記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Aromatase inhibitors (AIs) are the standard therapeutic approach for hormone receptor-positive postmenopausal breast cancer. However, there are concerns about increased cardiovascular risk due to their antioestrogenic effects. This study aimed to investigate the potential association between duration of AI treatment and the severity of coronary artery calcification (CAC). METHODS: The study included outpatients who initiated adjuvant endocrine therapy with AIs for breast cancer from August 2010 to October 2022. CAC was quantified according to a visual ordinal scoring system. Patient characteristics were assessed based on the presence of CAC. Independent risk factors for elevated CAC scores were identified through a multivariable logistic regression model. RESULTS: Among 357 patients, 44.8% exhibited CAC. No significant difference in AI treatment duration was observed between groups (1268 d [interquartile range (IQR) 725-1743 d] vs 1104 d [IQR 685-1683.25 d]; P = 0.236). Patients with CAC were characterised by higher age (63.06 y [56.81-68.78 y] vs 74.39 y [68.98-80.03 y]; P < 0.001), lower hemoglobin levels (g/dL: 13.20L [IQR 12.60-13.70L] vs 12.60 [IQR 11.60-13.43]; P < 0.001), and reduced estimated glomerular filtration rate (mL/min/1.73 m2: 72.00 [IQR 61.80-81.50] vs 62.80 [IQR 51.27-71.90]; P < 0.001) compared with those without CAC. The prevalences of hypertension, diabetes mellitus, and dyslipidemia were significantly higher in patients with CAC. No correlation was found between the duration of AI treatment and CAC score (R = -0.02; P = 0.78). Independent risk factors for CAC included higher age, lower hemoglobin levels, and the presence of hypertension and diabetes mellitus in postoperative patients with breast cancer. CONCLUSIONS: The duration of AI treatment does not exert a significant influence on CAC in postoperative patients with breast cancer.

DOI： 10.1016/j.cjca.2024.05.012

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1253/circj.CJ-24-0306

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掲載種別：研究論文（学術雑誌）  

DOI： 10.1093/omcr/omae026

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.ahjo.2024.100383

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIMS: As part of the Toon Health Study, which is an ongoing population-based cohort study, we aimed to develop a prediction model for N-terminal pro-brain natriuretic peptide (NT-proBNP) in a general Japanese population. We sought to explore the influence of various demographic and clinical factors on NT-proBNP levels and assess the model's performance. In addition, our objectives included internal validation and investigation of the diagnostic potential of the observed-to-predicted NT-proBNP ratio (OPR) at baseline for predicting the risk of heart failure with preserved ejection fraction (HFpEF). METHODS AND RESULTS: In this prospective cohort study, participants were recruited from Toon City, Japan, as part of the larger Toon Health Study, focusing on cardiovascular risk factors. We measured the NT-proBNP levels and used linear regression with penalization (ridge regression) to develop the model. The model incorporated 10 prespecified predictors (age, gender, body mass index, diastolic blood pressure, heart rate, haemoglobin, albumin, total cholesterol, haemoglobin A1c, and estimated glomerular filtration rate) and underwent assessment using R2 and root mean squared error (RMSE). Internal validation was conducted through bootstrapping. In a post hoc analysis, we explored the OPR's diagnostic potential using 5 year follow-up data (n = 636) to predict the elevation of NT-proBNP > 125 pg/mL at the 5 year follow-up as the risk of HFpEF. A total of 2505 participants (age: 60.4 ± 12.9 years, men: 35%) were enrolled in this study. There was a linear relationship between the observed and predicted values of NT-proBNP in which the logarithm of observed NT-proBNP was <6, which corresponds to 403 pg/mL in NT-proBNP. The prediction model demonstrated satisfactory performance (R2 : 0.291, RMSE: 0.688), with age identified as a dominant predictor. The stability of the model was underscored by the internal validation. The OPR at baseline predicted NT-proBNP > 125 pg/mL at the 5 year follow-up with an area under the curve of 0.793. CONCLUSIONS: This study introduces the first prediction model for NT-proBNP in a general Japanese population. Although the model has acceptable performance, ongoing refinement is essential. Our transparent approach to model development, alongside a web-based interactive tool, lays the groundwork for further improvements and external validation. The OPR holds potential for predicting the future risk of HFpEF. This research contributes to understanding the nuanced influence of patient backgrounds on levels of NT-proBNP in asymptomatic individuals within the context of a broader population-based cohort study.

DOI： 10.1002/ehf2.14691

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記述言語：英語  

BACKGROUND: Haemorrhage at the puncture site is a serious complication of percutaneous coronary intervention (PCI). CASE SUMMARY: A 73-year-old man underwent transfemoral intervention because of stable angina pectoris. After a rotational atherectomy, an everolimus-eluting stent was implanted from the left main trunk to the proximal site of the left anterior descending (LAD) artery. We also recognized that myocardial bridging was significantly induced at the middle portion of the LAD, which was not evident before the PCI. We suspected puncture-related haemorrhage and immediately performed lower limb arteriography. As a result, contrast media extravasation was observed at the branch of the right inferior epigastric artery. Finally, we performed coil embolization into the left common femoral artery, and the extravasation successfully disappeared. Four months later, he underwent coronary angiography. There were no findings of myocardial bridging. DISCUSSION: Myocardial bridging during a PCI procedure may indicate hypercontraction because of haemorrhage.

DOI： 10.1093/ehjcr/ytad439

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記述言語：英語  

DOI： 10.1038/s41440-023-01396-7

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記述言語：英語  

DOI： 10.1186/s41747-023-00347-8

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掲載種別：研究論文（学術雑誌）  

DOI： 10.1097/HJH.0000000000003520

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Although remote monitoring (RM) after pacemaker implantation is common, its cost-effectiveness has not been fully investigated. Therefore, we assessed the cost-effectiveness of RM compared with conventional follow-up (CFU) in Japanese patients with pacemakers. METHODS: A Markov model was constructed to analyze costs and quality-adjusted life years after pacemaker implantation. The target population was Japanese patients implanted with a dual-chamber pacemaker for bradycardia. Transition probabilities (e.g. atrial fibrillation, stroke, and device trouble) were obtained from literature and expert sources. Additionally, stroke risk was determined according to anticoagulation and CHADS2 scores. We used a 10-year horizon with sensitivity analyses for significant variables. RESULTS: Compared to CFU, RM was more effective; however, it was also more expensive. When the range of the Japanese willingness-to-pay threshold was considered to be \5,000,000, RM was at least cost-neutral relative to the CFU in all elderly patients with pacemakers for bradycardia. The cost-effectiveness of RM relative to CFU could be higher for patients with high CHADS2 scores, especially in patients with a CHADS2 score ≥ 3. Scenario analyses changing the interval between visits to an in-office evaluation in the CFU also demonstrated the same conclusions. In particular, when the interval between office visits was 1 year for the CFU, the RM could be more cost-effective. CONCLUSIONS: This study demonstrated that RM can be a cost-effective option for Japanese patients, especially those with high CHADS2 scores and long-term intervals between office visits.

DOI： 10.1016/j.jjcc.2023.06.003

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記述言語：英語  

DOI： 10.1007/s13300-023-01406-4

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1093/ehjdh/ztad026

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記述言語：英語  

DOI： 10.1016/j.cjco.2023.02.008

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIMS: Currently, virtual reality (VR) constitutes a vital aspect of digital health, necessitating an overview of study trends. We classified type A studies as those in which health care providers utilized VR devices and type B studies as those in which patients employed the devices. This study aimed to analyse the characteristics of each type of studies using natural language processing (NLP) methods. METHODS AND RESULTS: Literature related to VR in cardiovascular research was searched in PubMed between 2010 and 2022. The characteristics of studies were analysed based on their classification as type A or type B. Abstracts of the studies were used as corpus for text mining. A binary logistic regression model was trained to automatically categorize the abstracts into the two study types. Classification performance was evaluated by accuracy, precision, recall, F-1 score, and c-statistics of the receiver operator curve (ROC) analysis. In total, 171 articles met the inclusion criteria, where 120 (70.2%) were type A studies and 51 (29.8%) were type B studies. Type A studies had a higher proportion of case reports than type B studies (18.3% vs. 3.9%, P = 0.01). As for abstract classification, the binary logistic regression model yielded 88% accuracy and an area under the ROC of 0.98. The words 'training', '3d', and 'simulation' were the most powerful determinants of type A studies, while the words 'patients', 'anxiety', and 'rehabilitation' were more indicative for type B studies. CONCLUSIONS: NLP methods revealed the characteristics of the two types of VR-related research in cardiology.

DOI： 10.1093/ehjdh/ztad008

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Although premature atrial contractions (PACs) just after catheter ablation (CA) for atrial fibrillation (AF) are common, their clinical significance is uncertain. This study aimed to evaluate whether the PAC burden after an initial CA for AF was associated with late recurrence. METHODS: We enrolled 346 patients with AF (median age, 65 years; 30% female; 57% with paroxysmal AF) who underwent an initial radiofrequency CA and a 24-h Holter monitoring the day after the procedure. PAC was defined as supraventricular complexes occurring ≥30% earlier than expected compared with a previous RR interval, and the number of PAC/24 h during post-procedural Holter monitoring was analyzed. RESULTS: AF recurred in 106 patients (31%) during a median follow-up of 19 months. These patients had significantly more PAC/24 h than those without (median [interquartile range], 891 [316-4,351] beats vs. 409 [162-1,303] beats; P<0.01). The number of PACs was independently associated with AF recurrence after adjustment for clinical parameters and left atrial (LA) enlargement. Receiver operating characteristic curve analysis revealed that 1,431 PAC/24 h was the optimal cut-off value for predicting AF recurrence. ???Adding the PAC/24 h to the prediction model with LA diameter appeared to correctly reclassify patients who were thought to be at high risk for AF recurrence into the low-risk group and vice versa. CONCLUSIONS: The number of PACs was an independent risk factor for AF recurrence. A 24-h Holter recording the day after an initial CA is a simple and beneficial tool for the risk stratification of AF recurrence. This article is protected by copyright. All rights reserved.

DOI： 10.1111/pace.14648

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

A subset of interleukin (IL)-17A-producing γδ T cells called γδT17 cells may contribute to progression of hypertension. γδT17 cell development is in part dependent upon IL-23 receptor (IL-23R) stimulation. We hypothesized that angiotensin (Ang) II-induced blood pressure (BP) elevation and vascular injury would be blunted in Il23r knock-in (Il23rgfp/gfp) mice deficient in functional IL-23R. To test this hypothesis, we infused wild-type (WT) and Il23rgfp/gfp mice with Ang II (490 ng/kg/min, SC) for 7 or 14 days. We recorded BP by telemetry, assessed vascular function and remodeling using pressurized myography, and profiled T cell populations and cytokine production by flow cytometry. An additional set of Il23rgfp/gfp mice was infused with Ang II for 7 days and injected with interferon (IFN)-γ-neutralizing or control antibodies. Il23rgfp/gfp mice had smaller and stiffer mesenteric arteries and were not protected against Ang II-induced BP elevation. BP was higher in Il23rgfp/gfp mice than WT mice from day 3 until day 9 of Ang II infusion. Il23rgfp/gfp mice had less γδT17 cells and more IFN-γ-producing γδ, CD4+, and CD8+ T cells than WT mice. Seven days of Ang II infusion led to increased IFN-γ-producing γδ, CD4+, and CD8+ T cells in Il23rgfp/gfp mice, whereas only IFN-γ-producing γδ T cells were increased in WT mice. Blocking IFN-γ with a neutralizing antibody reduced the pressor response to 7 days of Ang II infusion in Il23rgfp/gfp mice. Functional IL-23R deficiency was associated with increased IFN-γ-producing T cells and exaggerated initial development of Ang II-induced hypertension, which was in part mediated by IFN-γ.

DOI： 10.1038/s41440-022-01055-3

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

As the quality of image generation by deep learning increases, it is becoming difficult to discern its authenticity from the image alone. Currently, generative models represented by generative adversarial networks (GAN) are increasingly utilized in the research field of cardiology, and their potential risks are also being pointed out. In this context, we assessed whether expert cardiologists can detect synthesized myocardial perfusion images (MPI) generated by GAN as fake. A total of 1448 polar maps collected from consecutive patients who underwent MPI for known or suspected coronary artery disease from January 2020 to December 2021 were used for the analysis. A deep convolutional GAN was trained on the polar maps to synthesize realistic MPI. The realism of the generated images in terms of human perception was evaluated by the visual Turing test (VTT) on our original website. The average correct answer rate of the VTT was only 61.1% with a standard deviation of 21.5, but this improved to 80.0±15.8 (%) in the second trial when given the clue information. In the era of machine intelligence and virtual reality, digital literacy is becoming more necessary for healthcare professionals to identify deepfakes.

DOI： 10.7759/cureus.30646

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.19102/icrm.2022.13106

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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 University Press (OUP)  

DOI： 10.1093/ehjdh/ztac052

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Previous studies have reported that a high neutrophil-to-lymphocyte ratio (NLR) is associated with disease severity and poor prognosis in COVID-19 patients. We aimed to investigate the clinical implications of NLR in patients with COVID-19 complicated with cardiovascular diseases and/or its risk factors (CVDRF). In total, 601 patients with known NLR values were selected from the CLAVIS-COVID registry for analysis. Patients were categorized into quartiles (Q1, Q2, Q3, and Q4) according to baseline NLR values, and demographic and clinical parameters were compared between the groups. Survival analysis was conducted using the Kaplan-Meier method. The diagnostic performance of the baseline and follow-up NLR values was tested using receiver operating characteristic (ROC) curve analysis. Finally, two-dimensional mapping of patient characteristics was conducted using t-stochastic neighborhood embedding (t-SNE). In-hospital mortality significantly increased with an increase in the baseline NLR quartile (Q1 6.3%, Q2 11.0%, Q3 20.5%; and Q4, 26.6%; p < 0.001). The cumulative mortality increased as the quartile of the baseline NLR increased. The paired log-rank test revealed significant differences in survival for Q1 vs. Q3 (p = 0.017), Q1 vs. Q4 (p < 0.001), Q2 vs. Q3 (p = 0.034), and Q2 vs. Q4 (p < 0.001). However, baseline NLR was not identified as an independent prognostic factor using a multivariate Cox proportional hazards regression model. The area under the curve for predicting in-hospital death based on baseline NLR was only 0.682, whereas that of follow-up NLR was 0.893. The two-dimensional patient map with t-SNE showed a cluster characterized by high mortality with high NLR at follow-up, but these did not necessarily overlap with the population with high NLR at baseline. NLR may have prognostic implications in hospitalized COVID-19 patients with CVDRF, but its significance depends on the timing of data collection.

DOI： 10.1038/s41598-022-17567-4

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記述言語：英語  

Coronary vasospasm sometimes coexists with Brugada syndrome (BrS) and is reportedly associated with poor prognosis. Although calcium channel blockers are considered first-line drugs to prevent coronary vasospasm, they also have the potential to induce ST elevation and ventricular fibrillation (VF) in BrS. Therefore, the optimal medication for such a complicated case is still underdetermined. We report a male patient who presented with VF due to BrS, which was later found to have coexisted with coronary vasospasm. He was treated with low-dose bepridil expecting both its anti-arrhythmic and vasodilatory effects, but a later acetylcholine provocation test showed no suppression of vasospasm. Based on these results, we decided to add nitrates to the medication. This case report illustrates that drug selection needs caution in BrS when complicated with vasospastic angina and that bepridil monotherapy may not be sufficient to suppress coronary vasospasm in such cases.

DOI： 10.1093/omcr/omac082

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) plays a crucial role in the optimal treatment strategy for patients with coronary heart disease. We tested the feasibility of feature extraction from MPI using a deep convolutional autoencoder (CAE) model. METHODS: Eight hundred and forty-three pairs of stress and rest myocardial perfusion images were collected from consecutive patients who underwent cardiac scintigraphy in our hospital between December 2019 and February 2022. We trained a CAE model to reproduce the input paired image data, so as the encoder to output a 256-dimensional feature vector. The extracted feature vectors were further dimensionally reduced via principal component analysis (PCA) for data visualization. Content-based image retrieval (CBIR) was performed based on the cosine similarity of the feature vectors between the query and reference images. The agreement of the radiologist's finding between the query and retrieved MPI was evaluated using binary accuracy, precision, recall, and F1-score. RESULTS: A three-dimensional scatter plot with PCA revealed that feature vectors retained clinical information such as percent summed difference score, presence of ischemia, and the location of scar reported by radiologists. When CBIR was used as a similarity-based diagnostic tool, the binary accuracy was 81.0%. CONCLUSION: The results indicated the utility of unsupervised feature learning for CBIR in MPI.

DOI： 10.1007/s12350-022-03030-4

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記述言語：英語  

DOI： 10.1038/s41440-022-00880-w

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s12928-022-00855-1

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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：Cureus, Inc.  

A left ventricular pseudoaneurysm is a rare but life-threatening complication after myocardial infarction. Because untreated pseudoaneurysms have a 30%-45% risk of rupture, surgery is the preferred therapeutic option. However, its diagnosis is sometimes challenging, as a pseudoaneurysm presents with non-specific symptoms that can mimic myocardial infarction or heart failure. We report a male patient with a history of aortic dissection surgery who presented with recurrent chest pain probably due to acute coronary syndrome. Transthoracic echocardiography revealed a cavity at the apex of the left ventricle, indicating a mechanical complication after myocardial infarction. As the coronary angiography was considered difficult because of the patient's anatomical problem, contrast-enhanced computed tomography (CT) was performed. CT angiography revealed multiple nodular cavities continued from within the left ventricle. It seemed that the pseudoaneurysm was formed in stages in the adherent pericardium after myocardial infarction, resulting in a bead-like appearance. Emergent pseudoaneurysmectomy and left ventricular wall repair were performed, and the patient was discharged without any complications. This case illustrates the utility of cardiac CT to establish the diagnosis of left ventricular pseudoaneurysm and coronary artery atherosclerosis.

DOI： 10.7759/cureus.22773

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1007/s10840-022-01171-7

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掲載種別：研究論文（学術雑誌）  

DOI： 10.1161/CIRCULATIONAHA.121.058869

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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：Cureus, Inc.  

Understanding the lead trajectory is important in preventing complications after cardiac rhythm device implantation. In this report, we sought to reconstruct the three-dimensional (3D) shape of a pacing lead from radiographs taken at 90-degree angles. All image data were obtained from a 65-year-old male patient, who underwent pacemaker implantation at our hospital due to third-degree atrioventricular block in 2016. Both frontal and lateral chest X-rays were taken just after the device implantation (supine position) and on the post-procedural day 1 (upright position), respectively. Fluorine-18-fluorodeoxyglucose positron emission tomography/CT was performed 75 days after the pacemaker implantation for the diagnosis of cardiac sarcoidosis. Contours of the ventricular leads were manually traced in each X-ray image and saved as Scalable Vector Format (SVG) files using the GNU Image Manipulation Program (GIMP). The 3D reconstruction was performed on Blender 2.93, which is an open-source computer graphics software. The lead trajectory could be reconstructed from bidirectional radiographs, which may allow for further investigation of the 3D shape change of the pacemaker leads.

DOI： 10.7759/cureus.20807

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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：Springer Science and Business Media {LLC}  

DOI： 10.1038/s41440-021-00830-y

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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 University Press ({OUP})  

DOI： 10.1093/ehjdh/ztab064

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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：S. Karger {AG}  

BACKGROUND: Pressurized myography is useful for the assessment of small artery structures and function. However, this procedure requires technical expertise for sample preparation and effort to choose an appropriate sized artery. In this study, we developed an automatic artery/vein differentiation and a size measurement system utilizing machine learning algorithms. METHODS AND RESULTS: We used 654 independent mouse mesenteric artery images for model training. The model yielded an Intersection-over-Union of 0.744 ± 0.031 and a Dice coefficient of 0.881 ± 0.016. The vessel size and lumen size calculated from the predicted vessel contours demonstrated a strong linear correlation with manually determined vessel sizes (R = 0.722 ± 0.048, p < 0.001 for vessel size and R = 0.908 ± 0.027, p < 0.001 for lumen size). Last, we assessed the relation between the vessel size before and after dissection using a pressurized myography system. We observed a strong positive correlation between the wall/lumen ratio before dissection and the lumen expansion ratio (R = 0.832, p < 0.01). Using multivariate binary logistic regression, 2 models estimating whether the vessel met the size criteria (lumen size of 160-240 μm) were generated with an area under the receiver operating characteristic curve of 0.761 for the upper limit and 0.747 for the lower limit. CONCLUSION: The U-Net-based image analysis method could streamline the experimental approach.

DOI： 10.1159/000516842

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記述言語：英語  

DOI： 10.1016/j.ajem.2021.04.068

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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 University Press ({OUP})  

Current knowledge suggests that hypertension is in part mediated by immune mechanisms. Both interleukin (IL)-23 and IL-17 are up-regulated in several experimental hypertensive rodent models, as well as in hypertensive humans in observational studies. Recent preclinical studies have shown that either IL-23 or IL-17A treatment induce blood pressure elevation. However, the IL-23/IL-17 axis has not been a major therapeutic target in hypertension, unlike in other autoimmune diseases. In this review, we summarize current knowledge on the role of these cytokines in immune mechanisms contributing to hypertension, and discuss the potential of IL-23/IL-17-targeted therapy for treatment of hypertension.

DOI： 10.1093/cvr/cvaa257

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIMS: Identifying the manufacturer and the type of cardiac implantable electronic devices (CIEDs) is important in emergent clinical settings. Recent studies have illustrated that artificial neural network models can successfully recognize CIEDs from chest X-ray images. However, all existing methods require a vast amount of medical data to train the classification model. Here, we have proposed a novel method to retrieve an identical CIED image from an image database by employing the feature point matching algorithm. METHODS AND RESULTS: A total of 653 unique X-ray images from 456 patients who visited our pacemaker clinic between April 2012 and August 2020 were collected. The device images were manually square-shaped, and was thereafter resized to 224 × 224 pixels. A scale-invariant feature transform (SIFT) algorithm was used to extract the keypoints from the query image and reference images. Paired feature points were selected via brute-force matching, and the average Euclidean distance was calculated. The image with the shortest average distance was defined as the most similar image. The classification performance was indicated by accuracy, precision, recall, and F1-score for detecting the manufacturers and model groups, respectively. The average accuracy, precision, recall, and F-1 score for the manufacturer classification were 97.0%, 0.97, 0.96, and 0.96, respectively. For the model classification task, the average accuracy, precision, recall, and F-1 score were 93.2%, 0.94, 0.92, and 0.93, respectively, all of which were higher than those of the previously reported machine learning models. CONCLUSION: Feature point matching is useful for identifying CIEDs from X-ray images.

DOI： 10.1111/pace.14209

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記述言語：英語  

DOI： 10.1016/j.cjca.2021.03.004

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: With the recent advances in computational science, machine-learning methods have been increasingly used in medical research. Because such projects usually require both a clinician and a computational data scientist, there is a need for interdisciplinary research collaboration. However, there has been no published analysis of research collaboration networks in cardiovascular medicine using machine intelligence. METHODS: Co-authorship network analysis was conducted on 2857 research articles published between 2009 and 2019. Bibliographic data were collected from the Web of Science, and the co-authorship networks were represented as undirected multigraphs. The network density, average degree, clustering coefficient, and number of communities were calculated, and the chronological changes were assessed. Thereafter, the leading authors were identified according to the centrality metrics. Finally, we investigated the significance of the characteristics of the co-authorship network in the largest component via a Monte Carlo simulation with the Barabasi-Albert model. RESULTS: The co-authorship network of the entire period consisted of 13,979 nodes and 68,668 weighted edges. A time-series analysis revealed a linear correlation between the number of nodes and the number of edges (R2 = 0.9937, p < 0.001). Additionally, the number of communities was linearly correlated with the number of nodes (R2 = 0.9788, p < 0.001). The average shortest path increased by a greater degree than the logarithm of the number of nodes, indicating the scale-free structure of the network. We identified D. Berman as the most central author with regard to the degree centrality and closeness centrality. S. Neubauer was the top-ranking author with regard to the betweenness centrality. Among the 22 authors who were ranked in the top 10 for any centrality, 14 authors (63.6%) had a medical degree (medical doctor, MD). The remaining eight non-MD researchers had a PhD in computational science-related fields. The number of communities detected in the Barabasi-Albert model simulation was similar to that for the largest component of the real network (6.21 ± 0.07 vs. 6, p = 0.096). CONCLUSIONS: A co-authorship network analysis revealed a structure of collaboration networks in the application of machine learning in the field of cardiovascular disease, which can be useful for planning future scientific collaboration.

DOI： 10.1016/j.ijmedinf.2020.104274

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Coronary angioscopy (CAS) is a useful modality to assess atherosclerotic changes, but interpretation of the images requires expert knowledge. Deep convolutional neural networks (DCNN) can be used for diagnostic prediction and image synthesis. METHODS: 107 images from 47 patients, who underwent CAS in our hospital between 2014 and 2017, and 864 images, selected from 142 MEDLINE-indexed articles published between 2000 and 2019, were analysed. First, we developed a prediction model for the angioscopic findings. Next, we made a generative adversarial networks (GAN) model to simulate the CAS images. Finally, we tried to control the output images according to the angioscopic findings with conditional GAN architecture. RESULTS: For both yellow colour (YC) grade and neointimal coverage (NC) grade, we could observe strong correlations between the true grades and the predicted values (YC grade, average r=0.80±0.02, p<0.001; NC grade, average r=0.73±0.02, p<0.001). The binary classification model for the red thrombus yielded 0.71±0.03 F1-score and the area under the receiver operator characteristic curve was 0.91±0.02. The standard GAN model could generate realistic CAS images (average Inception score=3.57±0.06). GAN-based data augmentation improved the performance of the prediction models. In the conditional GAN model, there were significant correlations between given values and the expert's diagnosis in YC grade but not in NC grade. CONCLUSION: DCNN is useful in both predictive and generative modelling that can help develop the diagnostic support system for CAS.

DOI： 10.1136/openhrt-2019-001177

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: To promote understanding of the pathogenesis of cognitive impairment or dementia, we explored the potential interaction between transient cerebral ischemia and amyloid-β (Aβ) infusion in mediating cognitive decline and examined the possible ameliorative effect of angiotensin II type 2 (AT2) receptor activation in vascular smooth muscle cells (VSMC) on this cognitive deficit. METHODS: Adult male wild-type mice (WT) and mice with VSMC-specific AT2 receptor overexpression (smAT2) were subjected to intracerebroventricular (ICV) injection of Aβ1-40. Transient cerebral ischemia was induced by 15 min of bilateral common carotid artery occlusion (BCCAO) 24 h after Aβ injection. RESULTS: Aβ injection in WT induced a cognitive decline, whereas BCCAO did not cause a significant cognitive deficit. In contrast, WT with BCCAO following Aβ injection exhibited more marked cognitive decline compared to Aβ injection alone, in concert with increases in superoxide anion production, nicotinamide adenine dinucleotide phosphate (NADPH) oxidase activity, and expression of p22phox, p40phox, monocyte chemoattractant protein (MCP)-1 and interleukin (IL)-1β in the hippocampus, and upregulation of RAGE (receptor for advanced glycation end product), an Aβ transporter. BCCAO following Aβ injection further enhanced neuronal pyknosis in the hippocampus, compared with BCCAO or Aβ injection alone. In contrast, smAT2 did not show a cognitive decline, increase in oxidative stress, inflammation, and RAGE level or neuronal pyknosis, which were induced by BCCAO with/without Aβ injection in WT. CONCLUSIONS: Transient cerebral ischemia might worsen Aβ infusion-mediated cognitive decline and vice versa, with possible involvement of amplified oxidative stress and inflammation and impairment of the RAGE-mediated Aβ clearance system, contributing to exaggerated neuronal degeneration. AT2 receptor activation in VSMC could play an inhibitory role in this cognitive deficit.

DOI： 10.1186/s12974-020-01775-8

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担当区分：筆頭著者,　責任著者   記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1253/circrep.CR-19-0011

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE OF REVIEW: To describe the important role played by innate and innate-like immunity in the pathophysiology of hypertension and vascular injury. RECENT FINDINGS: Innate immune cells, such as neutrophils, dendritic cells, myeloid-derived suppressor cells, and monocytes/macrophages and innate lymphoid cells such as natural killer cells and unconventional T lymphocytes like γδ T cells contribute to hypertensive mechanisms by priming adaptive immune cells, leading to the triggering of vascular inflammation and blood pressure elevation or alternatively protecting against vascular injury. Specifically, monocyte/macrophages and γδ T cells seem to play a crucial role in the initiation of hypertension via regulation of adaptive immunity. Innate and innate-like immunity play a leading role in the pathophysiology of hypertension. Recent advances in this field provide us clues for future therapeutic approaches.

DOI： 10.1007/s11906-019-0907-1

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Vascular calcification is a common finding in atherosclerosis and in patients with chronic kidney disease. The renin-angiotensin system plays a role in the pathogenesis of cardiovascular remodeling. Here, we examined the hypothesis that angiotensin II type 2 receptor (AT2) stimulation has inhibitory effects on phosphate-induced vascular calcification. In vivo, calcification of the thoracic aorta induced by an adenine and high-phosphate diet was markedly attenuated in smooth muscle cell-specific AT2-overexpressing mice (smAT2-Tg) compared with wild-type and AT2-knockout mice (AT2KO). Similarly, mRNA levels of relevant osteogenic and vascular smooth muscle cell marker genes were unchanged in smAT2-Tg mice, while their expression was significantly altered in wild-type mice in response to high dietary phosphate. Ex vivo, sections of thoracic aorta were cultured in media supplemented with inorganic phosphate. Aortic rings from smAT2-Tg mice showed less vascular calcification compared with those from wild-type mice. In vitro, calcium deposition induced by high-phosphate media was markedly attenuated in primary vascular smooth muscle cells derived from smAT2-Tg mice compared with the two other mouse groups. To assess the underlying mechanism, we investigated the effect of PPAR-γ, which we previously reported as one of the possible downstream effectors of AT2 stimulation. Treatment with a PPAR-γ antagonist attenuated the inhibitory effects on vascular calcification observed in smAT2-Tg mice fed an adenine and high-phosphate diet. Our results suggest that AT2 activation represents an endogenous protective pathway against vascular calcification. Its stimulation may efficiently reduce adverse cardiovascular events in patients with chronic kidney disease.

DOI： 10.1016/j.kint.2018.07.028

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Interferon-regulatory factor (IRF)-1-dependent genes in neurons play a role in ischemic neuronal death; however, the roles of IRF-1 in dementia are not well investigated. Therefore, we assessed the effect of IRF-1 on cognitive function using a vascular cognitive impairment mouse model created by chronic cerebral hypoperfusion. Male 10-week-old C57BL/6 (wild-type; WT) and IRF-1-knockout (IRF-1KO) mice were used in this study. A chronic cerebral hypoperfusion mouse model was generated by bilateral common carotid artery stenosis (BCAS) treatment. After 6 weeks of BCAS, the mice were subjected to the Morris water maze test five times a day for 5 days. In the Morris water maze task, escape latency was significantly prolonged in sham-operated IRF-1KO mice compared with sham-operated WT mice. However, BCAS treatment cancelled such difference in spatial learning between WT and IRF-1KO mice. BCAS treatment decreased CBF, but no significant difference was observed between the two strains after BCAS. Sham-operated IRF-1KO mice showed a decrease in mRNA expression of caspase-1 and an increase in IRF-2 expression in the hippocampus. Expression of angiotensin II type 2 (AT2) receptor, which induces better cognitive function, is regulated by IRF-1; however, no obvious difference in AT2 receptor expression was observed between the two strains even after BCAS. These results suggest that IRF-1 has a protective effect on cognitive decline in a normal condition; however, there was no obvious effect on cognition after chronic cerebral hypoperfusion treatment.

DOI： 10.1038/s41440-018-0080-y

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The brain renin-angiotensin system plays a crucial role in ischemic stroke. It is known that stimulation of the angiotensin II type 2 (AT2) receptor protects against ischemic brain injury. We recently demonstrated that AT2 receptor stimulation by compound 21 (C21), a direct AT2 receptor agonist, inhibited vascular intimal proliferation with activation of peroxisome proliferator-activated receptor-gamma (PPAR-γ). However, whether direct AT2 receptor stimulation protects against ischemic brain injury via PPAR-γ activation is still unknown. 8-week-old male C57BL/6 J mice were subjected to middle cerebral artery (MCA) occlusion. 2 weeks before MCA occlusion, they were administered C21 with or without GW9662, a PPAR-γ antagonist. Neurologic deficit, ischemic size, superoxide anion, superoxide dismutase (SOD) activity, expression of NADPH subunits and blood brain barrier (BBB) stabilization were assessed 24 h after MCA occlusion. Cerebral blood flow (CBF) was measured in the core and periphery of the MCA territory before, immediately after, 1 h and 24 h after MCA occlusion. Treatment with C21 markedly decreased the neurologic deficit and ischemic size with an increase in CBF, SOD activity and BBB stabilization genes compared with the non-treated group. Co-administration of GW9662 partially attenuated this protective effect of C21 on neurologic deficit and ischemic size via an increase in superoxide anion production and a decrease of SOD activity and BBB stabilization genes, while GW9662 treatment alone had no significant effect on neurologic deficit and ischemic size. These results suggest that direct AT2 receptor stimulation has a preventive effect on stroke-induced brain injury partly due to activation of PPAR-γ.

DOI： 10.1038/s41440-018-0082-9

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Our previous report indicated that vascular injury enhances vascular remodeling in fetal growth restriction (FGR) mice. The angiotensin II type 2 receptor (AT2R) is relatively highly expressed in fetal mice. Therefore, we investigated the roles of AT2R in FGR-induced cardiovascular disease using AT2R knockout (AT2KO) mice. Dams (wild-type and AT2KO mice) were fed an isocaloric diet containing 20% protein (NP) or 8% protein (LP) until delivery. Arterial blood pressure, body weight, and histological changes in organs were investigated in offspring. The birth weight of offspring from dams fed an LP diet (LPO) was significantly lower than that of offspring from dams fed an NP diet. The heart/body and kidney/body weight ratios in AT2KO-LPO at 12 weeks of age were significantly higher than those in the other groups. Greater thickness of the left ventricular wall, larger cardiomyocyte size and enhancement of perivascular fibrosis were observed in AT2KO-LPO. Interestingly, mRNA expression of collagen I and inflammatory cytokines was markedly higher in the AT2KO-LPO heart at 6 weeks of age but not at 12 weeks of age. AT2R signaling may be involved in cardiovascular disorders of adult offspring with FGR. Regulation of AT2R could contribute to preventing future cardiovascular disease in FGR offspring.

DOI： 10.1038/s41440-017-0004-2

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The classical renin-angiotensin system is known as the angiotensin (Ang)-converting enzyme/Ang II/Ang type 1 receptor axis, which induces various organ damage including cognitive decline. The angiotensin-converting enzyme 2/Ang-(1-7)/Mas axis is known to exert antagonistic actions against the classical renin-angiotensin system axis in the cardiovascular system. However, its roles in the brain remain unclear. We examined possible roles of the angiotensin-converting enzyme 2/Ang-(1-7)/Mas axis in cognitive function, employing vascular cognitive impairment model mice. METHODS AND RESULTS: Male 10-week-old C57BL6 (wild-type mice, Mas1 knockout mice, Ang II type 2 receptor knockout mice, and Ang II type 2 receptor/Mas1 double knockout mice were subjected to bilateral carotid artery stenosis (BCAS) surgery. Six weeks after treatment, they were subjected to cognitive tasks. Brain samples were used for histopathological analysis. Cognitive function was significantly impaired in wild-type and double knockout mice after BCAS. On the other hand, the cognitive function of Mas1 knockout mice was maintained in spite of the reduction of cerebral blood flow with BCAS. Total cell number in the dentate gyrus region was significantly reduced after BCAS in wild-type but not in Mas1 knockout mice. The number of doublecortin-positive cells in the subgranular zone was not significantly different between wild-type and Mas1 knockout mice. Ang-(1-7) administration did not improve cognitive function in all mice after BCAS surgery. CONCLUSIONS: Lack of the Mas receptor may have a protective effect against chronic brain ischemia when the Ang II type 2 receptor exists.

DOI： 10.1161/JAHA.117.008121

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The Morris water maze test (MWM) is one of the most popular and established behavioral tests to evaluate rodents' spatial learning ability. The conventional training period is around 5 days, but there is no clear evidence or guidelines about the appropriate duration. In many cases, the final outcome of the MWM seems predicable from previous data and their trend. So, we assumed that if we can predict the final result with high accuracy, the experimental period could be shortened and the burden on testers reduced. An artificial neural network (ANN) is a useful modeling method for datasets that enables us to obtain an accurate mathematical model. Therefore, we constructed an ANN system to estimate the final outcome in MWM from the previously obtained 4 days of data in both normal mice and vascular dementia model mice. Ten-week-old male C57B1/6 mice (wild type, WT) were subjected to bilateral common carotid artery stenosis (WT-BCAS) or sham-operation (WT-sham). At 6 weeks after surgery, we evaluated their cognitive function with MWM. Mean escape latency was significantly longer in WT-BCAS than in WT-sham. All data were collected and used as training data and test data for the ANN system. We defined a multiple layer perceptron (MLP) as a prediction model using an open source framework for deep learning, Chainer. After a certain number of updates, we compared the predicted values and actual measured values with test data. A significant correlation coefficient was derived form the updated ANN model in both WT-sham and WT-BCAS. Next, we analyzed the predictive capability of human testers with the same datasets. There was no significant difference in the prediction accuracy between human testers and ANN models in both WT-sham and WT-BCAS. In conclusion, deep learning method with ANN could predict the final outcome in MWM from 4 days of data with high predictive accuracy in a vascular dementia model.

DOI： 10.1371/journal.pone.0191708

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The Morris water maze test (MWM) is a useful tool to evaluate rodents' spatial learning and memory, but the outcome is susceptible to various experimental conditions. Thigmotaxis is a commonly observed behavioral pattern which is thought to be related to anxiety or fear. This behavior is associated with prolonged escape latency, but the impact of its frequency in the early stage on the final outcome is not clearly understood. We analyzed swim path trajectories in male C57BL/6 mice with or without bilateral common carotid artery stenosis (BCAS) treatment. There was no significant difference in the frequencies of particular types of trajectories according to ischemic brain surgery. The mouse groups with thigmotaxis showed significantly prolonged escape latency and lower cognitive score on day 5 compared to those without thigmotaxis. As the next step, we made a convolutional neural network (CNN) model to recognize the swim path trajectories. Our model could distinguish thigmotaxis from other trajectories with 96% accuracy and specificity as high as 0.98. These results suggest that thigmotaxis in the early training stage is a predictive factor for impaired performance in MWM, and machine learning can detect such behavior easily and automatically.

DOI： 10.1371/journal.pone.0197003

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掲載種別：研究論文（学術雑誌）  

DOI： 10.2174/1871522217666171019150511

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DOI： 10.1097/01.hjh.0000500554.97597.16

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DOI： 10.1097/01.hjh.0000500987.39434.12

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We investigated the possibility that coadministration of rosuvastatin and compound 21 (C21), a selective angiotensin II type 2 (AT2) receptor agonist, could exert synergistic preventive effects on vascular injury. Vascular injury was induced by polyethylene cuff placement on the femoral artery in 9-week-old male C57BL/6J mice. Mice were treated with rosuvastatin and/or with C21 after cuff placement. Neointima formation was determined 14 days after the operation and cell proliferation, and superoxide anion production and expression of inflammatory cytokines were examined 7 days after cuff placement. Neointima formation was significantly attenuated by the treatment of rosuvastatin (5 mg kg(-1) day(-1)) or C21 (10 μg kg(-1) day(-1)), associated with the decreases in proliferating cell nuclear antigen (PCNA) labeling index, oxidative stress, and the expression of inflammatory markers. Treatment with a noneffective dose of rosuvastatin (0.5 mg kg(-1) day(-1)) plus a low dose of C21 (1 μg kg(-1) day(-1)) inhibited the PCNA labeling index, superoxide anion production, mRNA expressions of NAD(P)H subunits, and mRNA and protein expressions of inflammatory markers associated with marked inhibition of neointima formation. Angiotensin II type 1 (AT1) receptor mRNA expression did not differ the groups. By contrast, AT2 receptor mRNA expression was increased by administration of C21 at the dose of 10 μg kg(-1) day(-1) but not by C21 at the dose of 1 μg kg(-1) day(-1) or rosuvastatin. The combination of rosuvastatin and AT2 receptor agonist exerted synergistic preventive effects on vascular remodeling associated with the decreases in cell proliferation, oxidative stress, and inflammatory reaction. That could be a powerful approach to vascular disease prevention.

DOI： 10.1124/jpet.116.233148

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Angiotensin II type 2 (AT2) receptor stimulation could exert beneficial effects on vascular remodeling. Previously, we reported that AT2 receptor stimulation ameliorated insulin resistance in diabetic mice accompanied by PPARγ activation which also plays a variety of crucial roles in the vasculature. Therefore, this study aimed to investigate the vascular protective effect of the AT2 receptor with activation of PPARγ involving AT2 receptor-interacting protein (ATIP). METHODS AND RESULTS: Vascular injury was induced by polyethylene-cuff placement around the femoral artery in C57BL/6J mice. Treatment with compound 21 (C21), an AT2 receptor agonist, decreased neointimal formation, cell proliferation, and the mRNA levels of monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor (TNF)-α, and interleukin-1β, and phosphorylation of nuclear factor-kappa B, and increased PPARγ DNA-binding activity in the injured artery, whereas these inhibitory effects of C21 were attenuated by co-treatment with a PPARγ antagonist, GW9662. Treatment of vascular smooth muscle cells (VSMC) with C21 prepared from smAT2 transgenic mice, which highly express the AT2 receptor in VSMC, increased both PPARγ activity and its DNA-binding activity determined by dual-luciferase assay and electrophoresis mobility shift assay (EMSA), respectively. We observed that ATIP was involved in PPARγ complex formation, and that transfection of siRNA of ATIP1 attenuated the AT2 receptor-mediated increase in PPARγ activity in VSMC. In response to AT2 receptor stimulation, ATIP was translocated from the plasma membrane to the nucleus. CONCLUSIONS: Our results suggest a new mechanism by which AT2 receptor stimulation activates PPARγ, thereby resulting in amelioration of vascular intimal proliferation, and that ATIP plays an important role in AT2 receptor-mediated PPARγ activation.

DOI： 10.1093/ajh/hpv168

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Browning of white adipose tissue (WAT) has been highlighted as a new possible therapeutic target for obesity, diabetes and lipid metabolic disorders, because WAT browning could increase energy expenditure and reduce adiposity. The new clusters of adipocytes that emerge with WAT browning have been named 'beige' or 'brite' adipocytes. Recent reports have indicated that the renin-angiotensin system (RAS) plays a role in various aspects of adipose tissue physiology and dysfunction. The biological effects of angiotensin II, a major component of RAS, are mediated by two receptor subtypes, angiotensin II type 1 receptor (AT1R) and type 2 receptor (AT2R). However, the functional roles of angiotensin II receptor subtypes in WAT browning have not been defined. Therefore, we examined whether deletion of angiotensin II receptor subtypes (AT1aR and AT2R) may affect white-to-beige fat conversion in vivo. AT1a receptor knockout (AT1aKO) mice exhibited increased appearance of multilocular lipid droplets and upregulation of thermogenic gene expression in inguinal white adipose tissue (iWAT) compared to wild-type (WT) mice. AT2 receptor-deleted mice did not show miniaturization of lipid droplets or alteration of thermogenic gene expression levels in iWAT. An in vitro experiment using adipose tissue-derived stem cells showed that deletion of the AT1a receptor resulted in suppression of adipocyte differentiation, with reduction in expression of thermogenic genes. These results indicate that deletion of the AT1a receptor might have some effects on the process of browning of WAT and that blockade of the AT1 receptor could be a therapeutic target for the treatment of metabolic disorders.

DOI： 10.1371/journal.pone.0167704

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

The classical renin-angiotensin system (RAS), known as the angiotensin (Ang)-converting enzyme (ACE)/Ang II/Ang II type 1 (AT1) receptor axis, induces various organ damages including cognitive decline. On the other hand, the ACE2/Ang-(1-7)/Mas receptor axis has been highlighted as exerting antagonistic actions against the classical RAS axis in the cardiovascular system. However, the roles of the ACE2/Ang-(1-7)/Mas axis in cognitive function largely remain to be elucidated, and we therefore examined possible roles of ACE2 in cognitive function. Male, 10-week-old C57BL6 (wild type, WT) mice and ACE2 knockout (KO) mice were subjected to the Morris water maze task and Y maze test to evaluate cognitive function. ACE2KO mice exhibited significant impairment of cognitive function, compared with that in WT mice. Superoxide anion production increased in ACE2KO mice, with increased mRNA levels of NADPH oxidase subunit, p22phox, p40phox, p67phox, and gp91phox in the hippocampus of ACE2KO mice compared with WT mice. The protein level of SOD3 decreased in ACE2KO mice compared with WT mice. The AT1 receptor mRNA level in the hippocampus was higher in ACE2KO mice compared with WT mice. In contrast, the AT2 receptor mRNA level in the hippocampus did not differ between the two strains. Mas receptor mRNA was highly expressed in the hippocampus compared with the cortex. Brain-derived neurotrophic factor (BDNF) mRNA and protein levels were lower in the hippocampus in ACE2KO mice compared with WT mice. Taken together, ACE2 deficiency resulted in impaired cognitive function, probably at least in part because of enhanced oxidative stress and a decrease in BDNF.

DOI： 10.1038/npjamd.2016.24

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We report a rare case of a hemodialysis patient with a calcified amorphous tumor (CAT) on both sides of the atrioventricular valve annulus. A 70-year-old female who had received hemodialysis for 23 years because of chronic glomerulonephritis presented to our hospital with acute heart failure. Echocardiography indicated the presence of mobile cardiac masses on the mitral valve and tricuspid valve annulus. We suspected the presence of a cardiac tumor or vegetation. The patient received 3 g/day sulbactam-ampicillin and 60 mg/day gentamicin. Surgery was performed on the 14th day after hospital admission. The patient underwent mitral valve replacement, tricuspid annuloplasty, and tumor resection. Based on the pathological findings, the cardiac tumor was diagnosed as a CAT.

DOI： 10.1007/s12574-015-0267-z

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

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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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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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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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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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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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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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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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記述言語：日本語   出版者・発行元：愛媛県公営企業管理局県立病院課  

症例は60歳男性、20XX年12月午前8時頃職場で卒倒し胸痛を訴え、救急要請された。来院時発語はあるも不穏な状態で、収縮期血圧90mmHg台、脈拍102回/分、SpO2;97%(4L/分マスク)、心電図でST上昇を認め、急性冠症候群の疑いで緊急冠動脈造影検査(CAG)を施行した。左冠動脈主幹部(LMT)の急性心筋梗塞が疑われたため、術前に右大腿動脈からIMPELLA CPを挿入した。CAGでLMTの完全閉塞を認めたため、経皮的冠動脈インターベンションを施行した。血栓吸引後に心室頻拍の状態となり酸素化低下したため、気管挿管し体外式膜型人工肺(ECMO)を確立した。エキシマレーザーにて血栓を含むプラークを蒸散後、LMTから前下行枝近位部にステントを留置した。peak CKは8155 IU/L、術翌日にV-A ECMO、第3病日にIMPELLA CPを離脱し、第5病日に抜管した。早期心臓リハビリテーションを導入し、第24病日に独歩退した。V-A ECMOとIMPELLAを併用する、いわゆるECPELLAにて救命し得た心原性ショックを伴う急性心筋梗塞の1例を経験したため報告する。(著者抄録)

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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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記述言語：日本語   出版者・発行元：愛媛県公営企業管理局県立病院課  

症例は83歳女性。20XX年4月に数日前からの起座呼吸を主訴に前医を受診し、うっ血性心不全と診断され当科を紹介受診した。心エコー検査にて左房壁に付着した可動性のある5×3cmの円形腫瘤像を認め、拡張期には僧帽弁口への嵌頓を認めた。左室流入路狭窄により心不全症状を来しており、僧帽弁の完全閉塞や全身塞栓症に進展する可能性が危惧されたため、同日当院心臓血管外科で緊急手術を施行し、病理組織検査では心臓原発肉腫と診断された。術後は合併症なく、第26病日に独歩退院した。入院4ヵ月前に施行した心エコー検査では腫瘍の指摘はなく、短期間に進行したと考えられる症例であり、心不全を契機に診断し得た心臓原発肉腫の1例を経験したため報告する。(著者抄録)

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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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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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記述言語：日本語   出版者・発行元：(一社)日本内分泌学会  

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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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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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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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記述言語：英語   出版者・発行元：(NPO)日本高血圧学会  

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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  

J-GLOBAL

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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  

J-GLOBAL

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記述言語：英語   出版者・発行元：(NPO)日本高血圧学会  

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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  

J-GLOBAL

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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  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本透析医学会  

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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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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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記述言語：日本語   出版者・発行元：(NPO)日本高血圧学会  

J-GLOBAL

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：LIPPINCOTT WILLIAMS & WILKINS  

Web of Science

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記述言語：英語   出版者・発行元：(NPO)日本高血圧学会  

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記述言語：英語   出版者・発行元：(NPO)日本高血圧学会  

DOI： 10.1016/j.ejphar.2015.05.059

Scopus

PubMed

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記述言語：英語   出版者・発行元：(NPO)日本高血圧学会  

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

J-GLOBAL

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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  

J-GLOBAL

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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  

J-GLOBAL

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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  

J-GLOBAL

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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  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(公社)日本超音波医学会  

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記述言語：日本語   出版者・発行元：(公社)日本超音波医学会  

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記述言語：日本語   出版者・発行元：(公社)日本超音波医学会  

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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  

J-GLOBAL

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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  

J-GLOBAL

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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  

J-GLOBAL

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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  

J-GLOBAL

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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  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：大阪警察病院  

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(公社)日本超音波医学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(NPO)日本冠疾患学会  

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本心臓病学会  

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記述言語：日本語   出版者・発行元：(NPO)日本冠疾患学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(NPO)日本冠疾患学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(NPO)日本冠疾患学会  

J-GLOBAL

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記述言語：日本語   出版者・発行元：(NPO)日本冠疾患学会  

J-GLOBAL

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