研究者詳細 - 中川　晃志

論文 - 中川　晃志

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Diagnostic Performance of Cardiac Computed Tomography for Detecting Patent Foramen Ovale: Evaluation Using Transesophageal Echocardiography and Catheterization as Reference Standards. 国際誌

Takashi Miki, Koji Nakagawa, Keishi Ichikawa, Tomofumi Mizuno, Rie Nakayama, Kentaro Ejiri, Satoshi Kawada, Yoichi Takaya, Masakazu Miyamoto, Toru Miyoshi, Teiji Akagi, Hiroshi Ito

Journal of cardiovascular development and disease 10 ( 5 ) 2023年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Patent foramen ovale (PFO) is associated with various diseases such as cryptogenic stroke, migraine, and platypnea-orthodeoxia syndrome. This study aimed to evaluate the diagnostic performance of cardiac computed tomography (CT) for PFO detection. MATERIALS AND METHODS: Consecutive patients diagnosed with atrial fibrillation and who underwent catheter ablation with pre-procedural cardiac CT and transesophageal echocardiography (TEE) were enrolled in this study. The presence of PFO was defined as (1) the confirmation of PFO using TEE and/or (2) the catheter crossing the interatrial septum (IAS) into the left atrium during ablation. CT findings indicative of PFO included (1) the presence of a channel-like appearance (CLA) on the IAS and (2) a CLA with a contrast jet flow from the left atrium to the right atrium. The diagnostic performance of both a CLA alone and a CLA with a jet flow was evaluated for PFO detection. RESULTS: Altogether, 151 patients were analyzed in the study (mean age, 68 years; men, 62%). Twenty-nine patients (19%) had PFO confirmed by TEE and/or catheterization. The diagnostic performance of a CLA alone was as follows: sensitivity, 72.4%; specificity, 79.5%; positive predictive value (PPV), 45.7%; negative predictive value (NPV), 92.4%. The diagnostic performance of a CLA with a jet flow was as follows: sensitivity, 65.5%; specificity, 98.4%; PPV, 90.5%; NPV, 92.3%. The diagnostic performance of a CLA with a jet flow was statistically superior to that of a CLA alone (p = 0.045), and the C-statistics were 0.76 and 0.82, respectively. CONCLUSION: A CLA with a contrast jet flow in cardiac CT has a high PPV for PFO detection, and its diagnostic performance is superior to that of a CLA alone.

DOI： 10.3390/jcdd10050193

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Pulmonary arteriovenous fistula in a rare location: The importance of excluding patent foramen ovale.

Mitsutaka Nakashima, Takashi Miki, Yoichi Takaya, Rie Nakayama, Koji Nakagawa, Satoshi Akagi, Norihisa Toh, Teiji Akagi, Hiroshi Ito

Journal of cardiology cases 27 ( 3 ) 124 - 127 2023年3月

記述言語：英語

UNLABELLED: A 46-year-old woman with a history of repeated thromboembolic stroke and anti-phospholipid antibody syndrome was referred to our hospital. Saline contrast transthoracic echocardiography showed that microbubbles appeared in the left atrium within 4 heartbeats. Thus, she was initially suspected as having a patent foramen ovale with associated paradoxical embolism. However, no evidence of patent foramen ovale or atrial septal defect could be found using transesophageal echocardiography. Saline contrast transesophageal echocardiography showed that microbubbles flowed into the left atrium through the left superior pulmonary vein. Ultimately, she was diagnosed as having a pulmonary arteriovenous malformation located at the upper left pulmonary lobe using contrast computed tomography and pulmonary artery angiography. Pulmonary arteriovenous malformations are typically located in the lower lobe of either lung and, in bubble studies, contrast appears in the left atrium after 4 heartbeats. Here, the pulmonary arteriovenous malformation was in the upper lobe, and contrast appeared in the left atrium at an earlier time point: one associated with patent foramen ovale. These findings made it difficult to differentiate the two diseases initially. This case suggests that pulmonary arteriovenous malformation should be carefully considered, even if microbubbles appear in the left atrium early on a saline contrast transthoracic echocardiograph. LEARNING OBJECTIVE: Pulmonary arteriovenous malformation occasionally appears in the upper lobe. In these cases, microbubbles may appear in the left atrium after detection in the right atrium with a time-course that is suggestive of a patent foramen ovale. Therefore, diagnosis should be carefully confirmed by using other multimodal imaging tests, such as transesophageal echocardiography, contrast computed tomography, or pulmonary artery angiography.

DOI： 10.1016/j.jccase.2022.11.005

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潜在性脳卒中を引き起こす卵円孔開存の心臓CTに関する形態学的特徴

三木崇史, 中川晃志, 辻真弘, 中島充貴, 西原大裕, 中山理絵, 高谷陽一, 三好亨, 赤木禎治, 伊藤浩

日本循環器学会学術集会(Web) 87回 PJ004 - 6 2023年3月

成人フォンタン患者における血漿容積状態計算の有用性

中島充貴, 杜徳尚, 川田哲史, 高谷陽一, 中川晃志, 三好亨, 西井伸洋, 赤木禎治, 伊藤浩

日本循環器学会学術集会(Web) 87回 OJ62 - 6 2023年3月

潜因性脳卒中を引き起こす卵円孔開存の心臓CTにおける形態学的特徴(Morphological Features on Cardiac CT of Patent Foramen Ovale Causing Cryptogenic Stroke)

三木崇史, 中川晃志, 辻真弘, 中島充貴, 西原大裕, 中山理絵, 高谷陽一, 三好亨, 赤木禎治, 伊藤浩

日本循環器学会学術集会抄録集 87回 PJ004 - 6 2023年3月

Temporary balloon occlusion test can overestimate the risk of acute pulmonary edema after transcatheter atrial septal defect closure. 国際誌

Koji Nakagawa, Teiji Akagi, Yoichi Takaya, Takashi Miki, Yasufumi Kijima, Rie Nakayama, Norihisa Toh, Nobuhiro Nishii, Kazufumi Nakamura, Hiroshi Morita, Hiroshi Ito

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 2023年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Atrial septal defect (ASD) closure can cause acute pulmonary edema. Before transcatheter closure is performed, temporary balloon occlusion test (BOT) is recommended in patients with left ventricular dysfunction to predict the risk of pulmonary edema. However, the accuracy of BOT has not been verified. This study aimed to compare hemodynamic differences between BOT and transcatheter closure. METHODS: A total of 42 patients with a single ASD over age 18 years who underwent BOT before transcatheter ASD closure between October 2010 and May 2020 were analyzed. Pulmonary capillary wedge pressure (PCWP) was measured using a Swan-Ganz catheter placed in the pulmonary artery at baseline, after 10 min of BOT, and after transcatheter closure. Amplatzer septal occluder was used for all transcatheter closures. RESULTS: Mean patient age was 64 ± 18 years (range, 18-78). Mean ASD diameter and pulmonary to systemic flow ratio were 18 ± 5 and 2.8 ± 1.0 mm, respectively. Mean PCWP at baseline, during BOT, and after transcatheter closure was 8.9 ± 2.9, 13.5 ± 4.2, and 9.5 ± 2.6 mmHg, respectively. The difference between BOT and after transcatheter closure values was significant (p < 0.001). During BOT, PCWP increased ≥18 mmHg in 7 patients, whereas after ASD closure, PCWP was <18 mmHg in all 7 and none developed acute pulmonary edema. CONCLUSION: Temporary balloon occlusion of an ASD and transcatheter ASD closure result in different hemodynamic change. BOT overestimates increase of PCWP after transcatheter ASD closure and requires careful interpretation. Well-designed, larger studies in higher-risk patients are warranted to verify the clinical implications of BOT in more detail.

DOI： 10.1002/ccd.30556

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修復術後ファロー四徴症・類縁疾患の遠隔期肺動脈弁置換術における右室拡張障害の意義

中島充貴, 杜徳尚, 小谷恭弘, 川田哲史, 高谷陽一, 中川晃志, 西井伸洋, 中村一文, 森田宏, 赤木禎治, 笠原真悟, 伊藤浩

日本成人先天性心疾患学会雑誌 12 ( 1 ) 149 - 149 2023年1月

奇異性脳塞栓症を起こした卵円孔開存は心臓CTでどう見えるのか?

三木崇史, 中川晃志, 辻真弘, 中島充貴, 西原大裕, 中山理絵, 高谷陽一, 三好亨, 赤木禎治, 伊藤浩

日本成人先天性心疾患学会雑誌 12 ( 1 ) 158 - 158 2023年1月

成人期Fontan術後症例においてPlasma Volume Statusは中心静脈圧と予後を推定する

中島充貴, 杜徳尚, 川田哲史, 高谷陽一, 中川晃志, 三好亨, 西井伸洋, 赤木禎治, 伊藤浩

日本成人先天性心疾患学会雑誌 12 ( 1 ) 136 - 136 2023年1月

Gore Cardioform ASD Occluderを用いた経皮的心房中隔欠損閉鎖術の初期成績

古田めぐみ, 赤木禎治, 三木崇史, 西原大裕, 中山理絵, 高谷陽一, 中川晃志, 伊藤浩

日本成人先天性心疾患学会雑誌 12 ( 1 ) 154 - 154 2023年1月

【<成人先天性心疾患特有の問題>】成人期の心房中隔欠損の特徴と治療戦略を知る

杜徳尚, 高谷陽一, 中川晃志, 赤木禎治, 伊藤浩

日本小児循環器学会雑誌 38 ( 4 ) 229 - 233 2022年12月

Gore Cardioform ASD Occluderを用いた経皮的心房中隔欠損閉鎖術の初期成績

古田めぐみ, 赤木禎治, 三木崇史, 西原大裕, 中山理絵, 高谷陽一, 中川晃志, 伊藤浩

日本心臓病学会学術集会抄録 70回 O - 3 2022年9月

ブレイン・ハートチームで挑む脳卒中予防・治療戦略地域で築くブレイン・ハートネットワーク PFOに起因する奇異性脳塞栓患者を的確に診断し治療に導く方策は?

三木崇史, 赤木禎治, 西原大裕, 中山理絵, 高谷陽一, 中川晃志, 伊藤浩, 木村舞

日本心臓病学会学術集会抄録 70回 S13 - 2 2022年9月

Overview of the 86th Annual Scientific Meeting of the Japanese Circulation Society - Cardiology Spreading Its Wings.

Kazufumi Nakamura, Toru Miyoshi, Satoshi Akagi, Norihisa Toh, Yukihiro Saito, Yoichi Takaya, Masatoki Yoshida, Koji Nakagawa, Satoshi Kawada, Hironobu Toda, Takashi Miki, Rie Nakayama, Fumi Yokohama, Keishi Ichikawa, Masashi Yoshida, Makiko Taniyama, Nobuhiro Nishii, Teiji Akagi, Hiroshi Morita, Hiroshi Ito

Circulation journal : official journal of the Japanese Circulation Society 86 ( 8 ) 1312 - 1318 2022年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

The 86thAnnual Scientific Meeting of the Japanese Circulation Society was held in a web-based format on March 11-13, 2022. In accordance with the internationalization policy of the JCS, the meeting was held with the Asian Pacific Society of Cardiology Congress 2022. The main theme was "Cardiology Spreading its Wings". The number of patients with heart failure and other cardiovascular diseases is increasing dramatically, and the fields dealt with by cardiovascular medicine are also greatly expanding. This conference was both intellectually satisfying and exciting for all participants, who numbered over 14,900. The meeting was completed with great success, and the enormous amount of cooperation and support from all involved was greatly appreciated.

DOI： 10.1253/circj.CJ-22-0349

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Amplatzer PFO Occluderを使用した経カテーテル卵円孔開存閉鎖術の初期成績

三木崇史, 赤木禎治, 中山理絵, 高谷陽一, 中川晃志, 伊藤浩

日本心血管インターベンション治療学会抄録集 30回 [MO397] - [MO397] 2022年7月

心臓CTによる卵円孔開存の診断能についての検討

三木崇史, 中川晃志, 市川啓之, 水野智文, 中山理絵, 川田哲史, 高谷陽一, 宮本真和, 三好亨, 赤木禎治, 伊藤浩

日本心血管インターベンション治療学会抄録集 30回 [MO267] - [MO267] 2022年7月

Gore Cardioform ASD Occluderを用いた心房中隔欠損症のカテーテル閉鎖術経食道エコーによるダブル4ポイント評価法

赤木禎治, 三木崇史, 高谷陽一, 中山理絵, 中川晃志, 伊藤浩

日本心血管インターベンション治療学会抄録集 30回 [MO398] - [MO398] 2022年7月

Intermittent orthodromic capture of the earliest activation site during atrial pacing in a case with reentrant atrial tachycardia originating from the atrioventricular node vicinity.

Akira Ueoka, Satoshi Nagase, Koji Nakagawa, Hiroshi Morita, Hiroshi Ito

Journal of arrhythmia 38 ( 3 ) 473 - 477 2022年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

Constant pacing (S1-S1: 520 ms) from the right atrial appendage (RAA) during reentrant atrial tachycardia originating from the atrioventricular node vicinity. RA-FW 1-2 was constantly captured antidromically. However, the earliest atrial activation site (EAAS = His1-2) was orthodromically (red circle) and antidromically (blue square) captured at a ratio of 3:1. The electrogram morphology at the EAAS was different between orthodromically and antidromically electrograms captured during pacing. Moreover, the interval between the S1 and orthodromically captured electrogram was gradually prolonged.

DOI： 10.1002/joa3.12702

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Ablation for unmappable ventricular tachycardia in a patient with complete transposition of the great arteries who underwent Rastelli repair.

Takashi Nishimoto, Nobuhiro Nishii, Saori Asada, Koji Nakagawa, Hiroshi Morita, Hiroshi Ito

Journal of cardiology cases 25 ( 4 ) 218 - 224 2022年4月

記述言語：英語

Catheter ablation (CA) of ventricular tachycardia (VT) after repair of congenital heart disease may be difficult because of complex anatomy and sometimes unmappable VT. Here, we report a 41-year-old woman with successful CA of unmappable VT in a patient with complete transposition of the great arteries after Rastelli repair. Clinical VT was induced by programmed electrical stimulation, when the mapping catheter was placed at the high anterior right ventricular outflow tract (RVOT). During VT, the local potential at the high anterior RVOT under the right ventricle (RV) - pulmonary artery (PA) conduit was equal to that at the timing of onset of QRS. The VT was unmappable because the hemodynamics deteriorated. Pace mapping was also tried at the aortic cusp and the left ventricular outflow tract (LVOT). Fractionated potential during sinus rhythm was observed at the noncoronary cusp, and the paced QRS morphology at this site was similar to that of the clinical VT, with a delay of 55 ms from pacing to the onset of QRS. However, mapping at the LVOT was impossible due to the difficulty of catheter manipulation. Radiofrequency energy was successfully applied at the noncoronary cusp and the high anterior RVOT under the RV-PA conduit. <Learning objective: This report is a rare case of successful catheter ablation of unmappable ventricular tachycardia (VT) in a patient with complete transposition of the great arteries after Rastelli repair. The VT was unmappable because of intolerable hemodynamics. However, we could speculate the exit or isthmus of the VT by pace mapping or local potential and eliminate the VT.>.

DOI： 10.1016/j.jccase.2021.09.012

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奇異性脳塞栓症患者における卵円孔開存(PFO)形態について年齢や心形態による検討

中山理絵, 高谷陽一, 赤木禎治, 三木崇史, 横濱ふみ, 中川晃志, 杜徳尚, 伊藤浩

超音波医学 49 ( Suppl. ) S700 - S700 2022年4月

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