研究者詳細 - 中川　晃志

論文 - 中川　晃志

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奇異性脳梗塞既往者の片頭痛に対する経カテーテル心房間短絡閉鎖術の効果

赤木禎治, 高谷陽一, 麻植浩樹, 中川晃志, 出口健太郎, 高橋義秋, 阿部康二, 伊藤浩, 佐野俊二

日本頭痛学会誌 42 ( 2 ) 120 - 120 2015年11月

Fate of Mitral Regurgitation After Transcatheter Closure of Atrial Septal Defect in Adults. 国際誌

Yoichi Takaya, Yasufumi Kijima, Teiji Akagi, Koji Nakagawa, Hiroki Oe, Manabu Taniguchi, Shunji Sano, Hiroshi Ito

The American journal of cardiology 116 ( 3 ) 458 - 62 2015年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

Although the volume overload of pulmonary circulation improves after atrial septal defect (ASD) closure, the increasing left ventricular preload may contribute to mitral regurgitation (MR) deterioration. We aimed to evaluate the impact of MR after transcatheter ASD closure on clinical outcomes in adults. A total of 288 consecutive patients who underwent transcatheter ASD closure were enrolled. Changes in MR were assessed at 1 month after the procedure. The end point was defined as cardiovascular events. After the procedure, MR ameliorated in 3 patients and unchanged in 253, whereas MR deteriorated in 32. During a median follow-up of 24 months, patients with MR deterioration had no cardiovascular events, and the event-free survival rate was not different between patients with MR deterioration and those with MR amelioration or no-change (p = 0.355). Even in patients with MR deterioration, the New York Heart Association functional class improved after the procedure, with no cases of worsening functional class. Multivariate logistic regression analysis showed that MR deterioration was independently related to advanced age and female gender. The degree of enlargement of mitral valve annulus diameter after the procedure was greater in patients with MR deterioration than in those with MR amelioration or no-change, and it was correlated with the degree of MR deterioration. In conclusion, MR deterioration occurs in a minority of adult patients after transcatheter ASD closure; however, it is not linked with adverse outcomes. MR deterioration may be provoked by geometric changes in mitral valve annulus, especially in women with advanced age.

DOI： 10.1016/j.amjcard.2015.04.042

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Comprehensive assessment of morphology and severity of atrial septal defects in adults by CT

Kazuhiro Osawa, Toru Miyoshi, Yusuke Morimitsu, Teiji Akagi, Hiroki Oe, Koji Nakagawa, Yoichi Takaya, Yasufumi Kijima, Shuhei Sato, Susumu Kanazawa, Hiroshi Ito

Journal of Cardiovascular Computed Tomography 9 ( 4 ) 354 - 361 2015年7月

Long-term outcome after transcatheter closure of atrial septal defect in older patients: impact of age at procedure. 国際誌

Yoichi Takaya, Teiji Akagi, Yasufumi Kijima, Koji Nakagawa, Shunji Sano, Hiroshi Ito

JACC. Cardiovascular interventions 8 ( 4 ) 600 - 6 2015年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVES: This study assessed long-term outcome after transcatheter atrial septal defect (ASD) closure in older patients, especially those older than 75 years of age. BACKGROUND: The clinical benefits of transcatheter ASD closure in this aged population are controversial. METHODS: A total of 244 patients older than 50 years of age were divided into 3 groups according to age at procedure (50 to 59 years: n=69; 60 to 74 years: n=120; 75 years and older: n=55). The primary endpoint was defined as all-cause mortality and hospitalization due to heart failure or stroke. Improvements in functional capacity and cardiac remodeling after the procedure were also assessed. RESULTS: During a median follow-up of 36 months, mortality and hospitalization due to heart failure or stroke occurred in 18 patients (7%). Among patients older than 75 years of age, 2 died of noncardiovascular disease, 2 were hospitalized due to heart failure, and 1 had a stroke. More than 90% of patients older than 75 years of age did not experience these events. Kaplan-Meier analysis showed that the event-free survival rate was not different among the 3 age groups (log-rank test, p=0.780). New York Heart Association functional class and right ventricular/left ventricular end-diastolic diameter ratio improved in patients older than 75 years of age, similar to the other age groups. CONCLUSIONS: Long-term outcome after transcatheter ASD closure in patients older than 75 years of age is similar to that in the other, relatively younger age groups. This suggests that transcatheter ASD closure can be considered a valuable therapeutic option in patients older than 75 years of age.

DOI： 10.1016/j.jcin.2015.02.002

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心臓サルコイドーシスにおける加算平均心電図による心室遅延電位(LP:Late Potential)の特徴

寒川睦子, 森田宏, 中川晃志, 西井伸洋, 永瀬聡, 中村一文, 河野晋久, 伊藤浩, 草野研吾, 大江透

心電図 35 ( Suppl.1 ) S - 23 2015年3月

心房中隔欠損症患者における心房細動カテーテルアブレーション後の欠損孔の変化(Reduction of defect diameters after the catheter ablation for atrial fibrillation in patients with atrial septal defect)

中川晃志, 赤木禎治, 永瀬聡, 高谷陽一, 西井伸洋, 中村一文, 森田宏, 伊藤浩

日本成人先天性心疾患学会雑誌 4 ( 1 ) 118 - 118 2015年1月

Incidence and Clinical Significance of Brugada Syndrome Masked by Complete Right Bundle-Branch Block.

Tadashi Wada, Satoshi Nagase, Hiroshi Morita, Koji Nakagawa, Nobuhiro Nishii, Kazufumi Nakamura, Kunihisa Kohno, Hiroshi Ito, Kengo F Kusano, Tohru Ohe

Circulation journal : official journal of the Japanese Circulation Society 79 ( 12 ) 2568 - 75 2015年

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Brugada syndrome (BrS)-type electrocardiogram (ECG) is concealed by complete right bundle-branch block (CRBBB) in some cases of BrS. Clinical significance of BrS masked by CRBBB is not well known. METHODS AND RESULTS: We reviewed an ECG database of 326 BrS patients who had type 1 ECG with or without pilsicainide. "BrS masked by CRBBB" was defined on ECG as <2-mm elevation of the J point at the time of CRBBB in the right precordial leads, and BrS-type J-point elevation ≥2 mm at the time of normalized QRS complex on relieved CRBBB. We identified 25 BrS patients (7.7%) with persistent (n=12) or intermittent CRBBB (n=13). Relief of CRBBB by pacing was performed in patients with persistent CRBBB. The prevalence of BrS masked by CRBBB was 3.1% (10/326 patients). Three patients had type 1 ECG, and 7 patients had type 2 or 3 ECG on relief of CRBBB. Two of these 10 patients had lethal arrhythmic events during the follow-up period (mean, 86.4±57.2 months). There was no prognostic difference between BrS masked by CRBBB and other BrS. CONCLUSIONS: In a small BrS population, CRBBB can completely mask typical BrS-type ECG. BrS masked by CRBBB is associated with the same risk of fatal ventricular tachyarrhythmia as other BrS.

DOI： 10.1253/circj.CJ-15-0618

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心室細動を初発症状とした心アミロイドーシスの1例

小野環, 森田宏, 木村朋生, 時岡浩二, 中川晃志, 西井伸洋, 永瀬聡, 中村一文, 伊藤浩, 田中健大, 柳井広之, 安藤翠, 由谷親夫

心臓 47 ( 1 ) S1_33 - S1_37 2015年

記述言語：日本語出版者・発行元：公益財団法人日本心臓財団

<p> 症例は79歳男性. 間質性肺炎加療中にステロイド精神病を発症し, 加療中に心室細動 (VF) となり自動体外式除細動器で蘇生された. 近医で冠動脈疾患は否定され, 完全右脚ブロックおよび軽度の左室肥大以外, 明らかな基礎疾患を認めず, 特発性VFなどが考えられた. 本人の精査希望なく, その後経過観察となっていたが, 経過中に心室頻拍を認めたため, 不整脈の原因精査目的に当科入院となった. 入院時の心電図で完全右脚ブロックを認めた. 電気生理学的検査で心室内に広範な低電位帯を認めたが, VFは誘発されなかった. 心筋生検でアミロイド沈着が認められ, 免疫染色からAAアミロイドーシスと診断された. 心アミロイドーシスによる心室細動と診断し, 植込み型除細動器植え込みを行った. 通常, 心アミロイドーシスは著明な心肥大や心不全により診断されるが, 今回, 心室細動を契機として診断された心アミロイドーシスの1例を経験したので, 若干の考察を加え報告する.</p>

DOI： 10.11281/shinzo.47.S1_33

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Three-dimensional echocardiography guided closure of complex multiple atrial septal defects. 国際誌

Yasufumi Kijima, Teiji Akagi, Koji Nakagawa, Yoichi Takaya, Hiroki Oe, Hiroshi Ito

Echocardiography (Mount Kisco, N.Y.) 31 ( 10 ) E304-6 2014年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

Transcatheter closure of complex multiple atrial septal defects (ASDs) remains a challenge. We describe our clinical experience with staged device deployment in a patient with multiple ASDs using four Amplatzer septal occluder devices. Three-dimensional transesophageal echocardiography imaging contributed not only to the therapeutic guidance of successful device deployment but also to the decision making for the staged device delivery approach in a case of morphologically complex multiple ASDs.

DOI： 10.1111/echo.12731

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Transcatheter closure of right-to-left atrial shunt in patients with platypnea-orthodeoxia syndrome associated with aortic elongation.

Yoichi Takaya, Teiji Akagi, Yasufumi Kijima, Koji Nakagawa, Manabu Taniguchi, Hayato Ohtani, Shunji Sano, Hiroshi Ito

Cardiovascular intervention and therapeutics 29 ( 3 ) 221 - 5 2014年7月

記述言語：英語掲載種別：研究論文（学術雑誌）

Platypnea-orthodeoxia is a rare condition characterized by dyspnea and oxygen desaturation induced by the upright position and relieved by recumbency. The most common cause of this syndrome is right-to-left shunt through interatrial communications such as patent foramen ovale (PFO) or atrial septal defect (ASD). In addition, this syndrome can be caused by other extracardiac components, including pulmonary emphysema, pericardial disease, and prominent Eustachian valve. We experienced 3 cases of this syndrome, including 1 patient with PFO and 2 patients with ASD. Computer tomography imaging revealed aortic elongation and compression of the right atrium by ascending aorta in all of 3 patients. Transcatheter closure of PFO or ASD was successfully performed in all patients, including immediate improvements of symptoms and oxygen saturation without any complications.

DOI： 10.1007/s12928-014-0244-x

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左室側壁心外膜側に不整脈基質が存在すると考えられたJ波症候群の1例

中川晃志, 永瀬聡, 和田匡史, 田中正道, 西井伸洋, 寒川睦子, 河野晋久, 中村一文, 森田宏, 草野研吾, 伊藤浩, 湯本晃久, 向原直木, 大江透

臨床心臓電気生理 37 127 - 135 2014年5月

Cardiac erosion after catheter closure of atrial septal defect: Septal malalignment may be a novel risk factor for erosion.

Yasufumi Kijima, Teiji Akagi, Koji Nakagawa, Worakan Promphan, Norihisa Toh, Kazufumi Nakamura, Shunji Sano, Hiroshi Ito

Journal of cardiology cases 9 ( 4 ) 134 - 137 2014年4月

記述言語：英語掲載種別：研究論文（学術雑誌）

Pericardial tamponade occurred 3 days after the catheter closure of an atrial septal defect (ASD) using Amplatzer Septal Occluder (St. Jude Medical, St. Paul, MN, USA). Before the closure, two-dimensional and real-time three-dimensional transesophageal echocardiography demonstrated a deficient aortic rim and atrial septal malalignment. Perforation of the right atrium toward the non-coronary sinus of the aortic root was confirmed at the emergent surgery. Cardiac erosion is one of the most catastrophic complications in ASD patients undergoing catheter closure with Amplatzer Septal Occluder. Hence, several risk factors for this complication are discussed and identified. Oversized device deployment and a deficient aortic rim are accepted factors potentially causing cardiac erosion. Besides, atrial septal malalignment, which is a morphological characteristic of ASD, may be a novel risk factor for cardiac erosion. <Learning objective: Cardiac erosion is a potentially lethal complication when catheter closure of atrial septal defects using Amplatzer Septal Occluder (St. Jude Medical, St. Paul, MN, USA) is provided to the patients. However, mechanisms of this complication remain to be completely elucidated. Atrial septal malalignment may be one of the novel risk factors for this catastrophic complication.>.

DOI： 10.1016/j.jccase.2013.12.004

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Left ventricular epicardial electrogram recordings in idiopathic ventricular fibrillation with inferior and lateral early repolarization 国際誌

Koji Nakagawa, Satoshi Nagase, Hiroshi Morita, Hiroshi Ito

Heart Rhythm 11 ( 2 ) 314 - 317 2014年2月

Catheter closure of patent foramen ovale in patients with cryptogenic cerebrovascular accidents: initial experiences in Japan.

Yasufumi Kijima, Teiji Akagi, Koji Nakagawa, Manabu Taniguchi, Akira Ueoka, Kentaro Deguchi, Norihisa Toh, Hiroki Oe, Kengo Kusano, Shunji Sano, Hiroshi Ito

Cardiovascular intervention and therapeutics 29 ( 1 ) 11 - 7 2014年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

Although numerous studies have shown an association between a patent foramen ovale (PFO) and cryptogenic cerebrovascular accidents (CVA), there has been no definitive control study that demonstrated the benefit of percutaneous device closure of a PFO compared to medical therapy in patients with CVA. Additionally, few clinical data exist for Japanese patients in this field. We demonstrate the initial experiences in catheter closure of a PFO as secondary prevention of CVA in Japan. Catheter closure of a PFO was attempted in 7 patients who were diagnosed with cryptogenic CVA. Mean age at the procedure was 54 ± 19 years. The presence of spontaneous interatrial right-to-left shunts was demonstrated by transesophageal contrast echocardiography without Valsalva maneuver in all of the patients. Amplatzer Cribriform device (n = 4) or Amplatzer PFO Occluder (n = 3) was used for the procedure and was successfully deployed. Device-related complications were not observed at the time of the procedure or during the follow-up period (mean period of 16 ± 9 months). Catheter closure of a PFO could be safely performed with Amplatzer Cribriform or Amplatzer PFO Occluder. This procedure may contribute to prevention of recurrent cryptogenic CVA in Japanese patients.

DOI： 10.1007/s12928-013-0193-9

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陳旧性下壁心筋梗塞に合併した難治性心室頻拍に対し中心静脈 (MCV) からの通電が有効と考えられた1例

和田匡史, 永瀬聡, 田中正道, 中川晃志, 西井伸洋, 河野晋久, 中村一文, 森田宏, 伊藤浩

心臓 46 ( 3 ) S3_203 - S3_211 2014年

記述言語：日本語出版者・発行元：Japan Heart Foundation

88歳男性. 陳旧性下壁心筋梗塞, バイパス手術・僧帽弁形成術・左室形成術・ICD植込み術後. 2012年12月, VTに対するICD頻回作動で入院. V1のR/S ratio=1で上方軸の薬剤抵抗性VTに対し第1回アブレーション (CA) を施行. 左室の下壁～下壁中隔移行部でのentrainmentでconcealed fusion, 頻拍周期 (TCL) =post pacing interval (PPI), Egm-QRS=Stim-QRSが得られた. 同部の通電でVTは停止しなかったが周囲へ追加通電後にVTは誘発不可能となった. しかし後日同波形のVTが再発. ICD頻回作動を認め第2回CA施行. 中心静脈 (MCV) にてconcealed fusion, TCL=PPI, Egm-QRS=Stim-QRSが得られ, 同部の通電でVT波形は変化. 追加通電後にVT誘発不可能となった. 以後, 同波形のVT再発なく無事退院となった.

DOI： 10.11281/shinzo.46.S3_203

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右室単発早期刺激により明瞭なcoved型そしてsaddleback型心電図が得られたBrugada症候群の1例

中川晃志, 永瀬聡, 和田匡史, 田中正道, 西井伸洋, 渡邊敦之, 中村一文, 森田宏, 河野晋久, 草野研吾, 大江透, 伊藤浩

心臓 45 ( Suppl.3 ) 143 - 148 2013年12月