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 15

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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.

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

15

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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.

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 18

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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.

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

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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.

著者

Junichi Sugita Katsuhito Fujiu

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.1, no.12, pp.558-563, 2019-12-10 (Released:2019-12-10)

参考文献数

60

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Maintaining a coordinated heart rhythm is essential for maintaining the heart’s pumping function and blood circulation. Every heartbeat is generated by electrical impulse propagation that is passing through gap junctions, which are composed of connexin proteins. In mammalian hearts, Cx43, Cx40, Cx45, and Cx30.2 are expressed and regulated by post-translational modification. Cardiac macrophages account for only a small number of total heart cells, but they reside all around the heart. They are primarily established prenatally, and they arise from embryonic yolk sac progenitors. Recently, increasing attention has been directed toward novel roles for cardiac resident macrophages, especially in the heart’s electrical impulse conduction. Here, we provide an overview of the recent findings on connexins, with a focus on the emerging function of cardiac macrophages, and we discuss the future directions of treatment for heart disease.

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

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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.

著者

Katsuhito Fujiu

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0579, (Released:2023-11-15)

参考文献数

22

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Despite advancements in treatments for heart failure and lethal arrhythmias, achieving satisfactory life prognoses remains a challenge. A fresh perspective on the pathogenesis of heart disease is imperative to improve these prognoses. Our research has highlighted the role of cardiac macrophages in inhibiting the onset of heart failure and sudden cardiac death. We have recently unveiled a collaborative mechanism involving immune cells, brain neural networks, and the kidneys, which work in concert to combat cardiovascular diseases. This intricate organ network, orchestrated by the brain neural network and immune system, is pivotal in maintaining whole-body homeostasis. Disruptions in this harmonious interplay can precipitate various conditions, including heart failure and multiple organ failure, underscoring the significance of technological advancements in analytical methods and the advent of artificial intelligence. Recent strides in circulatory organ research have facilitated concurrent high-level analysis of the neural network and cardiovascular system. This review encapsulates these cutting-edge reports, evaluates the progress of research anchored in the fundamental concept that system failure of the cardiovascular organ precipitates cardiovascular disease, and offers valuable insights to guide future research.

著者

Shintaro Yamada Eriko Hasumi Katsuhito Fujiu Haruo Yamauchi Issei Komuro

出版者

The Japanese Circulation Society

雑誌

Circulation Reports (ISSN:24340790)

巻号頁・発行日

vol.2, no.9, pp.542-543, 2020-09-10 (Released:2020-09-10)

被引用文献数

1

著者

Keigo Iwazaki Toshiya Kojima Takahide Murasawa Jun Yokota Hikaru Tanimoto Jun Matsuda Nobuaki Fukuma Takumi Matsubara Yu Shimizu Gaku Oguri Eriko Hasumi Hitoshi Kubo Kyungho Chang Katsuhito Fujiu Issei Komuro

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.59, no.3, pp.626-629, 2018-05-31 (Released:2018-05-30)

参考文献数

8

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A cardiac resynchronization therapy defibrillator (CRT-D) (Medtronic Inc. Protecta XT) was implanted in a 67-year-old man who had cardiac sarcoidosis with extremely low cardiac function. He had ventricular tachycardia which was controlled by catheter ablation, medication and pacing. The programmed mode was DDI, lower rate was 90 beats/minute, paced AV delay was 150 ms, and the noncompetitive atrial pacing (NCAP) function was programmed as 300 ms.After his admission for pneumonia and heart failure, we changed his DDI mode to a DDD mode because he had atrial tachycardia, which led to inadequate bi-ventricular pacing. After a while, there were cycle lengths which were longer than his device setting and alternately varied. We were able to avoid this phenomenon with AV delay of 120 ms and NCAP of 200 ms.NCAP is an algorithm which creates a gap above a certain period after the detection of an atrial signal during the postventricular atrial refractory period of the pacemaker. This is to prevent atrial tachycardia and repetitive non-reentrant ventriculoatrial (VA) synchrony in the presence of retrograde VA conduction. But in this case, NCAP algorithm induced much lower rate than the programmed basic lower rate. This situation produced some arrhythmias and exacerbated symptoms of heart failure. This had to be paid attention to, especially when the device was programmed at high basic heart rate.

著者

Takumi J Matsubara Katsuhito Fujiu Satoshi Kodera Kunihiro Kani Kohsaku Goto Yu Shimizu Gaku Oguri Eriko Hasumi Toshiya Kojima Issei Komuro

出版者

International Heart Journal Association

雑誌

International Heart Journal (ISSN:13492365)

巻号頁・発行日

vol.63, no.3, pp.486-491, 2022-05-30 (Released:2022-05-31)

参考文献数

13

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Asymptomatic or silent atrial fibrillation (AF) has long been a clinical problem due to the incidence of ischemic stroke. A method is needed to predict the development of silent AF before the occurrence of ischemic stroke. This study was focused on the symptoms of AF, especially palpitation, in pacemaker patients. We assessed the hypothesis that absence of palpitation during rapid ventricular pacing could be a predictor of future onset AF being asymptomatic.In this study, we assessed the presence of symptoms during RV pacing and AF symptoms on 145 pacemaker patients at the outpatient clinic by VVI pacing at 120 ppm. The relationship between symptoms during RV pacing and symptom during AF was assessed. The predictive value of absence of symptom during RV pacing on AF being asymptomatic was assessed.Of 145 patients, 74 had previous AF episode. Among the AF patients, absence of symptom during VVI pacing was associated with AF being asymptomatic.Of 145 patients, 71 had no previous AF events. There were 14 patients who had new-onset AF or atrial flutter (AFL) after the device implantation. Four of the 14 patients (28.6%) were symptomatic during first AF/AFL episode, and 10 (71.4%) were asymptomatic during first-onset AF. All ten patients who were asymptomatic during cardiac pacing test were asymptomatic during their initial episodes of AF as well.This study showed that absence of symptoms during rapid ventricular pacing was associated with first-onset AF being asymptomatic.

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

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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.