研究者詳細 - 中川　晃志

論文 - 中川　晃志

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複数の静脈アプローチにて成功しえた経皮的ペースメーカリード抜去術の1例

中川晃志, 西井伸洋, 田中正道, 久保元基, 永瀬聡, 森田宏, 草野研吾, 伊藤浩, 高垣昌巳, 佐野俊二, 庄田守男

Journal of Arrhythmia 28 ( Suppl. ) 388 - 388 2012年5月

重症心不全に伴う不整脈の薬物治療

中村一文, 中川晃志, 杉山洋樹, 森田宏, 草野研吾, 伊藤浩

呼吸と循環 60 ( 4 ) S2 - S4 2012年4月

カテーテル治療を行った多孔性心房中隔欠損症の2例

大澤晋, 赤木禎治, 木島康文, 中川晃志, 草野研吾, 伊藤浩, 佐野俊二

超音波医学 39 ( Suppl. ) S535 - S535 2012年4月

心不全を合併した心房細動症例に対する経口アミオダロンの効果

三好章仁, 草野研吾, 中川晃志, 西井伸洋, 永瀬聡, 中村一文, 森田宏, 伊藤浩

Progress in Medicine 32 ( Suppl.1 ) 464 - 467 2012年3月

記述言語：日本語出版者・発行元：(株)ライフ・サイエンス

心不全を合併した心房細動症例に対するアミオダロンの効果、安全性について検討した。心室性不整脈に対してアミオダロンを処方した124例を対象とした。処方時に発作性・持続性心房細動を合併していた症例は43例で、そのうち6ヵ月間経過観察できた心房細動症例は30例であった。アミオダロン投与による洞調律維持は18例で可能であった。洞調律維持群をsinus群、洞調律に回復しなかった群をAF群として検討した。LVEFはAF群では改善する傾向がみられた。心拍数はsinus群で低下傾向を示した。LADは両群ともに変化は認めなかった。BNP値はsinus群で有意に低下し、AF群では低下傾向を示した。KL-6は投与前後で有意差を認めず、KL-6が急上昇した1例は、CT所見で間質の線維化を認めたためアミオダロン投与を中止し、KL-6は投与前の数値にまで回復した。

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Catheter closure of atrial septal defect in patients with cryptogenic stroke: initial experience in Japan.

Yasufumi Kijima, Teiji Akagi, Manabu Taniguchi, Koji Nakagawa, Kentaro Deguchi, Tomoko Tomii, Kengo Kusano, Shunji Sano, Hiroshi Ito

Cardiovascular intervention and therapeutics 27 ( 1 ) 8 - 13 2012年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

A recent study has shown that cryptogenic stroke can occur even in patients with small or insignificant atrial septal defects (ASD). However, clinical experience in this field is still limited in Japan, also the efficacy and safety of catheter closure of such defects have not been identified. To evaluate the efficacy and safety of catheter closure of interatrial communication in patients with cryptogenic stroke, 13 patients who were diagnosed with cerebrovascular events due to cryptogenic embolism were included in this study. Mean age at procedure was 43 ± 15 (range 17-68) years. In all patients, the presence of spontaneous or provoked interatrial right-to-left shunts was demonstrated by transesophageal contrast echocardiography. Mean defect size evaluated by the balloon sizing technique was 9.2 ± 2.8 mm, and mean size of the Amplatzer Septal Occluder deployed was 9.5 ± 2.8 mm. Devices were successfully deployed in all patients, though one device migrated into the descending aorta was retrieved by a snare catheter. Complete closure was detected by transesophageal contrast echocardiography at 12 months after the procedure was in 11 (85%) of the 13 patients. During the follow-up period (30.1 ± 9.4 months), no recurrent thromboembolic event was observed. Catheter closure of interatrial right-to-left communications can be safely performed. This procedure may contribute to reduction or prevention of recurrent neurological events in this patient population.

DOI： 10.1007/s12928-011-0075-y

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心房中隔欠損に対するTest Balloon OcclusionはAmplatzerデバイス留置後の急性心不全リスクを過大評価する

中川晃志, 赤木禎治, 木島康文, 谷口学, 草野研吾, 伊藤浩, 佐野俊二

日本成人先天性心疾患学会雑誌 1 ( 1 ) 75 - 75 2012年1月

成人動脈管開存に対するAmplatzer Duct Occluderを用いたカテーテル閉鎖術

木島康文, 赤木禎治, 中川晃志, 谷口学, 草野研吾, 伊藤浩, 佐野俊二

日本成人先天性心疾患学会雑誌 1 ( 1 ) 74 - 74 2012年1月

多孔型心房中隔欠損症の経カテーテル的閉鎖術における三次元経食道心エコー図の有用性

谷口学, 赤木禎治, 渡辺修久, 岡本吉生, 木島康文, 中川晃志, 杜徳尚, 大月審一, 草野研吾, 伊藤浩, 佐野俊二

日本心臓病学会誌 6 ( Suppl.I ) 326 - 326 2011年8月

小児心疾患の最新治療心房中隔欠損症のカテーテル治療時代における外科治療の役割カテーテル治療不能例からの検討

木島康文, 赤木禎治, 谷口学, 中川晃志, 岡本吉生, 大月審一, 草野研吾, 伊藤浩, 佐野俊二

日本心臓病学会誌 6 ( Suppl.I ) 174 - 174 2011年8月

左室心外膜側にて著明なJ波とOut of QRS Potentialが記録されたBrugada症候群(J Wave Syndrome)の1例

田中正道, 永瀬聡, 中川晃志, 多田毅, 村上正人, 西井伸洋, 中村一文, 幡芳樹, 森田宏, 河野晋久, 草野研吾, 伊藤浩, 大江透

臨床心臓電気生理 34 205 - 215 2011年5月

記述言語：日本語出版者・発行元：臨床心臓電気生理研究会

症例は39歳、男性。心室細動自然発作を認めるBrugada症候群との診断で当院入院。心電図ではV2でのsaddle back型ST上昇とI、II、aV1、V3-6でのJ波を認めた。心臓電気生理学的検査では、経冠静脈的に左室側壁心外膜側に多極カテーテルを挿入し電位の記録を行ったところ、単極誘導では明瞭なJ波が記録され、双極誘導ではJ波の成分に伴いout of QRS potentialが記録された。単極誘導でのJ波は心房ペーシング、およびisoproterenol投与で減高し、pilsicainide投与で増高した。また双極誘導でのout of QRS電位は心房ペーシングおよびisoproterenol投与で短縮しpilsicainide投与で延長した。再分極異常の性質を示す左室心外膜側J波がout of QRS potentialとしても記録され、J wave syndromeの成因を考えるうえで興味深い症例と考えられここに報告する。(著者抄録)

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J Waves in Patients with Vasospastic Angina

Koji Nakagawa, Satoshi Nagase, Masamichi Tanaka, Nobuhiro Nishii, Hiroshi Morita, Kunihisa Kohno, Kengo Kusano, Tohru Ohe, Hiroshi Ito

journal of arrhythmia 27 191 2011年

掲載種別：研究論文（学術雑誌）

Objectives: The purpose of this study was to determine whether J wave is a marker of arrhythmic risk in patients with vasospastic angina (VSA). Background: Both VSA and the presence of J waves in ECG are associated with fatal ventricular arrhythmias and sudden death. However, the prevalence of J waves among VSA patients is little known. Methods: We reviewed 66 patients with VSA in our hospital retrospectively and assessed the association between the presence of J wave and clinical backgrounds among them. J wave was defined as an elevation of the QRS-ST junction of > 0.1mV from baseline. Results: Spontaneous VF and syncope occurred in 9 (13.6%) and 14 (21.2%) of all patients, respectively. J waves were observed in 33 patients (50%) and were significantly more prevalent in males than females (60.4% vs. 16.7%, Pμ0.01). Arrhythmic symptoms (ventricular arrhythmias or syncope) were observed frequently in patients with J waves, compared to without J wave (48.4% vs. 23.8%, Pμ0.05). Both of the locations and height of J waves were not associated with the history of arrhythmic symptoms. Conclusions: J waves are observed frequently among male patients with VSA. The presence of J waves potentially influence the development of lethal ventricular arrhythmias associated with VSA. © 2011, Japanese Heart Rhythm Society. All rights reserved.

DOI： 10.4020/jhrs.27.OP03_4

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Torn atrial septum during transcatheter closure of atrial septal defect visualized by real-time three-dimensional transesophageal echocardiography. 国際誌

Yasufumi Kijima, Manabu Taniguchi, Teiji Akagi, Koji Nakagawa, Kengo Kusano, Hiroshi Ito, Shunji Sano

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 23 ( 11 ) 1222.e5-8 2010年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

Transcatheter closure of atrial septal defects (ASDs) has become an accepted and reliable procedure. Although various complications have been recognized, tear of the atrial septal rim is a rare complication. We report a case of atrial septal rim tear that was diagnosed during the procedure by real-time three-dimensional transesophageal echocardiography (TEE). The device was successfully implanted 3 months after the initial intervention. RT3D TEE is more useful for displaying the entire shape of the defect and its spatial relationship (RT3D) with its neighboring structures compared with conventional two-dimensional echocardiography. By using both two-dimensional and RT3D TEE images, especially in cases with complicated ASD morphology, both the echocardiologist and interventionalist gain valuable information on the morphology of the ASD before and during the procedure.

DOI： 10.1016/j.echo.2010.04.004

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SCN5A mutation is associated with early and frequent recurrence of ventricular fibrillation in patients with Brugada syndrome.

Nobuhiro Nishii, Masahiro Ogawa, Hiroshi Morita, Kazufumi Nakamura, Kimikazu Banba, Daiji Miura, Naoko Kumagai, Akira Matsunaga, Hiroshi Kawamura, Shigemi Urakawa, Kohei Miyaji, Masahiro Nagai, Katsumasa Satoh, Koji Nakagawa, Masamichi Tanaka, Shigeki Hiramatsu, Takeshi Tada, Masato Murakami, Satoshi Nagase, Kunihisa Kohno, Kengo Fukushima Kusano, Keijiro Saku, Tohru Ohe, Hiroshi Ito

Circulation journal : official journal of the Japanese Circulation Society 74 ( 12 ) 2572 - 8 2010年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Mutations in SCN5A are reportedly linked to Brugada syndrome (BS), but recent observations suggest that they are not necessarily associated with ventricular fibrillation (VF) in BS patients. Therefore, the clinical importance of SCN5A mutations in BS patients was examined in the present study. METHODS AND RESULTS: The 108 BS patients were examined for SCN5A mutations and various parameters were compared between patients with and without mutations. An implantable cardioverter defibrillator (ICD) was implanted in 49 patients and a predictor of appropriate ICD shock was investigated. The existence of a SCN5A mutation was not associated with initial VF episodes (21.7% vs 20.0%, P=0.373). In the secondary prevention group, appropriate shock-free survival rate was significantly lower in patients with spontaneous type 1 ECG than in those without (41.1% vs 85.7% at 2 years, P=0.014). The appropriate shock-free survival rate was also significantly lower in patients with SCN5A mutations than in those without (28.6% vs 83.3% at 1 year, P=0.040). Appropriate shock was more frequent in patients with SCN5A mutations than in those without (6.6±6.2 vs 1.7±3.0, P=0.007). CONCLUSIONS: SCN5A mutations are associated with early and frequent VF recurrence, but not with initial VF episodes. This is the first report on the genotype-phenotype interaction and clinical significance of this mutation.

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Efficacy of low-dose bepridil for prevention of ventricular fibrillation in patients with Brugada syndrome with and without SCN5A mutation. 国際誌

Masato Murakami, Kazufumi Nakamura, Kengo F Kusano, Hiroshi Morita, Koji Nakagawa, Masamichi Tanaka, Takeshi Tada, Norihisa Toh, Nobuhiro Nishii, Satoshi Nagase, Yoshiki Hata, Kunihisa Kohno, Daiji Miura, Tohru Ohe, Hiroshi Ito

Journal of cardiovascular pharmacology 56 ( 4 ) 389 - 95 2010年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

It has been reported that bepridil prevents ventricular fibrillation (VF) in patients with Brugada syndrome, but the comparative efficacy with and without mutation in the SCN5A gene has not been elucidated. The purpose of this study was to assess the efficacy of low-dose bepridil (100 mg/day) for VF prevention in patients with Brugada syndrome with and without SCN5A mutation. Among 130 patients with Brugada-type electrocardiogram (ECG), low-dose bepridil was administered to seven patients because of repetitive VF episodes, including three with and four without SCN5A mutation. Preventive effect for VF recurrence and changes of the ECG and the signal-averaged ECG were evaluated. Frequencies of VF episodes were reduced after treatment with low-dose bepridil in all three patients with the SCN5A mutation (before: 0.33 versus after: 0.02 episodes/month, P < 0.01), but not in all four patients without the SCN5A mutation (before: 0.43 versus after: 2.94 episodes/month, P = nonsignificant). Levels of ST-segment elevation at J points and duration of low-amplitude signals less than 40 µV in the terminal filtered QRS complex (LAS40) in signal-averaged ECG were improved exclusively in patients with the SCN5A mutation. Treatment with bepridil prevented recurrence of VF along with improvement of ST elevation and LAS40 in patients with Brugada syndrome with the SCN5A mutation.

DOI： 10.1097/FJC.0b013e3181f03c2f

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小開胸心外膜アプローチにて心室頻拍に対するアブレーションを行った不整脈源性右室心筋症の1例

田中正道, 永瀬聡, 中川晃志, 村上正人, 西井伸洋, 森田宏, 草野研吾, 伊藤浩, 高垣昌己, 佐野俊二

心電図 30 ( Suppl.4 ) S - 201 2010年9月

上大静脈と下大静脈の周囲を興奮が各々旋回するDual-Loop Reentryによる術後心房頻拍の1例

多田毅, 永瀬聡, 村上正人, 平松茂樹, 田中正道, 中川晃志, 西井伸洋, 中村一文, 幡芳樹, 森田宏, 草野研吾, 伊藤浩, 大江透

臨床心臓電気生理 33 21 - 29 2010年5月

記述言語：日本語出版者・発行元：臨床心臓電気生理研究会

症例は32歳、女性。開胸術の既往があり、頻拍発作を主訴に来院。心電図にて心房頻拍を認めアブレーション目的に入院。CARTOを用いたvoltage mappingにて右房側壁は強く障害され、activation mappingにて右房内興奮は右房側壁を前方より後方へ伝播し、後壁を横断、中隔を後方から前方へ伝播した後、三尖弁-上大静脈間、いわゆるupper-loopと三尖弁-下大静脈間、いわゆるlower-loopを伝播した。以上より右房側壁にcommon channelを持ち、upper loopとlower loopを同時に旋回するdual-loop reentryと診断した。Common channelでfragmented electrogramが記録され、同部位の通電で速やかに頻拍は停止した。上大静脈と下大静脈周囲を興奮が各々旋回するまれなdual-loop reentryの1例と考える。(著者抄録)

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アミオダロン肺障害における臨床的特徴とアンギオテンシン系拮抗薬の効果

二階堂暁, 草野研吾, 中村一文, 多田毅, 三浦綾, 田中正道, 中川晃志, 村上正人, 西井伸洋, 福家聡一郎, 永瀬聡, 森田宏, 伊藤浩, 大江透

Progress in Medicine 30 ( Suppl.1 ) 662 - 666 2010年3月

記述言語：日本語出版者・発行元：(株)ライフ・サイエンス

アミオダロン肺障害(AIPT)における臨床的特徴とアンギオテンシン系拮抗薬(ASA)の効果について検討した。対象は96例(男性74例、女性22例、平均年齢58.1歳)で、基礎疾患は拡張型心筋症39例、虚血性心疾患26例、肥大型心筋症10例、観察期間は平均33.8ヵ月であった。1)11例(11.5%)にAIPTが認められ、AIPT(+)群ではAIPT(-)群に比し繰り返す心不全のエピソードが有意に多かった。2)ヒト肺胞上皮細胞にアミオダロン添加でアポトーシスは濃度依存性に増加し、アミオダロンにアンギオテンシンII追加でとアポトーシスは有意に増強されたが、アンギオテンシンII受容体拮抗薬添加でアポトーシスは有意に抑制された。3)AIPT(+)群ではAIPT(-)群に比しASA投与量は有意に少なかった。多変量解析では繰り返す心不全エピソードとASA投与量が各々独立したAIPT発症の予測因子であった。

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Application of real-time three-dimensional transesophageal echocardiography using a matrix array probe for transcatheter closure of atrial septal defect. 国際誌

Manabu Taniguchi, Teiji Akagi, Nobuhisa Watanabe, Yoshio Okamoto, Koji Nakagawa, Yasufumi Kijima, Norihisa Toh, Shinichi Ohtsuki, Kengo Kusano, Shunji Sano

Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 22 ( 10 ) 1114 - 20 2009年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: The aim of this study was to demonstrate the utility of real-time three-dimensional (3D) transesophageal echocardiography (RT3D-TEE) using a matrix array 3D transesophageal echocardiographic probe for morphologic evaluation and guidance of transcatheter closure of atrial septal defects (ASDs). METHODS: Forty-eight consecutive patients scheduled for the intervention were included. Two-dimensional (2D) transesophageal echocardiography (2D-TEE) and RT3D-TEE were performed before and during the procedures. Measurements of maximal ASD diameter and surrounding rims obtained on RT3D-TEE were compared with those obtained on 2D-TEE. RESULTS: In 46 patients (96%), optimal 3D images for the morphologic evaluation of ASDs were obtained. RT3D-TEE facilitated the evaluation of ASD morphology and surrounding rims and was able to provide intraprocedural information clearly. A Bland-Altman plot showed a mean maximal diameter difference of -0.12 mm between the means (95% limits of agreement, -2.2 to 2.5 mm). CONCLUSION: RT3D-TEE is a clinically useful, complementary option to 2D-TEE for evaluation of ASD morphology and for interventional guidance.

DOI： 10.1016/j.echo.2009.06.008

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成人における経カテーテル的心房中隔欠損閉鎖術前後における肺動脈楔入圧の変化

谷口学, 赤木禎治, 中川晃志, 木島康文, 草野研吾, 伊藤浩, 佐野俊二

日本心臓病学会誌 4 ( Suppl.I ) 435 - 435 2009年8月

非Brugada型特発性心室細動12例の検討

平松茂樹, 森田宏, 中川晃志, 田中正道, 村上正人, 多田毅, 西井伸洋, 永瀬聡, 幡芳樹, 草野研吾

心電図 29 ( Suppl.3 ) S - 380 2009年6月

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