研究者総覧

甲谷 友幸 (カブトヤ トモユキ)

  • 成人先天性心疾患センター 准教授
Last Updated :2021/09/22

研究者情報

学位

  • 医学博士(自治医科大学)

ホームページURL

J-Global ID

研究キーワード

  • テロメア長   家庭血圧計   生活習慣病   血圧測定   細胞老化   夜間高血圧   トリガー血圧計   夜間低酸素   血管内皮機能   睡眠時無呼吸症候群   スリープサージ   

研究分野

  • ライフサイエンス / 循環器内科学

経歴

  • 2014年04月  自治医科大学医学部学内講師

学歴

  • 1997年03月 - 現在   自治医科大学   医学部   医学科

研究活動情報

論文

  • Yusuke Oba, Tomoyuki Kabutoya, Satoshi Hoshide, Kazuo Eguchi, Kazuomi Kario
    JOURNAL OF CLINICAL HYPERTENSION 19 4 402 - 409 2017年04月 [査読有り][通常論文]
     
    This study aimed to investigate the relationship between nondipper pulse rate (PR) and hypertensive target organ damage. Ambulatory blood pressure monitoring was conducted in 940 high-risk Japanese patients enrolled in the Japan Morning Surge Home Blood Pressure Study. Nondipper PR was defined as (awake PR-sleep PR)/awake PR <0.1. The authors measured the patients' brain natriuretic peptide (BNP) and left ventricular mass index (LVMI). The nondipper PR group (n=213) had a significantly higher prevalence of high BNP (35pg/mL, 39.9% vs 26.1%; P<.001) than the dipper PR group (n=727). LVMI was significantly higher in the nondipper PR patients compared with the dipper PR patients among the women (mean LVMI: 111.3 +/- 32.4 vs 104.2 +/- 26.7g/m(2), P=.03) but not the men (mean LVMI: 117.6 +/- 32.0 vs 117.2 +/- 33.1g/m(2), P=.92). In conclusion, the nondipper PR was associated with cardiac overload.
  • Kuno T, Imaeda S, Asakawa Y, Nakamura H, Takemura G, Asahara D, Kanamori A, Kabutoya T, Numasawa Y
    Case reports in cardiology 2017 9473917  2017年 [査読有り][通常論文]
  • Kazuo Eguchi, Tomoyuki Kabutoya, Satoshi Hoshide, Shizukiyo Ishikawa, Kazuomi Kario
    JOURNAL OF CLINICAL HYPERTENSION 18 12 1250 - 1257 2016年12月 [査読有り][通常論文]
     
    The authors aimed to investigate the blood pressure (BP)-lowering ability of eplerenone in drug-resistant hypertensive patients. A total of 57 drug-resistant hypertensive patients whose home BP was 135/85 mm Hg were investigated. The patients were randomized to either an eplerenone group or a control group and followed for 12 weeks. The efficacy was evaluated by clinic, home, and ambulatory BP monitoring. Urinary albumin, pulse wave velocity, and flow-mediated vasodilation (FMD) were also evaluated. Home morning systolic BP (148 +/- 15 vs 140 +/- 15 mm Hg) and evening systolic BP (137 +/- 16 vs 130 +/- 16 mm Hg) were significantly lowered in the eplerenone group (n=35) compared with baseline (both P<.05), while unchanged in the control group (n=22). BP reductions in the eplerenone group were most pronounced for ambulatory awake systolic BP (P=.04), awake diastolic BP (P=.004), and 24-hour diastolic BP (P=.02). FMD was significantly improved in the eplerenone group. In patients with drug-resistant hypertension, add-on use of eplerenone was effective in lowering BP, especially home and ambulatory awake BP.
  • Tomoyuki Kabutoya, Yasushi Imai, Hiroaki Watanabe, Tomonori Watanabe, Takahiro Komori, Kazuomi Kario
    INTERNATIONAL HEART JOURNAL 57 1 118 - 120 2016年01月 [査読有り][通常論文]
     
    A 48-year-old woman underwent cardiac resynchronization therapy defibrillator implantation. Coronary sinus (CS) venography showed only one adequate anterior branch for a left ventricular lead. We were able to introduce a quadripolar left ventricular lead (Medtronic 4398-88 cm) to the distal portion of the anterior branch. Although phrenic nerve stimulation (PNS) occurred due to distal bipolar pacing (distal 1 mid 2, with 21-mm distance) and proximal pacing (mid 3 proximal 4, distance 21mm), short-spaced bipolar pacing (mid 2-3, distance 1.3 mm) did not induce PNS until 9V pacing. Shared bipolar pacing from each left ventricular electrode (distal 1 to proximal 4) as cathode and a right ventricular (RV) coil as anode resulted in PNS by 3.0V at 0.4 ms. Although quadripolar pacing could avoid PNS by switching the pacing site (ie, from distal bipolar to proximal bipolar), it might not avoid PNS in cases where the phrenic nerve and CS branch are parallel and in close proximity. We found that even though the phrenic nerve and CS branch were parallel and close, short-spaced bipolar pacing could avoid PNS. In conclusion, short-spaced bipolar pacing selected by quadripolar pacing might be beneficial to avoid PNS when the implantable branch is limited.
  • Tomoyuki Kabutoya, Kazuomi Kario
    HYPERTENSION RESEARCH 38 11 713 - 715 2015年11月 [査読有り][通常論文]
  • Tomoyuki Kabutoya, Satoshi Hoshide, Yukiyo Ogata, Kazuo Eguchi, Kazuomi Kario
    JOURNAL OF CLINICAL HYPERTENSION 16 2 156 - 156 2014年02月 [査読有り][通常論文]
  • Takahiro Komori, Kazuo Eguchi, Tomoyuki Kabutoya, Joji Ishikawa, Satoshi Hoshide, Kazuomi Kario
    CLINICAL AND EXPERIMENTAL HYPERTENSION 36 8 538 - 544 2014年 [査読有り][通常論文]
     
    Background: Masked uncontrolled hypertension (MUH), defined as controlled office blood pressure (BP) but uncontrolled out-of-office BP in treated hypertensives, is a risk factor for cardiovascular disease. We tested the hypothesis that MUH is associated with a greater degree of diastolic dysfunction than controlled hypertension (CH) or uncontrolled hypertension (UH). Methods and results: We studied 299 treated patients who had at least one cardiovascular risk factor (age, 63 +/- 10 years; male sex, 43%), consisting of 94 (31.4%) patients with UH, 46 (15.4%) with MUH, 56 (18.7%) with treated white-coat hypertension (WCH), and 103 (34.4%) with CH. We performed office and home BP monitoring, electrocardiography, echocardiography and blood tests. Diastolic dysfunction was defined as an E-wave to e'-wave (E/e') ratio >= 8 measured by Doppler echocardiography. The value of E/e' was higher in the MUH (8.3 +/- 2.7) and UH (8.3 +/- 2.7) groups than in the CH group (7.3 +/- 2.3; p +/- 0.08, p = 0.02, respectively). In multivariable analysis, MUH was associated with a significantly higher likelihood of diastolic dysfunction than CH (odds ratio 2.90 versus CH, p<0.01) after adjusting for significant covariates. Conclusions: MUH and UH were associated with a greater degree of diastolic dysfunction than CH. Even in treated patients, out-of-office BP is important to stratify the risk of cardiovascular disease.
  • Tomoyuki Kabutoya, Satoshi Hoshide, Yukiyo Ogata, Kazuo Eguchi, Kazuomi Kario
    JOURNAL OF CLINICAL HYPERTENSION 15 9 630 - 636 2013年09月 [査読有り][通常論文]
     
    The relationships between home blood pressure (BP), masked hypertension defined by home BP, and integrated flow-mediated vasodilation (FMD) response remain unclear. The authors enrolled 257 patients (mean age, 63.5years; 51% men) who had at least one cardiovascular risk factor. FMD of the brachial artery was measured with a semiautomatic edge-detection algorithm. The integrated FMD response was calculated as the area under the dilation curve during 120seconds after deflation (FMD-AUC120) and the FMD magnitude as the percentage change in peak diameter (FMD). Masked hypertension was defined by office BP <140/90mm Hg and home BP 135mm Hg and/or 85mm Hg. Home systolic BP was inversely correlated with FMD-AUC120 and FMD (FMD-AUC120: r=-.23, P<.001; FMD: r=-.13, P=.041), and office systolic BP was inversely associated with FMD-AUC120 (r=-.16, P=.011), but not with FMD. After adjusting for covariates, home systolic BP (=-.27, P=.003), but not office BP, was inversely associated with FMD-AUC120, whereas FMD was not associated with office or home systolic BP. FMD-AUC120 was significantly lower in patients with masked hypertension compared with those with normotension (7.7 +/- 6.7 vs 11.5 +/- 8.8mmxs, P=.048). Home systolic BP and masked hypertension defined by home BP were associated with a decrease in FMD-AUC(120).
  • Satoshi Hoshide, Motoki Fukutomi, Kazuo Eguchi, Tomonori Watanabe, Tomoyuki Kabutoya, Kazuomi Kario
    Clinical and Experimental Hypertension 35 1 40 - 44 2013年 [査読有り][通常論文]
     
    The aim of this study was to compare the differences in the levels of a highly sensitive cardiac troponin T (Hs-cTnT) between Losartan (LOS) plus hydrochlorothiazide (HCTZ) and amlodipine. Seventy-eight hypertensive patients were randomized to receive LOS/HCTZ or amlodipine for 8 weeks. Both treatments decreased clinic and 24-hour blood pressure to the same extent. The Hs-cTnT level was significantly reduced in the amlodipine group (P < .05), but such a reduction was not found in the LOS/HCTZ group in the upper half group of Hs-cTnT level at baseline. Amlodipine had a more beneficial effect than LOS/HCTZ in patients with high Hs-cTnT levels. © 2013 Informa Healthcare USA, Inc.
  • Tomoyuki Kabutoya, Shizukiyo Ishikawa, Joji Ishikawa, Satoshi Hoshide, Kazuomi Kario
    ANNALS OF NONINVASIVE ELECTROCARDIOLOGY 17 3 252 - 259 2012年07月 [査読有り][通常論文]
     
    Background: There have been few reports on the relationship between P-wave characteristics and long-term cardiovascular events. Methods: A nested case-control study was conducted as part of the Jichi Medical School cohort study, which enrolled 12,490 subjects in a community-dwelling population. The mean follow-up period was 10.7 years. The P-wave characteristics of 526 patients who suffered cardiovascular events (fatal/nonfatal stroke, fatal/nonfatal myocardial infarction, and sudden death) within the follow-up period (case group) were compared with those of 1578 matched controls (control group). The P-wave morphology was classified as normal, deflected, and notched type in precordial leads. A broad P wave was defined as a maximum P-wave duration of more than 120 ms in any of the 12 leads. Results: The mean age was 64 +/- 8 years and the percentage of males was 54% in both groups. A notched P wave at baseline was observed in 10.1% of the case group and 6.0% of the control group (P = 0.001). A notched P wave was a significant predictor of cardiovascular events after adjustment for covariates (odds ratio = 1.59; 95% confidence interval = 1.082.33). Among the patients with left ventricular hypertrophy as evaluated by the SokolowLyon criteria or Cornell product criteria, there was no significant difference in cardiovascular events between those with and those without a notched P wave, but in the absence of left ventricular hypertrophy, patients with a notched P wave suffered more cardiovascular events than those without a notched P wave by each criteria. Conclusion: P-wave morphologic characteristics were effective for predicting cardiovascular events.
  • Tomoyuki Kabutoya, Satoshi Hoshide, Yukiyo Ogata, Tomohiko Iwata, Kazuo Eguchi, Kazuomi Kario
    JOURNAL OF THE AMERICAN SOCIETY OF HYPERTENSION 6 2 109 - 116 2012年03月 [査読有り][通常論文]
     
    The relationship between having a cardiovascular risk factor and endothelial dysfunction observed on a time-course analysis of brachial artery flow-mediated vasodilation (FMD) remains unclear. We enrolled 257 patients who had at least one cardiovascular risk factor. We measured FMD magnitude of the percentage change in peak diameter (Delta FMD), maximum FMD rate calculated as the maximum slope of dilation (FMD-MDR), and integrated FMD response calculated as the area under the dilation curve during the 60- and 120-second dilation periods (FMD-AUC(60) and FMD-AUC(120)) using a semiautomatic edge-detection algorithm. FMD-AUC(60) and FMD-AUC(120) were negatively correlated with the Framingham risk score (FMD-AUC(60): r = -0.15, P = .023; FMD-AUC(120): r = -0.17, P = .007), whereas this association was not found in the case of either the Delta FMD or the FMR-MDR. The Framingham risk score was significantly higher in patients in the lowest tertile for FMD-AUC(120) (FMD-AUC(120) <5.0 mm x second) than in those in the highest tertile for FMD-AUC(120) (FMD-AUC(120) >= 11.0 MM X second) (12.9 +/- 8.7 vs. 8.6 +/- 7.8%, P = .002). The lowest tertile for FMD-AUC(120) was independently associated with the Framingham risk score (beta = 0.10, P = .011), after adjustments were made for age, gender, and smoking and drinking status. FMD-AUC(120) was associated with cardiovascular risk. J Am Soc Hypertens 2012;6(2):109-116. (C) 2012 American Society of Hypertension. All rights reserved.
  • Tomoyuki Kabutoya, Satoshi Hoshide, Joji Ishikawa, Kazuo Eguchi, Kazuyuki Shimada, Kazuomi Kario
    AMERICAN JOURNAL OF HYPERTENSION 23 7 749 - 755 2010年07月 [査読有り][通常論文]
     
    BACKGROUND There have been few reports on the relationship between variation in the diurnal pulse rate (PR) in relation to a nondipper blood pressure (BP) pattern and cardiovascular events in elderly hypertensives. METHODS Ambulatory BP monitoring (ABPM) was conducted at baseline in 811 older Japanese hypertensives (clinical BP >140/90 mm Hg; age >50 years old) enrolled in the Jichi Medical School ABPM study, wave 1. They were followed up for an average of 41 months, and the incidence of subsequent cardiovascular event and death was evaluated. PR nondipping status was defined as (awake PR sleep PR)/awake PR <0.1. RESULTS The mean age of patients was 72.3 +/- 9.8 years (311 men and 500 women). The nondipper patients had a higher risk of cardiovascular events (11.5% vs. 6.1%, P = 0.006) and stroke (9.9% vs. 5.7%, P = 0.039) than the dippers. Patients were classified into four subgroups: BP dipping plus PR dipping status (n = 471), BP dipping plus PR nondipping (n = 37), BP nondipping plus PR dipping (n = 250), and BP nondipping plus PR nondipping (n = 53).The combination of BP and PR nondipping constituted a higher risk of cardiovascular events and stroke than the other three combinations combined (cardiovascular events: 17,0% vs. 7.5%, P = 0.015; stroke: 17.0% vs. 6.6%, P = 0.005). On Cox proportional hazards modeling, BP nondipping with PR nondipping led to a significant synergistic increase in the risk of stroke (hazard ratio: 8.92; 95% confidence interval: 1.03-77.5, P = 0.048). CONCLUSIONS A blunted PR dip might predict a stroke in elderly hypertensives with a nondipping BP status.
  • Tomoyuki Kabutoya, Joji Ishikawa, Satoshi Hoshide, Kazuo Eguchi, Kazuyuki Shimada, Kazuomi Kario
    JOURNAL OF CLINICAL HYPERTENSION 12 5 345 - 349 2010年05月 [査読有り][通常論文]
     
    There has been no report comparing the changes in home blood pressure (HBP) and target organ damage between depressive and nondepressive hypertensives receiving antihypertensive therapy based on HBP monitoring. This study was a multicenter prospective study conducted by 7 doctors at 2 institutions. The authors prospectively studied 42 hypertensive patients with home systolic blood pressure > 135 mm Hg. Participants were divided into a depression group (Beck Depression Inventory score > 10; n=21) and a nondepression group (Beck Depression Inventory score < 9, matched for HBP level; n=21). The authors performed antihypertensive therapy to reduce home systolic blood pressure to below 135 mm Hg and, 6 months later, evaluated the urinary albumin/creatinine ratio (UACR). Although patients in the depression group tended to require the addition of a greater number of medications than those in the nondepression group (2.3 +/- 1.0 vs 1.7 +/- 1.0 drugs, P <.05), HBP was reduced similarly in both groups at 6 months (depression group: 150 +/- 17/78 +/- 11 mm Hg to 139 +/- 11/73 +/- 8 mm Hg, P <.001; nondepression group: 150 +/- 11/76 +/- 9 mm Hg to 135 +/- 9/70 +/- 8 mm Hg, P <.01). The reduction of UACR was smaller in the depression group than in the nondepression group (2.4 vs 10.1 mg/gCr, P <.05). Depressive hypertensive patients required a larger number of antihypertensive drugs to control HBP, and showed a smaller reduction in UACR than nondepressive hypertensives.
  • Tomoyuki Kabutoya, Kazuomi Kario
    HYPERTENSION RESEARCH 32 9 732 - 734 2009年09月 [査読有り][通常論文]
  • Tomoyuki Kabutoya, Joji Ishikawa, Satoshi Hoshide, Kazuo Eguchi, Kazuyuki Shimada, Kazuomi Kario
    JOURNAL OF CLINICAL HYPERTENSION 11 8 422 - 425 2009年08月 [査読有り][通常論文]
     
    In this study, we evaluated whether antihypertensive therapy using a home blood pressure monitor (HBPM) equipped with a graphic display of weekly and monthly averaged blood pressure (BP) can obtain better BP control than the conventional HBPM. Sixty-five hypertensive outpatients who had HBP > 135/85 mm Hg were enrolled by 8 doctors in 2 different hospitals. The patients were randomly assigned either a graph-equipped HBPM (graph-equipped HBPM group; n=33) or an HBPM without the graph function (conventional HBPM group; n=32). The patients were treated with antihypertensive medications targeting HBP < 135/85 mm Hg. After 2 months, the home systolic BP level was lower in the graph-equipped HBPM group than in the conventional HBPM group (141.3 +/- 15.4 vs 147.7 +/- 10.8 mm Hg; P <.05); its reduction was significantly larger in the former group (11.9 vs 5.6 mm Hg; P <.05). Using an HBP device with a graphic display could accelerate the achievement of BP control.
  • Tomoyuki Kabutoya, Joji Ishikawa, Satoshi Hoshide, Kazuo Eguchi, Shizukiyo Ishikawa, Kazuyuki Shimada, Kazuomi Kario
    AMERICAN JOURNAL OF HYPERTENSION 22 1 35 - 40 2009年01月 [査読有り][通常論文]
     
    BACKGROUND The negative white-coat effect (WCE), a phenomenon in which out-of-office blood pressure (BP) is higher than clinic BP, has not been well examined, unlike the WCE. METHODS As part of the Jichi Morning Hypertension Research study, in which clinic and home BP were measured in 969 hypertensive outpatients, 405 patients with normal clinic BP were separately analyzed, Clinic BP was measured on two different occasions, and home BP was measured twice in the morning and twice in the evening for three consecutive days. Clinic and home BP were each averaged from all readings, and negative WCE was defined as clinic systolic BP (SBP) lower than home SBP. RESULTS Negative WCE was observed in 324 (33%) of the patients overall and in 173 (42%) of the patients with controlled BP (clinic BP < 140/90 mm Hg). In multiple logistic regression analysis adjusting for covariates including home SBP and pulse rate, negative WCE was correlated with older age (odds ratio (OR) 1.03, 95% confidence interval (CI) 1.01-1.06) and male gender (OR 1.08, 95% CI 1.01-1.14) in overall subjects. Among patients with well-controlled clinic BP, negative WCE was significantly correlated with the presence of ischemic heart disease (OR 1.17, 95% CI 1.04-1.31). The association of negative WCE with age and male gender remained significant under stringent criteria (negative WCE < -10.2 mm Hg (the mean -1 s.d.)). CONCLUSIONS Negative WCE remaining even after clinic BP is controlled may be related to cardiovascular risk factors such as older age, male gender, and a history of ischemic heart disease.
  • Tomoyuki Kabutoya, Joji Ishikawa, Satoshi Hoshide, Kazuo Eguchi, Seiichi Shibasaki, Yoshio Matsui, Shizukiyo Ishikawa, Thomas G. Pickering, Kazuyuki Shimada, Kazuomi Kario
    CLINICAL AND EXPERIMENTAL HYPERTENSION 30 3-4 255 - 265 2008年 [査読有り][通常論文]
     
    Background. Recently, it was reported that high pulse rate (PR), which was measured using by self-measured blood pressure (BP) monitoring at home, was associated with cardiovascular risk. However, the predictor of high PR at home in treated hypertensives is unknown. In this study, we studied the predictor of high PR and evaluated pulse rate variability (PRV). Methods. In the JMS-1 study, 611 hypertensive outpatients were recruited. Self-measured BP monitoring was conducted consecutively twice in the morning and evening for three days. PR analysis was conducted using the average of these two measurements for three days (six readings in total). We defined home PR as the mean of these six readings. Home PRV was defined as the standard deviation of these six readings. Results. Multivariate linear regression analysis demonstrated that current smoking (beta = 0.12, p = 0.002), diabetes (beta = 0.16, p < 0.001), lack of angiotensin-converting enzyme (ACE) inhibitor use (beta = 0.10, p = 0.008), decreased brain-type natriuretic peptide (BNP; beta = 0.17, p < 0.001), and elevated home diastolic blood pressure (beta = 0.14, p = 0.009) were determinants of high PR. Determinants of decreased home PRV were female gender (beta = 0.10, p < 0.03) and increased hemoglobin A1c (HbA1c; beta = 0.15, p < 0.001). When we divided the patients into four groups according to home PR and its variability, hypertensives whose home PR was high and variability was low were found to have high HbA1c (ANOVA, p > 0.05). Conclusions. Smoking habit, diabetes, lack of ACE inhibitor use, and low BNP value were determinants of home PR, and female gender and higher HbA1c were significantly associated with its low variability. Home PR and its variability may be useful for detecting high-risk hypertensive patients, particularly with autonomic neuropathy.
  • Kabutoya T, Kario K
    Clinical calcium 15 1631 - 1641 10 2005年10月 [査読有り][通常論文]

MISC

受賞

  • 2008年 自治医科大学 自治医科大学医学部研究奨励金(高血圧患者のモーニングサージと血管内皮機能,圧受容体反射の関連)
     
    受賞者: 甲谷 友幸

共同研究・競争的資金等の研究課題



Copyright © MEDIA FUSION Co.,Ltd. All rights reserved.