Faculty Profiles - NAKAMURA Kazufumi

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植込み型除細動器を植込まれたBrugada症候群患者における適切作動, 不適切作動の検討(共著）

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

Journal of Arrhythmia 25 293 2009

Brugada症候群の再分極異常とVF発症との関連性の検討(共著）

寒川睦子, 中津高明, 豊永慎二, 間島圭一, 森田宏, 西井伸洋, 三浦大志, 多田毅, 村上正人, 平松茂樹, 永瀬聡, 中村一文, 幡芳樹, 草野研吾, 草地省蔵, 大江透

Journal of Arrhythmia 25 376 2009

左室後乳頭筋起源と考えられた心室期外収縮に対しアブレーションを施行した1例

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

日本循環器学会中国地方会(Web) 94th 2009

デバイス設定変更にてT波オーバーセンスを回避できた1例

西井伸洋, 多田毅, 村上正人, 永瀬聡, 中村一文, 幡芳樹, 河野晋久, 森田宏, 草野研吾, 伊藤浩

日本循環器学会中国地方会(Web) 95th 2009

貧血と房室ブロックの重症度に相関が見られた一例

森田宏, 西井伸洋, 永瀬聡, 中村一文, 幡芳樹, 草野研吾, 伊藤浩

日本循環器学会中国地方会(Web) 95th 2009

心室頻拍に対し抗頻拍ペーシングが入りICDでdetectできない心室細動様波形となった重症拡張型心筋症の1例

柚木佳, 西井伸洋, 永瀬聡, 幡芳樹, 中村一文, 森田宏, 草野研吾

日本循環器学会中国地方会(Web) 94th 2009

II度房室ブロックを指摘され,植込み型除細動器植込み術を施行された筋強直性ジストロフィーの1例

尾上豪, 西井伸洋, 永瀬聡, 幡芳樹, 中村一文, 森田宏, 草野研吾

日本循環器学会中国地方会(Web) 94th 2009

Home monitoringシステムによる植込み型除細動器正常作動の検出経験

西井伸洋, 平松茂樹, 多田毅, 村上正人, 永瀬聡, 中村一文, 幡芳樹, 河野晋久, 森田宏, 草野研吾

日本循環器学会中国地方会(Web) 94th 2009

Radial augmentation index associated with increase in B-type natriuretic peptide in patients with hypertension

Satoru Sakuragi, Takeshi Maruo, Manabu Taniguchi, Satoshi Nagase, Kazufumi Nakamura, Kengo Fukushima Kusano, Tohru Ohe

INTERNATIONAL JOURNAL OF CARDIOLOGY 130 ( 3 ) 414 - 419 2008.11

Language：English Publisher：ELSEVIER IRELAND LTD

Brain natriuretic peptide (BNP) level has been used as a marker of left ventricular (LV) systolic dysfunction (LVSD), even though some patients with atherosclerosis have a high BNP level irrespective of LV function. In this study, we investigate whether augmentation index (AI), which is an index of wave reflection, is involved in increasing BNP level in hypertensive patients without LVSD. Sixty treated hypertensive patients were enrolled in this study. Radial AI (r-AI) was measured in all patients. The patients were classified into tertiles on the basis of r-AI to identify the characteristics of the patients with a high r-AI.
BNP level was significantly higher in the patients classified into the highest tertile of r-AI. In echocardiography, e ', which is index of left ventricular (LV) diastolic function, decreased and LV mass index (LVMI) increased gradually with r-AI, whereas there was no difference in LV ejection fraction ( LVEF). r-AI significantly correlated with LVMI (r=0.35, p < 0.01) and e ' (r=-0.30, p < 0.05). In univariate analysis, age, heart rate, r-AI, LVEF, e ' and LVMI were significantly correlated with BNP level, whereas multivariate analysis demonstrated that only r-AI and LVEF correlated with BNP level. In conclusion, an increase in r-AI was significantly associated with an increase in BNP level in hypertensive patients without LVSD. LV hypertrophy and diastolic dysfunction associated with increase in r-AI may be involved in increase in BNP level. (c) 2007 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.ijcard.2007.08.129

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119) 右房内に巨大血栓を認めた一例(第92回日本循環器学会中国・四国合同地方会)

森あい子, 川田哲史, 永瀬聡, 中村一文, 森田宏, 武田賢治, 岡岳文, 草野研吾, 大江透, 佐野俊二, 豊永慎二

Circulation journal : official journal of the Japanese Circulation Society 72 1042 - 1042 2008.10

85) SLEに伴う重症二次性肺高血圧が正常化した一例(第92回日本循環器学会中国・四国合同地方会)

廣田稔, 草野研吾, 赤木達, 福家聡一郎, 永瀬聡, 中村一文, 森田宏, 岡岳文, 大江透

Circulation journal : official journal of the Japanese Circulation Society 72 1038 - 1038 2008.10

171) Pergolide投与中に僧帽弁閉鎖不全による心不全を呈した1例(第92回日本循環器学会中国・四国合同地方会)

杉山洋樹, 武田賢治, 永瀬聡, 中村一文, 岡岳文, 草野研吾, 大江透

Circulation journal : official journal of the Japanese Circulation Society 72 1048 - 1048 2008.10

157) AED(自動体外式除細動器)の有効性と限界(第92回日本循環器学会中国・四国合同地方会)

尾上豪, 森田宏, 永瀬聡, 中村一文, 岡岳文, 草野研吾, 大江透, 氏家良人

Circulation journal : official journal of the Japanese Circulation Society 72 1046 - 1046 2008.10

50) 両心不全の原因が全身性硬化症による二次性心筋症であると考えられた一症例(第92回日本循環器学会中国・四国合同地方会)

野坂和正, 草野研吾, 尾上豪, 福家聡一郎, 永瀬聡, 中村一文, 森田宏, 武田賢治, 岡岳文, 大江透

Circulation journal : official journal of the Japanese Circulation Society 72 1034 - 1034 2008.10

Longer repolarization in the epicardium at the right ventricular outflow tract causes type 1 ECG in patients with Brugada syndrome

NAGASE Satoshi, FUKUSHIMA KUSANO Kengo, MORITA Hiroshi, NISHII Nobuhiro, HIRAMATSU Shigeki, NAKAMURA Kazufumi, OHE Tohru

28 ( 5 ) 428 - 428 2008.10

Update on genetic analysis in Brugada syndrome

Daiji Miura, Kazufumi Nakamura, Tohru Ohe

HEART RHYTHM 5 ( 10 ) 1495 - 1496 2008.10

Fragmented QRS as a Marker of Conduction Abnormality and a Predictor of Prognosis of Brugada Syndrome

Hiroshi Morita, Kengo F. Kusano, Daiji Miura, Satoshi Nagase, Kazufumi Nakamura, Shiho T. Morita, Tohru Ohe, Douglas P. Zipes, Jiashin Wu

CIRCULATION 118 ( 17 ) 1697 - 1704 2008.10

Language：English Publisher：LIPPINCOTT WILLIAMS & WILKINS

Background-Conduction abnormalities serve as a substrate for ventricular fibrillation (VF) in patients with Brugada syndrome (BS). Signal-averaged electrograms can detect late potentials, but the significance of conduction abnormalities within the QRS complex is still unknown. The latter can present as multiple spikes within the QRS complex (fragmented QRS [f-QRS]). We hypothesized that f-QRS could indicate a substrate for VF and might predict a high risk of VF for patients with BS.
Methods and Results-In study 1, we analyzed the incidence of f-QRS in 115 patients with BS (13 resuscitated from VF, 28 with syncope, and 74 asymptomatic). f-QRS was observed in 43% of patients, more often in the VF group (incidence of f-QRS: VF 85%, syncope 50%, and asymptomatic 34%, P < 0.01). SCN5A mutations occurred more often in patients with f-QRS (33%) than in patients without f-QRS (5%). In patients with syncope or VF, only 6% without f-QRS experienced VF during follow-up (43 +/- 25 months), but 58% of patients with f-QRS had recurrent syncope due to VF (P < 0.01). In study 2, to investigate the mechanism of f-QRS, we studied in vitro models of BS in canine right ventricular tissues (n = 4) and optically mapped multisite action potentials. In the experimental model of BS, ST elevation resulted from a large phase 1 notch of the action potential in the epicardium, and local epicardial activation delay reproduced f-QRS in the transmural ECG.
Conclusions-f-QRS appears to be a marker for the substrate for spontaneous VF in BS and predicts patients at high risk of syncope. (Circulation. 2008; 118: 1697-1704.)

DOI： 10.1161/CIRCULATIONAHA.108.770917

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Expression of monocyte chemoattractant protein-1 in idiopathic dilated cardiomyopathy

Makoto Kobayashi, Kazufumi Nakamura, Kengo Fukushima Kusano, Yoichi Nakamura, Keiko Ohta-Ogo, Satoshi Nagase, Satoru Sakuragi, Tohru Ohe

INTERNATIONAL JOURNAL OF CARDIOLOGY 126 ( 3 ) 427 - 429 2008.6

Language：English Publishing type：Rapid communication, short report, research note, etc. (scientific journal) Publisher：ELSEVIER IRELAND LTD

Immunological factors have been involved in the pathogenesis of dilated cardiomyopathy (DCM). The cytotoxic action of macrophages is one of the main factors causing cardiac myocyte damage. Monocyte chemoattractant protein-1 (MCP-1) is a major signal for the accumulation of monocytes/macrophages. We examined whether MCP-1 was expressed in the myocardium of DCM patients and whether the expression level was correlated with the degree of impairment of cardiac function. The expression of MCP-1 in the myocardium was determined by immunohistochemistry in endomyocardial biopsy samples from 13 patients. The expression of MCP-1 was found in all myocardial samples from DCM patients but not in those from control subjects. Positive staining for MCP-1 was distinct in cardiac myocytes, interstitium and infiltrating cells. Semi-quantitative analysis revealed that the expression of MCP-1 was inversely correlated with left ventricular ejection fraction. In conclusion, the expression level of MCP-1 in the myocardium was correlated with the degree of impairment of cardiac function in patients with DCM. (C) 2007 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.ijcard.2007.01.109

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Repolarization heterogeneity in the right ventricular outflow tract: Correlation with ventricular arrhythmias in Brugada patients and in an in vitro canine Brugada model

Hiroshi Morita, Douglas P. Zipes, Kengo Fukushima-Kusano, Satoshi Nagase, Kazufumi Nakamura, Shiho T. Morita, Tohru Ohe, Jiashin Wu

HEART RHYTHM 5 ( 5 ) 725 - 733 2008.5

Language：English Publisher：ELSEVIER SCIENCE INC

BACKGROUND Brugada syndrome (BrS) is characterized by repolarization abnormality with ST-segment elevation in the right ventricular outflow tract (RVOT).
OBJECTIVE Although action potential (AP) heterogeneity is associated with induction of ventricular arrhythmias (VA) in BrS, clinical evidence and its experimental correlations are still absent and are the focus of this study.
METHODS We evaluated repolarization heterogeneity in 15 patients with BrS using body surface mapping and in 8 pairs of isolated canine RVOT and right ventricular anteroinferior (RVAI) preparations having drug-induced BrS using optical mapping.
RESULTS Patients had large J-ST-segment elevation and long QT interval in the RVOT at baseline. Administration of pilsicainide (1 mg/kg) exaggerated J-ST-segment elevation, caused simultaneous Long and short QT intervals in the RVOT, and induced polymorphic ventricular tachycardia (VT) and T wave alternans (TWA). Dispersion of QT within the RVOT after pilsicainide was greater in patients that had syncope or ventricutar fibrillation than those that did not. Ventricular arrhythmias originated from the RVOT along with local electrocardiogram changes and TWA. Repolarization heterogeneity was much Less in areas outside the RVOT. Inducing BrS increased AP heterogeneity (with and without spike-and-dome) within the RVOT epicardium. Phase 2 reentry and TWA originated from the epicardium in 88% and 50% of RVOT preparations, respectively. In contrast, the RVOT endocardium and RVAI had Little AP heterogeneity, with neither reentry nor TWA.
CONCLUSION The instability and heterogeneity of repolarization within the epicardium of the RVOT seem to be associated with arrhythmogenesis in both patients and in the in vitro tissue models of BrS.

DOI： 10.1016/j.hrthm.2008.02.028

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50) メキシレチン投与によりQT間隔延長が著明に軽減した先天性QT延長症候群の一例(第91回日本循環器学会中国地方会)

尾上豪, 福家聡一郎, 岡岳文, 永瀬聡, 中村一文, 草野研吾, 大江透

Circulation journal : official journal of the Japanese Circulation Society 72 954 - 954 2008.4

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