Kengo Kusano

National Cerebral and Cardiovascular Center

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Satoshi Nagase

National Cerebral and Cardiovascular Center

Kazufumi Nakamura

Okayama University

Hiroshi Morita

Okayama University

Tohru Ohe

Okayama Prefecture

Takeshi Aiba

National Cerebral and Cardiovascular Center

Teruo Noguchi

National Cerebral and Cardiovascular Center

Takashi Noda

Tohoku University Hospital

Toshihisa Anzai

Hokkaido University

Satoshi Yasuda

Tohoku University

Wataru Shimizu

Nippon Medical School

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National Cerebral and Cardiovascular Center

Osaka University

Okayama University

Kyoto University

The University of Tokyo

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Japanese Circulation Society

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Tohoku University

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Correction to: Three-dimensional assessment of coronary high-intensity plaques with T1-weighted cardiovascular magnetic resonance imaging to predict periprocedural myocardial injury after elective percutaneous coronary intervention

Journal of Cardiovascular Magnetic Resonance (2020)

Hayato Hosoda Yasuhide Asaumi Teruo Noguchi Yoshiaki Morita Yu Kataoka

In the original publication of this article [1] the wording of '3Di-PMR' was different between the text and figures.

Angiology

Cardiac magnetic resonance

10.1186/s12968-020-00620-4

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Association Between Deleterious SCN5A Variants and Ventricular Septal Defect in Young Patients With Brugada Syndrome

Japanese Journal of Electrocardiology (2023)

Keisuke Suzuki Keiko Sonoda Kengo Kusano Minoru Horie Seiko Ohno

心室中隔欠損(VSD)は小児において頻度の高い先天性心疾患である.一方Brugada症候群(BrS)は心室細動や突然死を引き起こす遺伝性疾患で,中年に多く小児では稀である.日本人不整脈コホートでは20歳未満でBrSと診断された患者は36人おり,うち5人(14%)がVSDを合併していたため,われわれは彼らの臨床像や遺伝的背景を検討した.VSD合併BrS患者は,VSDのない群と比較すると早期にBrSと診断されていた(4.0±4.6 yrs vs 11.5±5.1 yrs,p=0.004).BrS患者36人中15人にSCN5A変異を同定したが,VSDを合併した5人は全員がSCN5A変異を有しており(R367S,R533*,R893C,W1345C,G1743R),すべて機能喪失型変異であった.VSD患者で右側胸部誘導のST上昇が認められる場合には,BrSを疑い遺伝子検査を含む適切なスクリーニング検査を行う必要がある.

10.5105/jse.43.225

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Abstract 5672: Novel SCN5A Mutations and SNP in Patients with Brugada Syndrome

Circulation (2008)

Kazufumi Nakamura Daiji Miura Kaoru Kobayashi Mamoru Ouchida Kenji Shimizu

Background: Sodium channel alpha 5 subunit (SCN5A) mutations are important genetic abnormalities of Brugada syndrome (BS). Here we report novel SCN5A mutations in patients with BS. Methods and Results: Genomic mutations in the SCN5A gene were analyzed by PCR and direct sequencing in 121 patients with BS (119 men and 2 women). Thirteen (11%) of the patients had SCN5A mutation and five (4%) of the patients had single nucleotide polymorphisms (SNP) associated with BS. Eleven patients had single point mutations, one patient had a deletion (1380 del N) and one patient had a mutation within the splicing junction (IVS21+1 g>a). The whole-cell patch clamp technique revealed that four novel mutations (F532C, R814Q, G833R, R878C) showed loss of function, and peak INa of a novel SNP (L1988R) transiently expressed in HEK 293 cells was significantly reduced (P<0.05). RT-PCR analysis revealed that the intronic mutation (IVS21+1 g>a) resulted in exon 21 deletion of SCN5A in cardiac biopsy specimens from the patient (Figure ). Conclusions: We detected five novel SCN5A mutations (1380 del N, F532C, R814Q, G833R, R878C) and a novel disease-associated SNP (L1988R) in patients with BS. We showed a novel analysis of splicing mutation (IVS21+1 g>a) that resulted in exon skipping in the heart.

SNP

splice

10.1161/circ.118.suppl_18.s_981-c

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P1558The impact of cardiac magnetic resonance imaging on the prediction for systemic embolism in patients with anterior acute myocardial infarction

European Heart Journal (2017)

Naoki Maniwa Masashi Fujino Shouji Kawakami Kazuhiro Nakao Tomoaki Kanaya

Cardiac magnetic resonance

10.1093/eurheartj/ehx502.p1558

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Association of increased plasma adipocyte fatty acid-binding protein with coronary artery disease in non-elderly men

Cardiovascular Diabetology (2011)

Masayuki Doi Toru Miyoshi Satoshi Hirohata Kazufumi Nakamura Shinichi Usui

Adipocyte fatty acid-binding protein (A-FABP) has been reported to play critical roles in the development of atherosclerosis. We investigated whether an increased in plasma A-FABP level can be independently associated with the presence of coronary artery disease (CAD).Two hundred eleven consecutive male patients (mean age: 66 years, range: 33-87 years) were enrolled from inpatients who underwent coronary angiography. Age-matched male subjects (n = 211) having no evidence of CAD served as controls. Plasma A-FABP levels were measured by enzyme-linked immunosorbent assays.Plasma A-FABP levels in CAD patients were significantly higher than in control subjects (median [IQR], 20.6 [15.7-27.8] ng/mL vs. 15.1 [11.7-19.9] ng/mL, p < 0.01). Multivariate logistic regression analysis revealed that an increased plasma A-FABP level was independently associated with the presence of CAD in all subjects (adjusted odds ratio: 1.76, 95% confidence interval: 1.14 to 2.70, p = 0.01). Furthermore, sub-analysis based on age showed that this association remained significant in subjects aged < 65 years (adjusted odds ratio: 3.06, 95% confidence interval: 1.34 to 6.98, p < 0.01), but not in subjects aged ≥65 years.Increased plasma A-FABP in non-elderly men had a significant association with the presence of CAD, independent of established CAD risk factors.

Angiology

10.1186/1475-2840-10-44

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A Predictor of Recurrence after the 2nd Standard Circumferential PV Isolation in Patients with Paroxysmal Atrial Fibrillation

Japanese Journal of Electrocardiology (2015)

Hiroshi Kawakami Kazuhiro Satomi Kohei Ishibashi Ikutaro Nakajima Koji Miyamoto

発作性心房細動（PAF）に対する肺静脈隔離術（PVI）の有用性は確立されている．しかし，複数回のPVIを行ったにもかかわらず，再発をきたす症例は存在する．今回われわれは，当施設でPAFに対し2度目のカテーテルアブレーション（セカンドセッション）を行った連続61例を対象に，その患者背景，最終アブレーション成績，再発因子を後ろ向きに検討した．セカンドセッション後1年間で，61例のうち，21例に再発（AF 12例，心房頻拍9例）を認めた．再発群（n＝21）と非再発群（n＝40）の間に，年齢・性別・AF罹患期間・CHADS2スコア・心房径などの患者背景に差は認めなかった．しかし，セカンドセッション時にPV再伝導を認めた割合は，非再発群で有意に多かった（非再発群：39/40；97.5％ vs. 再発群：17/21；80.9％, p＝0.025）．また，両群間でNon-PV fociの合併率には差はなかったが（再発群：14/21；66.7％vs. 非再発群：17/40；42.5％, p＝0.073），Non-PV fociの起源を特定し，最終的に消失し得た割合は非再発群に有意に多かった（再発群：7/14；50％ vs. 非再発群：15/17；88％, p＝0.019）．結論として，Non-PV fociの存在はAFアブレーションの成績に大きく関与しており，可能な限りその起源を特定し，消失を目指すことが重要であることが示された．

Paroxysmal atrial fibrillation

10.5105/jse.35.15

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Device Therapy for Ventricular Arrhythmias in Patients with Ischemic Heart Disease

Japanese Journal of Electrocardiology (2014)

Ikutaro Nakajima Takashi Noda Kohei Ishibashi Yuko Yamada Koji Miyamoto

欧米を中心に行われた虚血性心疾患を主とする大規模臨床試験では,植込み型除細動器(ICD)が収縮不全心において高い突然死予防効果を示すことが明らかにされている.また,心臓再同期療法(CRT)は慢性心不全患者の症状・生命予後を改善する有効な治療であるが,虚血性心筋症(ICM)患者では非虚血性に比して効果が限局的との報告もある.CRTのICM患者への有効な反応が得られれば,それに付随して抗不整脈作用も期待されるが,ICM患者における致死性不整脈予防効果には一定した見解がない.そこで,ICM患者に対するICDおよびCRTの選択という観点で,両者の位置付けを再考すべく,自施設での症例を対象に症例背景や予後の検討を行った.後ろ向きに検討したところ,左室駆出率が同等という条件下では,心不全がより軽症例・QRS幅の狭い例・突然死2次予防を目的とする例で,CRTよりもICDが選択されていた.平均観察期間871日間で,両群間に生存率や心不全回避率に差を認めなかった.致死性不整脈の発生に関しては,2次予防目的で植込みを行った患者では差が認められなかったが,1次予防目的に限定すると,CRT群で有意に低率であった.ICM患者の約半数でCRTへの有効な反応を示したが,慢性腎臓病,永続性心房細動,非左脚ブロック症例では,あまり効果がみられなかった.したがって,一定の条件を満たせば,ICMにおいてもCRTは有効であり,心不全に対する効果と同様に抗不整脈作用も期待される.

10.5105/jse.34.137

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Usefulness of first-pass myocardial perfusion imaging at rest in combination with 64-row detector computed tomography angiography for assessing coronary artery disease

European Heart Journal (2013)

Kazuhiro Osawa Toru Miyoshi Yasushi Koyama Keiji Hashimoto S. Nagase

Background: Multidetector coronary computed tomography angiography (CCTA) can detect coronary stenosis, but it has limited ability to evaluate myocardial ischemia. Recent studies have also demonstrated the usefulness of stress CT myocardial perfusion imaging (CT-MPI) to detect myocardial ischemia, but the procedure is complicated. Therefore, we evaluated the usefulness of first-pass CT-MPI at rest in combination with CCTA for diagnosing coronary artery disease (CAD). Methods: A total of 105 patients with suspected CAD were enrolled. First-pass CT-MPI at rest was performed simultaneously with CCTA, and images of CT-MPI were reconstructed as color maps. 33 patients in the 105 patients were also performed SPECT-MPI. Diagnostic accuracy was assessed by comparison with invasive coronary angiography. Results: First-pass CT-MPI at rest in combination with CCTA increased diagnostic performance compared with CCTA alone. With per-vessel analysis, the sensitivity, specificity, positive predictive value, and negative predictive value increased from 83% to 88%, from 89% to 92%, from 63% to 72%, and from 96% to 97%, respectively. The area under the receiver operating characteristic (ROC) curve for detecting CAD also increased from 0.860 to 0.900 (p = 0.03). There was no significant difference in the area under the ROC curve between CCTA in combination with first-pass CT-MPI and stress SPECT-MPI (0.86 vs. 0.80, p=0.24 on a per-vessel basis and 0.79 vs. 0.76, p=0.92 on a per-patient basis). In additon, first-pass CT-MPI at rest was particularly useful for assessing unevaluable segments by CCTA alone owing to severe calcification and motion artifacts. Comparison with with multi-modalities Comparison with with multi-modalities Conclusion: First-pass CT-MPI at rest thus complements CCTA for detecting CAD.

10.1093/eurheartj/eht308.896

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Abstract 14329: Impact of Low Body Mass Index on Cardiac Tamponade During Catheter Ablation for Atrial Fibrillation

Circulation (2022)

Reina Tonegawa‐Kuji Michikazu Nakai Koshiro Kanaoka Kengo Kusano Yoshitaka Iwanaga

Background: Cardiac tamponade is a potentially fatal complication of catheter ablation for atrial fibrillation (AF). The risk of cardiac tamponade during AF ablation in underweight patients has never been investigated. This study aimed to evaluate the impact of body mass index (BMI) on the prediction of cardiac tamponade during AF ablation. Methods: Patients who underwent catheter ablation for AF between April 2016 and March 2018 were analyzed using a Japanese nationwide claims database, the Japanese Registry of All Cardiac and Vascular Diseases and the Diagnosis Procedure Combination (JROAD-DPC). Mixed-effects multivariable logistic regression analysis was performed to investigate the association between BMI and cardiac tamponade. Results: A total of 59,807 hospitalizations (median age: 67 [60-73], 29% women) with catheter ablation for AF were analyzed. Cardiac tamponade occurred in 657 patients (1.1%). Multivariable analysis revealed that being underweight (BMI <18.5) was associated with an increased risk of cardiac tamponade (odds ratio [OR] 1.46, 95% confidence interval [CI] 1.05-2.02) when compared with having a normal weight (BMI 18.5-<25) (Figure). Other predictors of an increased risk of cardiac tamponade were age >75 years, female sex, history of heart failure, hypertension, diabetes, and dialysis treatment. In a stratified analysis by ablation technique, being underweight was associated with an increased risk of cardiac tamponade in the radiofrequency ablation group, but it was not a significant predictor in the cryoballoon ablation group. Conclusions: In this analysis of a large nationwide database of patients with AF who underwent ablation, being underweight was independently associated with an increased risk of cardiac tamponade during AF ablation. Clinicians should consider the higher risk of cardiac tamponade in the underweight population and take appropriate measures to reduce this risk.

Underweight

10.1161/circ.146.suppl_1.14329

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Transthyretin derived amyloid deposits in the atrium and the aortic valve: insights from multimodality evaluations and mid-term follow up

BMC Cardiovascular Disorders (2023)

Atsushi Okada Takashi Kakuta Naoki Tadokoro Emi Tateishi Yoshiaki Morita

Abstract Background Recent studies have reported atrial involvement and coexistence of aortic stenosis in transthyretin (ATTR) cardiac amyloidosis (CA). However, pathological reports of extraventricular ATTR amyloid deposits in atrial structures or heart valves are limited, and the clinical implications of ATTR amyloid deposits outside the ventricles are not fully elucidated. Case presentation We report 3 cases of extraventricular ATTR amyloid deposits confirmed in surgically resected aortic valves and left atrial structures, all of which were unlikely to have significant ATTR amyloidosis infiltrating the ventricles as determined by multimodality evaluation including 99m technetium-pyrophosphate scintigraphy, cardiac magnetic resonance, endomyocardial biopsy and their mid-term clinical course up to 5 years. These findings suggested that these were extraventricular ATTR amyloid deposits localized in the aortic valve and the left atrium. Conclusions While long-term observation is required to fully clarify whether these extraventricular ATTR amyloid deposits are truly localized outside the ventricles or are early stages of ATTR-CA infiltrating the ventricles, our 3 cases with multimodality evaluations and mid-term follow up suggest the existence of extraventricular ATTR amyloid deposits localized in the aortic valve and left atrial structures.

Amyloid (mycology)

10.1186/s12872-023-03319-3

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Citations (3)