Faculty Profiles - NAKAMURA Kazufumi

Papers - NAKAMURA Kazufumi

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Guidelines for treatment of chronic heart failure

124 ( 1 ) 71 - 73 2012.4

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 2012.4

プロスタグランジンI2はFasリガンドを介して特発性肺動脈性肺高血圧症患者の肺動脈平滑筋細胞のアポトーシスを誘導し肺血管リモデリングを改善する

赤木達, 中村一文, 草野研吾, 松原広己, 伊藤浩

日本臨床分子医学会学術総会プログラム・抄録集 49回 89 - 89 2012.4

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 2012.3

Language：Japanese Publisher：(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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Brugada症候群における下壁側壁誘導でのJ waveの意義 Brugada症候群における下壁側壁誘導での早期再分極の影響

時岡浩二, 草野研吾, 谷山真規子, 杜徳尚, 吉田賢司, 三好亨, 西井伸洋, 永瀬聡, 中村一文, 河野晋久, 森田宏, 伊藤浩, 大江透

心電図 32 ( Suppl.1 ) S - 87 2012.2

Sustained monomorphic ventricular tachycardia in patients with Brugada syndrome

Take Yutaka, Morita Hiroshi, Toh Norihisa, Nishii Nobuhiro, Hashimoto Katsushi, Nagase Satoshi, Nakamura Kazuhumi, Kohno Kunihisa, Kusano Kengo, Ohe Tohru, Ito Hiroshi

Shinzo 44 ( 2 ) S2_55 - S2_55 2012

著明に拡張した肺動脈による左冠動脈主幹部狭窄をPCIにて治療しえた肺高血圧症の1例

赤木達, 中村一文, 内藤洋一郎, 草野研吾, 伊藤浩

Therapeutic Research 32 ( 10 ) 1217 - 1218 2011.10

Language：Japanese Publisher：ライフサイエンス出版(株)

56歳女。著明に拡張した主肺動脈が左冠動脈主幹部を圧排し、左冠動脈の血流低下が左心機能低下と肺高血圧症の悪化をもたらしていた。同部に対してIABP補助下に冠動脈ステント留置術を行い、肺高血圧の改善はあまりみられなかったが、左心機能の改善が得られた。

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Other Link： https://search.jamas.or.jp/default/link?pub_year=2011&ichushi_jid=J01759&link_issn=&doc_id=20111111100004&doc_link_id=issn%3D0289-8020%26volume%3D32%26issue%3D10%26spage%3D1217&url=http%3A%2F%2Fwww.pieronline.jp%2Fopenurl%3Fissn%3D0289-8020%26volume%3D32%26issue%3D10%26spage%3D1217&type=PierOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00005_2.gif

Beta-Blockers and Oxidative Stress in Patients with Heart Failure. Reviewed International journal

Nakamura K, Murakami M, Miura D, Yunoki K, Enko K, Tanaka M, Saito Y, Nishii N, Miyoshi T, Yoshida M, Oe H, Toh N, Nagase S, Kohno K, Morita H, Matsubara H, Kusano KF, Ohe T, Ito H

Pharmaceuticals (Basel, Switzerland) 4 ( 8 ) 1088 - 1100 2011.8

Language：English Publishing type：Research paper (scientific journal)

Oxidative stress has been implicated in the pathogenesis of heart failure. Reactive oxygen species (ROS) are produced in the failing myocardium, and ROS cause hypertrophy, apoptosis/cell death and intracellular Ca(2+) overload in cardiac myocytes. ROS also cause damage to lipid cell membranes in the process of lipid peroxidation. In this process, several aldehydes, including 4-hydroxy-2-nonenal (HNE), are generated and the amount of HNE is increased in the human failing myocardium. HNE exacerbates the formation of ROS, especially H₂O₂ and ·OH, in cardiomyocytes and subsequently ROS cause intracellular Ca(2+) overload. Treatment with beta-blockers such as metoprolol, carvedilol and bisoprolol reduces the levels of oxidative stress, together with amelioration of heart failure. This reduction could be caused by several possible mechanisms. First, the beta-blocking effect is important, because catecholamines such as isoproterenol and norepinephrine induce oxidative stress in the myocardium. Second, anti-ischemic effects and negative chronotropic effects are also important. Furthermore, direct antioxidative effects of carvedilol contribute to the reduction of oxidative stress. Carvedilol inhibited HNE-induced intracellular Ca(2+) overload. Beta-blocker therapy is a useful antioxidative therapy in patients with heart failure.

DOI： 10.3390/ph4081088

PubMed

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糖尿病と心血管疾患拡張不全における糖代謝異常の関与

中村一文, 三好亨, 三浦大志, 麻植浩樹, 伊藤浩

日本心臓病学会誌 6 ( Suppl.I ) 167 - 167 2011.8

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 2011.5

Language：Japanese Publisher：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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53歳女性Brugada症例のLate Potential(LP)と心拍変動との関連性、LPの日内変動性の検討ホルター心電図を用いて

寒川睦子, 豊永慎二, 間島圭一, 中津高明, 藤田政雄, 草地省蔵, 大江透, 西井伸洋, 永瀬聡, 森田宏, 中村一文, 草野研吾, 伊藤浩

心電図 31 ( Suppl.1 ) S - 20 2011.5

Indication of implantable cardioverter defibrillator for myotonic dystrophy in patients with high degree atrio-ventricular block

Take Yutaka, Morita Hiroshi, Nishii Nobuhiro, Nagase Satoshi, Kazufumi Nakamura, Kohno Kunihisa, Kusano Kengo, Ito Hiroshi

Shinzo 43 ( 2 ) S2_39 - S2_45 2011

PJ3-053 New Onset of Ventricular Fibrillation Episodes in Asymptomatic Patients with Brugada Syndrome -Are Patients with Class IIb Safe?-

Morita Hiroshi, Satoshi Nagase, Norihisa Toh, Nobuhiro Nishii, Kazufumi Nakamura, Kengo Kusano, Tohru Ohe, Hiroshi Ito

Journal of Arrhythmia 27 2011

Publishing type：Research paper (scientific journal)

Introduction: Japanese guideline of the Brugada syndrome (BS) defined the indication of the implantable cardioverter defibrillater (ICD) in asymptomatic patients with BS as patients having both family history of sudden death (FH) and induced ventricular fibrillation (VF) by programmed electrical stimulation (PES) (class IIa). When patients had one of these criteria, ICD indication considered as class IIb. We analyzed new onset of VF episodes in asymptomatic patients. Methods and Results: We analyzed 99 asymptomatic patients with Brugada type ECG. Fourty-seven patients had FH. VF was induced by PES in 44 patients. Criteria of ICD indication of class IIa, IIb, and III were met in 20, 50, and 29 patients, respectively. Three patients experienced new-onset VF episode during follow-up periods (84±43 months). Although there was no new-onset VF in patients with class IIa, all patients who experienced VF episodes belonged to class IIb (6%). All patients with new-VF had spontaneous type 1 ECG, induced VF by PES, positive late potential and fragmented QRS, but did not have FH and SCN5A mutation. Conclusion: Prediction of prognosis in patients with BS-ECG based on BS-guideline has limited value and occurrence of VF is not rare in patients with class IIb of ICD indication. © 2011, Japanese Heart Rhythm Society. All rights reserved.

DOI： 10.4020/jhrs.27.PJ3_053

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Pronounced Late Potential at Night Time, Bradycardia, and Pronounced Vagal Activity May Be a Risk Marker of Ventricular Fibrillation in Brugada Syndrome

Mutsuko Sangawa, Hiroshi Morita, Nobuhiro Nishii, Sastoshi Nagase, Kazufumi Nakamura, Kengo Kusano, Hiroshi Ito

journal of arrhythmia 27 ( 4 ) 280 2011

Publishing type：Research paper (scientific journal)

Backgrond: Ventricular Late Potential(LPs) detected signal averaged ECGs have been used widely to detect high risk patients. In Brugada syndrome(BrS), Ventricular fibrillation(VF) frequently occurs at nighttime and pronounced vagal activity. Purpose: We examine relationship between LPs and Heart rate, Vagal activity, and circadian variation of LPs in BrS. Methods: We evaluated 24hours HolterECGs of total 14 BrS and 10 normal controls. We evaluated LPs (fQRS,LAS40,RMS40), RR interval and High frequency (HF:0.15-0.4Hz) of frequency domaine analysis. We examined relationship between LPs and RRinterval, LnHF. Results: Relationship between LAS40 and RRinterval, relationship between LAS40 and LnHF were obtained as a liner regression line and significant positive correlation inBrS. LAS40/RRslope was significantly sharpened in BrSwithVF than BrSwithout VF, Controls (24 ±11 vs 3±13 vs -4±20, p<0.01, BrSwithVF vs BrSwithoutVF vs Controls). LAS40 at bradycardia was significantly pronounced in BrS withVF than BrS withoutVF, Controls (48±3 vs 32±12 vs 22±11, p<0.01, BrS withVF vs BrS withoutVF vs Controls). LAS40/LnHFslope were significantly sharpened than Controls.(3.0±3.2 vs -0.4±3.0, p<0.05, BrS vs Controls). Conclusion: In BrS, LPs were pronounced at bradycardia and night time and at pronounced vagal acitivity. Pronounced LPs at bradycardia and nighttime, at pronounced vagalacitivity may be a risk marker of VF inBrS. © 2011, Japanese Heart Rhythm Society. All rights reserved.

DOI： 10.4020/jhrs.27.OP36_4

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Impact of Infero/Lateral Early Repolarization Pattern in Patients with Brugada Syndrome

Koji Tokioka, Kengo Kusano, Hiroshi Morita, Satoshi Nagase, Kunihisa Kohno, Kazufumi Nakamura, Nobuhiro Nishii, Daiji Miura, Hiroshi Ito, Tohru Ohe

journal of arrhythmia 27 ( 4 ) 286 2011

Publishing type：Research paper (scientific journal)

Background: Inferolateral early repolarization (ER) pattern is often observed in Brugada syndrome (BrS). However, its clinical implication in this syndrome is still controversial. Method: Total two-hundred forty five Brugada ECG patients (mean age 48 years, men/female=235/10), including documented ventricular fibrillation (VF) in 27, were evaluated. Infero/lateral ER pattern was defined as a notched or slurring>1mm J-wave at least consecutive two of inferior (II, III, aVF) or lateral (I, aVL, V4, V5, V6) leads. The presence of this ER pattern was compared with clinical, electrocardiographic and genetic parameters. Results: Infero/lateral ER pattern was observed in 25 (10.2%) BrS patients (inferior leads in 12, lateral leads in 11 and both in 2) and was significantly associated with patients of documented VF (P<0.01) and with prolonged PQ interval (P<0.04). However they were not associated with the frequency of spontaneous type-1 ECG, wide QRS complex (>120ms), family history of sudden death, positive late potential on signal averaged ECG and SCN5A mutation. Increased number of positive ER leads have a trend of increasing documented VF patients (>3 leads; 54%). Conclusion: These data indicates that infero/lateral ER reflects the expansion of repolarization abnormality in the ventricle and may be associated with high-risk phenotype in BrS. © 2011, Japanese Heart Rhythm Society. All rights reserved.

DOI： 10.4020/jhrs.27.CP1_07

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Anti-tachycardia pacing degenerated fast ventricular tachycardia into undetectable life-threatening tachyarrhythmia in a patient with non-ischemic dilated cardiomyopathy.

Kei Yunoki, Nobuhiro Nishii, Hiroshi Morita, Jun Iwasaki, Satoshi Nagase, Kazufumi Nakamura, Yoshiki Hata, Kunihisa Kohno, Kengo F Kusano, Hiroshi Ito

Journal of cardiology cases 2 ( 3 ) e159-e162 2010.12

Language：English Publishing type：Research paper (scientific journal)

A 45-year-old man with dilated cardiomyopathy was admitted to our hospital due to congestive heart failure (CHF). Despite the optimal medical treatment, his condition had not improved because of severe left ventricular dysfunction. Because he experienced non-sustained ventricular tachycardia (VT), a biventricular implantable cardioverter-defibrillator (Bi-V ICD) was implanted for reduction of dyssynchrony and primary prevention of lethal tachyarrhythmia. After discharge, he developed CHF and was transported to our hospital by ambulance. In the ambulance, monomorphic sustained VT with 200 bpm suddenly occurred. The ICD detected it as fast VT and anti-tachycardia pacing (ATP) was delivered. After the ATP therapy, RR intervals of VT became irregular and prolonged. Ventricular fibrillation-like electrical activity was recorded by a far-field electrogram from the defibrillator, but the tachycardia cycle length exceeded 400 ms which is under the tachycardia detection rate. The device failed to deliver a shock and the patient had to be rescued with an external shock. This is a rare case of fast VT that degenerated into undetectable life-threatening tachyarrhythmia by ATP.

DOI： 10.1016/j.jccase.2010.06.003

PubMed

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Brugada症候群における酸化ストレスと心室細動発症の関連

田中正道, 中村一文, 大郷恵子, 三浦大志, 三浦綾, 西井伸洋, 永瀬聡, 幡芳樹, 森田宏, 草野研吾, 大江透, 伊藤浩, 由谷親夫

心臓 42 ( 10 ) 1369 - 1369 2010.10

53歳女性Brugada症例のホルター心電図を用いた加算平均心電図指標(Late Potential)と心拍変動との関連、日内変動の検討

寒川睦子, 藤田政雄, 豊永慎二, 間島圭一, 中津高明, 草地省蔵, 森田宏, 西井伸洋, 永瀬聡, 中村一文, 大江透, 草野研吾, 伊藤浩

心電図 30 ( Suppl.4 ) S - 171 2010.9

遅延電位の24時間Holter心電図記録を用いたBrugada症候群の速度依存性脱分極のダイナミクス(Rate-dependent depolarization dynamics in Brugada syndrome using 24hours Holter recordings of Late Potential)

寒川睦子, 藤田政雄, 豊永慎二, 間島圭一, 中津高明, 草地省蔵, 森田宏, 西井伸洋, 永瀬聡, 中村一文, 大江透, 草野研吾, 伊藤浩

心電図 30 ( Suppl.4 ) S - 197 2010.9

植え込み型除細動器による心腔内除細動が心筋組織・心機能にあたえる影響についての検討

杜徳尚, 西井伸洋, 中村一文, 永瀬聡, 河野晋久, 森田宏, 草野研吾, 伊藤浩

日本心臓病学会誌 5 ( Suppl.I ) 291 - 291 2010.8

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Papers - NAKAMURA Kazufumi