Faculty Profiles - iwasaki keiichiro

Papers - iwasaki keiichiro

Division display 1 - 20 of about 38 ／ All the affair displays >>

Impact of Serum Indoxyl Sulfate on One-Year Adverse Events in Chronic Kidney Disease Patients with Heart Failure Reviewed

Keiichiro Iwasaki, Toru Miyoshi, Chikara Urabe, Satoru Sakuragi, Yusuke Kawai, Soichiro Fuke, Masayuki Doi, Atsushi Takaishi, Takefumi Oka, Naoto Tokunaga, Hiroshi Ito

Journal of Clinical Medicine 13 ( 15 ) 4384 - 4384 2024.7

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal) Publisher：MDPI AG

Background/Objectives: Indoxyl sulfate, a uremic toxin, is associated with mortality and cardiovascular events in patients with chronic kidney disease (CKD). This study aimed to evaluate the prognostic implications of serum indoxyl sulfate levels in patients with heart failure and CKD. Methods and Results: This was a prospective multicenter observational study. Overall, 300 patients with chronic heart failure with a previous history of hospitalization and an estimated glomerular filtration rate (eGFR) of 45 mL/min/1.73 m2 or less (CKD stage G3b to G5) without dialysis were analyzed. The primary outcome assessed in a time-to-event analysis from the measurement of indoxyl sulfate was a composite of all-cause death, hospitalization for heart failure, nonfatal myocardial infarction, and nonfatal stroke. Clinical events were followed-up to one year after indoxyl sulfate measurement. The median patient age was 75 years, and 57% of the patients were men. We divided the cohort into low and high indoxyl sulfate categories according to a median value of 9.63 mg/mL. The primary outcome occurred in 27 of 150 patients (18.0%) in the low indoxyl sulfate group and 27 of 150 patients (18.0%) in the high indoxyl sulfate group (hazard ratio, 1.00; 95% confidence interval, 0.58 to 1.70, p = 0.99). In the post hoc exploratory analyses, the results were consistent across age, sex, body mass index, left ventricular ejection fraction, eGFR, and N-terminal pro b-type natriuretic peptide. Conclusions: Among heart failure patients with CKD stages G3b to 5G, serum indoxyl sulfate concentrations were not significantly associated with the subsequent occurrence of cardiovascular events.

DOI： 10.3390/jcm13154384

researchmap

Prognostic Implications of Insulin Resistance in Heart Failure in Japan

Keiichiro Iwasaki, Kazufumi Nakamura, Satoshi Akagi, Yoichi Takaya, Hironobu Toda, Toru Miyoshi, Shinsuke Yuasa

Nutrients 16 ( 12 ) 1888 - 1888 2024.6

Publishing type：Research paper (scientific journal) Publisher：MDPI AG

Diabetes mellitus (DM) is a major risk and prognostic factor for heart failure (HF). Insulin resistance (IR) is an important component of DM, but the relationship between IR and HF prognosis has not yet been established across a wide variety of HF populations. We retrospectively evaluated the relationship between IR and clinical outcomes of HF patients at our hospital between 2017 and 2021. IR was defined as a homeostatic model assessment of IR (HOMA-IR) index ≥ 2.5, calculated from fasting blood glucose and insulin concentrations. The primary outcome was a composite of all-cause death and hospitalisation for HF (HHF). Among 682 patients included in the analyses, 337 (49.4%) had IR. The median age was 70 [interquartile range (IQR): 59–77] years old, and 66% of the patients were men. Among the patients, 41% had a left ventricular ejection fraction below 40%, and 32% had DM. The median follow-up period was 16.5 [IQR: 4.4–37.3] months. IR was independently associated with the primary outcome (HR: 1.91, 95% CI: 1.39–2.62, p < 0.0001), death (hazard ratio [HR]: 1.86, 95% confidence interval [CI]: 1.28–2.83, p < 0.01), and HHF (HR: 1.91, 95% CI: 1.28–2.83, p < 0.01). HOMA-IR is an independent prognostic factor of HF in a wide variety of HF populations.

DOI： 10.3390/nu16121888

researchmap

経皮的補助人工心臓を使用したVA-ECMOと使用しなかったVA-ECMOの臨床的および心エコー学的転帰(Clinical and echocardiographic outcomes among VA-ECMO with or without percutaneous ventricular assist device)

岩崎慶一朗, 角南春樹, 赤木達, 中村一文

人工臓器 52 ( 2 ) S - 156 2023.10

A successful bridge to recovery with Impella 5.0 and subsequent hybrid cardiac resynchronization therapy in systemic right ventricle failure: a case report. International journal

Keiichiro Iwasaki, Nobuhiro Nishii, Satoshi Akagi, Hiroshi Ito

European heart journal. Case reports 7 ( 5 ) ytad214 2023.5

Language：English

BACKGROUND: Impella 5.0 is currently used as a temporary mechanical circulatory support device in cardiogenic shock (CS). However, Impella 5.0 implantation for the systemic right ventricle (sRV) has not been well documented. CASE SUMMARY: A 50-year-old man with atrial switch for dextro-transposition of the great arteries was transferred to our hospital for the treatment of embolic acute myocardial infarction of the left main trunk lesion with CS. To stabilize haemodynamics, we implanted Impella 5.0 via the left subclavian artery in the sRV. After optimal medical therapy initiation and gradual weaning of Impella 5.0, Impella 5.0 was successfully explanted. An electrocardiogram was obtained, which showed complete right branch block with a QRS duration of 172 ms. Acute invasive haemodynamic evaluation of cardiac resynchronization therapy (CRT) pacing showed that dP/dt increased from 497 to 605 mmHg/s (21.7% improvement), and hybrid cardiac resynchronization therapy defibrillator (CRTD) with a sRV epicardial lead was subsequently implanted. The patient was discharged without inotropic support. DISCUSSION: Coronary artery embolism is a rare but serious complication of dextro-transposition of the great arteries after atrial switch operations. Impella 5.0 implantation is a feasible bridge strategy for refractory CS due to sRV failure. Although CRT implantation in patients with sRV is controversial, an acute invasive haemodynamic evaluation can help assess its potential benefits.

DOI： 10.1093/ehjcr/ytad214

PubMed

researchmap

特集 SGLT2阻害薬を用いた新しい治療戦略 : 糖尿病×心不全×慢性腎臓病 Invited

岩﨑慶一朗, 伊藤浩

日本医事新報 5145 18 - 29 2022.12

慢性心不全の薬物治療 Invited

岩﨑慶一朗, 伊藤浩

診断と治療 110 ( 10 ) 1255 - 1260 2022.10

急性心筋梗塞による心原性ショックに対してインペラ5.0およびCRTD植込を行った完全大血管転位マスタード術後の一例

岩崎慶一朗, 角南春樹, 赤木達, 西井伸洋, 伊藤浩

人工臓器 51 ( 2 ) S - 191 2022.10

Impact of sleep-disordered breathing on ventricular tachyarrhythmias after left ventricular assist device implantation

Yuto Kumai, Osamu Seguchi, Hiroki Mochizuki, Yuki Kimura, Keiichiro Iwasaki, Kensuke Kuroda, Seiko Nakajima, Yorihiko Matsumoto, Takuya Watanabe, Masanobu Yanase, Makoto Sata, Satsuki Fukushima, Tomoyuki Fujita, Taishiro Chikamori, Junjiro Kobayashi, Norihide Fukushima

Journal of Artificial Organs 25 ( 3 ) 223 - 230 2022.9

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Sleep-disordered breathing (SDB) is associated with an increased risk of adverse events in patients with heart failure (HF); however, its impact in patients implanted with a left ventricular assist device (LVAD) remains unclear. We aimed to investigate the prevalence of SDB in patients with LVAD and its impact on their clinical outcomes. Fifty consecutive patients with LVAD who underwent portable sleep monitoring between September 2017 and April 2018 were prospectively enrolled, and they were followed up for 170 ± 36 days. According to their respiratory disturbance indexes (RDIs), they were categorized into the SDB group (RDI ≥ 15, n = 12) and the non-SDB group (RDI < 15, n = 38). The incidence of adverse events during the follow-up period was investigated after enrollment. Multivariate logistic regression analysis revealed significant differences in SDB in LVAD-implanted patients in terms of the logarithmic transformation brain natriuretic peptide (BNP) values (p = 0.005). The optimal BNP cut-off value for SDB prediction in LVAD-implanted patients was 300 pg/mL (sensitivity: 58.3%, specificity: 94.7%). During follow-up, ventricular tachyarrhythmias (VTas) occurred significantly more frequently in the SDB group (4 [33%] vs. 2 [5%] patients, p = 0.02); Atrial tachyarrhythmia (ATa) also tended to occur more frequently in the SDB group (2 [25%] vs. 2 [2%] patients, p = 0.07). SBD was prevalent in 24% of the LVAD-implanted patients with advanced HF. Furthermore, SDB was significantly associated with high BNP levels and was also potentially associated with subsequent incidence of VTa in patients with LVAD.

DOI： 10.1007/s10047-021-01307-y

PubMed

researchmap

Other Link： https://link.springer.com/article/10.1007/s10047-021-01307-y/fulltext.html

左冠動脈主幹部の急性心筋梗塞で救急搬送された完全大血管転移症術後患者の一例

遠藤豊宏, 飯田倫公, 森久寿, 岸之上隆雄, 山地達也, 谷本匡史, 大西伸彦, 高石篤志, 岩崎慶一郎, 赤木達

日本心血管インターベンション治療学会抄録集 30回 [MO492] - [MO492] 2022.7

SGLT2阻害薬を心不全にどのように使うか Invited

岩﨑慶一朗, 伊藤浩

循環器内科 91 ( 6 ) 701 - 706 2022.6

Pathophysiology and Treatment of Diabetic Cardiomyopathy and Heart Failure in Patients with Diabetes Mellitus International journal

Kazufumi Nakamura, Toru Miyoshi, Masashi Yoshida, Satoshi Akagi, Yukihiro Saito, Kentaro Ejiri, Naoaki Matsuo, Keishi Ichikawa, Keiichiro Iwasaki, Takanori Naito, Yusuke Namba, Masatoki Yoshida, Hiroki Sugiyama, Hiroshi Ito

International Journal of Molecular Sciences 23 ( 7 ) 3587 - 3587 2022.3

Language：English Publishing type：Research paper (scientific journal) Publisher：MDPI AG

There is a close relationship between diabetes mellitus and heart failure, and diabetes is an independent risk factor for heart failure. Diabetes and heart failure are linked by not only the complication of ischemic heart disease, but also by metabolic disorders such as glucose toxicity and lipotoxicity based on insulin resistance. Cardiac dysfunction in the absence of coronary artery disease, hypertension, and valvular disease is called diabetic cardiomyopathy. Diabetes-induced hyperglycemia and hyperinsulinemia lead to capillary damage, myocardial fibrosis, and myocardial hypertrophy with mitochondrial dysfunction. Lipotoxicity with extensive fat deposits or lipid droplets is observed on cardiomyocytes. Furthermore, increased oxidative stress and inflammation cause cardiac fibrosis and hypertrophy. Treatment with a sodium glucose cotransporter 2 (SGLT2) inhibitor is currently one of the most effective treatments for heart failure associated with diabetes. However, an effective treatment for lipotoxicity of the myocardium has not yet been established, and the establishment of an effective treatment is needed in the future. This review provides an overview of heart failure in diabetic patients for the clinical practice of clinicians.

DOI： 10.3390/ijms23073587

PubMed

researchmap

Corrigendum to ‘Impact of Bridge-to-Bridge Strategies from Paracorporeal to Implantable Left Ventricular Assist Devices on the Pre-Heart Transplant Outcome: A single-center analysis of 134 cases’ [Journal of Cardiology 77 (2021) 408–416] International journal

Seiko Nakajima Doi, Osamu Seguchi, Masahiro Yamamoto, Tomoyuki Fujita, Satsuki Fukushima, Hiroki Mochizuki, Keiichiro Iwasaki, Yuki Kimura, Koichi Toda, Yuto Kumai, Kensuke Kuroda, Takuya Watanabe, Masanobu Yanase, Junjiro Kobayashi, Takeshi Kimura, Norihide Fukushima

Journal of Cardiology 78 ( 3 ) 257 - 260 2021.9

Clinical potential of hemodynamic ramp test by simultaneous echocardiography and right heart catheterization for aortic insufficiency in a patient with continuous-flow left ventricular assist device

Yasumori Sujino, Kensuke Kuroda, Koichi Yoshitake, Nobuichiro Yagi, Eiji Anegawa, Hiroki Mochizuki, Keiichiro Iwasaki, Seiko Nakajima, Takuya Watanabe, Masanobu Yanase, Satsuki Fukushima, Tomoyuki Fujita, Junjiro Kobayashi, Norihide Fukushima

Journal of Artificial Organs 24 ( 2 ) 265 - 268 2021.6

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Abstract

Aortic insufficiency (AI) is an important adverse event in patients with continuous-flow (CF) left ventricular assist device (LVAD) support. AI is often progressive, resulting in elevated 2-year morbidity and mortality. The effectiveness of echocardiographic ramp studies in patients with AI has been unclear. Here, we describe a patient with a CF-LVAD implant who underwent aortic valve replacement (AVR), following assessment of AI using a hemodynamic ramp test with simultaneous echocardiography and right heart catheterization (RHC). The patient was a 21-year-old man with cardiogenic shock due to acute myocarditis, who underwent HeartWare CF-LVAD (HVAD) implantation. Heart failure persisted despite increased doses of diuretics and inotrope, as well as an increased HVAD pump rate. HVAD monitoring revealed a correlation between increased HVAD pump rate and flow at each speed step. A hemodynamic ramp test with simultaneous transthoracic echocardiography and RHC revealed a significant discrepancy between HVAD pump flow and cardiac output (CO) at each speed step; moreover, pulmonary capillary wedge pressure remained high. Therefore, the patient underwent AVR. Subsequently, his low CO symptoms disappeared and inotropes were successfully discontinued. A postoperative hemodynamic ramp test revealed that AVR had successfully closed the loop of blood flow and reduced the discrepancy between HVAD pump flow and CO, thereby increasing CO. The patient was then discharged uneventfully. In conclusion, a hemodynamic ramp test with simultaneous echocardiography and RHC was useful for the evaluation of the causal relationship between AI and low CO, and for selection of surgical treatment for AI in a patient with CF-LVAD.

DOI： 10.1007/s10047-020-01210-y

PubMed

researchmap

Other Link： https://link.springer.com/article/10.1007/s10047-020-01210-y/fulltext.html

Impact of bridge-to-bridge strategies from paracorporeal to implantable left ventricular assist devices on the pre-heart transplant outcome: A single-center analysis of 134 cases International journal

Journal of Cardiology 77 ( 4 ) 408 - 416 2021.4

Language：English Publishing type：Research paper (scientific journal) Publisher：Elsevier BV

BACKGROUND: In Japan, patients with heart failure who have a paracorporeal left ventricular assist device (pLVAD) and cannot be weaned from the VAD may undergo conversion to implantable continuous-flow LVAD (iLVAD) via a bridge-to-bridge (BTB) strategy for bridge-to-transplantation (BTT). This study aimed to evaluate the real-world clinical status of BTB strategies. METHODS: Among 134 patients who underwent iLVAD implantation for BTT, 34 patients underwent conversion from pLVAD to iLVAD (BTB group) and 100 patients underwent iLVAD implantation primarily (primary iLVAD group). The clinical characteristics and outcomes were compared between the two groups. RESULTS: No significant difference was found in the overall survival between the two groups (p = 0.26; log-rank test). However, the 1-year survival rate and the 1-year freedom from the composite events of death, stroke, systemic infection, and bleeding rate were lower in the BTB group than in the primary iLVAD group (survival rate, 88.2% vs. 99.0%, p = 0.0040; composite event-free survival rate, 26.1% vs. 49.8%, p = 0.030; log-rank test). Multivariate analysis indicated that the BTB strategy [hazard ratio (HR) 1.70, 95% confidence intervals (CI) 1.03-2.72; p=0.036] and serum total bilirubin levels at iLVAD implantation [HR 1.31, 95% CI 1.00-1.65; p=0.043] were independent predictors of 1-year composite events. CONCLUSIONS: The BTB strategy is useful in providing long-term survival in patients with acute critical diseases. However, the early mortality rate after conversion is higher in patients who underwent the BTB strategy.

DOI： 10.1016/j.jjcc.2020.11.003

PubMed

researchmap

Influence of Induction Therapy Using Basiliximab With Delayed Tacrolimus Administration in Heart Transplant Recipients ― Comparison With Standard Tacrolimus-Based Triple Immunosuppression ―

Takuya Watanabe, Masanobu Yanase, Osamu Seguchi, Tomoyuki Fujita, Toshimitsu Hamasaki, Seiko Nakajima, Kensuke Kuroda, Yuto Kumai, Koichi Toda, Keiichiro Iwasaki, Yuki Kimura, Hiroki Mochizuki, Eiji Anegawa, Yasumori Sujino, Nobuichiro Yagi, Koichi Yoshitake, Kyoichi Wada, Sachi Matsuda, Hiromi Takenaka, Megumi Ikura, Kazuki Nakagita, Shin Yajima, Yorihiko Matsumoto, Naoki Tadokoro, Takashi Kakuta, Satsuki Fukushima, Hatsue Ishibashi-Ueda, Junjiro Kobayashi, Norihide Fukushima

Circulation Journal 84 ( 12 ) 2212 - 2223 2020.11

Incidence, Factors, and Prognostic Impact of Re-Exploration for Bleeding After Continuous-Flow Left Ventricular Assist Device Implantation ― A Japanese Single-Center Study ―

Keiichiro Iwasaki, Koichi Yoshitake, Nobuichiro Yagi, Yasumori Sujino, Eiji Anegawa, Hiroki Mochizuki, Kensuke Kuroda, Seiko Nakajima, Takuya Watanabe, Osamu Seguchi, Masanobu Yanase, Satsuki Fukushima, Tomoyuki Fujita, Junjiro Kobayashi, Hiroshi Ito, Norihide Fukushima

Circulation Journal 84 ( 11 ) 1949 - 1956 2020.10

A Novel Extracorporeal Continuous-Flow Ventricular Assist System for Patients With Advanced Heart Failure ― Initial Clinical Experience ―

Osamu Seguchi, Tomoyuki Fujita, Nana Kitahata, Keiichiro Iwasaki, Kensuke Kuroda, Seiko Nakajima, Takuya Watanabe, Masanobu Yanase, Satsuki Fukushima, Tomonori Tsukiya, Nobumasa Katagiri, Toshihide Mizuno, Yoshiaki Takewa, Toshimitsu Hamasaki, Kaori Onda, Teruyuki Hayashi, Haruko Yamamoto, Eisuke Tatsumi, Junjiro Kobayashi, Norihide Fukushima

Circulation Journal 84 ( 7 ) 1090 - 1096 2020.6

Effect of Therapeutic Modification on Outcomes in Heart Transplantation Over the Past Two Decades ― A Single-Center Experience in Japan ―

Masanobu Yanase, Keiichiro Iwasaki, Takuya Watanabe, Osamu Seguchi, Seiko Nakajima, Kensuke Kuroda, Hiroki Mochizuki, Sachi Matsuda, Hiromi Takenaka, Megumi Ikura, Naoki Tadokoro, Satsuki Fukushima, Tomoyuki Fujita, Hatsue Ishibashi-Ueda, Takeshi Nakatani, Soichiro Kitamura, Junjiro Kobayashi, Kenichi Tsujita, Hisao Ogawa, Norihide Fukushima

Circulation Journal 84 ( 6 ) 965 - 974 2020.5

Publishing type：Research paper (scientific journal) Publisher：Japanese Circulation Society

Background: During these 2 decades (1999-2019), many therapeutic strategies have been developed in the field of heart transplant (HTx) to improve post-HTx outcomes. In the present study, 116 consecutive HTx adults between 1999 and 2019 were retrospectively reviewed to evaluate the influences of a therapeutic modification on post HTx outcomes. Methods and Results: Patient survival, functional status and hemodynamics after HTx and modification of therapeutic strategies were reviewed. The overall cumulative survival rate at 10 and 20 years post-HTx was 96.4 and 76.7%, respectively. There were no significant differences in survival rate or exercise tolerance after HTx between extracorporeal and implantable continuous flow-LVAD. Post-HTx patient survival in patients, irrespective of the donor risk factors such as donor age, low LVEF, history of cardiac arrest, was equivalent across cohorts, while longer TIT and higher inotrope dosage prior to procurement surgery were significant risk factors for survival. In 21 patients given everolimus (EVL) due to renal dysfunction, serum creatinine significantly decreased 1 year after initiation. In 22 patients given EVL due to transplant coronary vasculopathy (TCAV), maximum intimal thickness significantly decreased 3 years after initiation. Conclusions: The analysis of a 20-year single-center experience with HTx in Japan shows encouraging improved results when several therapeutic modifications were made; for example, proactive use of donor hearts declined by other centers and the use of EVL in patients with renal dysfunction and TCAV.

DOI： 10.1253/circj.cj-19-1209

Scopus

PubMed

researchmap

Effect of the Creatinine Excretion Rate Index, a Marker of Sarcopenia, on Prediction of Intracranial Hemorrhage in Patients With Advanced Heart Failure and a Continuous-Flow Left Ventricular Assist Device

Keiichiro Iwasaki, Osamu Seguchi, Shunsuke Murata, Kunihiro Nishimura, Koichi Yoshitake, Nobuichiro Yagi, Yasumori Sujino, Eiji Anegawa, Hiroki Mochizuki, Kensuke Kuroda, Seiko Nakajima, Takuya Watanabe, Masanobu Yanase, Satsuki Fukushima, Tomoyuki Fujita, Junjiro Kobayashi, Hiroshi Ito, Norihide Fukushima

Circulation Journal 84 ( 6 ) 949 - 957 2020.5

Mechanical Circulatory Support Combined With Immunosuppression for the Treatment of Giant Cell Myocarditis ― A Single-Center Experience in Japan ―

Seiko Nakajima-Doi, Hiroki Mochizuki, Keiichiro Iwasaki, Kensuke Kuroda, Takuya Watanabe, Naoki Tadokoro, Atsushi Okada, Yasuhide Asaumi, Hideaki Kanzaki, Satsuki Fukushima, Osamu Seguchi, Masanobu Yanase, Chisato Izumi, Tomoyuki Fujita, Junjiro Kobayashi, Norihide Fukushima

Circulation Journal 84 ( 5 ) 815 - 819 2020.4

　 PREV - NEXT 　

< iwasaki keiichiro >

Papers - iwasaki keiichiro