研究者詳細 - 大石　充

論文 - 大石　充

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大石充 . 【General Physicianにとっての脳卒中・循環器病診療update～脳卒中・循環器病対策基本法でどう変わるか?～】脳卒中・循環器病の一次予防　脳心血管病一次予防に向けた高血圧治療 . 日本内科学会雑誌112 ( 3 ) 332 - 337 2023年3月

Kuwahata So, Ushikai Jumpei, Yamakawa Nobuhide, Inaba Masaya, Kusumoto Keisuke, Kamekou Masahiro, Saihara Keishi, Takenaka Toshihiro, Murata Nobutaka, Kato Tomoyuki, Ohishi Mitsuru . 肺性心に起因する右心不全患者における心イベント前後の心音バイオマーカーの変化(Changes in cardiac acoustic biomarkers before and after cardiac events in a patient with right-sided heart failure due to cor pulmonale) . Journal of Cardiology Cases27 ( 3 ) 108 - 112 2023年3月

記述言語：英語出版者・発行元：(一社)日本心臓病学会

症例は68歳男性で、気腫合併肺線維症による肺性心を有していた。今回、労作時呼吸困難のため来院した。急性心不全の診断で入院となり、カテコールアミンとフロセミド治療で状態は改善した。約2週間後に退院し、在宅酸素療法を開始し、その後当院にてタダラフィル、エナラプリル等の内服療法を行っていた。退院後の安定期(31日間)、心不全増悪前(発症直前2週間)、心不全増悪による入院期間を含む7ヵ月間、週に2回心音と心電図を記録して、心音バイオマーカー(CAB)として定量化を行い、CABの変化と心不全による入院との関係性を調査した。入院に至る心不全増悪が始まる直前の増悪前期間中に、おそらく右心からのものと思われる第3心音(S3)強度の可聴不能な変化が観察された。第4心音(S4)強度の値は、安定期および増悪前には高値であったが、入院中に著しく低下した。S3およびS4を含むCABが右心不全増悪と治療により変化することから、増悪徴候の早期検出に有用であることが示唆された。

大石充 . 【General Physicianにとっての脳卒中・循環器病診療update～脳卒中・循環器病対策基本法でどう変わるか?～】脳卒中・循環器病の一次予防脳心血管病一次予防に向けた高血圧治療 . 日本内科学会雑誌112 ( 3 ) 332 - 337 2023年3月

記述言語：英語出版者・発行元：(一社)日本心臓病学会

鉛山かおり, 波野史典, 市來仁志, 鎌田博之, 吉元一成, 二宮雄一, 堀添善尚, 笠畑拓志, 政元いずみ, 山口宗一, 橋口照人, 大石充 . 左房内Pentraxin3の心房細動アブレーション前後の変化と左房機能関連因子との関連 . 日本循環器学会学術集会抄録集87回 CO5 - 7 2023年3月

鎌田博之, 川添晋, 市來仁志, 吉元一成, 二宮雄一, 入來泰久, 窪薗琢郎, 宮原広典, 徳重浩一, 大石充 . 鹿児島県離島住民のQT延長(QT Prolongation on Residents of Remote Islands in Kagoshima Prefecture) . 日本循環器学会学術集会抄録集87回 PJ107 - 2 2023年3月

二宮雄一, 川添晋, 窪薗琢郎, 徳重明央, 市來仁志, 鎌田博之, 吉元一成, 池田義之, 宮原広典, 徳重浩一, 大石充 . 禁煙後の体重増加と将来の高血圧との関連性(Association between Weight Gain after Smoking Cessation and Future Hypertension) . 日本循環器学会学術集会抄録集87回 PJ013 - 2 2023年3月

Hidaka Y, Tabira T, Maruta M, Makizako H, Ikeda Y, Nakamura A, Han G, Miyata H, Shimokihara S, Akasaki Y, Kamasaki T, Kubozono T, Ohishi M . Relationship between grave visitation and apathy among community-dwelling older adults . Psychogeriatrics.23 ( 3 ) 401 - 410 2023年2月査読

Shibata Keisuke, Tokushige Akihiro, Hamamoto Yuki, Higuchi Koji, Imamura Masakazu, Ikeda Yoshiyuki, Ohishi Mitsuru . Kagoshima-DVTスコアは消化器癌患者における癌関連血栓症の有用な予測モデルである(The Kagoshima-DVT Score Is a Useful Predictive Model for Cancer-Associated Thrombosis in Patients With Gastrointestinal Cancer) . Circulation Reports5 ( 2 ) 19 - 26 2023年2月

記述言語：英語出版者・発行元：(一社)日本循環器学会

Dダイマー≧1.5μg/mL、年齢≧60歳、女性、グルココルチコイド治療継続中、深部静脈血栓症(DVT)高リスク癌、および長時間の不動状態をスコア化したKagoshima-DVTスコア(KDS)を用いて、初回化学療法を受けた消化器癌患者250名(男性158名、女性92名、年齢中央値67歳)の癌関連血栓症(CAT)リスクを評価した。患者はKDSにより低リスク120名(48%)、中リスク97名(38.8%)および高リスク(13.2%)に層別された。61名(27.1%)がCATを発症した。低リスク群の19名(17.6%)、中リスク群の30名(35.3%)および高リスク群の12名(36.4%)がCATを発症した。1年以内のCAT発症の時間依存性ROC曲線下面積は、CATリスク評価モデルであるKhoranaスコア(0.494)と比べてKDS(0.653)で大きかった。CATリスク評価においてKDSはKhoranaスコアより優れていると考えられた。

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年1月査読

出版者・発行元：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

Shimono H, Tokushige A, Kanda D, Ohno A, Hayashi M, Fukuyado M, Akao M, Kawasoe M, Arikawa R, Otsuji H, Chaen H, Okui H, Oketani N, Ohishi M . 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 cardiology.81 ( 6 ) 553 - 563 2023年1月査読国際誌

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Cardiology

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 ± 12.4 years, 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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PubMed

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年1月査読

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年1月

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年1月

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年1月

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年1月

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 2023年査読

記述言語：日本語出版者・発行元：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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PubMed

Shimono H, Tokushige A, Kanda D, Ohno A, Hayashi M, Fukuyado M, Akao M, Kawasoe M, Arikawa R, Otsuji H, Chaen H, Okui H, Oketani N, Ohishi M . 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年

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Heart and Vessels

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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PubMed

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 2023年査読

記述言語：日本語出版者・発行元：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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PubMed

CiNii Research

Masumitsu T, Kubozono T, Miyata M, Makizako H, Tabira T, Takenaka T, Kawasoe S, Tokushige A, Niwa S, Ohishi M . Association of Sleep Duration and Cardio-Ankle Vascular Index in Community-Dwelling Older Adults . Journal of Atherosclerosis and Thrombosis29 ( 12 ) 1864 - 1871 2022年12月査読

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：一般社団法人日本動脈硬化学会

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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論文 - 大石 充

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論文 - 大石　充