Faculty Profiles - OHISHI Mitsuru

Papers - OHISHI Mitsuru

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Shibata K, Tokushige A, Hamamoto Y, Higuchi K, Imamura M, Ikeda Y, Ohishi M . The Kagoshima-DVT Score Is a Useful Predictive Model for Cancer-Associated Thrombosis in Patients With Gastrointestinal Cancer . Circ Rep.5 ( 2 ) 19 - 26 2023.1Reviewed

Publisher：The Japanese Circulation Society

Background: Cancer-associated thrombosis (CAT) is a common complication of cancer and has received increasing attention; the Khorana Risk Score (KRS) is a recommended but insufficient risk assessment model for CAT. We propose a novel Kagoshima-DVT score (KDS) to predict preoperative deep vein thrombosis (DVT). This scoring method scores D-dimer ≥1.5 μg/mL, age ≥60 years, female sex, ongoing glucocorticoids, cancer with high risk of DVT, and prolonged immobility. The purpose of this study was to compare the performance of the KDS and KRS in predicting CAT in patients with gastrointestinal cancer.Methods and Results: In all, 250 patients without a history of thrombosis who received their first chemotherapy for gastrointestinal cancer were divided into low- (48.0%), intermediate- (38.8%), and high-risk (13.2%) groups for CAT development by the KDS. The patients’ median age was 67 years and 63.2% were men. In all, 61 (27.1%) patients developed CAT (17.6%, 35.3%, and 36.4% of patients in the low-, intermediate, and high-risk groups, respectively; log-rank P=0.006). The area under the time-dependent receiver operating characteristic curve for CAT occurrence within 1 year was larger for the KDS than KRS (0.653 vs. 0.494).Conclusions: A high KDS at the start of first chemotherapy is a risk indicator for CAT development during chemotherapy. Moreover, the KDS is more useful than the KRS in predicting CAT risk.

DOI： 10.1253/circrep.cr-22-0112

Hirokazu Shimono, Akihiro Tokushige, Daisuke Kanda, Ayaka Ohno, Masao Hayashi, Mana Fukuyado, Mitsumasa Akao, Mariko Kawasoe, Ryo Arikawa, Hideaki Otsuji, Hideto Chaen, Hideki Okui, Naoya Oketani, Mitsuru Ohishi . Association between the number of Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria and clinical outcomes in patients with acute coronary syndrome. . Journal of cardiology81 ( 6 ) 553 - 563 2023.1Reviewed International journal

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

BACKGROUND: Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria have been used to identify high-risk patients undergoing percutaneous coronary intervention (PCI) in current clinical practice. This study aimed to evaluate the association between the number of ARC-HBR criteria and clinical outcomes in patients with acute coronary syndrome (ACS) after an emergent PCI. METHODS: We assessed 338 consecutive patients with ACS who underwent successful emergent PCI between January 2017 and December 2020. The ARC-HBR score was calculated by assigning 1 point to each major criterion and 0.5 points to each minor criterion. The patients were classified into low (ARC-HBR score<1), intermediate (1≤ARC-HBR score<2), and high (ARC-HBR score≥2) bleeding risk groups. We investigated the association between the ARC-HBR score and major adverse cardiovascular events (MACEs), defined as a composite of all-cause death, non-fatal myocardial infarction, and non-fatal stroke. We also compared the diagnostic ability of the ARC-HBR score and Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) risk score. RESULTS: The mean age of the patients was 67.6±12.4years, and 78.4% were men. During the median follow-up of 864 (557-1309) days, 70 patients developed MACEs. Kaplan-Meier curves showed that the cumulative incidence of MACE was significantly higher as the ARC-HBR score increased in a stepwise manner (log-rank p<0.001). There were no significant differences in the area under the receiver operating characteristic curve (AUC) for predicting MACE within two years after an emergent PCI between the ARC-HBR and CADILLAC risk scores (AUC: 0.763 vs. 0.777). CONCLUSIONS: ARC-HBR score was independently associated with an increased risk of MACE in patients with ACS after an emergent PCI. Moreover, it had a similar diagnostic ability for predicting MACE within two years compared to the CADILLAC risk score.

DOI： 10.1016/j.jjcc.2023.01.003

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Miyauchi E, Kuwazuru K, Arikawa R, Tokutake D, Chaen H, Oketani N, Ohishi M . Clinical Features of the Aslanger Pattern to Compensate for the Limitation of ST-Elevation Myocardial Infarction (STEMI) Criteria . Cureus.15 ( 1 ) e33227. 2023.1Reviewed

大石充 . 【高血圧の最新診断・治療update-診断・治療の最新動向-】高血圧診療の動向　脳卒中・循環器病対策基本法における地域高血圧管理の重要性 . 日本臨床81 ( 1 ) 26 - 31 2023.1

大石充 . 【高血圧診療の百年の変遷と新たな展開】各種降圧薬の特徴と使い方　カルシウム拮抗薬 . 臨牀と研究100 ( 1 ) 19 - 23 2023.1

大石充 . 【高血圧の最新診断・治療update-診断・治療の最新動向-】高血圧診療の動向脳卒中・循環器病対策基本法における地域高血圧管理の重要性 . 日本臨床81 ( 1 ) 26 - 31 2023.1

大石充 . 【高血圧診療の百年の変遷と新たな展開】各種降圧薬の特徴と使い方カルシウム拮抗薬 . 臨牀と研究100 ( 1 ) 19 - 23 2023.1

Shibata K, Tokushige A, Hamamoto Y, Arima S, Matsumoto K, Higashi M, Ikeda Y, Ohishi M . A case of cardiac metastasis of neuroendocrine tumor with 2-year follow-up . Journal of Cardiology Cases.28 ( 3 ) 91 - 94 2023Reviewed

Language：Japanese Publisher：Journal of Cardiology Cases

A 55-year-old male underwent surgery for thymus gland tumors six years previously, and for lung and pancreas tumors three years previously, which were pathologically diagnosed as neuroendocrine tumors (NETs). During routine medical checkups, a giant negative T-wave was observed on the electrocardiogram. Echocardiography revealed a tumor at the apex. A surgical biopsy was performed; the tumor was diagnosed as a cardiac metastasis of NETs, and chemotherapy was initiated. Two years later, echocardiography confirmed that the tumor had not increased in size. A 2-year follow-up of NETs cardiac metastasis is rare; we therefore report this case. Learning objective: Neuroendocrine tumors are considered slowly progressing tumors, but despite the presence of cardiac metastasis, accurate diagnosis and appropriate treatment have allowed the patient to survive the disease for more than two years.

DOI： 10.1016/j.jccase.2023.05.002

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Hirokazu Shimono, Akihiro Tokushige, Daisuke Kanda, Ayaka Ohno, Masao Hayashi, Mana Fukuyado, Mitsumasa Akao, Mariko Kawasoe, Ryo Arikawa, Hideaki Otsuji, Hideto Chaen, Hideki Okui, Naoya Oketani, Mitsuru Ohishi . Association of preoperative clinical frailty and clinical outcomes in elderly patients with stable coronary artery disease after percutaneous coronary intervention. . Heart and vessels38 ( 10 ) 1205 - 1217 2023

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

There are few reports on the long-term clinical outcome after percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (CAD) complicated with frailty. This novel study investigated the association between pre-PCI frailty and long-term clinical outcomes in elderly patients aged 65 years or older with stable CAD who underwent elective PCI. We assessed 239 consecutive patients aged 65 years or older with stable CAD who underwent successful elective PCI at Kagoshima City Hospital between January 1st, 2017 and December 31st, 2020. Frailty was retrospectively assessed using the Canadian Study and Aging Clinical Frailty Scale (CFS). Based on the pre-PCI CFS, patients were divided into two groups: the non-frail (CFS < 5) and the frail (CFS ≥ 5) group. We investigated the association between pre-PCI CFS and major adverse cardiovascular events (MACEs) defined as the composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, and heart failure requiring hospitalization. Additionally, we assessed the association between pre-PCI CFS and major bleeding events defined as Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding. The mean age was 74.8 ± 7.0 years, and 73.6% were men. According to the pre-PCI frailty assessment, 38 (15.9%) and 201 (84.1%) were classified as frail and non-frail groups, respectively. During a median follow-up of 962 (607-1284) days, 46 patients developed MACEs and 10 patients developed major bleeding events. Kaplan-Meier curves showed a significantly higher incidence of MACE in the frail group compared to those in the non-frail group (Log-rank p < 0.001). Even in multivariate analysis, pre-PCI frailty (CFS ≥ 5) was independently associated with MACE (HR 4.27, 95% CI 1.86-9.80, p-value: < 0.001). Additionally, the cumulative incidence of major bleeding events was significantly higher in the frail group than in the non-frail group (Log-rank p = 0.001). Pre-PCI frailty was an independent risk factor for MACE and bleeding events in elderly patients with stable CAD who underwent elective PCI.

DOI： 10.1007/s00380-023-02276-3

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窪薗琢郎, 池田義之, 大石充 . Development of predictive equation and score for 5-year metabolic syndrome incidence in Japanese adults . PLOS ONE18 ( 4 April ) e0284139 2023Reviewed

Language：Japanese Publisher：Plos One

Background Predicting metabolic syndrome (MetS) is important for identifying high-risk cardiovascular disease individuals and providing preventive interventions. We aimed to develop and validate an equation and a simple MetS score according to the Japanese MetS criteria. Methods In total, 54,198 participants (age, 54.5±10.1 years; men, 46.0%), with baseline and 5-year follow-up data were randomly assigned to 'Derivation' and 'Validation' cohorts (ratio: 2:1). Multivariate logistic regression analysis was performed in derivation cohort and scores were assigned to factors corresponding to β-coefficients. We evaluated predictive ability of the scores using area under the curve (AUC), then applied them to validation cohort to assess reproducibility. Results The primary model ranged 0-27 points had an AUC of 0.81 (sensitivity: 0.81, specificity: 0.81, cut-off score: 14), and consisted of age, sex, blood pressure (BP), body mass index (BMI), serum lipids, glucose measurements, tobacco smoking, and alcohol consumption. The simplified model (excluding blood tests) ranged 0-17 points with an AUC of 0.78 (sensitivity: 0.83, specificity: 0.77, cut-off score: 15) and included: age, sex, systolic BP, diastolic BP, BMI, tobacco smoking, and alcohol consumption. We classified individuals with a score <15 and ≥15 points as low- and high-risk MetS, respectively. Furthermore, the equation model generated an AUC of 0.85 (sensitivity: 0.86, specificity: 0.55). Analysis of the validation and derivation cohorts yielded similar results. Conclusion We developed a primary score, an equation model, and a simple score. The simple score is convenient, well-validated with acceptable discrimination, and could be used for early detection of MetS in high-risk individuals. Copyright:

DOI： 10.1371/journal.pone.0284139

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Masumitsu Tomomi, Kubozono Takuro, Miyata Masaaki, Makizako Hyuma, Tabira Takayuki, Takenaka Toshihiro, Kawasoe Shin, Tokushige Akihiro, Niwa Sayoko, Ohishi Mitsuru . Association of Sleep Duration and Cardio-Ankle Vascular Index in Community-Dwelling Older Adults . Journal of Atherosclerosis and Thrombosis29 ( 12 ) 1864 - 1871 2022.12Reviewed

Language：English Publishing type：Research paper (scientific journal) Publisher：Japan Atherosclerosis Society

Aim: This study aims to investigate the association of the Cardio-Ankle Vascular Index (CAVI) with self-reported sleep duration and sleep quality in community-dwelling older adults aged ≥ 65 years.Methods: The Tarumizu Study was a cohort of community-based health checkups conducted in the Tarumizu City, Japan, in 2018 and 2019. In total, 997 participants aged ≥ 65 years (median age, 74 years) were examined. We obtained the average sleep duration and sleep quality using self-reported questionnaires and classified them into three separate groups according to sleep duration (＜6 h, 6–8 h, and ≥ 8 h) and sleep quality (good, medium, and poor). The arterial stiffness was measured using the CAVI.Results: As per our findings, the CAVI was significantly higher in the ≥ 8 h sleep group (CAVI=9.6±1.3) than in the ＜6 h (CAVI=9.1±1.1) or 6–8 h (CAVI=9.1±1.2) groups (p＜0.001). After adjustment for age, sex, systolic blood pressure, current smoking status, body mass index, frequency of exercise, educational background, frailty, sleep medication, sleep quality, and nap duration, multivariable regression analysis demonstrated that the CAVI was significantly higher in the ≥ 8 h group than in the 6–8 h group (p=0.016). In contrast, multivariable regression analysis showed that there was no significant association between sleep quality and CAVI.Conclusions: A significant association was noted between long sleep duration (≥ 8 h) and elevated CAVI in community-dwelling older adults aged ≥ 65 years. We, therefore, suggest that long sleep duration, not sleep quality, is correlated with arterial stiffness in older adults.

DOI： 10.5551/jat.63594

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椎葉竜平, 中井雄貴, 富岡一俊, 谷口善昭, 白土大成, 木内悠人, 竹中俊宏, 窪薗琢郎, 大石充, 牧迫飛雄馬 . 地域在住高齢者における前糖尿病および糖尿病と筋量、筋力、身体機能との関係 . 日本予防理学療法学会学術大会プログラム・抄録集1.Suppl.No.1 ( 0 ) 6 - 6 2022.12

Language：Japanese Publisher：日本予防理学療法学会

【はじめに、目的】サルコペニアは転倒や死亡のリスクを増大させる要因であり、サルコペニアの危険因子のひとつには糖尿病が挙げられる。血糖値が糖尿病の基準には満たないが、正常より高い状態は前糖尿病と分類され、前糖尿病は糖尿病へ進行するリスクが高い。サルコペニアの割合はHbA1c値に比例して増加すると報告されており、前糖尿病の段階からサルコペニアの診断基準である筋量、筋力、身体機能が低下している可能性がある。これらを検討することは早期から機能低下を把握する上で重要である。本研究では、地域在住高齢者における前糖尿病および糖尿病と筋量、筋力、身体機能の関係を検討した。【方法】地域コホート研究（垂水研究2019）に参加した地域在住高齢者687名のうち、脳卒中、認知症の既往、要介護認定者を除く609名（平均74.0±6.3歳、女性62.1%）を対象とした。基礎情報として、年齢、性別、内服数、糖尿病の病歴を聴取した。四肢骨格筋指数（生体電気インピーダンス法）、握力、5回椅子立ち上がりテスト、HbA1c値を測定した。HbA1c値が5.7%未満を非糖尿病群、5.7～6.4%を前糖尿病群とし、6.5%以上または糖尿病の既往がある者を糖尿病群と分類した。四肢骨格筋指数は男性7.0kg/m 2 未満、女性5.7kg/m 2 未満を筋量低下、握力は男性28kg未満、女性18kg未満を筋力低下とした。また、5回椅子立ち上がりテストは12秒以上を身体機能低下とした。筋量低下、筋力低下、身体機能低下のそれぞれを従属変数とし、糖尿病分類（非糖尿病群、前糖尿病群、糖尿病群）を独立変数としたロジスティック回帰分析を行った。共変量は年齢、性別、多剤併用の有無および筋量低下の有無、筋力低下の有無または身体機能低下の有無とした。【結果】前糖尿病および糖尿病を有する者の割合はそれぞれ25.0%、15.1% であった。各群における筋量低下の割合は、非糖尿病群40.5%、前糖尿病群33.6%、糖尿病群23.9%であった。筋力低下の割合は、非糖尿病群20.3%、前糖尿病群25.7％、糖尿病群32.6%であった。また、身体機能低下の割合は、非糖尿病群6.6%、前糖尿病群7.9%、糖尿病群14.1%であった。非糖尿病群と比較して前糖尿病群では筋力低下のオッズ比が1.70（95%信頼区間：1.02-2.82）と有意に高かった。非糖尿病群と比較して糖尿病群では筋量低下のオッズ比が0.37（95%信頼区間：0.20-0.69）と有意に低かった。また、糖尿病群では筋力低下のオッズ比が2.10（95%信頼区間：1.15-3.85）、身体機能低下のオッズ比が2.28（95%信頼区間：1.00-5.17）と有意に高かった。【結論】非糖尿病の者と比較して、前糖尿病を有する者では筋力が低下しており、糖尿病を有する者では筋量は保持しているが、筋力および身体機能が低下していることが示唆された。筋力低下や身体機能低下は将来の日常生活動作能力の低下に影響するため、前糖尿病や糖尿病を有する者は早期から運動介入を検討することが必要だろう。【倫理的配慮、説明と同意】本研究は鹿児島大学疫学研究等倫理委員会の承認（170351疫）を得て実施した。ヘルシンキ宣言に基づき、対象者には研究内容について口頭と書面にて説明をし、同意を得た。

DOI： 10.57304/jsptpsuppl.1.suppl.no.1.0_6

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Kawabata T., Kubozono T., Ojima S., Kawasoe S., Akasaki Y., Salim A.A., Ikeda Y., Miyata M., Takenaka T., Ohishi M. . Insufficient blood pressure control is independently associated with increased arterial stiffness . Hypertension Research45 ( 12 ) 1861 - 1868 2022.12Reviewed

Language：Japanese Publisher：Hypertension Research

Hypertension is a risk factor for atherosclerosis. Achieving the therapeutic target value of blood pressure (BP) prevents the onset of cardiovascular events; however, it is not clear how antihypertensive drug use and BP control status relate to arterial stiffness. The purpose of this study is to investigate the relationship between BP control status with or without antihypertensive drugs and arterial stiffness. Nine hundred eighty individuals (mean age: 68 ± 11 years) who participated in a community-based cohort study were enrolled. Arterial stiffness was evaluated using the cardio-ankle vascular index (CAVI). Higher BP was defined as a systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg. Participants were divided into four groups: normal, non higher BP without antihypertensive drugs (n = 421); untreated, higher BP without antihypertensive drugs (n = 174); good control, non higher BP with antihypertensive drugs (n = 209); and poor control, higher BP with antihypertensive drugs (n = 176). In multivariable logistic analysis adjusted for age, sex, dyslipidemia and diabetes mellitus medication use, obesity, smoking, alcohol drinking, and heart rate at the CAVI measurement for a high CAVI—using a borderline cutoff value of 8.0—the other three groups were significantly associated with a high CAVI when compared with the normal group. By contrast, multivariable logistic analysis of a high CAVI using an abnormal cutoff value of 9.0 demonstrated that the poor control and untreated groups were significantly associated with a high CAVI, whereas the good control group was not. In conclusion, even with antihypertensive drugs, poor BP control is independently associated with a high CAVI.

DOI： 10.1038/s41440-022-01039-3

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Daisuke Kanda, Yoshiyuki Ikeda, Takuro Takumi, Akihiro Tokushige, Takeshi Sonoda, Ryo Arikawa, Kazuhiro Anzaki, Ippei Kosedo, Mitsuru Ohishi . Impact of nutritional status on prognosis in acute myocardial infarction patients undergoing percutaneous coronary intervention. . BMC cardiovascular disorders22 ( 1 ) 3 - 3 2022.12Reviewed International journal

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

BACKGROUND: Malnutrition affects the prognosis of cardiovascular disease. Acute myocardial infarction (AMI) has been a major cause of death around the world. Thus, we investigated the impact of malnutrition as defined by Geriatric Nutritional Risk Index (GNRI) on mortality in AMI patients. METHODS: In 268 consecutive AMI patients who underwent percutaneous coronary intervention (PCI), associations between all-cause death and baseline characteristics including malnutrition (GNRI < 92.0) and Global Registry of Acute Coronary Events (GRACE) risk score were assessed. RESULTS: Thirty-three patients died after PCI. Mortality was higher in the 51 malnourished patients than in the 217 non-malnourished patients, both within 1 month after PCI (p < 0.001) and beyond 1 month after PCI (p = 0.017). Multivariate Cox proportional hazards regression modelling using age, left ventricular ejection fraction and GRACE risk score showed malnutrition correlated significantly with all-cause death within 1 month after PCI (hazard ratio [HR] 7.04; 95% confidence interval [CI] 2.30-21.51; p < 0.001) and beyond 1 month after PCI (HR 3.10; 95% CI 1.70-8.96; p = 0.037). There were no significant differences in area under the receiver-operating characteristic (ROC) curve between GRACE risk score and GNRI for predicting all-cause death within 1 month after PCI (0.90 vs. 0.81; p = 0.074) or beyond 1 month after PCI (0.69 vs. 0.71; p = 0.87). Calibration plots comparing actual and predicted mortality confirmed that GNRI (p = 0.006) was more predictive of outcome than GRACE risk score (p = 0.85) beyond 1 month after PCI. Furthermore, comparison of p-value for interaction of malnutrition and GRACE risk score for all-cause death within 1 month after PCI, beyond 1 month after PCI, and the full follow-up period after PCI were p = 0.62, p = 0.64 and p = 0.38, respectively. CONCLUSIONS: GNRI may have a potential for predicting the mortality in AMI patients especially in beyond 1 month after PCI, separate from GRACE risk score. Assessment of nutritional status may help stratify the risk of AMI mortality.

DOI： 10.1186/s12872-021-02448-x

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Kawabata Takeko, Kubozono Takuro, Ojima Satoko, Kawasoe Shin, Akasaki Yuichi, Salim Anwar Ahmed, Ikeda Yoshiyuki, Miyata Masaaki, Takenaka Toshihiro, Ohishi Mitsuru . 【アジアにおける高血圧管理の現状と展望】不十分な血圧コントロールは動脈スティフネス増大と独立して関連する(【Current evidence and perspectives for hypertension management in Asia】Insufficient blood pressure control is independently associated with increased arterial stiffness) . Hypertension Research45 ( 12 ) 1861 - 1868 2022.12

Language：English Publisher：Nature Publishing Group

垂水市で行われた地域住民を対象とするコホート研究に参加した980名を対象に、降圧薬を用いた場合と用いない場合の血圧コントロール状況と動脈スティフネスとの関連性を評価した。動脈スティフネスの評価には心臓足首血管指数(CAVI)を用いた。高血圧の定義は、収縮期血圧140mmHg以上または拡張期血圧90mmHg以上とした。未治療コントロール良好群421名(平均64±11歳)、未治療コントロール不良群174名(平均67±11歳)、治療コントロール良好群209名(平均73±9歳)、治療コントロール不良群176名(平均73±9歳)に分類した。CAVI評価時の年齢、性別、脂質異常症治療薬使用、糖尿病治療薬使用、肥満、喫煙、飲酒、心拍数を調整後、CAVI高値のカットオフ値を8.0とした場合は未治療コントロール良好群に比べて他の3群でCAVIが有意に高値であり、カットオフ値を9.0とした場合は治療コントロール不良群と未治療コントロール不良群でCAVIが有意に高値であった。降圧薬治療を行っても、血圧コントロール不良はCAVI高値と独立して関連することが示された。

Masumitsu Tomomi, Kubozono Takuro, Miyata Masaaki, Makizako Hyuma, Tabira Takayuki, Takenaka Toshihiro, Kawasoe Shin, Tokushige Akihiro, Niwa Sayoko, Ohishi Mitsuru . 地域在住高齢者での睡眠時間と心臓足首血管指数の関連性(Association of Sleep Duration and Cardio-Ankle Vascular Index in Community-Dwelling Older Adults) . Journal of Atherosclerosis and Thrombosis29 ( 12 ) 1864 - 1871 2022.12

Language：English Publisher：(一社)日本動脈硬化学会

65歳以上の地域住民を対象に、心臓足首血管指数(CAVI)と自己報告による睡眠の時間・質の関連性を横断的に調査した。2018～2019年に健康診断を受けた鹿児島県垂水市の高齢者コホート(垂水研究)から、65歳以上の997名(女性622名、年齢中央値74歳)を解析に組み入れた。睡眠時間で3群に分類した。その結果、睡眠時間が8時間以上であった長睡眠群は110名(女性56名、年齢中央値77歳)、6～8時間の中睡眠群は438名(女性269名、年齢中央値74歳)、6時間未満の短睡眠群は449名(女性297名、年齢中央値73歳)であった。この3群で平均CAVIを比較すると、長睡眠群では9.6±1.3となり、中睡眠群(9.1±1.2)または短睡眠群(9.1±1.1)よりも有意に高かった(P<0.001)。各種の因子(年齢、性別、収縮期血圧、現喫煙状態、BMI、運動頻度、学歴、フレイル、睡眠薬、睡眠の質、昼寝時間)で調整を行った多変量回帰分析の結果、長睡眠群のCAVIは中睡眠群よりも有意に高い(p=0.016)ことが証明された。こうした結果とは対照的に、睡眠の質とCAVIの有意な関連性は示されなかった。本解析結果から、高齢者では睡眠時間が長いことが動脈硬化度と相関し、睡眠の質は相関しないことが示唆された。

Language：English Publisher：Nature Publishing Group

Yoshihiko Akasaki, Takayuki Tabira, Michio Maruta, Hyuma Makizako, Masaaki Miyata, Gwanghee Han, Yuriko Ikeda, Atsushi Nakamura, Suguru Shimokihara, Yuma Hidaka, Taishiro Kamasaki, Takuro Kubozono, Mitsuru Ohishi . Social Frailty and Meaningful Activities among Community-Dwelling Older Adults with Heart Disease. . International journal of environmental research and public health19 ( 22 ) 15167 2022.11Reviewed International journal

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

Patients with heart disease are more likely to experience social frailty due to physical inactivity, which may affect meaningful activities such as hobbies. This study aimed to investigate (1) the association between heart disease and social frailty in community-dwelling older adults and (2) the characteristics of meaningful activities in community-dwelling older adults with heart disease. Data from 630 older adults who participated in a community-based health survey were obtained, including clinical history, meaningful activities, social frailty and psychosomatic functions. Participants were divided into two groups: those with heart disease (n = 79) and those without (n = 551), and comparisons were made. Social frailty was observed in 23.7% of participants with heart disease, and logistic regression revealed significant associations with heart disease and social frailty after adjusting for potential covariates (OR, 1.97; 95% CI, 1.06 3.67; p = 0.032). Participants with heart disease did not differ significantly in terms of satisfaction or performance; their frequency of engagement in meaningful activities was significantly lower than without heart disease (p = 0.041). These results suggest that heart disease and social frailty are associated in community-dwelling older adults, and that this demographic is inclined to engage in meaningful activities less frequently.

DOI： 10.3390/ijerph192215167

Scopus

PubMed

Kubota K., Miyanaga S., Iwatani N., Ohishi M. . Unknown atrial septal defect was diagnosed during the course of treatment for portopulmonary hypertension: A case report . Journal of Cardiology Cases26 ( 5 ) 383 - 385 2022.11

Language：Japanese Publisher：Journal of Cardiology Cases

Portopulmonary hypertension (POPH) is a condition defined by the development of pulmonary arterial hypertension (PAH) that is associated with liver disease or portal hypertension. Untreated POPH has a poor prognosis. POPH can be treated with PAH-targeted therapy and can sometimes resolve with liver transplantation (LT); however, poorly controlled POPH can preclude LT owing to an increased peri-operative risk. We report a case of POPH that was diagnosed as an unknown atrial septal defect during PAH-targeted therapy. As observed in our case, the same patient may have several causes of PAH. It is important to confirm an unknown shunt disease using echocardiography during PAH-targeted therapy. Learning objective: It is difficult to detect unknown shunt disease in patients who are diagnosed with pulmonary arterial hypertension (PAH) owing to other causes. We report a case of portopulmonary hypertension that was diagnosed as an unknown atrial septal defect during PAH-targeted therapy. This report highlights the same patient may have several causes of PAH. It is important to confirm an unknown shunt disease using echocardiography during PAH-targeted therapy.

DOI： 10.1016/j.jccase.2022.08.003

Scopus

PubMed

Kubota Kayoko, Miyanaga Sunao, Iwatani Noriko, Ohishi Mitsuru . 門脈肺高血圧症の治療中に検出され診断に至った心房中隔欠損症　1症例報告(Unknown atrial septal defect was diagnosed during the course of treatment for portopulmonary hypertension: A case report) . Journal of Cardiology Cases26 ( 5 ) 383 - 385 2022.11

Language：English Publisher：(一社)日本心臓病学会

症例は51歳女性で、呼吸困難を主訴に近医を受診し、経胸壁心エコー検査で肺高血圧を指摘された。精査と加療を目的に当院へ紹介された。B型肝炎ウイルス感染による非代償性肝硬変の既往があった。受診時の心エコー検査で右室拡大を認め、推定右室収縮期圧は68mmHgであった。腹部CTで著明に拡張した上腸間膜静脈と脾腫を認めた。肺血流シンチグラフィーで肺血栓塞栓の所見はなかった。右心カテーテル検査で肺動脈圧は収縮期が68mmHg、拡張期が23mmHg、平均圧が41mmHg、心係数は5.49L/min/m2であった。門脈圧亢進症による門脈肺高血圧症と診断し、マシテンタンの投与を開始し、2ヵ月後にタダラフィルに切り替えた。4ヵ月後の心エコー検査で以前は見られなかったシャント血流が検出された。肺動脈圧は収縮期43mmHg、拡張期16mmHg、平均26mmHgに低下し、右房酸素飽和度は87.1%に上昇した。心房中隔欠損症と診断し、Amplatzer閉鎖栓を用いた経カテーテル閉鎖術を施行した。1年後に肝性脳症に対して肝移植が施行され、3年後の肺動脈圧は収縮期23mmHg、拡張期10mmHg、平均15mmHgであった。

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