Faculty Profiles - OHISHI Mitsuru

Papers - OHISHI Mitsuru

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Kubozono Takuro, Miyata Masaaki, Kawasoe Shin, Ojima Satoko, Yoshifuku Shiro, Miyahara Hironori, Maenohara Shigeho, Ohishi Mitsuru . High Pulse Wave Velocity Has a Strong Impact on Early Carotid Atherosclerosis in a Japanese General Male Population . Circulation Journal81 ( 3 ) 310 - 315 2017

Language：English Publishing type：Research paper (scientific journal) Publisher：The Japanese Circulation Society

Background:Although there have been several reports on the risk factors associated with intima-media thickness (IMT), many questions remain. The purpose of this study was to investigate the association between IMT and cardiovascular risk factors in a Japanese general population.Methods and Results:The study group consisted of 1,583 male subjects undergoing routine health checkups. IMT of the common carotid artery was measured by high-resolution ultrasonography. Brachial-ankle pulse wave velocity (baPWV) was measured using an automated device. Univariate analysis demonstrated that carotid IMT significantly associated with age, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), baPWV, fasting glucose, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C). Multiple logistic regression analysis for carotid atherosclerosis (carotid IMT ≥1.0 mm) was performed using obesity (BMI ≥25.0 kg/m2), high BP (SBP ≥130 mmHg or DBP ≥85 mmHg), dyslipidemia (LDL-C ≥140 mg/dL, TG ≥150 mg/dL, or HDL-C <40 mg/dL), impaired fasting glucose (IFG) (fasting glucose ≥110 g/dL), and high baPWV (≥1,400 cm/s). Carotid atherosclerosis was significantly associated with only high baPWV (OR: 2.22, 95% CI: 1.24–4.17, P<0.01).Conclusions:High baPWV was a stronger predictor of early carotid atherosclerosis than high BP, dyslipidemia, or IFG in a Japanese general male population.

DOI： 10.1253/circj.cj-16-0687

Maenosono Ryuichi, Mizukami Naoko, Oketani Naoya, Iriki Yasuhisa, Yunoue Shingo, Kobayashi Saori, Nakamura Yukimi, Oozono Nanase, Takasaki Kunikazu, Yuasa Toshinori, Kisanuki Akira, Ohishi Mitsuru, Hashiguchi Teruto . Relationship between Total Atrial Conduction Time and Recurrence of Atrial Fibrillation after Complex Fractionated Atrial Electrogram Ablation of Paroxysmal Atrial Fibrillation . Japanese Journal of Medical Ultrasound Technology42 ( 4 ) 399 - 409 2017

Language：Japanese Publisher：Japanese Society of Sonographers

Purpose: Recently, it has been reported that an index of the total atrial conduction time derived by tissue Doppler imaging (PA-TDI duration) has a superior accuracy for prediction of atrial fibrillation (AF) recurrence compared with the left atrial volume index (LAVI) after pulmonary vein isolation (PVI). We performed catheter ablation targeting complex fractionated atrial electrograms (CFAE ablation) on patients with AF and explored the independent predictor of AF recurrence after CFAE ablation.Subjects and methods: Our study included 160 patients with paroxysmal AF who underwent AF ablation (CFAE ablation or CFAE ablation＋PVI) for the first time. Of these, 107 patients in whom a measurement of PA-TDI duration was possible were divided into no recurrence and recurrence groups. Univariable and multivariable Cox proportional hazards analyses were performed to investigate predictors of AF recurrence after AF ablation. The receiver operator characteristics (ROC) curve was calculated to evaluate the performance of possible independent predictors of AF recurrence after AF ablation was obtained by multivariate analysis. The time-dependent changes of PA-TDI duration and LAVI were observed to investigate the predictors of AF recurrence after AF ablation.Results: The left atrial dimension (LAD) was significantly larger in the recurrence group than in the no recurrence group (41.1±5.4 mm to 38.1±5.1 mm, p＜0.01). In the multivariate analysis, the left atrial volume (LAV) and LAD were suggested as independent predictors of AF recurrence after AF ablation. However, the ROC curve analyses demonstrated that LAV and LAD had low accuracy of predicting AF recurrence after AF ablation (area under the curve: LAV, 0.609; LAD, 0.659). There were no significant differences in PA-TDI duration or LAVI in both strategies before ablation between the recurrence and the no recurrence groups. Six months after the ablation, the PA-TDI duration in the recurrence group was significantly longer than before ablation with both strategies (CFAE ablation: 142.9±18.5 ms to 155.4±17.6 ms, p＜0.01; CFAE ablation＋PVI: 135.6±20.3 ms to 155.1±21.8 ms, p＜0.01), and PA-TDI duration in the no recurrence group with CFAE ablation was significantly shorter than before ablation (141.8±23.3 ms to 131.1±23.9 ms, p＝0.011). However, there was no significant difference in LAVI between the recurrence and no recurrence groups for both strategies.Conclusion: The data obtained before ablation could not predict AF recurrence after CFAE ablation for patients with paroxysmal AF. However, longer PA-TDI duration at the 6-month followup may predict AF recurrence after CFAE ablation for paroxysmal AF.

DOI： 10.11272/jss.42.399

CiNii Research

Tokushige A., Ueda S., Tomiyama H., Ohishi M., Kohro T., Higashi Y., Takase B., Suzuki T., Ishizu T., Yamazaki T., Furumoto T., Kario K., Inoue T., Koba S., Takemoto Y., Hano T., Sata M., Ishibashi Y., Node K., Maemura K., Ohya Y., Furukawa T., Ito H., Yamashina A. . Association between waist-to-height ratio and endothelial dysfunction in patients with morbidity ― A report from the FMD-J study . Circulation Journal81 ( 12 ) 1911 - 1918 2017Reviewed

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Circulation Journal

Background: Waist circumference (WC), waist-to-height ratio (WHtR) and body mass index (BMI) are known as easy anthropometric markers of abnormal obesity and screening tools for predicting cardiovascular outcomes, but which indices are best is unclear. We therefore investigated the superiority and association between each index and low flow-mediated dilatation (FMD) as a surrogate marker for cardiovascular outcomes in patients with morbidity in a large Japanese prospective cohort. Methods and Results: A total of 1,645 Japanese patients who had coronary artery disease and hypertension or diabetes mellitus were enrolled, and 1,087 of them were analyzed. The high-WHtR group (≥0.5) showed greater morbidity and increased inflammation in association with atherosclerosis compared with the low-WHtR group. High WHtR and advanced age were identified as predictors of low FMD (odds ratio (OR) 1.39, 95% confidence interval (CI) 1.02–1.88, P=0.037 and OR 1.55, 95% CI 1.19–2.01, P=0.001, respectively). However, WC was not associated with that risk in either sex (male: OR 1.37, 95% CI 0.97–1.93, P=0.076; female: OR 1.08, 95% CI 0.68–1.73, P=0.74), and no association was evident between high BMI and low FMD (OR 0.92, 95% CI 0.71–1.19, P=0.54). Conclusions: WHtR offers a superior predictor of decreased FMD than other anthropometric indices, and progression of arteriosclerosis might be detected more sensitively. Further study is needed to investigate the relationship between cardiovascular mortality and WHtR.

DOI： 10.1253/circj.CJ-17-0211

Scopus

PubMed

Sasaki Yuichi, Ikeda Yoshiyuki, Iwabayashi Masaaki, Akasaki Yuichi, Ohishi Mitsuru . The Impact of Autophagy on Cardiovascular Senescence and Diseases . International Heart Journal58 ( 5 ) 666 - 673 2017

Language：English Publisher：International Heart Journal Association

The risk of cardiovascular disease increases with age, causing chronic disability, morbidity, and mortality in the elderly. Cardiovascular aging and disease are characterized by heart failure, cardiac ischemia-reperfusion injury, cardiomyopathy, hypertension, arterial stiffness, and atherosclerosis. As a cell ages, damaged organelles and abnormal proteins accumulate. A system for removing these cytoplasmic substrates is essential for maintaining homeostasis. Autophagy assists tissue homeostasis by forming a pathway by which these substances are degraded. Growing evidence suggests that autophagy plays a role in age-related and disease states of the cardiovascular system, and it may even be effective in preventing or treating cardiovascular disease. On the other hand, overexpression of autophagy in the heart and arteries can produce detrimental effects. We summarize the current understanding of the close relationship between autophagy and cardiovascular senescence.

DOI： 10.1536/ihj.17-246

Scopus

PubMed

CiNii Research

湯之上真吾, 水上尚子, 大園七瀬, 小林沙織, 前之園隆一, 堀添善尚, 茶圓秀人, 髙﨑州亜, 湯淺敏典, 木佐貫彰, 大石充 . 心エコー検査を契機に診断されたカルチノイド症候群の1例 . 超音波検査技術抄録集42 ( 0 ) S218 - S218 2017

小林沙織, 水上尚子, 大園七瀬, 湯之上真吾, 前之園隆一, 堀添善尚, 茶園秀人, 高崎州亜, 湯浅敏典, 木佐貫彰, 大石充 . 右室流出路波形を用いた肺高血圧評価における描出断面による影響 . 超音波検査技術抄録集42 ( 0 ) S122 - S122 2017

Chaen H, Kinchiku S, Miyata M, Kajiya S, Uenomachi H, Yuasa T, Takasaki K, Ohishi M. . Validity of a novel method for estimating low-density lipoprotein cholesterol levels in diabetic patients. . J Atheroscler Thromb23 ( 12 ) 1355 - 1364 2016.12Reviewed

Shinzo Hiroi, Yukio Shimasaki, Takashi Kikuchi, Yujiro Otsuka, Kosuke Iwasaki, Mitsuru Ohishi . Analysis of second- and third-line antihypertensive treatments after initial therapy with an angiotensin II receptor blocker using real-world Japanese data . HYPERTENSION RESEARCH39 ( 12 ) 907 - 912 2016.12Reviewed

Hiroi S, Shimasaki Y, Kikuchi T, Otsuka Y, Iasaki K, Ohishi M. . Analysis of second- and third-line antihypertensive treatments after initial therapy with an angiotensin II receptor blocker using real-world Japanese data. . Hypertens Res39 ( 12 ) 907 - 912 2016.12Reviewed

Hiroi Shinzo, Shimasaki Yukio, Kikuchi Takashi, Otsuka Yujiro, Iwasaki Kosuke, Ohishi Mitsuru . 実際の日本人データを用いたアンジオテンシンII受容体拮抗薬による初回治療後のセカンドラインおよびサードライン降圧薬治療の解析(Analysis of second- and third-line antihypertensive treatments after initial therapy with an angiotensin II receptor blocker using real-world Japanese data) . Hypertension Research39 ( 12 ) 907 - 912 2016.12

Language：English Publisher：Nature Publishing Group

2008～2015年の日本医療データセンター(JMDC)およびメディカル・データ・ビジョン社(MDV)の健康保険請求データを用いて、日本人高血圧患者に対するアンジオテンシンII受容体拮抗薬(ARB)処方後のセカンドラインおよびサードライン降圧薬治療に頻繁に併用されている薬剤を調査した。JMDCデータベースでは、初回にARB単剤で治療された患者26998例のうち、最も多く処方されたセカンドライン降圧薬はカルシウムチャネル拮抗薬(CCB)であり、ARB処方開始1年以内に20%超の患者にCCBが追加投与されていた。一方、10%未満の患者はセカンドライン降圧薬として利尿薬を投与されていた。MDVデータベースでは、ARBにCCBを併用処方された患者48813例のうち、サードライン降圧薬として利尿薬が処方された患者はCCBまたはARBを用量増加した患者よりも多かった。利尿薬はCCB追加の2年以内に8%の患者に追加処方された。ARBおよびCCB投与患者への利尿薬の追加処方率は患者の臨床歴によって異なっていた。

Chaen Hideto, Kinchiku Shigesumi, Miyata Masaaki, Kajiya Shoko, Uenomachi Hitoshi, Yuasa Toshinori, Takasaki Kunitsugu, Ohishi Mitsuru . 糖尿病患者におけるLDLコレステロール値の新たな推定法の妥当性(Validity of a Novel Method for Estimation of Low-Density Lipoprotein Cholesterol Levels in Diabetic Patients) . Journal of Atherosclerosis and Thrombosis23 ( 12 ) 1355 - 1364 2016.12

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

日本人2型糖尿病患者において、新たなLDLコレステロール(LDL-C)値推定の手法としてMartin等により提案された方法(LDL-C(M))とFriedewaldの式を用いた手法(LDL-C(F))および直接測定による手法(LDL-C(D))を比較し、LDL-C(M)の妥当性を評価した。当該糖尿病患者1828例(男性1067例、女性761例、平均60.6±11.9歳)を対象に、LDL-C(M)とLDL-C(F)値を選択的可溶化法で測定したLDL-C(D)のそれと比較した。直線回帰分析では、LDL-C(M)はLDL-C(F)よりも強くLDL-C(D)と相関性を有していた。LDL-C(F)およびLDL-C(M)測定に及ぼす血清トリグリセリド(TG)濃度の影響を調査したところ、LDL-C(D)値からのLDL-C(F)値の逸脱に及ぼすTG値の影響は、LDL-C(M)で示されたものよりも大きかった。日本人2型糖尿病患者においてMartin等により提案された方法で推定されたLDL-Cは、Friedewald式で推定されたものよりも有用であることが示された。

Namino Fuminori, Yamakuchi Munekazu, Iriki Yasuhisa, Maenosono Ryuichi, Oketani Naoya, Ohishi Mitsuru, Maruyama Ikuro, Hashiguchi Teruto . 心房細動アブレーション治療における血管内皮機能への影響の解明　CAVIの新たな有用性の探索(Comparison between cardio-ankle vascular index and biomarkers of endothelial function in patients with atrial fibrillation underwent catheter ablation) . 福田記念医療技術振興財団情報 ( 29 ) 103 - 112 2016.12

Language：English Publisher：(公財)福田記念医療技術振興財団

カテーテルアブレーションを施行した心房細動(AF)患者を対象に、術前と術後6ヵ月後の心臓足首血管指数(CAVI)を比較し、CAVIが内皮障害のマーカーとなりうるか検討した。カテーテルアブレーションを施行したAF患者101名(男81名、女20名、平均年齢61.8±8.6歳)を対象とした。6ヵ月後に来院しなかった23名は除いた。78名のうち、洞調律(SR)に回復した患者は33名、AFが再発した患者は45名であった。ベースライン時のCAVIについて、SR回復群とAF再発群との間に有意差はなかった。6ヵ月後のCAVIは両群ともベースライン時と差がなかった。CAVIは年齢と強い相関があり、左室駆出分画と弱い相関がみられた。内皮細胞のバイオマーカーである血清トロンボモデュリン濃度は、SR回復群の方がベースライン時は高値で、両群とも6ヵ月後は上昇していた。ベースライン時の血漿プラスミノーゲンアクチベーターインヒビター1濃度は両群間で差はなく、両群とも6ヵ月後に上昇していた。primary-miR-126とmature miR-126はAF再発群で6ヵ月後に低下し、内皮機能の新しいバイオマーカーとなり得ると考えられた。

Namino Fuminori, Yamakuchi Munekazu, Iriki Yasuhisa, Maenosono Ryuichi, Oketani Naoya, Ohishi Mitsuru, Maruyama Ikuro, Hashiguchi Teruto . 心房細動アブレーション治療における血管内皮機能への影響の解明 CAVIの新たな有用性の探索(Comparison between cardio-ankle vascular index and biomarkers of endothelial function in patients with atrial fibrillation underwent catheter ablation) . 福田記念医療技術振興財団情報 ( 29 ) 103 - 112 2016.12

Language：English Publisher：(公財)福田記念医療技術振興財団

Kawasoe S, Kubozono T, Yoshifuku S, Ojima S, Oketani N, Miyata M, Miyahara H, Maenohara S, Ohishi M. . Uric acid level and prevalence of atrial fibrillation in 285,882 Japanese general population. . Cir J80 ( 12 ) 2453 - 2459 2016.11Reviewed

赤崎雄一, 大石充 . 【循環器疾患治療薬:薬の使い方、どこまで理解していますか?】血圧異常を治す　本態性高血圧症での使い方 . Heart View20 ( 12 ) 88 - 93 2016.11

Kawasoe Shin, Kubozono Takuro, Yoshifuku Shiro, Ojima Satoko, Oketani Naoya, Miyata Masaaki, Miyahara Hironori, Maenohara Shigeho, Ohishi Mitsuru . 一般日本人285882名における尿酸値と心房細動の有病率(Uric Acid Level and Prevalence of Atrial Fibrillation in a Japanese General Population of 285,882) . Circulation Journal80 ( 12 ) 2453 - 2459 2016.11

Language：English Publisher：(一社)日本循環器学会

日本人における血清尿酸値と心房細動(AF)の相関を横断的に検討した。1979～2013年に定期健診を受け、高尿酸血症治療を行っていない日本人285882名(男性130897名、女性154985名、平均58±15歳)を対象とした。年齢、BMI、推定糸球体濾過量、収縮期血圧、尿酸値を十分位に分類し、AF有病率が最も低い十分位に対するオッズ比を男女別に算出した。男性の平均尿酸値は6.0±1.4mg/dL、AF有病率は1.8%であり、尿酸値4.4～4.9mg/dLでAF有病率が最も低く、5.4～5.6mg/dLから>7.8mg/dL、<4.3mg/dLではAF有病率が有意に上昇した。女性の平均尿酸値は4.5±1.1mg/dL、AF有病率は0.7%であり、尿酸値3.6～3.8mg/dLでAF有病率が最も低く、5.0～5.2mg/dLから>5.9mg/dLではAF有病率が有意に上昇した。他の臨床的共変量を調整した場合も、男女ともに尿酸値とAFの独立した相関が認められた。

赤崎雄一, 大石充 . 【循環器疾患治療薬:薬の使い方、どこまで理解していますか?】血圧異常を治す本態性高血圧症での使い方 . Heart View20 ( 12 ) 88 - 93 2016.11

樋口公嗣, 竹中俊宏, 大石充 . 【Fabry病診断・治療の進歩と今後】心合併症の診断・治療 . 腎・高血圧の最新治療5 ( 4 ) 173 - 176 2016.10

Language：Japanese Publisher：(有)フジメディカル出版

Fabry病は、ライソゾーム酵素の一つであるα-ガラクトシダーゼ(α-galactosidase A:α-gal A)の酵素活性の低下または欠損により生じる。この酵素活性の低下により、基質であるスフィンゴ糖脂質が進行性に蓄積し多臓器障害をもたらす。このように、Fabry病の臓器障害は全身に及ぶが、亜型である心Fabry病では臓器障害は心臓に限局している。この病型の違いには、Fabry病では酵素活性がほぼ欠損しているのに対して、心Fabry病では酵素活性がわずかに残存していることが関連していると推察されている。2004年より、本邦でも酵素補充療法が可能となり、早期診断・早期治療の重要性が明らかになってきている。心Fabry病を含むFabry病の心病変は、初期には左室肥大と拡張障害が主体であり、病初期のFabry病に特異的な所見は認めない。このため左室肥大を認める症例では、Fabry病の鑑別診断が重要となる。(著者抄録)

入來泰久, 桶谷直也, 大石充 . ふらつきの原因検索に植込み型ループレコーダーが有用だった1例 . 日本老年医学会雑誌53 ( 4 ) 467 - 468 2016.10

宮内孝浩, 肥後建樹郎, 海江田智絵, 大坪秀雄, 藤野聡司, 川添晋, 窪薗琢郎, 大石充 . Methotrexate(MTX)関連リンパ増殖性疾患の経過観察中に徐脈頻脈や致死性不整脈を来たした1例 . 日本老年医学会雑誌53 ( 4 ) 467 - 467 2016.10

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Papers - OHISHI Mitsuru