Faculty Profiles - MORITA Hiroshi

Papers - MORITA Hiroshi

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Impact of High-Sensitivity Cardiac Troponin T on Clinical Outcomes in Patients With Cardiac Sarcoidosis.

Yoichi Takaya, Koji Nakagawa, Toru Miyoshi, Nobuhiro Nishii, Hiroshi Morita, Kazufumi Nakamura, Shinsuke Yuasa

Circulation journal : official journal of the Japanese Circulation Society 2025.2

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

BACKGROUND: The prognostic utility of high-sensitivity cardiac troponin T (hs-cTnT) on clinical outcomes in cardiac sarcoidosis (CS) remains unknown, so we evaluated hs-cTnT in the chronic phase of CS. METHODS AND RESULTS: We enrolled 92 consecutive patients with CS in the chronic phase after medical therapies. Patients were divided into 2 groups according to hs-cTnT level: 0.014 ng/mL: high hs-cTnT (n=37); normal hs-cTnT (n=55). The primary endpoint was cardiac death and the secondary endpoint was cardiac death, ventricular tachyarrhythmias, or hospitalization for heart failure. The mean age of patients was 63±11 years, and 75 received steroid treatment. During a median follow-up of 63 months, there were 9 cardiac deaths: 7 (19%) patients with high hs-cTnT and 2 (4%) patients with normal hs-cTnT. The rate of cardiac death was higher in patients with high hs-cTnT than in those with normal hs-cTnT (log-rank, P<0.01). Cox proportional hazard analysis showed that hs-cTnT was an independent predictor of cardiac death. The events rate was higher in patients with high hs-cTnT than in those with normal hs-cTnT (log-rank, P<0.01): cardiac death, ventricular tachyarrhythmias or hospitalization for heart failure occurred in 24 (65%) patients with high hs-cTnT and 11 (20%) patients with normal hs-cTnT. CONCLUSIONS: Elevated hs-cTnT was linked with adverse outcomes in CS patients, suggesting it is an effective prognostic biomarker.

DOI： 10.1253/circj.CJ-24-0801

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Life-Threatening Ventricular Tachyarrhythmia in Isolated Cardiac Sarcoidosis Compared With Cardiac Sarcoidosis With Extracardiac Involvement

Yoichi Takaya, Koji Nakagawa, Toru Miyoshi, Nobuhiro Nishii, Hiroshi Morita, Kazufumi Nakamura, Shinsuke Yuasa

The American Journal of Cardiology 2024.12

Efficacy of Ivabradine in Preventing Inappropriate Shock due to Sinus Tachycardia in a Patient with Cardiac Sarcoidosis

Takuro Masuda, Kazufumi Nakamura, Nobuhiro Nishii, Saori Asada, Akira Ueoka, Masakazu Miyamoto, Koji Nakagawa, Yoichi Takaya, Hironobu Toda, Hiroshi Morita, Shinsuke Yuasa

International Heart Journal 65 ( 6 ) 1167 - 1171 2024.11

Differences in clinical significance of atrial tachyarrhythmias in idiopathic ventricular fibrillation vs Brugada syndrome: A multicenter study

Tomofumi Mizuno, Nobuhiro Nishii, Hiroshi Morita, Takuro Masuda, Akira Ueoka, Saori Asada, Yoshimasa Morimoto, Masakazu Miyamoto, Satoshi Kawada, Tadashi Wada, Shigeki Hiramatsu, Keisuke Okawa, Motoki Kubo, Koji Nakagawa, Atsuyuki Watanabe, Kazufumi Nakamura, Shinsuke Yuasa

Heart Rhythm O2 5 ( 11 ) 796 - 804 2024.11

Impact of extracardiac sarcoidosis on clinical outcomes in patients with cardiac sarcoidosis: Importance of continued screening for cardiac involvement. International journal

Yoichi Takaya, Koji Nakagawa, Toru Miyoshi, Nobuhiro Nishii, Hiroshi Morita, Kazufumi Nakamura, Shinsuke Yuasa

International journal of cardiology 413 132368 - 132368 2024.7

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

BACKGROUND: The prognostic impact of extracardiac sarcoidosis remains unknown in cardiac sarcoidosis (CS). We aimed to evaluate the influence of extracardiac sarcoidosis on clinical outcomes and the effect of continued outpatient visits for screening of cardiac involvement. METHODS: Ninety-nine patients with CS were divided into two groups: patients with systemic CS who had prior extracardiac sarcoidosis, patients with isolated CS who had no prior extracardiac sarcoidosis. Patients with systemic CS were divided according to the continuation of outpatient visits. The endpoint was cardiac death, fatal ventricular arrhythmia, or hospitalization for heart failure. RESULTS: At the time of diagnosing CS, patients with isolated CS had a higher prevalence of high-grade atrioventricular block or fatal ventricular arrhythmia, and left ventricular contractile dysfunction than those with systemic CS. Over a median follow-up of 42 months, cardiac events occurred in 19 (37%) of 52 patients with systemic CS and in 27 (57%) of 47 patients with isolated CS. The event-free survival rate was worse in patients with isolated CS than in those with systemic CS. Cox proportional hazard analysis showed that the absence of prior extracardiac sarcoidosis was an independent predictor of adverse outcomes. Patients with systemic CS who ceased outpatient visits had a lower left ventricular ejection fraction with severe heart failure symptoms and a worse event-free survival rate than those who continued outpatient visits. CONCLUSIONS: The presence of extracardiac sarcoidosis is associated with clinical outcomes. The cessation of screening for cardiac involvement after diagnosing extracardiac sarcoidosis is associated with adverse outcomes.

DOI： 10.1016/j.ijcard.2024.132368

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Late gadolinium enhancement in early repolarization syndrome

Hiroshi Morita, Saori Asada, Satoshi Nagase, Akira Ueoka, Takuro Masuda, Masakazu Miyamoto, Koji Nakagawa, Nobuhiro Nishii, Shinsuke Yuasa

Heart Rhythm 2024.7

Demonstration of Arrhythmia Substrate-Associated Dispersion of Repolarization by Epicardial Unipolar Mapping in Brugada Syndrome. International journal

Satoshi Nagase, Naoya Kataoka, Hiroshi Morita, Tsukasa Kamakura, Akira Ueoka, Toshihiro Nakamura, Satoshi Oka, Yuichiro Miyazaki, Akinori Wakamiya, Kenzaburo Nakajima, Nobuhiko Ueda, Mitsuru Wada, Kohei Ishibashi, Yuko Inoue, Koji Miyamoto, Takeshi Aiba, Kengo Kusano

JACC. Clinical electrophysiology 2024.5

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

BACKGROUND: Epicardial unipolar mapping has not been thoroughly investigated in Brugada syndrome (BrS). OBJECTIVES: This study aims to examine the characteristics of epicardial unipolar potentials in BrS and investigate the differences from overt cardiomyopathy. METHODS: Epicardial mapping was performed in 8 patients with BrS and 6 patients with cardiomyopathy. We investigated the J-wave amplitudes using unipolar recordings at delayed potential (DP) sites via bipolar recordings. The repolarization time (RT) at and around the DP recording sites was measured, and maximum dispersion of the RT divided by the distance was defined as the RT dispersion index. RESULTS: Epicardial mapping at baseline revealed significantly higher J-wave amplitude with bipolar DP in patients with BrS than in patients with cardiomyopathy. J-wave amplitude ≥0.42 mV had 99.1% sensitivity and 100% specificity for diagnosing BrS. The RT dispersion index was significantly higher in patients with BrS than in patients with cardiomyopathy at baseline. In all patients with BrS, coved-type unipolar electrograms without negative T waves (short RT) appeared close to coved-type electrograms with negative T waves (long RT) at the DP recording sites after pilsicainide administration. Thus, a steep RT dispersion was observed in this region, and ventricular arrhythmias emerged from this shorter RT area in all 3 patients with BrS in whom ventricular arrhythmias were induced. CONCLUSIONS: Bipolar DP-related prominent unipolar J waves and steep repolarization gradients may be more specific for characterizing BrS than for overt cardiomyopathy. Ventricular arrhythmias in BrS are associated with a steep repolarization gradient, indicating phase 2 re-entry as a possible cause.

DOI： 10.1016/j.jacep.2024.05.012

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Clinical characteristics of electrical storm in patients with early repolarization syndrome

Hiroshi Morita, Akira Ueoka, Tomofumi Mizuno, Takuro Masuda, Saori Asada, Kentaro Ejiri, Masakazu Miyamoto, Satoshi Kawada, Koji Nakagawa, Nobuhiro Nishii, Shinsuke Yuasa

Heart Rhythm 21 ( 5 ) 562 - 570 2024.5

Risk stratification for the occurrence of ventricular fibrillation in patients with early repolarization syndrome

Hiroshi Morita, Saori Asada, Akira Ueoka, Tomofumi Mizuno, Takuro Masuda, Masakazu Miyamoto, Satoshi Kawada, Koji Nakagawa, Nobuhiro Nishii, Shinsuke Yuasa

Heart Rhythm 2024.5

Artificial intelligence to detect noise events in remote monitoring data

Nobuhiro Nishii, Kensuke Baba, Ken'ichi Morooka, Haruto Shirae, Tomofumi Mizuno, Takuro Masuda, Akira Ueoka, Saori Asada, Masakazu Miyamoto, Kentaro Ejiri, Satoshi Kawada, Koji Nakagawa, Kazufumi Nakamura, Hiroshi Morita, Shinsuke Yuasa

Journal of Arrhythmia 2024.4

Publishing type：Research paper (scientific journal) Publisher：Wiley

Abstract

Background

Remote monitoring (RM) of cardiac implantable electrical devices (CIEDs) can detect various events early. However, the diagnostic ability of CIEDs has not been sufficient, especially for lead failure. The first notification of lead failure was almost noise events, which were detected as arrhythmia by the CIED. A human must analyze the intracardiac electrogram to accurately detect lead failure. However, the number of arrhythmic events is too large for human analysis. Artificial intelligence (AI) seems to be helpful in the early and accurate detection of lead failure before human analysis.

Objective

To test whether a neural network can be trained to precisely identify noise events in the intracardiac electrogram of RM data.

Methods

We analyzed 21 918 RM data consisting of 12 925 and 1884 Medtronic and Boston Scientific data, respectively. Among these, 153 and 52 Medtronic and Boston Scientific data, respectively, were diagnosed as noise events by human analysis. In Medtronic, 306 events, including 153 noise events and randomly selected 153 out of 12 692 nonnoise events, were analyzed in a five‐fold cross‐validation with a convolutional neural network. The Boston Scientific data were analyzed similarly.

Results

The precision rate, recall rate, F1 score, accuracy rate, and the area under the curve were 85.8 ± 4.0%, 91.6 ± 6.7%, 88.4 ± 2.0%, 88.0 ± 2.0%, and 0.958 ± 0.021 in Medtronic and 88.4 ± 12.8%, 81.0 ± 9.3%, 84.1 ± 8.3%, 84.2 ± 8.3% and 0.928 ± 0.041 in Boston Scientific. Five‐fold cross‐validation with a weighted loss function could increase the recall rate.

Conclusions

AI can accurately detect noise events. AI analysis may be helpful for detecting lead failure events early and accurately.

DOI： 10.1002/joa3.13037

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心臓突然死;診断と予防・治療の最前線(Significant Delayed Conduction and Ventricular Tachycardia Morphologies are Associated with Electrical Strom in Patients with Cardiac Sarcoidosis)

森田宏, 中川晃志, 小倉聡一郎, 上岡亮, 水野智文, 増田拓郎, 浅田早央莉, 宮本真和, 川田哲史, 西井伸洋, 中村一文

日本循環器学会学術集会抄録集 88回 SY04 - 1 2024.3

Prevalence and Characteristics of Syncope and Loss of Consciousness Following Cardioverter-Defibrillator Implantation in Patients with Brugada Syndrome during Long-Term Follow-Up(タイトル和訳中)

浅田早央莉, 森田宏, 水野智文, 増田拓郎, 上岡亮, 宮本真和, 中川晃志, 西井伸洋, 中村一文

日本循環器学会学術集会抄録集 88回 OJ21 - 9 2024.3

The Usefulness of Stellate Ganglion Phototherapy for Electrical Storm of Ventricular Tachycardias(タイトル和訳中)

宮本真和, 森田宏, 山口聡美, 吉田優, 水野智文, 増田拓郎, 上岡亮, 浅田早央莉, 川田哲史, 中川晃志, 西井伸洋, 中村一文

日本循環器学会学術集会抄録集 88回 OJ01 - 3 2024.3

Effect of Tafamidis on Serum Transthyretin Levels in Patients with Transthyretin Amyloidosis Cardiomyopathy(タイトル和訳中)

森淳史, 中村一文, 斎藤幸弘, 吉田賢司, 谷山真規子, 三好亨, 森田宏, 赤木禎治, 西井伸洋, 中川晃志

日本循環器学会学術集会抄録集 88回 PJ065 - 2 2024.3

Local dispersion of repolarization in the occurrence of ventricular fibrillation in Brugada syndrome: Possibility of phase 2 reentry? International journal

Satoshi Nagase, Satoshi Oka, Tsukasa Kamakura, Takeshi Aiba, Hiroshi Morita, Kengo Kusano

Pacing and clinical electrophysiology : PACE 2024.1

Language：English

To date, there have been no reports of recording epicardial electrograms at the onset of spontaneous ventricular fibrillation (VF) in patients with Brugada syndrome (BrS). In the case of BrS, unipolar and bipolar electrogram recording on the right ventricular epicardium revealed that dispersion of repolarization with delayed potential was associated with spontaneous occurrence of VF. Phase 2 reentry associated with shortening and dispersion of action potential could have been recorded for the first time in BrS. Epicardial unipolar mapping can guide accurate and appropriate ablation for the elimination of arrhythmia substrate in J wave syndrome.

DOI： 10.1111/pace.14917

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Significant delayed conduction and characteristic ventricular tachycardias in patients with cardiac sarcoidosis and electrical storm. International journal

Hiroshi Morita, Koji Nakagawa, Akira Ueoka, Tomofumi Mizuno, Takuro Masuda, Saori Asada, Masakazu Miyamoto, Satoshi Kawada, Nobuhiro Nishii, Kazufumi Nakamura

Journal of cardiovascular electrophysiology 2023.12

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

INTRODUCTION: Electrical storm (ES) of ventricular tachyarrhythmias (VTAs) is an important cause of sudden death in patients with cardiac sarcoidosis (CS). VTAs in CS are associated with myocardial scarring and inflammation. However, little is known about the risk factors of ES in patients with CS and VTAs. The objective of this study is to clarify the characteristics and risk factors for the development of ES in patients with CS. METHODS: The study population included consecutive 52 patients with CS and sustained VTA. Twenty-five out of 52 patients experienced ES. We evaluated clinical characteristics, imaging modalities, and electrocardiogram (ECG) parameters to determine the risk factors associated with ES. RESULTS: Half of the patients experienced VTAs as the initial symptom of sarcoidosis, and eight patients had ES as the initial VTA episode. There were no differences in cardiac imaging abnormalities between patients with and without ES. Among ECG markers, significant QRS fragmentation (odds ratio [OR]: 7.9, p = .01) and epsilon waves (OR: 12.24, p = .02) were associated with ES. Among the ventricular tachycardia (VT) characteristics, multiple morphologies of monomorphic VTs (OR: 10.9, p < .01), short VT cycle lengths (OR: 12.5, p < .01), and polymorphic VT (OR: 13.5, p < .01) were associated with ES. Bidirectional VTs were detected in 10 patients with ES and one patient without ES. Immunosuppressive therapy relieved ES in some patients. CONCLUSIONS: ES was common in patients with CS and VTAs. Significant depolarization abnormalities that appeared as QRS fragmentation, epsilon waves, and specific VT characteristics were associated with ES.

DOI： 10.1111/jce.16156

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A variability of the QRS morphology during wide QRS tachycardia. International journal

Saori Asada, Koji Nakagawa, Nobuhiro Nishii, Hiroshi Morita, Kazufumi Nakamura

Pacing and clinical electrophysiology : PACE 46 ( 12 ) 1568 - 1571 2023.12

Management of sensing issues with a subcutaneous implantable cardioverter-defibrillator in a patient with Brugada syndrome: A case report. International journal

Satoshi Kawada, Nobuhiro Nishii, Tomofumi Mizuno, Masakazu Miyamoto, Koji Nakagawa, Hiroshi Morita

HeartRhythm case reports 9 ( 12 ) 878 - 882 2023.12

Syncope and loss of consciousness after implantation of a cardioverter-defibrillator in patients with Brugada syndrome: Prevalence and characteristics in long-term follow-up. International journal

Saori Asada, Hiroshi Morita, Tomofumi Mizuno, Takuro Masuda, Akira Ueoka, Masakazu Miyamoto, Satoshi Kawada, Koji Nakagawa, Nobuhiro Nishii

Heart rhythm O2 4 ( 10 ) 641 - 649 2023.10

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

BACKGROUND: Syncope is a significant prognostic factor in patients with Brugada syndrome (BrS). However, the risk of ventricular arrhythmia in patients with nonarrhythmic loss of consciousness (LOC) is similar to that in asymptomatic patients. LOC events after implantable cardioverter-defibrillator (ICD) implantation may provide insights into underlying causes of the initial LOC episode. OBJECTIVE: The purpose of this study was to examine LOC characteristics following ICD implantation. METHODS: We retrospectively analyzed 112 patients with BrS (mean age 47 years; 111 men) who were treated with an ICD. The patients were classified into 3 groups based on symptoms at implantation: asymptomatic (35 patients); LOC (46 patients); and ventricular tachyarrhythmia (VTA) (31 patients). We evaluated the incidence and cause of LOC during long-term follow-up after ICD implantation. RESULTS: During mean follow-up of 12.2 years, 41 patients (37%) experienced LOC after ICD implantation. Arrhythmic LOC occurred in 5 asymptomatic patients, 14 LOC patients, and 16 patients with VTA. Nonarrhythmic LOC, similar to the initial episode, occurred after ICD implantation in 6 patients with prior LOC (2 with neurally mediated syncope and 4 with epilepsy). Most epileptic patients experienced LOC during rest or sleeping, and did not show an abnormal encephalogram during initial evaluation of the LOC episodes. CONCLUSION: After ICD implantation, 13% of patients had nonarrhythmic LOC similar to the initial episode. Accurate classification of LOC based on a detailed medical history is important for risk stratification, although distinguishing arrhythmic LOC from epilepsy-related LOC episodes can be challenging depending on the circumstances and characteristics of the LOC event.

DOI： 10.1016/j.hroo.2023.09.007

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非動脈硬化性末梢血管疾患の診断と治療 Radiation-induced arteriopathyと考えられた症例に対して、医原性尿管腸骨動脈瘻を生じた1例

戸田洋伸, 吉田雅言, 中川晃志, 三好亨, 西井伸洋, 中村一文, 森田宏

脈管学 63 ( Suppl. ) S141 - S141 2023.10

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Papers - MORITA Hiroshi