文献一覧: Hiroyuki Morita (著者)

23 0 0 0 OA Deep Learning Algorithm to Detect Cardiac Sarcoidosis From Echocardiographic Movies

著者: Susumu Katsushika Satoshi Kodera Mitsuhiko Nakamoto Kota Ninomiya Nobutaka Kakuda Hiroki Shinohara Ryo Matsuoka Hirotaka Ieki Masae Uehara Yasutomi Higashikuni Koki Nakanishi Tomoko Nakao Norifumi Takeda Katsuhito Fujiu Masao Daimon Jiro Ando Hiroshi Akazawa Hiroyuki Morita Issei Komuro
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: vol.86, no.1, pp.87-95, 2021-12-24 (Released:2021-12-24)
参考文献数: 27
被引用文献数: 2 16

Background:Because the early diagnosis of subclinical cardiac sarcoidosis (CS) remains difficult, we developed a deep learning algorithm to distinguish CS patients from healthy subjects using echocardiographic movies.Methods and Results:Among the patients who underwent echocardiography from January 2015 to December 2019, we chose 151 echocardiographic movies from 50 CS patients and 151 from 149 healthy subjects. We trained two 3D convolutional neural networks (3D-CNN) to identify CS patients using a dataset of 212 echocardiographic movies with and without a transfer learning method (Pretrained algorithm and Non-pretrained algorithm). On an independent set of 41 echocardiographic movies, the area under the receiver-operating characteristic curve (AUC) of the Pretrained algorithm was greater than that of Non-pretrained algorithm (0.842, 95% confidence interval (CI): 0.722–0.962 vs. 0.724, 95% CI: 0.566–0.882, P=0.253). The AUC from the interpretation of the same set of 41 echocardiographic movies by 5 cardiologists was not significantly different from that of the Pretrained algorithm (0.855, 95% CI: 0.735–0.975 vs. 0.842, 95% CI: 0.722–0.962, P=0.885). A sensitivity map demonstrated that the Pretrained algorithm focused on the area of the mitral valve.Conclusions:A 3D-CNN with a transfer learning method may be a promising tool for detecting CS using an echocardiographic movie.

2022-06-27 05:36:14
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10 0 0 0 OA Diagnosing Heart Failure from Chest X-Ray Images Using Deep Learning

著者: Takuya Matsumoto Satoshi Kodera Hiroki Shinohara Hirotaka Ieki Toshihiro Yamaguchi Yasutomi Higashikuni Arihiro Kiyosue Kaoru Ito Jiro Ando Eiki Takimoto Hiroshi Akazawa Hiroyuki Morita Issei Komuro
出版者: International Heart Journal Association
雑誌: International Heart Journal (ISSN:13492365)
巻号頁・発行日: vol.61, no.4, pp.781-786, 2020-07-30 (Released:2020-07-30)
参考文献数: 13
被引用文献数: 26

The development of deep learning technology has enabled machines to achieve high-level accuracy in interpreting medical images. While many previous studies have examined the detection of pulmonary nodules in chest X-rays using deep learning, the application of this technology to heart failure remains rare. In this paper, we investigated the performance of a deep learning algorithm in terms of diagnosing heart failure using images obtained from chest X-rays. We used 952 chest X-ray images from a labeled database published by the National Institutes of Health. Two cardiologists verified and relabeled a total of 260 "normal" and 378 "heart failure" images, with the remainder being discarded because they had been incorrectly labeled. Data augmentation and transfer learning were used to obtain an accuracy of 82% in diagnosing heart failure using the chest X-ray images. Furthermore, heatmap imaging allowed us to visualize decisions made by the machine. Deep learning can thus help support the diagnosis of heart failure using chest X-ray images.

2020-11-07 19:35:05
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9 0 0 0 OA Cost-Effectiveness of Dapagliflozin for Chronic Kidney Disease in Japan

著者: Satoshi Kodera Hiroyuki Morita Hiroshi Nishi Norifumi Takeda Jiro Ando Issei Komuro
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-22-0086, (Released:2022-09-06)
参考文献数: 43
被引用文献数: 3

Background: The cost-effectiveness of sodium-glucose cotransporter 2 (SGLT2) inhibitors for chronic kidney disease (CKD) has not been evaluated in Japan, so we analyzed the cost-effectiveness of dapagliflozin, an SGLT2 inhibitor, for CKD stages 3a and 3b.Methods and Results: We used the Markov model for CKD to assess the costs and benefits associated with and without dapagliflozin from a health system perspective. We estimated the incremental cost-effectiveness ratio (ICER), expressed as per quality-adjusted life-years (QALYs). An ICER <5 million Japanese yen (JPY)/QALY was judged to be cost-effective. The effect of dapagliflozin on renal and cardiovascular events was based on published clinical trials. In patients with CKD stage 3a, the ICER of dapagliflozin over standard treatment was 4.03 million JPY/QALY gained. With a cost-effectiveness threshold of 5 million JPY/QALY gained, the cost-effectiveness probability of dapagliflozin over standard treatment was 52.6%. In patients with CKD stage 3b, the ICER of dapagliflozin over standard treatment was 0.12 million JPY/QALY gained. The cost-effectiveness probability of dapagliflozin over standard treatment was 75.2%.Conclusions: The results seemed to show acceptable cost-effectiveness when dapagliflozin was used for CKD stage 3b. On the other hand, cost-effectiveness of dapagliflozin for CKD stage 3a was ambiguous, and further validation is needed.

2022-09-07 06:02:30
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9 0 0 0 OA JCS/JHFS 2018 Guideline on the Diagnosis and Treatment of Cardiomyopathies

著者: Hirokai Kitaoka Hiroyuki Tsutsui Toru Kubo Tomomi Ide Taishiro Chikamori Keiichi Fukuda Noboru Fujino Taiki Higo Mitsuaki Isobe Chizuko Kamiya Seiya Kato Yasuki Kihara Koichiro Kinugawa Shintaro Kinugawa Shigetoyo Kogaki Issei Komuro Nobuhisa Hagiwara Minoru Ono Yuichiro Maekawa Shigeru Makita Yoshiro Matsui Shouji Matsushima Yasushi Sakata Yoshiki Sawa Wataru Shimizu Kunihiko Teraoka Miyuki Tsuchihashi-Makaya Hatsue Ishibashi-Ueda Masafumi Watanabe Michihiro Yoshimura Arata Fukusima Satoshi Hida Shungo Hikoso Teruhiko Imamura Hiroko Ishida Makoto Kawai Toshiro Kitagawa Takashi Kohno Satoshi Kurisu Yoji Nagata Makiko Nakamura Hiroyuki Morita Hitoshi Takano Tsuyoshi Shiga Yasuyoshi Takei Shinsuke Yuasa Teppei Yamamoto Tetsu Watanabe Takashi Akasaka Yoshinori Doi Takeshi Kimura Masafumi Kitakaze Masami Kosuge Morimasa Takayama Hitonobu Tomoike on behalf of the Japanese Circulation Society Joint Working Group
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-20-0910, (Released:2021-07-22)
参考文献数: 687
被引用文献数: 47

2021-08-27 20:34:56
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9 0 0 0 OA Cost-Effectiveness of Percutaneous Coronary Intervention Compared With Medical Therapy for Ischemic Heart Disease in Japan

著者: Satoshi Kodera Hiroyuki Morita Arihiro Kiyosue Jiro Ando Issei Komuro
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: vol.83, no.7, pp.1498-1505, 2019-06-25 (Released:2019-06-25)
参考文献数: 35
被引用文献数: 4 11

Background:The cost-effectiveness of percutaneous coronary intervention (PCI) for ischemic heart disease is undetermined in Japan. The aim of this study was to analyze the cost-effectiveness of PCI compared with medical therapy for ST-elevation myocardial infarction (STEMI) and angina pectoris (AP) in Japan.Methods and Results:We used Markov models for STEMI and AP to assess the costs and benefits associated with PCI or medical therapy from a health system perspective. We estimated the incremental cost-effectiveness ratio (ICER), expressed as quality-adjusted life-years (QALY), and ICER <¥5 m per QALY gained was judged to be cost-effective. The impact of PCI on cardiovascular events was based on previous publications. In STEMI patients, the ICER of PCI over medical treatment was ¥0.97 m per QALY gained. The cost-effectiveness probability of PCI was 99.9%. In AP patients, the ICER of fractional flow reserve (FFR)-guided PCI over medical treatment was ¥4.63 m per QALY gained. The cost-effectiveness probability of PCI was 50.4%. The ICER of FFR-guided PCI for asymptomatic patients was ¥23 m per QALY gained.Conclusions:In STEMI patients, PCI was cost-effective compared with medical therapy. In AP patients, FFR-guided PCI for symptomatic patients could be cost-effective compared with medical therapy. FFR-guided PCI for asymptomatic patients with myocardial ischemia was not cost-effective.

2021-08-02 05:36:40
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9 0 0 0 OA Deep Learning Algorithm to Detect Cardiac Sarcoidosis From Echocardiographic Movies

著者: Susumu Katsushika Satoshi Kodera Mitsuhiko Nakamoto Kota Ninomiya Nobutaka Kakuda Hiroki Shinohara Ryo Matsuoka Hirotaka Ieki Masae Uehara Yasutomi Higashikuni Koki Nakanishi Tomoko Nakao Norifumi Takeda Katsuhito Fujiu Masao Daimon Jiro Ando Hiroshi Akazawa Hiroyuki Morita Issei Komuro
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-21-0265, (Released:2021-06-26)
参考文献数: 27
被引用文献数: 16

2021-06-29 09:40:03
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8 0 0 0 OA Characteristic Imaging Phenotype of Arrhythmogenic Cardiomyopathy With Filamin C Gene Variant

著者: Shunsuke Inoue Hiroyuki Morita
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-23-0616, (Released:2023-09-05)
参考文献数: 14

2023-12-16 10:22:39
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7 0 0 0 OA Cost-Effectiveness of Dapagliflozin for Chronic Kidney Disease in Japan

著者: Satoshi Kodera Hiroyuki Morita Hiroshi Nishi Norifumi Takeda Jiro Ando Issei Komuro
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: vol.86, no.12, pp.2021-2028, 2022-11-25 (Released:2022-11-25)
参考文献数: 43
被引用文献数: 3

2023-03-08 09:28:41
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5 0 0 0 OA Characteristics and Outcomes of Super-Elderly Patients (Aged ≥90 Years) Hospitalized for Heart Failure ― Analysis of a Nationwide Inpatient Database ―

著者: Hidehiro Kaneko Hidetaka Itoh Haruki Yotsumoto Hiroyuki Kiriyama Tatsuya Kamon Katsuhito Fujiu Kojiro Morita Nobuaki Michihata Taisuke Jo Hiroyuki Morita Hideo Yasunaga Issei Komuro
出版者: The Japanese Circulation Society
雑誌: Circulation Reports (ISSN:24340790)
巻号頁・発行日: vol.2, no.8, pp.393-399, 2020-08-07 (Released:2020-08-07)
参考文献数: 30
被引用文献数: 15 19

Background:Although the aged population is increasing in developed countries, clinical evidence on super-elderly heart failure (HF) patients is scarce. This study determined the characteristics and outcomes of Japanese hospitalized super-elderly HF patients (aged ≥90 years) using a nationwide inpatient database.Methods and Results:A comprehensive analysis was performed of 447,818 HF patients in the Diagnosis Procedure Combination database who were hospitalized and discharged between January 2010 and March 2018. Among the study population, 243,028 patients (54.3%) were aged ≥80 years and 64,628 patients (14.4%) were aged ≥90 years. The percentage of elderly patients increased over time. Elderly patients were more likely to be female and had a higher New York Heart Association functional class at admission. Invasive and advanced procedures were rarely performed, whereas infectious complications were more common in patients with older age. Length of hospital stay and in-hospital mortality increased with age. Multivariable logistic regression analysis fitted with a generalized estimating equation showed higher in-hospital mortality in patients aged ≥80 and ≥90 years (odds ratios 1.99 and 3.23, respectively) compared with those aged <80 years.Conclusions:The number of hospitalized super-elderly HF patients has increased, and these patients are associated with worse clinical outcomes. The results of this study may be useful in establishing an optimal management strategy for super-elderly HF patients in the era of HF pandemic.

2023-06-11 15:04:36
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4 0 0 0 OA Enduring Relevance of the Stages of Change Model for Transforming Lifestyle Behaviors

著者: Atsushi Mizuno Hidehiro Kaneko Yuta Suzuki Akira Okada Norifumi Takeda Hiroyuki Morita Katsuhito Fujiu Koichi Node Hideo Yasunaga Issei Komuro
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-23-0292, (Released:2023-06-30)
参考文献数: 13
被引用文献数: 1

Background: The applicability of the Stages of Change model for cardiovascular disease-related behaviors, such as smoking, exercise, diet, and sleep quality, is unclear.Methods and Results: Using a large-scale epidemiological dataset, we found that baseline behavior change intention, as per the transtheoretical model, was associated with modifications of unhealthy lifestyles including cigarette smoking, physical inactivity, skipping breakfast, and poor sleep quality.Conclusions: Our results suggest that an individual’s motivation to change assessed by a general questionnaire may contribute to lifestyle modification and potentially prevent subsequent cardiovascular disease.

2023-07-25 18:48:14
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3 0 0 0 OA Deep Learning Models for Predicting Left Heart Abnormalities From Single-Lead Electrocardiogram for the Development of Wearable Devices

著者: Masataka Sato Satoshi Kodera Naoto Setoguchi Kengo Tanabe Shunichi Kushida Junji Kanda Mike Saji Mamoru Nanasato Hisataka Maki Hideo Fujita Nahoko Kato Hiroyuki Watanabe Minami Suzuki Masao Takahashi Naoko Sawada Masao Yamasaki Shinnosuke Sawano Susumu Katsushika Hiroki Shinohara Norifumi Takeda Katsuhito Fujiu Masao Daimon Hiroshi Akazawa Hiroyuki Morita Issei Komuro
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-23-0216, (Released:2023-11-14)
参考文献数: 41
被引用文献数: 2

Background: Left heart abnormalities are risk factors for heart failure. However, echocardiography is not always available. Electrocardiograms (ECGs), which are now available from wearable devices, have the potential to detect these abnormalities. Nevertheless, whether a model can detect left heart abnormalities from single Lead I ECG data remains unclear.Methods and Results: We developed Lead I ECG models to detect low ejection fraction (EF), wall motion abnormality, left ventricular hypertrophy (LVH), left ventricular dilatation, and left atrial dilatation. We used a dataset comprising 229,439 paired sets of ECG and echocardiography data from 8 facilities, and validated the model using external verification with data from 2 facilities. The area under the receiver operating characteristic curves of our model was 0.913 for low EF, 0.832 for wall motion abnormality, 0.797 for LVH, 0.838 for left ventricular dilatation, and 0.802 for left atrial dilatation. In interpretation tests with 12 cardiologists, the accuracy of the model was 78.3% for low EF and 68.3% for LVH. Compared with cardiologists who read the 12-lead ECGs, the model’s performance was superior for LVH and similar for low EF.Conclusions: From a multicenter study dataset, we developed models to predict left heart abnormalities using Lead I on the ECG. The Lead I ECG models show superior or equivalent performance to cardiologists using 12-lead ECGs.

2023-12-25 23:30:21
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2 0 0 0 OA Comprehensive Cardiac Rehabilitation as a Therapeutic Strategy for Abdominal Aortic Aneurysm

著者: Atsuko Nakayama Hiroyuki Morita Issei Komuro
出版者: The Japanese Circulation Society
雑誌: Circulation Reports (ISSN:24340790)
巻号頁・発行日: vol.1, no.11, pp.474-480, 2019-11-08 (Released:2019-11-08)
参考文献数: 55
被引用文献数: 2

Abdominal aortic aneurysms (AAA) are referred to as “time bombs”. The only way to prevent AAA rupture is elective repair beforehand using surgical replacement or an endovascular procedure. Non-surgical strategies to prevent AAA expansion are under intense investigation. At each AAA stage, that is, occurrence, expansion, and rupture, the mechanisms and risk factors are different, as discussed in this review. Based on the mechanism and risk factors for AAA expansion, the most effective strategy against AAA expansion need to be identified, but so far none has. Exercise is known to be essential for preventing atherosclerosis related to the coexistence of AAA and CAD, but some doctors are hesitant to prescribe exercise programs to AAA patients given that BP elevation during exercise can cause AAA expansion or rupture. In our retrospective study and prospective study on the safety and effectiveness of exercise for AAA patients, the protective role of mild-moderate exercise against expansion of small AAA was clearly shown. The stability of AAA on exercise might be related to reduced inflammatory activity in the aortic wall, stabilized elevation in BP during exercise, increased aortic blood flow, upregulation of transforming growth factor-β1, moderated BMI and/or fat, or improved endothelial function. Until a revolutionary drug emerges that can regress AAA, cardiac rehabilitation remains the best strategy for preventing AAA expansion and rupture.

2019-11-09 02:45:38
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1 0 0 0 OA Functional Evaluation of Human Bioengineered Cardiac Tissue Using iPS Cells Derived from a Patient with Lamin Variant Dilated Cardiomyopathy

著者: Koichiro Miura Katsuhisa Matsuura Yu Yamasaki Itoyama Daisuke Sasaki Takuma Takada Yoshiyuki Furutani Emiko Hayama Masamichi Ito Seitaro Nomura Hiroyuki Morita Masashi Toyoda Akihiro Umezawa Kenji Onoue Yoshihiko Saito Hiroyuki Aburatani Toshio Nakanishi Nobuhisa Hagiwara Issei Komuro Tatsuya Shimizu
出版者: International Heart Journal Association
雑誌: International Heart Journal (ISSN:13492365)
巻号頁・発行日: vol.63, no.2, pp.338-346, 2022-03-30 (Released:2022-03-30)
参考文献数: 35
被引用文献数: 5

Dilated cardiomyopathy (DCM) is caused by various gene variants and characterized by systolic dysfunction. Lamin variants have been reported to have a poor prognosis. Medical and device therapies are not sufficient to improve the prognosis of DCM with the lamin variants. Recently, induced pluripotent stem (iPS) cells have been used for research on genetic disorders. However, few studies have evaluated the contractile function of cardiac tissue with lamin variants. The aim of this study was to elucidate the function of cardiac cell sheet tissue derived from patients with lamin variant DCM. iPS cells were generated from a patient with lamin A/C (LMNA) -mutant DCM (LMNA p.R225X mutation). After cardiac differentiation and purification, cardiac cell sheets that were fabricated through cultivation on a temperature-responsive culture dish were transferred to the surface of the fibrin gel, and the contractile force was measured. The contractile force and maximum contraction velocity, but not the maximum relaxation velocity, were significantly decreased in cardiac cell sheet tissue with the lamin variant. A qRT-PCR analysis revealed that mRNA expression of some contractile proteins, cardiac transcription factors, Ca2+-handling genes, and ion channels were downregulated in cardiac tissue with the lamin variant.Human iPS-derived bioengineered cardiac tissue with the LMNA p.R225X mutation has the functional properties of systolic dysfunction and may be a promising tissue model for understanding the underlying mechanisms of DCM.

2022-04-04 03:13:19
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1 0 0 0 OA Age-Dependent Echocardiographic and Pathologic Findings in a Rat Model with Duchenne Muscular Dystrophy Generated by CRISPR/Cas9 Genome Editing

著者: Hidetoshi Sugihara Koichi Kimura Keitaro Yamanouchi Naomi Teramoto Tomoko Okano Masao Daimon Hiroyuki Morita Katsu Takenaka Takanori Shiga Jun Tanihata Yoshitsugu Aoki Tokiko Inoue-Nagamura Hiroshi Yotsuyanagi Issei Komuro
出版者: International Heart Journal Association
雑誌: International Heart Journal (ISSN:13492365)
巻号頁・発行日: pp.20-372, (Released:2020-11-13)
参考文献数: 25
被引用文献数: 9

Duchenne muscular dystrophy (DMD) is X-linked recessive myopathy caused by mutations in the dystrophin gene. Although conventional treatments have improved their prognosis, inevitable progressive cardiomyopathy is still the leading cause of death in patients with DMD. To explore novel therapeutic options, a suitable animal model with heart involvement has been warranted.We have generated a rat model with an out-of-frame mutation in the dystrophin gene using CRISPR/Cas9 genome editing (DMD rats). The aim of this study was to evaluate their cardiac functions and pathologies to provide baseline data for future experiments developing treatment options for DMD.In comparison with age-matched wild rats, 6-month-old DMD rats showed no significant differences by echocardiographic evaluations. However, 10-month-old DMD rats showed significant deterioration in left ventricular (LV) fractional shortening (P = 0.024), and in tissue Doppler peak systolic velocity (Sa) at the LV lateral wall (P = 0.041) as well as at the right ventricular (RV) free-wall (P = 0.004). These functional findings were consistent with the fibrotic distributions by histological analysis.Although the cardiac phenotype was milder than anticipated, DMD rats showed similar distributions and progression of heart involvement to those of patients with DMD. This animal may be a useful model with which to develop effective drugs and to understand the underlying mechanisms of progressive heart failure in patients with DMD.

2020-11-21 16:20:39
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1 0 0 0 OA Cost-Effectiveness Analysis of Cardiovascular Disease Treatment in Japan

著者: Satoshi Kodera Arihiro Kiyosue Jiro Ando Hiroshi Akazawa Hiroyuki Morita Masafumi Watanabe Issei Komuro
出版者: International Heart Journal Association
雑誌: International Heart Journal (ISSN:13492365)
巻号頁・発行日: vol.58, no.6, pp.847-852, 2017-11-01 (Released:2017-12-12)
参考文献数: 47
被引用文献数: 20

The quality-adjusted life year (QALY) and incremental cost-effectiveness ratio (ICER) are important concepts in cost-effectiveness analysis, which is becoming increasingly important in Japan. QALY is used to estimate quality of life (QOL) and life years, and can be used to compare the efficacies of cancer and cardiovascular treatments. ICER is defined as the difference in cost between treatments divided by the difference in their effects, with a smaller ICER indicating better cost-effectiveness. Here, we present a review of cost-effectiveness analyses in Japan as well other countries. A number of treatments were shown to be cost-effective, e.g., statin for secondary prevention of cardiovascular disease, aspirin for primary prevention of cardiovascular disease, DOAC for high-risk atrial fibrillation, beta blockers, ACE inhibitors, and ARB for heart failure, sildenafil and bosentan for pulmonary hypertension, CABG for multi-vessel coronary disease, ICD for ventricular tachycardia, and CRT for heart failure with low ejection fraction, while others were not cost-effective, e.g., epoprostenol for pulmonary hypertension and LVAD for end-stage heart failure. Further investigations are required regarding some treatments, e.g., PCSK-9 inhibitors for familial hypercholesterolemia, PCI for multi-vessel coronary disease, catheter ablation for atrial fibrillation, and TAVI for severe aortic stenosis. Ethical aspects should be taken into consideration when utilizing the results of cost-effectiveness analysis in medical policy.

2020-09-24 21:39:16
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1 0 0 0 OA Effect of Metabolically Healthy Obesity on the Development of Carotid Plaque in the General Population: A Community-Based Cohort Study

著者: Hidetaka Itoh Hidehiro Kaneko Hiroyuki Kiriyama Yuriko Yoshida Koki Nakanishi Yoshiko Mizuno Masao Daimon Hiroyuki Morita Yutaka Yatomi Nobutake Yamamichi Issei Komuro
出版者: Japan Atherosclerosis Society
雑誌: Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
巻号頁・発行日: pp.48728, (Released:2019-06-22)
参考文献数: 40
被引用文献数: 23

Aim: Obesity and metabolic syndrome (MetS) frequently coexist and are both important risk factors for cardiovascular disease. However, the pathophysiological role of obesity without MetS, also referred to as metabolically healthy obesity (MHO), remains unclear. In this study, we aim to clarify the effect of MHO on the development of carotid plaque using a community-based cohort.Methods: We examined 1,241 subjects who underwent health checkups at our institute. Obesity was defined by a body mass index of ≥ 25.0 kg/m2. Subjects were divided into three groups: non-obese, MHO, and metabolically unhealthy obesity (MUO).Results: The prevalence of carotid plaque, defined as intima-media thickness (IMT) ≥ 1.1 mm, was higher in subjects with MUO and MHO than in non-obese subjects. Multivariable analysis demonstrated that MHO (odds ratio 1.6, p=0.012) and MUO (odds ratio 1.9, p=0.003) as well as age of ≥ 65 years, male sex, hypertension, and diabetes mellitus were independently associated with carotid plaque formation. A similar trend was observed in each subgroup according to age and sex.Conclusions: MHO increased the prevalence of carotid plaque when compared with non-obese subjects, suggesting the potential significance of MHO in the development of subsequent cardiovascular diseases.

2019-06-26 19:37:38
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1 0 0 0 OA Cost-Effectiveness of Percutaneous Coronary Intervention Compared With Medical Therapy for Ischemic Heart Disease in Japan

著者: Satoshi Kodera Hiroyuki Morita Arihiro Kiyosue Jiro Ando Issei Komuro
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-19-0148, (Released:2019-06-05)
参考文献数: 35
被引用文献数: 11

2019-06-17 01:19:15
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1 0 0 0 OA Cost-Effectiveness of PCSK9 Inhibitor Plus Statin in Patients With Triple-Vessel Coronary Artery Disease in Japan

著者: Satoshi Kodera Hiroyuki Morita Arihiro Kiyosue Jiro Ando Tomoyuki Takura Issei Komuro
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: vol.82, no.10, pp.2602-2608, 2018-09-25 (Released:2018-09-25)
参考文献数: 39
被引用文献数: 2 12

Background: The addition of a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor to statin therapy reduces the rate of cardiovascular events. This study examined the cost-effectiveness of PCSK9 inhibitor+statin compared with standard therapy (statin monotherapy) in the treatment of triple-vessel coronary artery disease (CAD) in Japan. Methods and Results: A Markov model was applied to assess the costs and benefits associated with PCSK9 inhibitor+statin over a projected 30-year period from the perspective of a public healthcare payer in Japan. The incremental cost-effectiveness ratio (ICER), expressed as the quality-adjusted life-years (QALYs), was estimated. The effects on survival and numbers of events were based on the FOURIER trial and the CREDO Kyoto registry. The ICER of PCSK9 inhibitor+statin over standard therapy was 13.5 million (95% confidence interval 7.6–23.5 million) Japanese Yen (JPY) per QALY gained for triple-vessel CAD. The probability of the cost-effectiveness of PCSK9 inhibitor+statin vs. standard therapy was 0.0008% at a cost-effectiveness threshold of 5 million JPY. In patients with poorly controlled familial hypercholesterolemia (FH) with triple-vessel CAD, the ICER was 3.4 million JPY per QALY gained. Conclusions: PCSK9 inhibitor plus statin did not show good cost-effectiveness for triple-vessel CAD; however, it showed good cost-effectiveness for patients with triple-vessel CAD and poorly controlled FH in Japan.

2018-10-31 18:25:07
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1 0 0 0 OA Phenotypic Screening Using Patient-Derived Induced Pluripotent Stem Cells Identified Pyr3 as a Candidate Compound for the Treatment of Infantile Hypertrophic Cardiomyopathy

著者: Taku Sakai Atsuhiko T. Naito Yuki Kuramoto Masamichi Ito Katsuki Okada Tomoaki Higo Akito Nakagawa Masato Shibamoto Toshihiro Yamaguchi Tomokazu Sumida Seitaro Nomura Akihiro Umezawa Shigeru Miyagawa Yoshiki Sawa Hiroyuki Morita Jong-Kook Lee Ichiro Shiojima Yasushi Sakata Issei Komuro
出版者: International Heart Journal Association
雑誌: International Heart Journal (ISSN:13492365)
巻号頁・発行日: pp.17-730, (Released:2018-08-11)
参考文献数: 28
被引用文献数: 13

Hypertrophic cardiomyopathy (HCM) is a genetic disorder that is characterized by hypertrophy of the myocardium. Some of the patients are diagnosed for HCM during infancy, and the prognosis of infantile HCM is worse than general HCM. Nevertheless, pathophysiology of infantile HCM is less investigated and remains largely unknown. In the present study, we generated induced pluripotent stem cells (iPSCs) from two patients with infantile HCM: one with Noonan syndrome and the other with idiopathic HCM. We found that iPSC-derived cardiomyocytes (iPSC-CMs) from idiopathic HCM patient were significantly larger and showed higher diastolic intracellular calcium concentration compared with the iPSC-CMs from healthy subject. Unlike iPSC-CMs from the adult/adolescent HCM patient, arrhythmia was not observed as a disease-related phenotype in iPSC-CMs from idiopathic infantile HCM patient. Phenotypic screening revealed that Pyr3, a transient receptor potential channel 3 channel inhibitor, decreased both the cell size and diastolic intracellular calcium concentration in iPSC-CMs from both Noonan syndrome and idiopathic infantile HCM patients, suggesting that the target of Pyr3 may play a role in the pathogenesis of infantile HCM, regardless of the etiology. Further research may unveil the possibility of Pyr3 or its derivatives in the treatment of infantile HCM.

2018-08-31 14:00:31
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1 0 0 0 OA Periprocedural Complications in Patients Undergoing Catheter Ablation of Atrial Fibrillation Without Discontinuation of a Vitamin K Antagonist and Direct Oral Anticoagulants

著者: Toshiya Kojima Katsuhito Fujiu Nobuaki Fukuma Hiroshi Matsunaga Tsukasa Oshima Jun Matsuda Takumi Matsubara Yu Shimizu Gaku Oguri Eriko Hasumi Hiroyuki Morita Issei Komuro
出版者: The Japanese Circulation Society
雑誌: Circulation Journal (ISSN:13469843)
巻号頁・発行日: pp.CJ-17-1114, (Released:2018-04-13)
参考文献数: 20
被引用文献数: 7

Background:Periprocedural anticoagulation is important in catheter ablation (CA) of atrial fibrillation (AF) and there is increasing evidence that uninterrupted vitamin K antagonist (VKA) therapy is superior to interrupted anticoagulation strategies. Since the emergence of direct oral anticoagulants (DOACs), numerous studies have shown promising results for their use in uninterrupted strategies. However, further studies are needed to further deﬁne the efﬁcacy and safety of performing AF ablation with uninterrupted factor XA inhibitors or direct thrombin inhibitors.Methods and Results:We have performed CA of AF without discontinuation of either VKA or DOAC therapy since April 2014. A total of 376 patients with AF underwent CA including pulmonary vein isolation. All of the patients were divided into 2 groups (uninterrupted VKA or uninterrupted DOACs). Anticoagulation with DOACs was associated with fewer complications than uninterrupted VKA therapy (P=0.04). There were significant differences between groups in the rates of congestive heart failure, left ventricular ejection fraction, body weight, and estimated glomerular filtration rate and of the CHADS2, CHA2DS2-VASc and HAS-BLED scores. Therefore, we also analyzed the results using the propensity score-matching method. We found no significant difference in periprocedural complications between uninterrupted VKA or DOACs therapy (P=0.65).Conclusions:CA of AF without discontinuation of DOACs is not inferior to CA without discontinuation of a VKA, with regard to ischemic or hemorrhagic complications.

2018-04-13 12:56:22
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