研究者業績

小林 欣夫

コバヤシ ヨシオ  (Yoshio Kobayashi)

基本情報

所属
千葉大学 大学院医学研究院循環器内科学 教授
学位
博士(医学)(千葉大学)

J-GLOBAL ID
200901031812437900
researchmap会員ID
5000068706

論文

 880
  • Yuichi Saito, Taku Inohara, Shun Kohsaka, Hideki Wada, Itaru Takamisawa, Kyohei Yamaji, Tetsuya Amano, Yoshio Kobayashi, Ken Kozuma
    American Heart Journal 2023年1月  
  • Yuichi Saito, Osamu Hashimoto, Takashi Nakayama, Haruka Sasaki, Keita Yumoto, Susumu Oshima, Tetsuya Tobaru, Shunichi Kushida, Junji Kanda, Yoshiaki Sakai, Shinichi Okino, Shigeru Fukuzawa, Akihiko Abiko, Tomonori Itoh, Yoshitake Nakamura, Takahiro Nakashima, Satoshi Yasuda, Kenji Goto, Hideo Takebayashi, Takashi Oshitomi, Tomohiro Sakamoto, Sunao Kojima, Yoritaka Otsuka, Toshiharu Himi, Yusuke Inagaki, Junichi Yamaguchi, Kenichi Hagiya, Mamoru Nanasato, Yoshio Kobayashi
    International Journal of Cardiology 371 49-53 2023年1月  
  • Hideki Kitahara, Hiraku Kumamaru, Shun Kohsaka, Daichi Yamashita, Tomoyoshi Kanda, Kaoru Mastuura, Kazuo Shimamura, Goro Matsumiya, Yoshio Kobayashi
    Circulation journal : official journal of the Japanese Circulation Society 2022年12月27日  
    BACKGROUND: Limited data are available for clinical outcomes in patients who underwent urgent or emergency transcatheter aortic valve implantation (TAVI). This study investigated in-hospital and 1-year outcomes and explored prognostic covariates in urgent/emergency TAVI using nationwide registry data.Methods and Results: Among 26,775 patients who underwent TAVI between August 2013 and December 2019, 25,495 with 1-year follow-up information were analyzed in this study. Baseline and procedural characteristics, as well as clinical adverse events, were compared between the urgent/emergency and elective TAVI groups. The primary outcome was all-cause mortality within 1 year after TAVI. Multivariable Cox regression models were constructed to identify independent predictors after urgent or emergency TAVI. Urgent or emergency TAVI was performed in 578 (2.3%) patients. The Society of Thoracic Surgeons score was significantly higher in the urgent/emergency than elective TAVI group (13.3% vs. 6.0%; P<0.001). Device success rate was comparable between the 2 groups. All-cause death-free survival within 1 year was lower in the urgent/emergency than elective TAVI group (77.2% vs. 92.2%; log rank P<0.001). Malignancy, albumin and creatinine concentrations, ejection fraction, and mean pressure gradient were associated with 1-year mortality in the urgent/emergency TAVI group. CONCLUSIONS: Despite higher surgical risk and more comorbidities, the procedure was successfully performed in patients undergoing urgent/emergency TAVI, although it should be noted that prognosis was worse than for elective TAVI.
  • Yusei Nishikawa, Hiroyuki Takaoka, Tomonori Kanaeda, Haruhiro Takahira, Sakuramaru Suzuki, Shuhei Aoki, Hiroki Goto, Katsuya Suzuki, Satomi Yashima, Manami Takahashi, Makiko Kinoshita, Haruka Sasaki, Noriko Suzuki-Eguchi, Koichi Sano, Yoshio Kobayashi
    Heart and vessels 38(5) 721-730 2022年12月19日  
    Recently, myocardial extracellular volume (ECV) analysis has been measurable on computed tomography (CT) using new software. We evaluated the use of cardiac CT to estimate the myocardial ECV of left ventricular (LV) myocardium (LVM) to predict reverse remodeling (RR) in cases of atrial fibrillation (AF) after catheter ablation (CA). Four hundred and seven patients underwent CA for AF in our institution from April 2014 to Feb 2021. Of these, 33 patients (8%) with an LVEF ≤ 50% and who had undergone CT were included in our study. We estimated the LVM ECV using commercial software to analyze the CT data. RR was defined as an improvement in LVEF to > 50% after CA. LVEF increased to > 50% in 24 patients (73%) after CA. In all 24 patients, LVM ECV, LV end-diastolic and end-systolic volumes (LVEDV and LVESV), and the n-terminal fragment of pro-B-type natriuretic peptide (NT-proBNP) were significantly lower than in the other nine patients (P = 0.0037, 0.0273, 0.0443, and < 0.0001). On receiver operating characteristic curve analysis, the best cut-off of ECV, LVEDV, LVESV and NT-proBNP for the prediction of RR were 37.73%, 120 mL, 82 mL, and 1267 pg/mL, respectively. We newly defined the ENL (ECV, NT-proBNP, and LVEDV) score as the summed score for the presence or absence (1 or 0; maximum score = 3) of ECV, NT-proBNP, and LVEDV values less than or equal to each best cut-off value, and found that this score gave the highest area under the curve for the prediction of RR (0.9583, P < 0.0001). The ENL score may be useful for predicting RR in patients with AF undergoing CA.
  • Tatsuro Yamazaki, Yuichi Saito, Daichi Yamashita, Hideki Kitahara, Yoshio Kobayashi
    Heart and Vessels 2022年12月9日  
  • Ami Niwano, Haruka Sasaki, Hiroyuki Takaoka, Kenji Kawasaki, Kentaro Atarashi, Jun-Ichiro Ikeda, Goro Matsumiya, Kazuyuki Matsushita, Yoshio Kobayashi
    Journal of cardiology cases 26(6) 404-406 2022年12月  
    UNLABELLED: Papillary fibroelastoma (PFE) is a rare, slow-growing cardiac tumor. We encountered an 80-year-old man with PFE accidentally revealed by transthoracic echocardiography (TTE) to evaluate cardiac function before a non-cardiac operation. A 10-mm mass lesion adhered to the anterior papillary muscle of the left ventricle, which had not been detected with TTE performed nine months before. Emergency cardiac surgery to remove the mass was performed, and the mass was diagnosed as a PFE. The PFE grew to 10 mm in a maximum of 9 months; to our knowledge, this is the fastest growth of PFE in the left ventricle reported to date. LEARNING OBJECTIVE: Papillary fibroelastoma (PFE) is a rare, slow-growing cardiac tumor. The surgical indication of PFE is sometimes controversial. The rapid growth of PFE might be considered as a criterion for surgery because this might result in the rapid progression of symptoms and complications.
  • Yusuke Kondo, Takatsugu Kajiyama, Toshinori Chiba, Masahiro Nakano, Yoshio Kobayashi
    IJC Heart &amp; Vasculature 43 101137-101137 2022年12月  
  • Kazunari Asada, Yuichi Saito, Takanori Sato, Tadahiro Matsumoto, Daichi Yamashita, Sakuramaru Suzuki, Shinichi Wakabayashi, Hideki Kitahara, Koichi Sano, Yoshio Kobayashi
    Circulation Journal 2022年11月23日  
  • 高岡 浩之, 大門 道子, 佐々木 晴香, 青木 秀平, 小林 欣夫
    Heart View 26(12) 191-201 2022年11月  
    <文献概要>▼心電図は心筋疾患の鑑別に際し初期段階で施行される検査であり,各心筋症における特徴的異常所見の理解が必要である。▼CTやMRIなどの画像診断の進歩は目覚ましく,心電図を踏まえた適切な心筋疾患診断のため,その継続的な知識のupdateが重要である。
  • Takanori Sato, Yuichi Saito, Sakuramaru Suzuki, Tadahiro Matsumoto, Daichi Yamashita, Kan Saito, Shinichi Wakabayashi, Hideki Kitahara, Koichi Sano, Yoshio Kobayashi
    Life 12(10) 1672-1672 2022年10月21日  
    Among patients with acute myocardial infarction (MI) complicated by cardiogenic shock (CS), in-hospital mortality remains high. In the present study, we aimed to identify factors associated with clinical outcomes of acute MI patients with CS in a contemporary setting. A total of 1102 patients with acute MI undergoing primary percutaneous coronary intervention were included, among whom 196 (17.8%) were complicated by CS. The primary outcome was all-cause death during hospitalization, and factors associated with in-hospital mortality were explored in patients with acute MI and CS. Of the 196 patients with acute MI complicated by CS, 77 (39.3%) died during hospitalization. The rates of non-ST-segment elevation MI (NSTEMI) (33.8% vs. 19.3%, p = 0.02) and culprit lesion in the left main or left anterior descending coronary artery (68.8% vs. 47.9%, p = 0.004) were higher, while left ventricular ejection fraction (LVEF) was lower (24.4 ± 11.7% vs. 39.7 ± 13.8%, p &lt; 0.001) in non-survivors than in survivors. Multivariable analysis identified NSTEMI presentation and lower LVEF as independent predictors of in-hospital death. In conclusion, NSTEMI and low LVEF were identified as factors associated with higher in-hospital mortality. The identification of even higher-risk subsets and targeted therapeutic strategies may be warranted to improve survival of patients with acute MI and CS.
  • Takashi Hiraga, Yuichi Saito, Kazuya Tateishi, Naoto Mori, Takayo Murase, Takashi Nakamura, Seigo Akari, Kan Saito, Hideki Kitahara, Yoshio Kobayashi
    Medicina 58(10) 1423-1423 2022年10月10日  
    Background and Objectives: Although previous studies showed that an activity of xanthine oxidoreductase (XOR), a rate-limiting enzyme in purine metabolism, beyond the serum uric acid level, was associated with the development of coronary artery disease (CAD), the underlying mechanisms are unclear. Because endothelial dysfunction and a greater blood pressure (BP) variability may play a role, we investigated the relations among the endothelial function, XOR, and BP variability. Materials and Methods: This was a post-hoc study using pooled data of patients with a stable CAD from two prospective investigations, in which the systemic endothelial function was assessed with the reactive hyperemia index (RHI) and the XOR activity was measured. The BP variability was evaluated using BP measurements during the three- and four-day hospitalization. Results: A total of 106 patients with a stable CAD undergoing a percutaneous coronary intervention were included. Of the 106 patients, 46 (43.4%) had a systemic endothelial dysfunction (RHI &lt; 1.67). The multivariable analysis identified a higher body mass index (BMI), female gender, and diabetes as factors associated with an endothelial dysfunction. A higher BMI was also related to an elevated XOR activity, in addition to current smoking. No significant correlation was observed between the RHI and XOR activity. Similarly, the in-hospital BP variability was associated with neither the endothelial function nor XOR. Conclusions: Among patients with a stable CAD, several factors were identified as being associated with a systemic endothelial dysfunction or an elevated XOR activity. However, no direct relations between the endothelial function, XOR, and BP variability were found.
  • Kan Saito, Hideki Kitahara, Takaaki Mastuoka, Naoto Mori, Kazuya Tateishi, Yoshihide Fujimoto, Yoshio Kobayashi
    Heart and vessels 37(10) 1701-1709 2022年10月  
    BACKGROUND: This study aims to clarify whether myocardial bridge (MB) could influence atherosclerotic plaque characteristics assessed using near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) imaging. METHODS: One hundred and sixteen patients who underwent percutaneous coronary intervention (PCI) using NIRS-IVUS imaging were included. MB was defined as an echo-lucent band surrounding left anterior descending artery (LAD). In MB patients, LAD was divided into three segments: proximal, MB, and distal segments. In non-MB patients, corresponding three segments were defined based on the average length of the above segments. Segmental maximum plaque burden and lipid content derived from NIRS-IVUS imaging in the section of maximum plaque burden were evaluated in each segment. Lipid content of atherosclerotic plaque was evaluated as lipid core burden index (LCBI) and maxLCBI4mm. LCBI is the fraction of pixels indicating lipid within a region multiplied by 1000, and the maximum LCBI in any 4-mm region was defined as maxLCBI4mm. RESULTS: MB was identified in 42 patients. MB was not associated with maximum plaque burden in proximal segment. LCBI and maxLCBI4mm were significantly lower in patients with MB than those without in proximal segment. Multivariable analysis demonstrated both MB and maximum plaque burden in proximal segment to be independent predictors of LCBI in proximal segment. CONCLUSIONS: Lipid content of atherosclerotic plaque assessed by NIRS-IVUS imaging was significantly smaller in patients with MB than those without. MB could be considered as a predictor of lipid content of atherosclerotic plaque when assessed by NIRS-IVUS imaging.
  • 小野 亮平, 王 斯睿, 岩花 東吾, 劉 浩, 小林 欣夫
    脈管学 62(Suppl.) S130-S130 2022年10月  
  • 岩花 東吾, 加藤 央隼, 小野 亮平, 青木 薫子, 岡田 将, 黄野 皓木, 渡邉 倫子, 松宮 護郎, 小林 欣夫
    人工臓器 51(2) S-151 2022年10月  
  • Kazuya Tateishi, Yuichi Saito, Tatsuro Yamazaki, Hideki Kitahara, Yoshio Kobayashi
    Diabetes Epidemiology and Management 8 100104-100104 2022年10月  
  • 後藤 宏樹, 高岡 浩之, 山岸 嘉希, 坂井 上之, 村山 大知, 松本 浩史, 大門 道子, 佐々木 晴香, 青木 秀平, 鈴木 克也, 高橋 愛, 八島 聡美, 木下 真己子, 江口 紀子, 金枝 朋宜, 小林 欣夫
    循環器内科 92(3) 242-250 2022年9月  
  • 浅田 一成, 高岡 浩之, 後藤 宏樹, 鈴木 櫻丸, 高平 青洋, 高橋 愛, 八島 聡美, 木下 真己子, 佐々木 晴香, 江口 紀子, 金枝 朋宜, 小林 欣夫, 桃井 瑞生
    日本心臓病学会学術集会抄録 70回 S33-4 2022年9月  
  • 青木 秀平, 高岡 浩之, 浅田 一成, 後藤 宏樹, 高橋 愛, 八島 聡美, 木下 真己子, 江口 紀子, 佐々木 晴香, 金枝 朋宜, 小林 欣夫, 齋藤 千紘
    日本心臓病学会学術集会抄録 70回 S27-1 2022年9月  
  • 近藤 祐介, 龍崎 智子, 仲野 美代, 中野 正博, 梶山 貴嗣, 伊藤 竜, 北川 真理, 菅原 暢文, 千葉 俊典, 小林 欣夫
    日本心臓病学会学術集会抄録 70回 O-1 2022年9月  
  • 龍崎 智子, 近藤 祐介, 中野 正博, 梶山 貴嗣, 仲野 美代, 伊藤 竜, 北川 真理, 菅原 暢文, 千葉 俊典, 吉野 裕, 鳴海 頌子, 小林 欣夫
    日本心臓病学会学術集会抄録 70回 O-2 2022年9月  
  • Yuichi Saito, Atsushi Tanaka, Yuji Koide, Hisako Yoshida, Daigaku Uchida, Kazuo Matsunaga, Naoto Yokota, Chikara Ueyama, Yoshio Kobayashi, Koichi Node
    RMD Open 8(2) e002505-e002505 2022年9月  
    Objectives Although uric acid lowering therapies, including xanthine oxidase (XO) inhibition, may reduce the absolute level of blood pressure (BP), the effect of XO inhibition on BP variability is largely unknown. The aim of the present analysis was to evaluate the impact of febuxostat, an XO inhibitor, on BP variability in a randomised trial setting. Methods This was a subanalysis of the PRIZE Study, a randomised trial to evaluate the potential effect of febuxostat on carotid intima–media thickness progression. Patients with hyperuricemia and carotid plaques were randomly assigned to the febuxostat or control group. During a 24-month period, office BP and pulse rate (PR) were measured ≥3 times. BP and PR variabilities were assessed with SD and coefficient of variation (CV). The effect of febuxostat on BP and PR variabilities was adjusted with age, sex and baseline BP or PR, expressed with 95% CIs. Results A total of 472 patients were included into the present subanalysis. During the 24-month follow-up period, the febuxostat group had a significantly lower adjusted mean systolic BP (128.4 (126.8–130.0) vs 130.7 (129.1–132.2) mm Hg, p=0.04) and CV of systolic BP (7.4 (6.7–8.0) vs 8.2 (7.6–8.8), p=0.04) than the control group. Adjusted SD of PR was also lower in the febuxostat group than their counterpart (5.95 (4.93–6.97) vs 7.33 (6.32–8.33), p=0.04). Conclusion XO inhibition with febuxostat was associated with reduced visit-to-visit BP variability as well as reduced PR variability in patients with hyperuricemia and carotid plaques. Trial registration numbers University Hospital Medical Information Network Clinical Trial Registry (UMIN000012911 and UMIN000041322).
  • 近藤 祐介, 龍崎 智子, 仲野 美代, 中野 正博, 梶山 貴嗣, 伊藤 竜, 北川 真理, 菅原 暢文, 千葉 俊典, 小林 欣夫
    日本心臓病学会学術集会抄録 70回 O-1 2022年9月  
  • 龍崎 智子, 近藤 祐介, 中野 正博, 梶山 貴嗣, 仲野 美代, 伊藤 竜, 北川 真理, 菅原 暢文, 千葉 俊典, 吉野 裕, 鳴海 頌子, 小林 欣夫
    日本心臓病学会学術集会抄録 70回 O-2 2022年9月  
  • Sakuramaru Suzuki, Yuichi Saito, Daichi Yamashita, Tadahiro Matsumoto, Takanori Sato, Shinichi Wakabayashi, Hideki Kitahara, Koichi Sano, Yoshio Kobayashi
    Heart, Lung and Circulation 31(9) 1228-1233 2022年9月  
  • Takahiro Kobayashi, Hideki Kitahara, Ken Kato, Yuichi Saito, Yoshio Kobayashi
    Circulation journal : official journal of the Japanese Circulation Society 2022年8月27日  
    BACKGROUND: Dialysis patients have strong intracoronary calcification, accelerated by secondary hyperparathyroidism as well as atherosclerosis. We evaluated the association of intact parathyroid hormone (iPTH) level with intracoronary calcification evaluated by intravascular ultrasound (IVUS), and its impact on both stent expansion after percutaneous coronary intervention (PCI) and long-term clinical outcomes, in dialysis patients with coronary artery disease (CAD).Methods and Results: A total of 116 patients on dialysis, who underwent PCI with IVUS guidance between March 2012 and December 2020, were enrolled. Patients were divided into 2 groups based on their median iPTH level. The degree of intracoronary calcification was evaluated by calcification score using grayscale IVUS in the target lesions. Preprocedural calcification scores were significantly higher in the high iPTH group compared with the low iPTH group (2.9±1.1 vs. 2.1±0.7, P<0.001). After PCI, the high iPTH group had a significantly lower stent expansion index (0.6±0.2 vs. 0.7±0.1, P<0.001) and stent symmetry index (0.5±0.1 vs. 0.7±0.1, P<0.001) compared with the low iPTH group. The incidence of major adverse cardiac or cerebrovascular events within 3 years was significantly higher in the high iPTH group (log-rank P<0.05). CONCLUSIONS: High iPTH level is likely to increase intracoronary calcification, and cause inadequate stent expansion, which may be associated with increased risk of future adverse events in dialysis patients with CAD requiring PCI.
  • Shuhei Aoki, Hiroyuki Takaoka, Ryo Ito, Hiroki Ikeuchi, Noriko Suzuki-Eguchi, Haruka Sasaki, Makiko Kinoshita, Manami Takahashi, Satomi Yashima, Katsuya Suzuki, Hiroki Goto, Hideki Kitahara, Junji Moriya, Goro Matsumiya, Yoshio Kobayashi
    Internal medicine (Tokyo, Japan) 62(7) 1017-1022 2022年8月20日  
    We treated a female patient known to have a double-chambered right ventricle (DCRV) who presented with symptoms of an acute myocardial infarction (AMI). Emergent coronary artery catheterization revealed acute right coronary artery (RCA) occlusion and proximal left anterior descending (LAD) stenosis. We performed percutaneous coronary intervention (PCI) for the RCA occlusion. Right heart catheterization revealed a pressure gradient across the mid-RV of 58 mmHg. Computed tomography and magnetic resonance imaging revealed no other congenital cardiac abnormalities. She underwent surgical repair of the RV stenosis and coronary artery bypass surgery for LAD stenosis.
  • Yutaka Yoshino, Hiroyuki Takaoka, Hiromichi Oishi, Shuhei Aoki, Hiroki Goto, Manami Takahashi, Satomi Yashima, Noriko Suzuki-Eguchi, Haruka Sasaki, Makiko Kinoshita, Hideki Kitahara, Yoshio Kobayashi
    Circulation journal : official journal of the Japanese Circulation Society 86(12) 2040-2040 2022年8月20日  
  • Satomi Yashima, Hiroyuki Takaoka, Togo Iwahana, Yusei Nishikawa, Joji Ota, Shuhei Aoki, Makiko Kinoshita, Manami Takahashi, Haruka Sasaki, Noriko Suzuki-Eguchi, Hiroki Goto, Katsuya Suzuki, Yoshio Kobayashi
    Heart and vessels 38(2) 185-194 2022年8月13日  
    Cardiac computed tomography (CT) is useful for the screening of coronary artery stenosis, and extracellular volume fraction (ECV) analysis by CT using new dedicated software is now available. Here, we evaluated the utility of ECV analysis using cardiac CT to predict patient prognosis in cases with dilated cardiomyopathy (DCM). We analyzed 70 cases with DCM and cardiac computed tomography (CT) with available late-phase images. We evaluated the ECV of the left ventricular myocardium (LVM) using commercially available software (Ziostation 2, Ziosoft Inc, Japan). ECV on LVM was 33.96 ± 5.04%. Major adverse cardiac events (MACE) occurred in 21 cases (30%). ECV of the LVM on CT, endo-systolic volume, and rate of significant valvular disease were significantly higher in cases with MACE than in those without (37.16 ± 5.91% vs. 32.59 ± 3.95%, 194 ± 109 vs. 138 ± 78 ml and 57% vs. 20%, all P values < 0.05). LVEF was significantly lower in cases with MACE than in those without (23 ± 8 vs. 31 ± 11%, P = 0.0024). The best cut-off value of ECV on LVM for prediction of MACE was 32.26% based on receiver operating characteristics analysis. Cases with ECV ≥ 32.26% had significantly higher MACE based on Kaplan-Meier analysis (P = 0.0032). Only ECV on LVM was an independent predictor of MACE based on a multivariate Cox proportional hazards model (P = 0.0354). Evaluation of ECV on LVM by CT is useful for predicting MACE in patients with DCM.
  • Kan Saito, Yuichi Saito, Hideki Kitahara, Yoshio Kobayashi
    Heart and Vessels 2022年7月8日  
  • Ryohei Ono, Togo Iwahana, Hirotoshi Kato, Noriyuki Hattori, Yoshio Kobayashi
    Journal of cardiology cases 26(1) 9-12 2022年7月  
    Cardiorenal syndrome is the term that describes the interaction between the heart and kidney that leads to diuretic resistance and worsening renal function. Prolonged anuria generally represents irreversible renal failure, and recovery of renal function after prolonged anuria in patients with heart failure has rarely been reported. Moreover, increased central venous pressure including heart failure is associated with impaired renal function. We herein report a rare case of a 46-year-old man with dilated cardiomyopathy who presented with dyspnea and generalized edema. His body weight increased from 90 kg to 128 kg in one year and he was hospitalized. Central venous pressure (CVP) on admission was 33 mmHg. Intravenous catecholamines were not effective; thus, he was started on continuous hemodiafiltration. Anuria occurred after hemodiafiltration due to heart failure, sepsis, and antibiotics use. However, he experienced weight reduction of over 70 kg, under hemodialysis guided by central venous pressure measurement, and renal function recovery after 87 days of anuria. His CVP had improved to 5 mmHg at discharge. This case showed continuous trial to reduce the CVP and raise cardiac output could result in the recovery of impaired renal function even in the presence of prolonged anuria. <Learning objective: We report a rare case of a patient with dilated cardiomyopathy who experienced weight reduction of over 70 kg under hemodialysis guided by central venous pressure (CVP) measurement and renal function recovery after 87 days of anuria due to chronic heart failure. Even in the presence of prolonged anuria, continuous trial to reduce the CVP and raise cardiac output could result in the recovery of impaired renal function.>.
  • Yoshiaki Kawase, Hitoshi Matsuo, Shoichi Kuramitsu, Yasutsugu Shiono, Takashi Akasaka, Nobuhiro Tanaka, Tetsuya Amano, Ken Kozuma, Masato Nakamura, Hiroyoshi Yokoi, Yoshio Kobayashi, Yuji Ikari
    Cardiovascular intervention and therapeutics 37(3) 425-439 2022年7月  
    Fractional flow reserve and instantaneous wave-free ratio are widely accepted and recommended in Western and Japanese guidelines for appropriate percutaneous coronary intervention. There are, however, many differences in clinical situations between Japan and Western countries. Therefore, the Task Force on coronary physiology of the Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT) has proposed an expert consensus document to summarize current evidence and suggest the practical use of physiological lesion assessment in Japan.
  • Tatsuro Yamazaki, Yuichi Saito, Takahiro Kobayashi, Hideki Kitahara, Yoshio Kobayashi
    Journal of Cardiology 2022年7月  
  • Yuichi Saito, Kazuma Oyama, Kenichi Tsujita, Satoshi Yasuda, Yoshio Kobayashi
    Journal of Cardiology 2022年7月  
  • Tatsuro Yamazaki, Yuichi Saito, Takahiro Kobayashi, Hideki Kitahara, Yoshio Kobayashi
    Journal of Cardiology 80(1) 9-13 2022年7月  
  • Manami Takahashi, Hiroyuki Takaoka, Joji Ota, Satomi Yashima, Makiko Kinoshita, Noriko Suzuki-Eguchi, Haruka Sasaki, Hiroki Goto, Shuhei Aoki, Hideki Kitahara, Koichi Sano, Yoshio Kobayashi
    Internal medicine (Tokyo, Japan) 62(2) 169-176 2022年6月7日  
    Purpose High-quality images can be obtained with 320-slice computed tomography (CT) with model-based iterative reconstruction (MBIR). We therefore investigated the diagnostic accuracy of 320-slice CT with MBIR for detecting significant coronary artery stenosis. Methods This was a retrospective study of 160 patients who underwent coronary CT and invasive coronary angiography (ICA). The first 100 consecutive patients (Group 1) underwent 320-slice CT without MBIR or small-focus scanning. The next 60 consecutive patients (Group 2) underwent 320-slice CT with both MBIR and small-focus scanning. Patients who underwent coronary artery bypass surgery were excluded. The diagnostic performance of 320-slice CT without MBIR or small-focus scanning and 320-slice CT with both of them, with ICA regarded as a reference standard, was compared to detect significant coronary artery stenosis (≥70% on CT, ≥75% on ICA). Results In a patient-based analysis, the sensitivity, specificity, and overall accuracy of detection of significant stenosis on CT against ICA were 95%, 85%, and 91% in Group 1, and 93%, 83%, and 90% in Group 2, respectively. No significant differences were observed between the two groups in the patient- and segment-based analyses. However, among cases with a severe coronary artery calcium score >400 (31 cases in Group 1 and 28 in Group 2), the specificity and overall accuracy were significantly higher (all p<0.01) in Group 2 than in Group 1 according to the segment-based analysis. Conclusion The diagnostic accuracy of the detection of coronary artery stenosis on CT was improved using 320-slice CT with MBIR.
  • Takanori Sato, Yuichi Saito, Tadahiro Matsumoto, Daichi Yamashita, Kan Saito, Shinichi Wakabayashi, Hideki Kitahara, Koichi Sano, Yoshio Kobayashi
    Journal of Cardiology 79(6) 747-751 2022年6月  
  • Yuichi Saito, Yuki Deguchi, Motohiro Nakao, Hirokazu Shiraishi, Naoya Sakamoto, Satoru Kobayashi, Yoshio Kobayashi
    Heart and Vessels 2022年5月30日  
  • Shintaro Nakano, Shun Kohsaka, Taishiro Chikamori, Kenji Fukushima, Yoshio Kobayashi, Ken Kozuma, Susumu Manabe, Hitoshi Matsuo, Masato Nakamura, Takayuki Ohno, Mitsuaki Sawano, Koichi Toda, Yasunori Ueda, Hiroyoshi Yokoi, Yodo Gatate, Tokuo Kasai, Yoshiaki Kawase, Naoya Matsumoto, Hitoshi Mori, Ryo Nakazato, Nozomi Niimi, Yuichi Saito, Ayumi Shintani, Ippei Watanabe, Yusuke Watanabe, Yuji Ikari, Masahiro Jinzaki, Masami Kosuge, Kenichi Nakajima, Takeshi Kimura
    Circulation journal : official journal of the Japanese Circulation Society 86(5) 882-915 2022年4月25日  
  • Takeshi Nishi, Masanobu Ishii, Kenichi Tsujita, Hiroshi Okamoto, Satoshi Koto, Michikazu Nakai, Yoko Sumita, Yoshitaka Iwanaga, Satoaki Matoba, Yoshio Kobayashi, Ken-Ichi Hirata, Yutaka Hikichi, Hiroyoshi Yokoi, Yuji Ikari, Shiro Uemura
    Journal of the American Heart Association 11(7) e023713 2022年4月5日  
    Background Clinical outcomes of acute myocardial infarction complicated by cardiogenic shock remain poor with high in-hospital mortality. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been widely used for patients with acute myocardial infarction complicated by cardiogenic shock refractory to conservative therapy, which is likely fatal without mechanical circulatory support. However, whether additional intra-aortic balloon pumping (IABP) use during VA-ECMO support improves clinical outcomes remains controversial. This study sought to investigate prognostic impact of the combined VA-ECMO plus IABP treatment compared with VA-ECMO alone. Methods and Results From the nationwide Japanese administrative case-mix Diagnostic Procedure Combination (DPC), the JROAD (Japanese Registry of All Cardiac and Vascular Diseases)-DPC, we identified 3815 patients with acute myocardial infarction complicated by cardiogenic shock who underwent primary percutaneous coronary intervention and managed with VA-ECMO. Of these, 2964 patients (77.7%) were managed with IABP (VA-ECMO plus IABP), whereas 851 (22.3%) were managed without IABP (VA-ECMO alone). We compared in-hospital, 7-day, and 30-day mortality between the VA-ECMO plus IABP versus the VA-ECMO alone support. Patients managed with VA-ECMO plus IABP demonstrated significantly lower in-hospital, 7-day, and 30-day mortality than those managed with VA-ECMO alone (adjusted odds ratios [95% CI] of 0.47 [95% CI, 0.38-0.59], 0.41 [95% CI, 0.33-0.51], and 0.30 [95% CI, 0.25-0.37], respectively). The findings were consistent in the propensity matching and inverse probability of treatment-weighting models. Conclusions This large-scale, nationwide study demonstrated that the combination of VA-ECMO plus IABP support was associated with significantly lower mortality compared with VA-ECMO support alone in patients presenting with acute myocardial infarction complicated by cardiogenic shock who underwent primary percutaneous coronary intervention.
  • Kenichi Fujii, Takashi Kubo, Hiromasa Otake, Gaku Nakazawa, Shinjo Sonoda, Kiyoshi Hibi, Toshiro Shinke, Yoshio Kobayashi, Yuji Ikari, Takashi Akasaka
    Cardiovascular intervention and therapeutics 37(2) 248-254 2022年4月  
    In this updated expert consensus document, the methods for the quantitative measurement and morphological assessment of optical coherence tomography (OCT)/optical frequency domain imaging images (OFDI) are briefly summarized. The focus is on the clinical application and the clinical evidence of OCT/OFDI to guide percutaneous coronary interventions.
  • Kazuya Tateishi, Yuichi Saito, Hideki Kitahara, Yoshio Kobayashi
    Heart and Vessels 2022年3月30日  
  • Yuichi Saito, Takeshi Nishi, Ken Kato, Hideki Kitahara, Yoshio Kobayashi
    Heart and Vessels 2022年3月17日  
  • Yuichi Saito, Kazuya Tateishi, Masato Kanda, Yuki Shiko, Yohei Kawasaki, Yoshio Kobayashi, Takahiro Inoue
    Journal of the American Heart Association 11(6) 2022年3月15日  
    Background <p lang="en">Lower primary percutaneous coronary intervention (PCI) volume is known to be associated with worse outcomes in patients with acute myocardial infarction (MI) at hospital level. The present study aimed to evaluate the relations of primary, elective, and total PCI volume and primary/total PCI volume ratio per hospital to in‐hospital mortality in patients with acute MI undergoing primary PCI. </p> Methods and Results <p lang="en">Using a large nationwide administrative database, we included a total of 83 076 patients from 154 hospitals in Japan undergoing PCI for either acute MI or elective cases. Relations of annual procedural volumes for primary, elective, and total PCI to in‐hospital mortality after acute MI at hospital level were evaluated. The ratio of primary to total PCI volume per hospital was also assessed. The primary end point was the ratio of observed to predicted mortality. Of 83 076 patients, 26 913 (32.4%) underwent primary PCI for acute MI, among whom 1561 (5.8%) died during hospitalization. Overall, observed in‐hospital mortality after acute MI and observed/predicted mortality ratio were higher in hospitals with lower primary, elective, and total PCI volumes. Observed/predicted in‐hospital mortality ratio was higher in hospitals with low primary/total PCI volume ratio, even in those with high total PCI volume. </p> Conclusions <p lang="en">Primary, elective, and total PCI volume at hospitals were inversely associated with in‐hospital mortality in patients with acute MI undergoing primary PCI. Lower ratio of primary to total PCI volume were related to higher in‐hospital mortality, suggesting primary/total PCI volume ratio as an institutional indicator of quality of care for acute MI. </p>
  • Tatsuro Yamazaki, Takeshi Nishi, Yuichi Saito, Kazuya Tateishi, Ken Kato, Hideki Kitahara, Yoshio Kobayashi
    Cardiovascular Intervention and Therapeutics 2022年3月8日  
  • Kan Saito, Yuichi Saito, Takahiro Muramatsu, Hideki Kitahara, Yoshihide Fujimoto, Shiroh Isono, Yoshio Kobayashi
    Heart and Vessels 2022年3月3日  
  • Ryohei Ono, Hiroyuki Takaoka, Satoko Ryuzaki, Noriko Suzuki-Eguchi, Yoshio Kobayashi
    BMJ case reports 15(3) 2022年3月3日  
  • 岩花 東吾, 加藤 央隼, 小野 亮平, 岡田 将, 松宮 護郎, 小林 欣夫
    日本循環器学会学術集会抄録集 86回 JO12-9 2022年3月  
  • 小野 亮平, 岩花 東吾, 加藤 央隼, 岡田 将, 小林 欣夫
    日本循環器学会学術集会抄録集 86回 PJ12-7 2022年3月  

MISC

 395
  • Yuichi Saito, Yoshio Kobayashi, Kenichi Tsujita, Koichiro Kuwahara, Yuji Ikari, Hiroyuki Tsutsui, Koichiro Kinugawa, Ken Kozuma
    Circulation Journal 88(11) 1727-1736 2024年11月  
    In patients with acute myocardial infarction (MI), heart failure (HF) is one of the most common complications that is associated with a significant burden of mortality and healthcare resources. The clinical benefits of key HF drugs, the so-called “4 pillars” or “fantastic 4”, namely β-blockers, mineralocorticoid receptor antagonists, angiotensin receptor-neprilysin inhibitor, and sodium-glucose cotransporter 2 inhibitors, have been established in patients with HF with reduced ejection fraction, whereas the effects of these drugs are not comprehensively appreciated in patients with acute MI. This review summarizes current evidence on pharmacological and device-based interventions for preventing HF after acute MI.
  • Yoshiyasu Minami, Junya Ako, Kenichi Tsujita, Hiroyoshi Yokoi, Yuji Ikari, Yoshihiro Morino, Yoshio Kobayashi, Ken Kozuma
    Cardiovascular Intervention and Therapeutics 39(3) 223-233 2024年7月  
    Abstract: Non-culprit lesion-related coronary events are a significant concern in patients with coronary artery disease (CAD) undergoing coronary intervention. Since several studies using intra-coronary imaging modalities have reported a high prevalence of vulnerable plaques in non-culprit lesions at the initial coronary event, the immediate stabilization of these plaques by intensive pharmacological regimens may contribute to the reduction in the adverse events. Although current treatment guidelines recommend the titration of statin and other drugs to attain the treatment goal of low-density lipoprotein cholesterol (LDL-C) level in patients with CAD, the early prescription of strong LDL-C lowering drugs with more intensive regimen may further reduce the incidence of recurrent cardiovascular events. In fact, several studies with intensive regimen have demonstrated a higher percentage of patients with the attainment of LDL-C treatment goal in the early phase following discharge. In addition to many imaging studies showing plaque stabilization by LDL-C lowering drugs, several recent reports have shown the efficacy of early statin and proprotein convertase subtilisin/kexin type 9 inhibitors on the immediate stabilization of non-culprit coronary plaques. To raise awareness regarding this important concept of immediate plaque stabilization and subsequent reduction in the incidence of recurrent coronary events, the term ‘Drug Intervention’ has been introduced and gradually applied in the clinical field, although a clear definition is lacking. The main target of this concept is patients with acute coronary syndrome as a higher prevalence of vulnerable plaques in non-culprit lesions in addition to the worse clinical outcomes has been reported in recent imaging studies. In this article, we discuss the backgrounds and the concept of drug intervention. Graphical Abstract: (Figure presented.)
  • AOKI Shuhei, TAKAOKA Hiroyuki, KINOSHITA Makiko, YASHIMA Satomi, SUZUKI Katsuya, NISHIKAWA Yusei, NOGUCHI Yoshitada, YOSHIDA Kazuki, SASAKI Haruka, SUZUKI Noriko, KOBAYASHI Yoshio
    日本循環器学会学術集会(Web) 88th 2024年  
  • 與子田一輝, 與子田一輝, 佐々木晴香, 佐々木晴香, 佐々木晴香, 高岡浩之, 鎌田知子, 川崎健治, 江口紀子, 江口紀子, 江口紀子, 小林欣夫, 松下一之, 松下一之
    超音波医学 Supplement 51 2024年  
  • YASHIMA Satomi, TAKAOKA Hiroyuki, TAKAHASHI Manami, KINOSHITA Makiko, AOKI Shuhei, KOBAYASHI Yoshio
    日本循環器学会学術集会(Web) 87th 2023年  

共同研究・競争的資金等の研究課題

 6