathway with simultaneous ARNI treatment is a potential therapeutic strategy for treating CRS with overt albuminuria.

    DOI: 10.1093/ehjopen/oead098

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  • Angiotensin II type 1 receptor-associated protein in immune cells: a possible key factor in the pathogenesis of visceral obesity. 国際誌

    Shunichiro Tsukamoto, Toru Suzuki, Hiromichi Wakui, Tatsuki Uehara, Juri Ichikawa, Hiroshi Okuda, Kotaro Haruhara, Kengo Azushima, Eriko Abe, Shohei Tanaka, Shinya Taguchi, Keigo Hirota, Sho Kinguchi, Akio Yamashita, Tomohiko Tamura, Kouichi Tamura

    Metabolism: clinical and experimental   149   155706 - 155706   2023年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND AND AIM: Dysregulation of angiotensin II type 1 receptor-associated protein (ATRAP) expression in cardiovascular, kidney, and adipose tissues is involved in the pathology of hypertension, cardiac hypertrophy, atherosclerosis, kidney injury, and metabolic disorders. Furthermore, ATRAP is highly expressed in bone marrow-derived immune cells; however, the functional role of immune cell ATRAP in obesity-related pathology remains unclear. Thus, we sought to identify the pathophysiological significance of immune cell ATRAP in the development of visceral obesity and obesity-related metabolic disorders using a mouse model of diet-induced obesity. METHODS: Initially, we examined the effect of high-fat diet (HFD)-induced obesity on the expression of immune cell ATRAP in wild-type mice. Subsequently, we conducted bone marrow transplantation to generate two types of chimeric mice: bone marrow wild-type chimeric (BM-WT) and bone marrow ATRAP knockout chimeric (BM-KO) mice. These chimeric mice were provided an HFD to induce visceral obesity, and then the effects of immune cell ATRAP deficiency on physiological parameters and adipose tissue in the chimeric mice were investigated. RESULTS: In wild-type mice, body weight increase by HFD was associated with increased expression of immune cell ATRAP. In the bone marrow transplantation experiments, BM-KO mice exhibited amelioration of HFD-induced weight gain and visceral fat expansion with small adipocytes compared BM-WT mice. In addition, BM-KO mice on the HFD showed significant improvements in white adipose tissue metabolism, inflammation, glucose tolerance, and insulin resistance, compared with BM-WT mice on the HFD. Detailed analysis of white adipose tissue revealed significant suppression of HFD-induced activation of transforming growth factor-beta signaling, a key contributor to visceral obesity, via amelioration of CD206+ macrophage accumulation in the adipose tissue of BM-KO mice. This finding suggests a relevant mechanism for the anti-obesity phenotype in BM-KO mice on the HFD. Finally, transcriptome analysis of monocytes indicated the possibility of genetic changes, such as the enhancement of interferon-γ response at the monocyte level, affecting macrophage differentiation in BM-KO mice. CONCLUSION: Collectively, our results indicate that ATRAP in bone marrow-derived immune cells plays a role in the pathogenesis of visceral obesity. The regulation of ATRAP expression in immune cells may be a key factor against visceral adipose obesity with metabolic disorders.

    DOI: 10.1016/j.metabol.2023.155706

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  • 腎尿細管RAS(renin-angiotensin system)の過剰活性化は尿細管M2マクロファージ発現を低下させ、糖尿病性糸球体障害を惹起する

    鈴木 徹, 春原 浩太郎, 涌井 広道, 小豆島 健護, 小林 竜, 金口 翔, 坪井 伸夫, 横尾 隆, 田村 功一

    日本高血圧学会総会プログラム・抄録集   45回   213 - 213   2023年9月

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    記述言語:日本語   出版者・発行元:(NPO)日本高血圧学会  

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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年8月

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    記述言語:英語   出版者・発行元:(一社)日本心血管インターベンション治療学会  

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  • Effects of a High-Protein Diet on Kidney Injury under Conditions of Non-CKD or CKD in Mice. 国際誌

    Shohei Tanaka, Hiromichi Wakui, Kengo Azushima, Shunichiro Tsukamoto, Takahiro Yamaji, Shingo Urate, Toru Suzuki, Eriko Abe, Shinya Taguchi, Takayuki Yamada, Ryu Kobayashi, Tomohiko Kanaoka, Daisuke Kamimura, Sho Kinguchi, Masahito Takiguchi, Kengo Funakoshi, Akio Yamashita, Tomoaki Ishigami, Kouichi Tamura

    International journal of molecular sciences   24 ( 9 )   2023年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Considering the prevalence of obesity and global aging, the consumption of a high-protein diet (HPD) may be advantageous. However, an HPD aggravates kidney dysfunction in patients with chronic kidney disease (CKD). Moreover, the effects of an HPD on kidney function in healthy individuals are controversial. In this study, we employed a remnant kidney mouse model as a CKD model and aimed to evaluate the effects of an HPD on kidney injury under conditions of non-CKD and CKD. Mice were divided into four groups: a sham surgery (sham) + normal diet (ND) group, a sham + HPD group, a 5/6 nephrectomy (Nx) + ND group and a 5/6 Nx + HPD group. Blood pressure, kidney function and kidney tissue injury were compared after 12 weeks of diet loading among the four groups. The 5/6 Nx groups displayed blood pressure elevation, kidney function decline, glomerular injury and tubular injury compared with the sham groups. Furthermore, an HPD exacerbated glomerular injury only in the 5/6 Nx group; however, an HPD did not cause kidney injury in the sham group. Clinical application of these results suggests that patients with CKD should follow a protein-restricted diet to prevent the exacerbation of kidney injury, while healthy individuals can maintain an HPD without worrying about the adverse effects.

    DOI: 10.3390/ijms24097778

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  • Author Correction: Angiotensin II type-1 receptor-associated protein interacts with transferrin receptor-1 and promotes its internalization. 国際誌

    Eriko Abe, Akio Yamashita, Keigo Hirota, Takahiro Yamaji, Kengo Azushima, Shingo Urate, Toru Suzuki, Shohei Tanaka, Shinya Taguchi, Shunichiro Tsukamoto, Tatsuki Uehara, Hiromichi Wakui, Kouichi Tamura, Hidehisa Takahashi

    Scientific reports   12 ( 1 )   21322 - 21322   2022年12月

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  • Angiotensin II type-1 receptor-associated protein interacts with transferrin receptor-1 and promotes its internalization. 国際誌

    Eriko Abe, Akio Yamashita, Keigo Hirota, Takahiro Yamaji, Kengo Azushima, Shingo Urate, Toru Suzuki, Shohei Tanaka, Shinya Taguchi, Shunichiro Tsukamoto, Tatsuki Uehara, Hiromichi Wakui, Kouichi Tamura, Hidehisa Takahashi

    Scientific reports   12 ( 1 )   17376 - 17376   2022年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Kidney fibrosis is a common pathway that leads to chronic kidney disease. Angiotensin II type-1 receptor (AT1R)-associated protein (ATRAP) was originally identified as an AT1R-binding protein. Previously, we reported that systemic knockout of ATRAP exacerbates kidney fibrosis in aged mice. Although these effects of ATRAP appeared to be AT1R-independent actions, the molecular mechanism remains poorly understood. To elucidate the molecular mechanism of ATRAP independent of AT1R, we explored novel ATRAP-interacting proteins. Mass spectrometric analysis of the immunoprecipitants of a Flag-tagged ATRAP complex revealed 376 candidate proteins that potentially interact with ATRAP. Gene ontology analysis revealed that proteins related to vesicle trafficking, membrane transport, and many membrane proteins, including transferrin receptor 1 (TfR1), were enriched. Because TfR1 promotes cellular iron uptake and iron is a key factor involved in kidney fibrosis, we focused on TfR1 and confirmed that it interacts with ATRAP. In addition, our findings revealed that enhanced ATRAP expression decreased cell-surface TfR1 expression without altering the overall cellular TfR1 expression levels. Furthermore, enhanced ATRAP expression attenuated cellular iron levels. Together, our results highlight the role of ATRAP as a suppressor of TfR1 that functions by facilitating TfR1 internalization, which affects iron metabolism and oxidative stress signaling.

    DOI: 10.1038/s41598-022-22343-5

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  • Vitamin D Levels in Black Americans and the Association with Left Ventricular Remodeling and Incident Heart Failure With Preserved Ejection Fraction: the Jackson Heart Study 査読

    Kamimura D, Yimer WK, Shah AM, Mentz RJ, Oshunbade A, Hamid A, Suzuki T, Clark D Ⅲrd, Waller J, Fox ER, Correa A, Butler J, Hall ME

    Journal of Cardiac Failure   2022年7月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Elsevier BV  

    DOI: 10.1016/j.cardfail.2022.07.049

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  • 受容体結合蛋白ATRAPの近位尿細管特異的高発現マウスの作製

    大上 尚仁, 浦手 進吾, 鈴木 徹, 春原 浩太郎, 山地 孝拡, 金口 翔, 畝田 一司, 小豆島 健護, 涌井 広道, 田村 功一

    日本腎臓学会誌   64 ( 3 )   270 - 270   2022年5月

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    記述言語:日本語   出版者・発行元:(一社)日本腎臓学会  

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  • GPCRシグナルにおける治療標的の探索 アンジオテンシン受容体結合因子を標的とした腎臓病治療

    涌井 広道, 鈴木 徹, 廣田 慧悟, 小豆島 健護, 山下 暁朗, 田村 功一

    日本腎臓学会誌   64 ( 3 )   182 - 182   2022年5月

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    記述言語:日本語   出版者・発行元:(一社)日本腎臓学会  

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  • Deficiency of the kidney tubular angiotensin II type1 receptor-associated protein ATRAP exacerbates streptozotocin-induced diabetic glomerular injury via reducing protective macrophage polarization. 国際誌

    Kotaro Haruhara, Toru Suzuki, Hiromichi Wakui, Kengo Azushima, Daisuke Kurotaki, Wataru Kawase, Kazushi Uneda, Ryu Kobayashi, Kohji Ohki, Sho Kinguchi, Takahiro Yamaji, Ikuma Kato, Kenichi Ohashi, Akio Yamashita, Tomohiko Tamura, Nobuo Tsuboi, Takashi Yokoo, Kouichi Tamura

    Kidney international   101 ( 5 )   912 - 928   2022年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Although activation of the renin-angiotensin system and of its glomerular components is implicated in the pathogenesis of diabetic nephropathy, the functional roles of the tubular renin-angiotensin system with AT1 receptor signaling in diabetic nephropathy are unclear. Tissue hyperactivity of the renin-angiotensin system is inhibited by the angiotensin II type 1 receptor-associated protein ATRAP, which negatively regulates receptor signaling. The highest expression of endogenous ATRAP occurs in the kidney, where it is mainly expressed by tubules but rarely in glomeruli. Here, we found that hyperactivation of angiotensin II type 1 receptor signaling in kidney tubules exacerbated diabetic glomerular injury in a mouse model of streptozotocin-induced diabetic nephropathy. These phenomena were accompanied by decreased expression of CD206, a marker of alternatively activated and tissue-reparative M2 macrophages, in the kidney tubulointerstitium. Additionally, adoptive transfer of M2- polarized macrophages into diabetic ATRAP-knockout mice ameliorated the glomerular injury. As a possible mechanism, the glomerular mRNA levels of tumor necrosis factor-α and oxidative stress components were increased in diabetic knockout mice compared to non-diabetic knockout mice, but these increases were ameliorated by adoptive transfer. Furthermore, proximal tubule-specific ATRAP downregulation reduced tubulointerstitial expression of CD206, the marker of M2 macrophages in diabetic mice. Thus, our findings indicate that tubular ATRAP-mediated functional modulation of angiotensin II type 1 receptor signaling modulates the accumulation of tubulointerstitial M2 macrophages, thus affecting glomerular manifestations of diabetic nephropathy via tubule-glomerular crosstalk.

    DOI: 10.1016/j.kint.2022.01.031

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  • Effects of tumor necrosis factor-α inhibition on kidney fibrosis and inflammation in a mouse model of aristolochic acid nephropathy. 国際誌

    Shinya Taguchi, Kengo Azushima, Takahiro Yamaji, Shingo Urate, Toru Suzuki, Eriko Abe, Shohei Tanaka, Shunichiro Tsukamoto, Daisuke Kamimura, Sho Kinguchi, Akio Yamashita, Hiromichi Wakui, Kouichi Tamura

    Scientific reports   11 ( 1 )   23587 - 23587   2021年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Tumor necrosis factor (TNF)-α is a potent mediator of inflammation and is involved in the pathophysiology of chronic kidney disease (CKD). However, the effects of TNF-α inhibition on the progression of kidney fibrosis have not been fully elucidated. We examined the effects of TNF-α inhibition by etanercept (ETN) on kidney inflammation and fibrosis in mice with aristolochic acid (AA) nephropathy as a model of kidney fibrosis. C57BL/6 J mice were administered AA for 4 weeks, followed by a 4-week remodeling period. The mice exhibited kidney fibrosis, functional decline, and albuminuria concomitant with increases in renal mRNA expression of inflammation- and fibrosis-related genes. The 8-week ETN treatment partially but significantly attenuated kidney fibrosis and ameliorated albuminuria without affecting kidney function. These findings were accompanied by significant suppression of interleukin (IL)-1β, IL-6, and collagen types I and III mRNA expression. Moreover, ETN tended to reduce the AA-induced increase in interstitial TUNEL-positive cells with a significant reduction in Bax mRNA expression. Renal phosphorylated p38 MAPK was significantly upregulated by AA but was normalized by ETN. These findings indicate a substantial role for the TNF-α pathway in the pathogenesis of kidney fibrosis and suggest that TNF-α inhibition could become an adjunct therapeutic strategy for CKD with fibrosis.

    DOI: 10.1038/s41598-021-02864-1

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  • Aristolochic Acid Induces Renal Fibrosis and Senescence in Mice. 国際誌

    Shingo Urate, Hiromichi Wakui, Kengo Azushima, Takahiro Yamaji, Toru Suzuki, Eriko Abe, Shohei Tanaka, Shinya Taguchi, Shunichiro Tsukamoto, Sho Kinguchi, Kazushi Uneda, Tomohiko Kanaoka, Yoshitoshi Atobe, Kengo Funakoshi, Akio Yamashita, Kouichi Tamura

    International journal of molecular sciences   22 ( 22 )   2021年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The kidney is one of the most susceptible organs to age-related impairments. Generally, renal aging is accompanied by renal fibrosis, which is the final common pathway of chronic kidney diseases. Aristolochic acid (AA), a nephrotoxic agent, causes AA nephropathy (AAN), which is characterized by progressive renal fibrosis and functional decline. Although renal fibrosis is associated with renal aging, whether AA induces renal aging remains unclear. The aim of the present study is to investigate the potential use of AAN as a model of renal aging. Here, we examined senescence-related factors in AAN models by chronically administering AA to C57BL/6 mice. Compared with controls, the AA group demonstrated aging kidney phenotypes, such as renal atrophy, renal functional decline, and tubulointerstitial fibrosis. Additionally, AA promoted cellular senescence specifically in the kidneys, and increased renal p16 mRNA expression and senescence-associated β-galactosidase activity. Furthermore, AA-treated mice exhibited proximal tubular mitochondrial abnormalities, as well as reactive oxygen species accumulation. Klotho, an antiaging gene, was also significantly decreased in the kidneys of AA-treated mice. Collectively, the results of the present study indicate that AA alters senescence-related factors, and that renal fibrosis is closely related to renal aging.

    DOI: 10.3390/ijms222212432

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  • Tissue-specific expression of the SARS-CoV-2 receptor, angiotensin-converting enzyme 2, in mouse models of chronic kidney disease. 国際誌

    Shunichiro Tsukamoto, Hiromichi Wakui, Kengo Azushima, Takahiro Yamaji, Shingo Urate, Toru Suzuki, Eriko Abe, Shohei Tanaka, Shinya Taguchi, Takayuki Yamada, Sho Kinguchi, Daisuke Kamimura, Akio Yamashita, Daisuke Sano, Masayuki Nakano, Tatsuo Hashimoto, Kouichi Tamura

    Scientific reports   11 ( 1 )   16843 - 16843   2021年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Elevated angiotensin-converting enzyme 2 (ACE2) expression in organs that are potential targets of severe acute respiratory syndrome coronavirus 2 may increase the risk of coronavirus disease 2019 (COVID-19) infection. Previous reports show that ACE2 alter its tissue-specific expression patterns under various pathological conditions, including renal diseases. Here, we examined changes in pulmonary ACE2 expression in two mouse chronic kidney disease (CKD) models: adenine-induced (adenine mice) and aristolochic acid-induced (AA mice). We also investigated changes in pulmonary ACE2 expression due to renin-angiotensin system (RAS) blocker (olmesartan) treatment in these mice. Adenine mice showed significant renal functional decline and elevated blood pressure, compared with controls. AA mice also showed significant renal functional decline, compared with vehicles; blood pressure did not differ between groups. Renal ACE2 expression was significantly reduced in adenine mice and AA mice; pulmonary expression was unaffected. Olmesartan attenuated urinary albumin excretion in adenine mice, but did not affect renal or pulmonary ACE2 expression levels. The results suggest that the risk of COVID-19 infection may not be elevated in patients with CKD because of their stable pulmonary ACE2 expression. Moreover, RAS blockers can be used safely in treatment of COVID-19 patients with CKD.

    DOI: 10.1038/s41598-021-96294-8

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  • アリストロキア酸腎症モデルマウスに対するTNF-α阻害による腎線維化抑制効果の検討

    田口 慎也, 小豆島 健護, 涌井 広道, 山地 孝拡, 浦手 進吾, 鈴木 徹, 安部 えりこ, 田中 翔平, 塚本 俊一郎, 山下 暁朗, 田村 功一

    日本腎臓学会誌   63 ( 4 )   449 - 449   2021年6月

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    記述言語:日本語   出版者・発行元:(一社)日本腎臓学会  

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  • アリストロキア酸腎症モデルマウスに対するTNF-α阻害による腎線維化抑制効果の検討

    田口 慎也, 小豆島 健護, 涌井 広道, 山地 孝拡, 浦手 進吾, 鈴木 徹, 安部 えりこ, 田中 翔平, 塚本 俊一郎, 山下 暁朗, 田村 功一

    日本腎臓学会誌   63 ( 4 )   449 - 449   2021年6月

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    記述言語:日本語   出版者・発行元:(一社)日本腎臓学会  

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  • CKDモデルマウスにおける肺ACE2発現に対するARBの効果(Effect of ARB on pulmonary ACE2 expression in CKD model mice)

    塚本 俊一郎, 涌井 広道, 小豆島 健護, 山地 孝拡, 浦手 進吾, 鈴木 徹, 安部 えりこ, 田中 翔平, 田口 慎也, 田村 功一

    日本内分泌学会雑誌   96 ( 4 )   1122 - 1122   2021年4月

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    記述言語:英語   出版者・発行元:(一社)日本内分泌学会  

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  • Physical Activity, Inflammation, Coronary Artery Calcification, and Incident Coronary Heart Disease in African Americans: Insights From the Jackson Heart Study 査読

    Kamimura D, Cain-Shields LR, Clark D 3rd, Oshunbade AA, Ashley KE, Guild CS, Loprinzi PD, Newton R, Blaha MJ, Suzuki T, Butler J, Hall JE, Correa A, Hall ME

    Mayo Clinic Proceedings   2021年3月

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

    DOI: 10.1016/j.mayocp.2020.09.042

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  • May need more comprehensive approach to residual risks in well controlled hypertensive patients. 国際誌

    Toru Suzuki, Daisuke Kamimura, Hiromichi Wakui, Kouichi Tamura

    Hypertension research : official journal of the Japanese Society of Hypertension   44 ( 2 )   253 - 255   2021年2月

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  • Tissue xanthine oxidoreductase activity in a mouse model of aristolochic acid nephropathy. 国際誌

    Takeo Ishii, Tomohiro Kumagae, Hiromichi Wakui, Shingo Urate, Shohei Tanaka, Eriko Abe, Toru Suzuki, Takahiro Yamaji, Sho Kinguchi, Ryu Kobayashi, Kotaro Haruhara, Takashi Nakamura, Shuzo Kobayashi, Kouichi Tamura

    FEBS open bio   11 ( 2 )   507 - 518   2021年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Xanthine oxidoreductase (XOR) is a critical enzyme in purine metabolism and uric acid production, and its levels are reported to increase during stress, thereby promoting organ damage. Herein, we investigated the activity of XOR in a mouse model of aristolochic acid I (AA)-induced nephropathy, a type of nephrotoxic chronic kidney disease (CKD). A persistent decrease in renal function was observed in mice up to 4 weeks after 4 weeks of AA (2.5 mg kg-1 ) administration. Renal histology revealed an increase in tubular interstitial fibrosis over time. Although AA administration did not change XOR activity in the plasma, heart, liver, or muscle, XOR activity was persistently increased in renal tissue. Our results suggest that the renal tissue-specific increase in XOR activity is involved in the progression of tubulo-interstitial disorders, specifically fibrosis.

    DOI: 10.1002/2211-5463.13083

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  • Cardiovascular and renal outcomes with SGLT-2 inhibitors versus GLP-1 receptor agonists in patients with type 2 diabetes mellitus and chronic kidney disease: a systematic review and network meta-analysis. 国際誌

    Takayuki Yamada, Mako Wakabayashi, Abhinav Bhalla, Nitin Chopra, Hirotaka Miyashita, Takahisa Mikami, Hiroki Ueyama, Tomohiro Fujisaki, Yusuke Saigusa, Takahiro Yamaji, Kengo Azushima, Shingo Urate, Toru Suzuki, Eriko Abe, Hiromichi Wakui, Kouichi Tamura

    Cardiovascular diabetology   20 ( 1 )   14 - 14   2021年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Emerging evidence suggests that sodium-glucose cotransporter-2 (SGLT-2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are associated with decreased risk of cardiovascular and renal events in type 2 diabetes mellitus (DM) patients. However, no study to date has compared the effect of SGLT-2 inhibitors with that of GLP-1 RAs in type 2 DM patients with chronic kidney disease (CKD). We herein investigated the benefits of SGLT-2 inhibitors and GLP-1 RAs in CKD patients. METHODS: We performed a systematic literature search through November 2020. We selected randomized control trials that compared the risk of major adverse cardiovascular events (MACE) and a composite of renal outcomes. We performed a network meta-analysis to compare SGLT-2 inhibitors with GLP-1 RAs indirectly. Risk ratios (RRs) with corresponding 95% confidence intervals (CI) were synthesized. RESULTS: Thirteen studies were selected with a total of 32,949 patients. SGLT-2 inhibitors led to a risk reduction in MACE and renal events (RR [95% CI]; 0.85 [0.75-0.96] and 0.68 [0.59-0.78], respectively). However, GLP-1 RAs did not reduce the risk of cardiovascular or renal adverse events (RR 0.91 [0.80-1.04] and 0.86 [0.72-1.03], respectively). Compared to GLP-1 RAs, SGLT-2 inhibitors did not demonstrate a significant difference in MACE (RR 0.94 [0.78-1.12]), while SGLT-2 inhibitors were associated with a lower risk of renal events compared to GLP-1 RAs (RR 0.79 [0.63-0.99]). A sensitivity analysis revealed that GLP-1 analogues significantly decreased MACE when compared to placebo treatment (RR 0.81 [0.69-0.95]), while exendin-4 analogues did not (RR 1.03 [0.88-1.20]). CONCLUSIONS: In patients with type 2 DM and CKD, SGLT-2 inhibitors were associated with a decreased risk of cardiovascular and renal events, but GLP-1 RAs were not. SGLT-2 inhibitors significantly decreased the risk of renal events compared to GLP-1 RAs. Among GLP-1 RAs, GLP-1 analogues showed a positive impact on cardiovascular and renal outcomes, while exendin-4 analogues did not.

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  • Effect of renin-angiotensin system blockers on contrast-induced acute kidney injury in patients with normal or mild-to-moderate reduced kidney function undergoing coronary angiography: A systematic review and meta-analysis. 国際誌

    Takayuki Yamada, Tomohiro Fujisaki, Nitin Chopra, Takahiro Yamaji, Kengo Azushima, Ryu Kobayashi, Sho Kinguchi, Shingo Urate, Toru Suzuki, Eriko Abe, Hiromichi Wakui, Kouichi Tamura, Daniel Steinberg

    Clinical nephrology   94 ( 5 )   227 - 236   2020年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: Contrast-induced acute kidney injury (CI-AKI) is a major complication after coronary angiography (CAG) or percutaneous coronary intervention (PCI) and is associated with increased morbidity and mortality. It remains controversial whether renin-angiotensin system (RAS) blockers increase or decrease CI-AKI. In this meta-analysis, we investigated the association between RAS blockers and CI-AKI in patients with normal kidney function or mild-to-moderate chronic kidney disease (CKD). MATERIALS AND METHODS: We performed a systematic search of PubMed, EMBASE, clinicaltrials.gov, and the Cochrane Library up to December 2019 for studies that assessed the association between RAS blockers and CI-AKI events after CAG/PCI. The primary outcome was the development of CI-AKI. Odds ratios (ORs) with corresponding 95% confidence interval (CI) were synthesized. RESULTS: Five randomized controlled trials (RCTs) and five observational studies were included, accounting for a total of 7,420 patients. Unstratified, RAS blocker administration was significantly associated with an increased risk of CI-AKI (pooled OR = 1.63, 95% CI 1.19 - 2.25, p = 0.003). However, the effect was not observed in RCTs (pooled OR = 1.22, 95% CI 0.54 - 2.74, p = 0.63). Sensitivity analysis in observational studies showed significant association (pooled OR = 1.77, 95% CI 1.22 - 2.55, p = 0.003) with high heterogeneity and evidence of publication bias. CONCLUSION: In patients with relatively-preserved renal function, the association of RAS blockers with an increased risk of CI-AKI after contrast media exposure was inconclusive, as sensitivity analysis showed conflicting results and bias. Although this study did not demonstrate significant evidence, it indicated that clinicians need to be vigilant in assessing the potential risk for RAS blockers to cause CI-AKI in low-risk patients.

    DOI: 10.5414/CN110171

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  • Systematic Review of the Association Between Worsening Renal Function and Mortality in Patients With Acute Decompensated Heart Failure. 国際誌

    Takayuki Yamada, Hiroki Ueyama, Nitin Chopra, Takahiro Yamaji, Kengo Azushima, Ryu Kobayashi, Sho Kinguchi, Shingo Urate, Toru Suzuki, Eriko Abe, Yusuke Saigusa, Hiromichi Wakui, Paulina Partridge, Alfred Burger, Claudio A Bravo, Maria A Rodriguez, Juan Ivey-Miranda, Kouichi Tamura, Jeffery Testani, Steven Coca

    Kidney international reports   5 ( 9 )   1486 - 1494   2020年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: Outcomes in acute decompensated heart failure (ADHF) have remained poor. Worsening renal function (WRF) is common among patients with ADHF. However, the impact of WRF on the prognosis is controversial. We hypothesized that in patients with ADHF, the achievement of concomitant decongestion would diminish the signal for harm associated with WRF. METHODS: We performed a systematic search of PubMed, EMBASE, and the Cochrane Library up to December 2019 for studies that assessed signs of decongestion in patients with WRF during ADHF admission. The primary outcome was all-cause mortality and heart transplantation. RESULTS: Thirteen studies were selected with a pooled population of 8138 patients. During the follow-up period of 60-450 days, 19.2% of patients died. Unstratified, patients with WRF versus no WRF had a higher risk for mortality (odds ratio [OR], 1.71 [95% confidence interval {CI}, 1.45-2.01]; P < 0.0001). However, patients who achieved decongestion had a similar prognosis (OR, 1.15 [95% CI, 0.89-1.49]; P = 0.30). Moreover, patients with WRF who achieved decongestion had a better prognosis compared with those without WRF or decongestion (OR, 0.63 [95% CI, 0.46-0.86]; P = 0.004). This tendency persisted for the sensitivity analyses. CONCLUSIONS: Decongestion is a powerful effect modifier that attenuates harmful associations of WRF with mortality. Future studies should not assess WRF as an endpoint without concomitant assessment of achieved volume status.

    DOI: 10.1016/j.ekir.2020.06.031

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  • 5/6腎摘慢性腎臓病モデルマウスによる高血圧とアンジオテンシン受容体結合因子(ATRAP)の関係についての検討

    田中 翔平, 小林 竜, 涌井 広道, 山地 孝拡, 鈴木 徹, 浦手 進吾, 安部 えりこ, 金口 翔, 小豆島 健護, 戸谷 義幸, 田村 功一

    日本腎臓学会誌   62 ( 4 )   370 - 370   2020年7月

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    記述言語:日本語   出版者・発行元:(一社)日本腎臓学会  

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  • AT1R結合タンパク質ATRAPの結合タンパク質探索による分子機能解析

    安部 えりこ, 涌井 広道, 山下 暁朗, 山地 孝拡, 浦手 進吾, 田中 翔平, 鈴木 徹, 金口 翔, 小林 竜, 小豆島 健護, 戸谷 義幸, 田村 功一

    日本腎臓学会誌   62 ( 4 )   369 - 369   2020年7月

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    記述言語:日本語   出版者・発行元:(一社)日本腎臓学会  

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  • Effects of Rikkunshito treatment on renal fibrosis/inflammation and body weight reduction in a unilateral ureteral obstruction model in mice. 国際誌

    Hiromichi Wakui, Takahiro Yamaji, Kengo Azushima, Kazushi Uneda, Kotaro Haruhara, Akiko Nakamura, Kohji Ohki, Sho Kinguchi, Ryu Kobayashi, Shingo Urate, Toru Suzuki, Daisuke Kamimura, Shintaro Minegishi, Tomoaki Ishigami, Tomohiko Kanaoka, Kohei Matsuo, Tomoyuki Miyazaki, Tetsuya Fujikawa, Akio Yamashita, Kouichi Tamura

    Scientific reports   10 ( 1 )   1782 - 1782   2020年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Chronic kidney disease (CKD) progresses to end-stage renal failure via renal tubulointerstitial fibrosis. Malnutrition, inflammation, and arteriosclerosis interact to exacerbate the poor prognosis of CKD, and their effective management is thus essential. The traditional Japanese medicine Rikkunshito (RKT) exerts appetite-stimulating effects via ghrelin, which attenuates inflammation and fibrosis. We evaluated the therapeutic effect of RKT in unilateral ureter obstruction (UUO)-induced renal fibrosis/inflammation and body weight loss in mice. UUO and sham-operated mice were fed a standard diet or diet containing 3.0% RKT. Renal fibrosis was investigated by histopathology and macrophage infiltration was determined by immunohistochemistry. Expression levels of genes associated with fibrosis, inflammation, ghrelin, and mitochondrial function were determined by quantitative reverse transcription-polymerase chain reaction and western blot analyses. RKT treatment partially prevented UUO-induced weight loss but failed to attenuate renal fibrosis and inflammation. Renal expression of sirtuin 1, a ghrelin-downstream signalling molecule, and gene expression of peroxisome proliferator-activated receptor-γ coactivator 1α and Bcl-2/adenovirus E1B interacting protein 3 were unaffected by RKT. These results indicate that RKT inhibits weight loss but does not improve renal fibrosis or inflammation in a rapidly progressive renal fibrosis mouse model. RKT may have a protective effect on weight loss associated with CKD.

    DOI: 10.1038/s41598-020-58214-0

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  • 薬剤を用いた加齢腎モデル作成の検討

    浦手 進吾, 涌井 広道, 山地 孝拡, 鈴木 徹, 田中 翔平, 安部 えりこ, 田村 功一

    Anti-aging Science   11 ( 1 )   68 - 68   2019年12月

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    記述言語:日本語   出版者・発行元:(株)メディカルレビュー社  

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  • Angiotensin II type 1 receptor-associated protein deficiency attenuates sirtuin1 expression in an immortalised human renal proximal tubule cell line. 国際誌

    Takahiro Yamaji, Akio Yamashita, Hiromichi Wakui, Kengo Azushima, Kazushi Uneda, Yumiko Fujikawa, Sona Haku, Ryu Kobayashi, Kohji Ohki, Kotaro Haruhara, Sho Kinguchi, Takeo Ishii, Takayuki Yamada, Shingo Urate, Toru Suzuki, Eriko Abe, Shohei Tanaka, Daisuke Kamimura, Tomoaki Ishigami, Yoshiyuki Toya, Hidehisa Takahashi, Kouichi Tamura

    Scientific reports   9 ( 1 )   16550 - 16550   2019年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The proximal tubule is a particularly important site for ageing-related kidney damage. Sirtuin 1 (SIRT1), an NAD+ (nicotinamide adenine dinucleotide)-dependent deacetylase in the proximal tubule, may be involved in renal injury associated with ageing. However, the mechanisms of SIRT1 regulation remain to be elucidated. We recently reported that angiotensin II type 1 receptor (AT1R)-associated protein (ATRAP)-deficient mice displayed age-associated renal function decline and tubulointerstitial fibrosis. Our data showed that SIRT1 protein expression was reduced in ATRAP-deficient mice, although the relationship between ATRAP deficiency and age-associated renal fibrosis is still not fully understood. It is, therefore, necessary to investigate how ATRAP affects SIRT1 protein expression to resolve ageing-associated kidney dysfunction. Here, since ageing studies are inherently lengthy, we used an ex vivo model of the proximal tubule to determine the role of ATRAP in SIRT1 protein expression. We first generated a clonal immortalised human renal proximal tubule epithelial cell line (ciRPTEC) expressing AT1R and ATRAP. Using this cell line, we demonstrated that ATRAP knockdown reduced SIRT1 protein expression in the ciRPTEC but did not alter SIRT1 mRNA expression. Thus, ATRAP likely mediates SIRT1 protein abundance in ciRPTEC.

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  • Higher plasma leptin levels are associated with reduced left ventricular mass and left ventricular diastolic stiffness in black women: insights from the Genetic Epidemiology Network of Arteriopathy (GENOA) study. 査読

    Kamimura D, Suzuki T, Wang W, deShazo M, Hall JE, Winniford MD, Kullo IJ, Mosley TH, Butler KR, Hall ME

    Hypertens Res.   41   629 - 638   2018年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1038/s41440-018-0062-0.

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  • Diastolic wall strain is associated with incident heart failure in African Americans: Insights from the atherosclerosis risk in communities study. 査読

    Kamimura D, Suzuki T, Hall ME, Wang W, Winniford MD, Shah AM, Rodriguez CJ, Butler KR, Mosley TH

    Journal of cardiology   71 ( 5 )   477 - 483   2018年5月

  • Elevated serum osteoprotegerin is associated with increased left ventricular mass index and myocardial stiffness 査読

    Kamimura D, Suzuki T, Furniss AL, Griswold ME, Kullo IJ, Lindsey ML, Winniford MD, Butler KR, Mosley TH, Hall ME

    JOURNAL OF CARDIOVASCULAR MEDICINE   18 ( 12 )   954 - 961   2017年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    AimOsteoprotegerin (OPG) is associated with a poor prognosis in patients with heart failure with preserved ejection fraction (HFpEF). OPG has also been associated with fibrosis and collagen cross-linking, which increase arterial and left ventricle (LV) myocardial stiffness. Little is known about the relation of OPG and LV structure and function in African-Americans who are disproportionately affected by HFpEF.Methods and resultsOur analysis included 1172 participants with preserved LV ejection fraction (&gt;50%) from the African-American cohort in the Genetic Epidemiology Network of Arteriopathy Study (mean age 63 years, 72% female). We used diastolic wall strain indicator measured by echocardiography to assess LV myocardial stiffness. Diastolic wall strain was calculated as (LV posterior thickness at end-systole-LV posterior thickness at end-diastole)/LV posterior thickness at end-systole. Associations between OPG levels and indices of arterial and LV structure and function were evaluated by using generalized linear mixed models and adjusted for possible confounders. OPG levels were correlated with age, female sex, presence of hypertension and diabetes, and lower estimated glomerular filtration rate (P&lt;0.05 for all). Multivariable analysis revealed that higher OPG levels were associated with greater LV mass index, increased LV myocardial stiffness, and higher N-terminal prohormone brain natriuretic peptide levels (P&lt;0.05 for all).ConclusionIn African-Americans, higher OPG levels were associated with characteristics common in patients with HFpEF and were significantly associated with known precursors to HFpEF. These findings indicate a potential role for OPG in the pathophysiology of HFpEF in African-Americans.

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  • Increased Left Ventricular Diastolic Stiffness Is Associated With Heart Failure Symptoms in Aortic Stenosis Patients With Preserved Ejection Fraction 査読

    Kamimura D, Suzuki T, Fox ER, Skelton TN, Winniford MD, Hall ME

    JOURNAL OF CARDIAC FAILURE   23 ( 8 )   581 - 588   2017年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS  

    Background: Clinical risk factors associated with heart failure (HF) symptoms in aortic stenosis (AS) patients with preserved ejection fraction (EF) have not been fully identified. We hypothesized that left ventricular (LV) diastolic stiffness is associated with HF symptoms in patients with AS.
    Methods and Results: We retrospectively evaluated 275 patients with at least moderate AS (aortic valve area &lt;1.5 cm(2)) and preserved EF (&gt;50%). LV diastolic stiffness was evaluated with the use of echocardiographic parameters, diastolic wall strain (DWS, a measure of LV wall stiffness), and K-LV (a marker of LV chamber stiffness). There were 69 patients with HF. Patients with HF were older, were more likely to be African American, had a higher body mass index, and had more hypertension and coronary artery disease (P &lt; .05 for all). Aortic valve area index and mean pressure gradient across the aortic valve were not different between patients with and without HF. Despite similar echocardiographic parameters of AS severity, patients with HF had stiffer LV (DWS 0.21 +/- 0.06 vs 0.25 +/- 0.06 [P &lt; .01], K-LV 0.17 +/- 0.11 vs 0.13 +/- 0.08 [P &lt; .01]). Logistic regression analyses revealed that after adjusting for age, race, body mass index, history of hypertension, and coronary artery disease, LV diastolic stiffness parameters remained significantly associated with HF symptoms.
    Conclusions: LV diastolic stiffness is independently associated with HF in AS patients with preserved EF.

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  • Physical Activity Is Associated With Reduced Left Ventricular Mass in Obese and Hypertensive African Americans 査読

    Kamimura D, Loprinzi PD, Wang W, Suzuki T, Butler KR, Mosley TH, Hall ME

    AMERICAN JOURNAL OF HYPERTENSION   30 ( 6 )   617 - 623   2017年6月

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

    BACKGROUND
    Physical activity (PA) has been associated with decreased left ventricular (LV) hypertrophy in previous studies. However, little is known about the relationship between PA and LV structure and factors which influence this relationship among African Americans.
    METHODS
    We evaluated 1,300 African Americans with preserved LV ejection fraction (EF &gt; 50%) from the Genetic Epidemiology Network of Arteriopathy (GENOA) Study (mean age 62.4 years, 73% women). PA index was calculated as 3 * heavy activity hours + 2 * moderate activity hours + slight activity hours/day. The relationship between PA index and LV structure was evaluated using generalized estimating equation. The association between PA index and LV mass index by age group, sex, body mass index (BMI), history of hypertension, diabetes or coronary heart disease, estimated glomerular filtration rate, and current smoking status were plotted.
    RESULTS
    After adjustment for these factors, higher PA index was independently associated with lower LV mass index (P &lt; 0.05). There were significant interactions between PA index and obesity (BMI = 30) and history of hypertension on LV mass index (P for interaction &lt; 0.05, for both). Higher PA index was associated with lower LV mass index more in obese or hypertensive participants compared with nonobese or nonhypertensive participants.
    CONCLUSIONS
    Higher PA index was associated with reduced LV hypertrophy in obese and hypertensive African Americans. Prospective studies aimed at assessing whether increasing PA prevents LV hypertrophy and potentially reduces the risk of heart failure in these at risk groups are warranted.

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  • Increased Proximal Aortic Diameter is Associated With Risk of Cardiovascular Events and All-Cause Mortality in Blacks The Jackson Heart Study 査読

    Kamimura D, Suzuki T, Musani SK, Hall ME, Samdarshi TE, Correa A, Fox ER

    JOURNAL OF THE AMERICAN HEART ASSOCIATION   6 ( 6 )   2017年6月

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

    Background-Enlargement of the proximal aorta is associated with aortic wall tissue remodeling, including fragmentation of the elastin fibers, increased synthesis of collagen, and calcification, all of which are associated with aortic wall stiffening. We hypothesized that the proximal aortic diameter (AoD) is associated with cardiovascular events in a community-based cohort of blacks.
    Methods and Results-We investigated the associations between AoD and cardiovascular events among 3018 black participants (mean age, 55.9 years; 69% women) without past history of cardiovascular disease in the Jackson Heart Study. AoD was measured using echocardiography at the level of the sinuses of Valsalva at end diastole. Cardiovascular event was defined as incident myocardial infarction, fatal coronary artery disease, stroke, or heart failure hospitalization. Cox proportional hazards regression models were used to evaluate the association between baseline AoD and cardiovascular events. Over a median follow-up of 8.3 years, there were 258 cardiovascular events (incident rate, 10.5 per 1000 person-years). After adjustment for traditional risk factors, increased AoD was significantly associated with cardiovascular events (hazard ratio per 1-cm increase, 1.72; 95% CI, 1.10-2.69; P&lt;0.05). Participants in the top AoD quintile had a higher incidence of cardiovascular events compared to those not in the top quintile (hazard ratio, 1.47; 95% CI, 1.11-1.94; P&lt;0.005) after adjustment for risk factors.
    Conclusions-Greater AoD was associated with an increased risk of cardiovascular events in a community-based cohort of blacks. AoD may be useful as a predictor of incident cardiovascular events and further investigation is warranted.

    DOI: 10.1161/JAHA.116.005005

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