基本情報
研究キーワード
4経歴
1-
2009年 - 現在
学歴
2-
- 1987年
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- 1987年
委員歴
11受賞
12論文
470-
Journal of arrhythmia 40(2) 363-373 2024年4月BACKGROUND: The precise details of atrial activation around the triangle of Koch (ToK) remain unknown. We evaluated the relationship between the atrial-activation pattern around the ToK and success sites for slow-pathway (SP) modification ablation in slow-fast atrioventricular reentrant tachycardia (AVNRT). METHODS: Thirty patients with slow-fast AVNRT who underwent successful ablation were enrolled. Atrial activation around the ToK during sinus rhythm was investigated using ultra-high-density mapping pre-ablation. The relationships among features of atrial-activation pattern and success sites were examined. RESULTS: Of 30 patients (22 cryoablation; 8 radiofrequency ablation), 26 patients had a collision site of two wavefronts of delayed atrial activation within ToK, indicating a success site. The activation-search function of Lumipoint software, which highlights only atrial activation with a spatiotemporal consistency, showed non-highlighted area on the tricuspid-annulus side of ToK. In 23 of the patients, a spiky potential was recorded at that collision site outside the Lumipoint-highlighted area. Fifteen cryoablation patients with a success site coincident with a collision site outside the Lumipoint-highlighted area had significantly more frequent disappearances of SP after initial cryoablation (46.7% vs. 0%, p = .029), fewer cryoablations (3.7 ± 1.8 vs. 5.3 ± 1.3, p = .045), and shorter procedure times (170 ± 57 vs. 228 ± 91 min, p = .082) compared to the seven cryoablation patients without such sites. Four patients had transient AV block by ablation inside the Lumipoint-highlighted area with fractionated signals, but no patient developed permanent AV block or recurrence post-procedure (median follow-up: 375 days). CONCLUSIONS: SP modification ablation at the collision site of atrial activation of the tricuspid-annulus side along with a spiky potential could provide a better outcome.
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Hypertension research : official journal of the Japanese Society of Hypertension 2024年3月26日Lack of the typical nocturnal blood pressure (BP) fall, i.e non-dipper, has been known as a cardiovascular risk. However, the influence of non-dipper on atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) has been unclear. We investigated the clinical impact of non-dipping as evaluated by 24-hour ambulatory BP monitoring on the long-term outcome of AF recurrence post-PVI in 76 AF patients with a history of increased BP. The PVI procedure was successful in all 76 patients (mean age, 66±9years; antihypertensive medication, 89%; non-paroxysmal AF, 24%). Twenty patients had AF recurrence during a median follow-up of 1138 days. There was no difference in BP levels between the AF recurrence and non-recurrence groups (average 24 h systolic BP:126 ± 17 vs.125 ± 14 mmHg; P = 0.84). On the other hand, the patients with non-dipper had a higher AF recurrence than those with dipper (38.9% vs.15.0%; P = 0.018). In Cox hazard analysis adjusted by age, non-paroxysmal AF and average 24-hr systolic BP level, the non-dipper was an independent predictor of AF recurrence (HR 2.78 [95%CI:1.05-7.34], P = 0.039). Non-dipper patients had a larger left atrial (LA) volume index than the dipper patients (45.9 ± 17.3 vs.38.3 ± 10.2 ml/m2, P = 0.037). Among the 58 patients who underwent high-density voltage mapping in LA, 11 patients had a low-voltage area (LVA) defined as an area with a bipolar voltage < 0.5 mV. However, there was no association of LVA with non-dipper or dipper (22.2% vs.16.1%, P = 0.555). Non-dipper is an independent predictor of AF recurrence post-PVI. Management of abnormal diurnal BP variation post-PVI may be important.
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Hypertension research : official journal of the Japanese Society of Hypertension 2024年3月15日Hypertension, a disease whose prevalence increases with age, induces pathological conditions of ischemic vascular disorders such as cerebral infarction and myocardial infarction due to accelerated arteriosclerosis and circulatory insufficiency of small arteries and sometimes causes hemorrhagic conditions such as cerebral hemorrhage and ruptured aortic aneurysm. On the other hand, as it is said that aging starts with the blood vessels, impaired blood flow associated with vascular aging is the basis for the development of many pathological conditions, and ischemic changes in target organs associated with vascular disorders result in tissue dysfunction and degeneration, inducing organ hypofunction and dysfunction. Therefore, we hypothesized that hypertension is associated with all age-related vascular diseases, and attempted to review the relationship between hypertension and diseases for which a relationship has not been previously well reported. Following our review, we hope that a collaborative effort to unravel age-related diseases from the perspective of hypertension will be undertaken together with experts in various specialties regarding the relationship of hypertension to all pathological conditions.
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Hypertension research : official journal of the Japanese Society of Hypertension 2024年3月5日Thirty-year % increase of adults with hypertension in the European/ Americas and South-East Asia/ Western Pacific (WHO region). Create using the data from: World Health Organization. Global report on hypertension: the race against a silent killer. Geneva, Switzerland: 2023.
MISC
189-
HYPERTENSION 45(5) 887-893 2005年5月Diabetes and hypertension are potent risk factors for cerebrovascular disease. We studied the effects of an angiotensin II type 1 receptor blockade (ARB) on brain damage in hypertensives in relation to diabetes. We studied cerebral metabolism ( by proton magnetic resonance spectroscopy) and hemodynamics (by phase-contrast magnetic resonance angiography) before and 3 to 4 months after candesartan therapy in 20 diabetic hypertensives (DHTs) and 20 matched nondiabetic hypertensives (HTs). Silent multiple cerebral infarcts detected by brain MRI were more common in DHTs than in HTs (50% versus 25%). Cerebral N-acetyl aspartate (NAA; an indicator of functional neuronal mass) was lower in DHTs than in HTs (8.35 versus 9.58 mmol/kg; P=0.007). Baseline quantitative volume flow in the internal carotid arteries (ICAs) and the middle cerebral arteries (MCAs) was comparable between the 2 groups, whereas cerebrovascular reserve (CVR) assessed using acetazolamide ( a cerebral arteriolar dilator) in ICAs (25% versus 35%; P=0.03) and MCAs (20% versus 31%; P=0.01) was lower in DHTs than in HTs. These baseline CVR and NAA values of DHT group were lower than those of 12 matched normotensives (CVR: 44% for ICA; 41% for MCA; NAA: 10.5 mmol/kg; all P<0.005). After candesartan therapy, CVR in ICAs and MCAs was significantly increased (P=0.001) independently of the reduction of the 24-hour blood pressure level, whereas the cerebral NAA level did not change. In conclusion, brain damage is advanced in DHTs. ARB partly improved the impaired cerebral microvascular function in DHTs.
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Circulation journal : official journal of the Japanese Circulation Society 69 187-187 2005年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 69 202-202 2005年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 69 569-570 2005年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 69 490-490 2005年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 69 322-322 2005年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 69 113-113 2005年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 69 113-114 2005年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 69 114-114 2005年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 69 353-353 2005年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 69 404-404 2005年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 69 369-370 2005年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 69 364-364 2005年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 69 163-163 2005年3月1日
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HYPERTENSION 45(2) 203-208 2005年2月White-coat hypertension (WCH) has been associated with a low risk for stroke, but long-term data are scanty. We analyzed individual data from 4 prospective cohort studies from the United States, Italy, and Japan that used comparable methodology for 24-hour noninvasive ambulatory blood pressure monitoring (ABPM). Overall, 4406 subjects with essential hypertension and 1549 healthy normotensive controls who were untreated at the time of initial ABPM were followed for a median of 5.4 years up to censoring or occurrence of a first stroke. At entry, mean age of subjects was 56 years ( range 18 to 97). Prevalence of WCH was 9%. During follow-up, there were 213 new cases of stroke. Stroke rate ( x 100 person years) was 0.35 in the normotensive group, 0.59 in the WCH group, and 0.65 in the group with ambulatory hypertension. In a multivariate analysis, the adjusted hazard ratio for stroke was 1.15 (95% confidence interval [CI], 0.61 to 2.16) in the WCH group ( P = 0.66) and 2.01 ( 95% CI, 1.31 to 3.08) in the ambulatory hypertension group ( P = 0.001) compared with the normotensive group. After the sixth year of follow-up, the incidence of stroke tended to increase in the WCH group, and the corresponding hazard curve crossed that of the ambulatory hypertension group by the ninth year of follow-up. In conclusion, WCH was not associated with a definitely increased risk of stroke during the total follow-up period. However, WCH might not be a benign condition for stroke in the long term.
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Japan Medical Association Journal 48 363-376 2005年
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Circulation journal : official journal of the Japanese Circulation Society 68 131-131 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 281-281 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 281-281 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 508-509 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 398-399 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 471-471 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 473-473 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 217-217 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 423-424 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 609-609 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 575-575 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 351-351 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 329-329 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 205-205 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 199-200 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 198-198 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 197-197 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 197-197 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 153-153 2004年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 68 156-156 2004年3月1日
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Science Press, London 1-68 2004年
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Circulation journal : official journal of the Japanese Circulation Society 67 573-573 2003年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 67 394-394 2003年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 67 13-13 2003年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 67 382-382 2003年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 67 382-382 2003年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 67 158-158 2003年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 67 121-121 2003年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 66 131-131 2002年3月31日
所属学協会
11Works(作品等)
2共同研究・競争的資金等の研究課題
28-
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