Faculty Profiles - NAKAMURA Kazufumi

MISC - NAKAMURA Kazufumi

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Complete right bundle branch block and QRS-T discordance can be the initial clue to detect S-ICD ineligibility

Motomi Tachibana, Nobuhiro Nishii, Yoshimasa Morimoto, Satoshi Kawada, Akihito Miyoshi, Hiroyasu Sugiyama, Koji Nakagawa, Atsuyuki Watanabe, Kazufumi Nakamura, Hiroshi Morita, Hiroshi Ito

JOURNAL OF CARDIOLOGY 70 ( 1-2 ) 23 - 28 2017.7

Language：English Publisher：ELSEVIER SCIENCE BV

Background: In order to minimize inappropriate shocks of subcutaneous implantable cardioverter-defibrillators (S-ICD), it is important to recognize who is suitable for S-ICD indication. This study aimed to clarify what types of cardiac disease are likely to fulfill the S-ICD screening criteria and ineligible factors for S-ICD in the standard 12-lead electrocardiogram (ECG).
Methods: A total of 348 patients with heart disease were enrolled. They were assessed by supine and standing ECG recording to simulate the 3 S-ICD sensing vectors and standard 12-lead ECG, simultaneously. Clinical and ECG characteristics were analyzed to compare the patients who are eligible and ineligible with S-ICD screening ECG indication.
Results: The mean age of study patients was 49 21 years and 244 (70%) were men. Nineteen percent of patients were unsuitable for S-ICD. There was no significant difference in ineligibility for S-ICD among cardiac diseases (p = 0.48). Univariate analysis showed complete right bundle branch block (CRBBB), QRS-T discordance in lead II, and QRS-T discordance in 3 leads (I, II, and aVF) were more frequent in patients who were ineligible for S-ICD than in the eligible group. Multivariate regression analysis showed CRBBB and QRST discordance in 3 leads were independent predictors for ineligibility of S-ICD.
Conclusion: There are no differences in eligibility of S-ICD among types of cardiac diseases. CRBBB and QRS-T discordance were independent predictors for ineligibility. (C) 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.jjcc.2016.11.014

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High Frequency of Acute Adverse Cardiovascular Events After Lung Transplantation in Patients With Pulmonary Arterial Hypertension Receiving Preoperative Long-Term Intravenous Prostacyclin

Satoshi Akagi, Takahiro Oto, Motomu Kobayashi, Kentaroh Miyoshi, Seiichiro Sugimoto, Masaomi Yamane, Kazufumi Nakamura, Toshihiro Sarashina, Shinichiro Miyoshi, Hiroshi Ito

INTERNATIONAL HEART JOURNAL 58 ( 4 ) 557 - 561 2017.7

Language：English Publisher：INT HEART JOURNAL ASSOC

Adverse cardiovascular events after lung transplantation (LT) increase the mortality in patients with pulmonary arterial hypertension (PAH). Long-term intravenous prostacyclin is the usual treatment in severe patients with PAH, but it may increase the risk of hemorrhage due to its antiplatelet aggregation effect or thrombocytopenia. We investigated the impact of length of intravenous prostacyclin therapy on acute adverse cardiovascular events including hemorrhagic complication after LT. We retrospectively compared the incidence of adverse events (death, intrathoracic hematoma and bleeding, cardiac congestion or shock, cerebral infarction and pulmonary embolism) within 30 days after LT between no/short-term (median 0.6 years, n = 13) and long-term (median 3.7 years, n = 15) intravenous prostacyclin groups. There were no differences in the dose of intravenous prostacyclin and pulmonary artery pressure between the two groups. Among 22 adverse events (0.8 +/- 1.1 events/patient), 4 events occurred in the no/short-term intravenous prostacyclin group and 18 occurred in the long-term intravenous prostacyclin group. The event rate per patient in the long-term intravenous prostacyclin group (1.2 +/- 1.3 events/patient) was significantly higher than that in the no/short-term intravenous prostacyclin group (0.3 +/- 0.5 events/patient) (P < 0.05). Intrathoracic hematoma and bleeding was the most frequent adverse event (9 events, 41%). Preoperative long-term intravenous prostacyclin therapy increases acute adverse cardiovascular events after LT in patients with PAH.

DOI： 10.1536/ihj.16-389

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Epicardially placed implantable cardioverter-defibrillator for a child with congenital long QT syndrome

Hirotaro Sugiyama, Motomi Tachibana, Hiroshi Morita, Nobuhiro Nishii, Akihito Miyoshi, Hiroyasu Sugiyama, Koji Nakagawa, Atsuyuki Watanabe, Kazufumi Nakamura, Hiroshi Ito

Journal of Arrhythmia 33 ( 3 ) 237 - 239 2017.6

Language：English Publisher：Elsevier B.V.

A 7-year-old boy presented at our hospital with syncope. At birth, electrocardiography had shown a long QT interval with torsade de pointes (TdP). Congenital long QT syndrome (LQTS) had been diagnosed by genetic testing, and was successfully controlled with oral propranolol. At age 7, TdP had recurred with syncope. Electrocardiography revealed a prominent long QT interval with T-wave alternans. The propranolol dose was increased, but TdP remained uncontrolled. A cardioverter-defibrillator (ICD) was implanted epicardially, and TdP completely resolved with atrial pacing. We report this rare case of ICD implantation in a child with LQTS.

DOI： 10.1016/j.joa.2016.10.561

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Effect of remote ischemia or nicorandil on myocardial injury following percutaneous coronary intervention in patients with stable coronary artery disease: A randomized controlled trial

Toru Miyoshi, Kentaro Ejiri, Kunihisa Kohno, Makoto Nakahama, Masayuki Doi, Mitsuru Munemasa, Masaaki Murakami, Atsushi Takaishi, Yusuke Kawai, Tetsuya Sato, Katsumasa Sato, Takefumi Oka, Natsuki Takahashi, Satoru Sakuragi, Atsushi Mima, Kenki Enko, Shingo Hosogi, Seiji Nanba, Ryoichi Hirami, Kazufumi Nakamura, Hiroshi Ito

INTERNATIONAL JOURNAL OF CARDIOLOGY 236 36 - 42 2017.6

Language：English Publisher：ELSEVIER IRELAND LTD

Background: The effect of remote ischemic preconditioning (RIPC) and nicorandil on periprocedural myocardial injury (pMI) in patients with planned percutaneous coronary intervention (PCI) remains controversial. The aim of this randomized trial was to evaluate the effect of RIPC or nicorandil on pMI following PCI in patients with stable coronary artery disease (CAD) compared with a control group.
Methods: Patients with stable CAD who planned to undergo PCI were assigned to a 1: 1: 1 ratio to control, RIPC, or intravenous nicorandil (6mg/h). Automated RIPC was performed by a device, which performs intermittent arm ischemia through three cycles of 5min of inflation and 5min of deflation of a pressure cuff. The primary outcome was the incidence of pMI, determined by an elevation in high-sensitive troponin T or creatine kinase myocardial band at 12 or 24 h after PCI. The secondary outcomes were ischemic events during PCI and adverse clinical events at 8 months after PCI.
Results: A total of 391 patients were enrolled. The incidence of pMI following PCI was not significantly different between the control group (48.9%) and RIPC group (39.5%; p = 0.14), or between the control group and nicorandil group (40.3%; p = 0.17). There were no significant differences in ischemic events during PCI or adverse clinical events within 8 months after PCI among the three groups.
Conclusions: This study demonstrated moderate reductions in biomarker release and pMI by RIPC or intravenous nicorandil prior to the PCI consistently, but may have failed to achieve statistical significance because the study was underpowered. (C) 2017 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.ijcard.2017.02.028

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Comparable effect of aliskiren or a diuretic added on an angiotensin II receptor blocker on augmentation index in hypertension: A multicentre, prospective, randomised study

Toru Miyoshi, Takashi Murakami, Satoru Sakuragi, Masayuki Doi, Seiji Nanba, Atsushi Mima, Youkou Tominaga, Takafumi Oka, Yutaka Kajikawa, Kazufumi Nakamura, Hiroshi Ito

Open Heart 4 ( 1 ) 296 - 301 2017.3

Language：English Publisher：BMJ Publishing Group

Background The effects of antihypertensive drug combination therapy on central blood pressure (BP) and augmentation index (AI) have not been fully elucidated. We investigated the effects of the direct renin inhibitor, aliskiren, or a diuretic added to an angiotensin II receptor blocker on AI in patients with essential hypertension. Methods A 24-week, prospective, multicentre, randomised, open-label study enrolled 103 patients already treated with valsartan. Participants were randomly allocated to receive either valsartan with aliskiren (V+A), or valsartan with trichlormethiazide (V+T). The primary outcome was the change in AI derived from radial artery tonometry. Secondary outcome measures included systolic and diastolic BP, cardio-ankle vascular index (CAVI, which reflects arterial stiffness) and urinary 8-hydroxydeoxyguanosine concentration. Results After 24 weeks, systolic and diastolic BP were significantly reduced in both groups to a broadly comparable extent. There was no significant difference in AI at the end of the study between the V+A group and the V+T group (between-group difference: -2.3%, 95% CI -6.9% to 2.2%, p=0.31). Central BP at the end of the study also did not differ between the two groups (p=0.62). There was no significant difference in the CAVI between the groups at the end of the study. Urinary 8-hydroxydeoxyguanosine concentration was significantly lower in the V+A group than in the V+T group (p &lt
0.01), suggesting that V+A attenuated oxidative stress more than V+T. Conclusion The combination of valsartan and aliskiren had an effect on AI comparable with that of the combination of valsartan and trichlormethiazide.

DOI： 10.1136/openhrt-2017-000591

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Reverse Right Ventricular Remodeling After Lung Transplantation in Patients With Pulmonary Arterial Hypertension Under Combination Therapy of Targeted Medical Drugs

Toshihiro Sarashina, Kazufumi Nakamura, Satoshi Akagi, Takahiro Oto, Hiroki Oe, Kentaro Ejiri, Koji Nakagawa, Nobuhiro Nishii, Hiromi Matsubara, Motomu Kobayashi, Hiroshi Morimatsu, Shinichiro Miyoshi, Hiroshi Ito

CIRCULATION JOURNAL 81 ( 3 ) 383 - 390 2017.3

Language：English Publisher：JAPANESE CIRCULATION SOC

Background: Patients with pulmonary arterial hypertension (PAH) are currently treated with combination therapy of PAH-targeted drugs. Reverse right ventricular (RV) remodeling after lung transplantation (LTx) in patients with end-stage PAH despite combination therapy of PAH-targeted drugs has not been fully elucidated.
Methods and Results: A total of 136 patients, including 32 with PAH, underwent LTx from 1998 to 2014. We enrolled 12 consecutive patients with PAH treated with combination therapy of PAH-targeted drugs who underwent LTx and retrospectively analyzed the temporal and serial changes in hemodynamics and echocardiography before LTx and at 3 and 12 months after LTx. Before LTx, the RV was markedly dilated with substantially reduced RV fractional area change (RVFAC). At 3 months after LTx, pulmonary artery pressure, pulmonary vascular resistance and RV stroke work index were significantly decreased, while left ventricular stroke work index was increased. RV size assessed by echocardiography also significantly decreased and RVFAC improved. At 12 months after LTx, RVFAC was further increased and RV wall thickness was decreased significantly.
Conclusions: Although severe RV dysfunction and dilation were observed in patients with end-stage PAH despite combination therapy of PAH-targeted drugs, RV function and morphology were improved after reduction of RV pressure load by LTx.

DOI： 10.1253/circj.CJ-16-0838

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Local Left Ventricular Epicardial J Waves and Late Potentials in Brugada Syndrome Patients with Inferolateral Early Repolarization Pattern

Satoshi Nagase, Masamichi Tanaka, Hiroshi Morita, Koji Nakagawa, Tadashi Wada, Masato Murakami, Nobuhiro Nishii, Kazufumi Nakamura, Hiroshi Ito, Tohru Ohe, Kengo F. Kusano

FRONTIERS IN PHYSIOLOGY 8 ( JAN ) 947 - 60 2017.1

Language：English Publisher：FRONTIERS MEDIA SA

Background: Brugada syndrome (BrS) is characterized by J-point or ST-segment elevation on electrocardiograms (ECGs) and increased risk of ventricular fibrillation (VF). In BrS, epicardial depolarization abnormality with delayed potential on the right ventricular outflow tract is reportedly the predominant mechanism underlying VF. Yet VF occurrence is also associated with early repolarization (ER) pattern in the inferolateral ECG leads, which may represent the inferior and/or left lateral ventricular myocardium. The aim of this study was to examine epicardial electrograms recorded directly at the left ventricle (LV) in BrS patients after VF episodes.
Methods: In 12 BrS patients who had experienced VF episodes and 17 control subjects, a multipolar catheter was introduced into the left lateral coronary vein for unipolar and bipolar electrogram recordings at the LV epicardium. Both inferior and lateral ER patterns on ECG were observed in three BrS patients and six control subjects.
Results: In the epicardium, prominent J waves were detected using unipolar recording, and potentials after the QRS complex were detected using bipolar recording in three of the 12 BrS patients. These three patients also showed both inferior and lateral ER patterns on ECG. Neither prominent J waves nor potentials after the QRS complex were recorded at the endocardium of the LV in any of these three patients; nor were they seen at the epicardium in any of the control subjects. These features were accentuated on pilsicainide administration (n = 2) but diminished on constant atrial pacing (n = 3) and isoproterenol administration (n = 1). The J waves observed through unipolar recording coincided with the potentials after QRS complex observed through bipolar recording and with the inferolateral ER patterns on ECG.
Conclusions: We recorded prominent J waves in unipolar electrogram and potentials after QRS complex in bipolar electrogram at the LV epicardium in BrS patients with global ER pattern. The prominent J waves coincided with the potentials after QRS complex and the inferolateral ER pattern on ECG. The characteristics of the inferolateral ER pattern on ECG in these patients primarily represent depolarization feature.

DOI： 10.3389/fphys.2017.00014

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治療に難渋した壊死性好酸球性心筋炎の1例(共著）

小出祐嗣, 中村一文, 木村朋生, 中川晃志, 三好亨, 西井伸洋, 伊藤浩, 大澤晋, 笠原慎吾, 田中健大, 柳井広之, 安藤翠, 大郷恵子, 山中俊明

心臓 49 ( Suppl1 ) 159 - 167 2017

Progression of pulmonary artery dilatation in patients with pulmonary hypertension coexisting with a pulmonary artery aneurysm

Satoshi Akagi, Kazufumi Nakamura, Toshihiro Sarashina, Kentaro Ejiri, Shingo Kasahara, Hiroshi Ito

Journal of Cardiology 571 - 579 2017

Serum cystatin C levels are associated with coronary artery calcification in women without chronic kidney disease

Hiroyasu Sugiyama, Toru Miyoshi, Kazuhiro Osawa, Takashi Miki, Yuji Koide, Kazufumi Nakamura, Hiroshi Morita, Hiroshi Ito

Journal of Cardiology 283 - 289 2017

ACE阻害薬、ARB(共著）

谷本匡史, 中村一文

薬局 68 ( 7 ) 54 - 59 2017

特集肺高血圧症－診断と治療の新展開－肺動脈性肺高血圧症基礎研究の進歩(共著）

中村一文, 江尻健太郎, 赤木達

最新医学 72 ( 8 ) 49 - 53 2017

Analysis of arrhythmic events is useful to detect lead failure earlier in patients followed by remote monitoring

Nobuhiro Nishii, Akihito Miyoshi, Motoki Kubo, Masakazu Miyamoto, Yoshimasa Morimoto, Satoshi Kawada, Koji Nakagawa, Atsuyuki Watanabe, Kazufumi Nakamura, Hiroshi Morita, Hiroshi Ito

Journal of Cardiovascular Electrophysiology, Journal of Electrophysiology, Clinical Progress in Electrophysiology and Pacing, Clinical Progress in Pacing and Electrophysiology 379 - 386 2017

Exercise stress test reveals ineligibility for subcutaneous implantable cardioverter defibrillator in patients with Brugada syndrome

Motomi Tachibana, Nobuhiro Nishii, Hiroshi Morita, Koji Nakagawa, Atsuyuki Watanabe, Kazufumi Nakamura, Hiroshi Ito

Journal of Cardiovascular Electrophysiology, Journal of Electrophysiology, Clinical Progress in Electrophysiology and Pacing, Clinical Progress in Pacing and Electrophysiology 38 - 44 2017

Identification of electrocardiographic risk markers for the initial and recurrent episodes of ventricular fibrillation in patients with Brugada syndrome

Hiroshi Morita, Atsuyuki Watanabe, Satoshi Kawada, Masakazu Miyamoto, Yoshimasa Morimoto, Koji Nakagawa, Nobuhiro Nishii, Kazufumi Nakamura, Hiroshi Ito

Journal of Cardiovascular Electrophysiology, Journal of Electrophysiology, Clinical Progress in Electrophysiology and Pacing, Clinical Progress in Pacing and Electrophysiology 20 - 33 2017

His束近傍の副伝導路に対して,Freezor Xtraにより根治しえた一例

森本芳正, 渡邊敦之, 川田哲史, 橘元見, 中川晃志, 中村一文, 森田宏, 伊藤浩

日本循環器学会中国地方会(Web) 110th 2017

胸椎圧迫骨折が病態悪化に関与したと考えられた心房中隔欠損症によるPlatypnea-Orthodeoxia Syndromeの一例

原田洸, 大塚寛昭, 中川晃志, 高谷陽一, 渡邊敦之, 三好亨, 西井伸洋, 衛藤弘城, 赤木禎治, 中村一文, 伊藤浩

日本循環器学会中国地方会(Web) 110th 2017

Single Chamber ICDによりshock作動を起こした頻拍を,心臓電気生理学的検査にて上室頻拍と診断しえた1例

森本芳正, 西井伸洋, 森田宏, 三好章仁, 川田哲史, 杉山弘恭, 橘元見, 中川晃志, 渡邊敦之, 中村一文, 伊藤浩

日本循環器学会中国地方会(Web) 110th 2017

心肺停止に至ったQT短縮症候群の1例

山岡英功, 森田宏, 大塚寛昭, 戸田洋伸, 寺西仁, 杜徳尚, 中川晃志, 渡邊敦之, 西井伸洋, 中村一文, 伊藤浩

日本循環器学会中国地方会(Web) 111th 2017

肺高血圧症患者の肺移植後右室リバースリモデリング:特異的肺動脈性肺高血圧症治療薬の併用療法後の検討

更科俊洋, 中村一文, 赤木達, 江尻健太郎, 中川晃志, 西井伸洋, 森田宏, 伊藤浩

日本循環器学会中国地方会(Web) 110th 2017

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MISC - NAKAMURA Kazufumi