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-
Circulation journal : official journal of the Japanese Circulation Society 72 322-322 2008年3月1日
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JOURNAL OF HYPERTENSION 25(8) 1573-1575 2007年8月
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AMERICAN JOURNAL OF HYPERTENSION 20(7) 720-727 2007年7月Background: It is reported that blood pressure (BP) variability increases with aging, and cognitive dysfunction may be related to BP variability; however, there are no data showing that exaggerated BP variability is associated with cognitive dysfunction or quality of life (QOL) in the older elderly. We investigated the relationships and the differences between ambulatory BP variability and cognitive function or QOL in younger elderly and very elderly. Methods: We recruited both 101 very elderly (aged >= 80 years) and 101 younger elderly (aged 61 to 79 years). Twenty-four-hour ambulatory blood pressure monitoring, mini-mental state examinations (MMSE), and Medical Outcome Study Short-Form 36 Items Health Survey (SF-36) were performed for all subjects. Results: The mean standard deviation (SD) of daytime systolic BP in young elderly was 17.2 +/- 4.6 mm Hg (mean SD SD of mean SD), and that in very elderly was 21.2 +/- 4.3 mm Hg. The MMSE score significantly decreased with the tertile of SD of daytime systolic BP in very elderly (P = .004) and young elderly (P = .03). In very elderly, there was no significant association between the SD of daytime systolic BP and each of eight SF-36 categories. On the other hand, in younger elderly, two of eight SF-36 categories decreased with the tertile of SID of daytime systolic BP (P = .001 for Vitality and P = .003 for Role emotion). Conclusions: Very elderly had larger BP variability than younger elderly. Exaggerated ambulatory BP variability was related to cognitive dysfunction in the elderly, especially in the very elderly, and was related to lower QOL in the younger elderly. Am J Hypertens 2007;20: 720-727 (c) 2007 American Journal of Hypertension, Ltd.
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Circulation journal : official journal of the Japanese Circulation Society 71 871-871 2007年4月20日
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AMERICAN JOURNAL OF HYPERTENSION 20(4) 385-391 2007年4月Background: Masked hypertension (MHT: normal office blood pressure [BP] + elevated BP out of the office) is a significant predictor of target organ damage and cardiovascular disease. The purpose of this study was to investigate the subclinical arterial damage in unmedicated subjects with MHT detected by home BP measurement. Methods: We recruited 282 subjects not taking antihypertensive medication, who had at least one of the following five cardiovascular risk factors: high BP, hyperlipidemia, diabetes mellitus, current smoking, and chronic kidney disease. Furthermore, we classified them into four groups (normotension [NT], white-coat hypertension [WCHT], MHT, and sustained hypertension [SHT]) by office BP (140/90 mm Hg) and home BP (135/85 mm Hg) measurements. Arterial damage was evaluated by measuring carotid intima-media thickness (IMT) and brachial-ankle pulse wave velocity (baPWV). Results: Subjects with MHT had a higher prevalence of habitual alcohol drinkers than the other groups, and higher pulse rates at home than those with NT and WCHT. After adjustment for covariates, carotid IMT was the highest in MHT among the four groups (mean: 1.01 v 0.83 mm for NT, 0.86 mm for WCHT, and 0.91 mm for SHT, all P<.01). The baPWV was also significantly higher in MHT than NT and WCHT (mean: 1940 v 1663 and 1733 cm/sec, all P<.01), whereas the difference between MHT and SHT (2023 cm/sec) was not significant. Conclusions: This study shows that masked hypertensives detected by home BP are at higher risk for increased arterial damage than normotensives or white-coat hypertensives, and potentially than sustained hypertensives.
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Circulation journal : official journal of the Japanese Circulation Society 71 144-144 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 143-144 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 144-144 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 144-144 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 461-462 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 463-464 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 418-418 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 423-423 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 423-423 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 174-175 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 233-233 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 234-234 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 233-233 2007年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 71 383-383 2007年3月1日
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STROKE 38(3) 911-917 2007年3月Background and Purpose - High-sensitivity C-reactive protein (hsCRP), a marker of inflammation, is associated with atherosclerosis, hypertensive target organ damage, and cardiovascular events. In the general Japanese population, the level of hsCRP is reported to be lower than that in Western countries, and the relationships among hsCRP, silent cerebral infarcts (SCIs), and clinical stroke events in older Japanese hypertensives remain unclear. Methods - We conducted brain MRI and measured hsCRP at baseline in 514 older Japanese hypertensives ( clinic blood pressure >= 140/90 mm Hg, age >= 50 years old) who were enrolled in the Jichi Medical School ABPM Study, wave 1. They were followed up for an average of 41 months ( range: 1 to 68 months, 1751 person-years) and the incidence of subsequent clinical stroke events was evaluated. Results - The subjects with SCIs at baseline (n = 257) had a higher hsCRP level than those without SCIs ( geometric mean hsCRP [SD range];0.19 [0.18 to 0.21] versus 0.14 [0.13 to 0.16] mg/L, P = 0.007) after adjustment for confounding factors, and the OR for the presence of SCIs was increased with the quartile of hsCRP levels. In Cox regression analysis, the patients with above median hsCRP level (>= 0.21 mg/L) (hazard ratio [HR]: 2.50, 95% CI: 1.24 to 5.00, P = 0.01) and those with SCIs ( HR: 4.60, 95% CI: 1.91 to 11.03, P = 0.001) at baseline had independently higher risks for clinical stroke events after adjustment for age, smoking status, antihypertensive medication use, and 24-hour systolic blood pressure level. Compared with the patients with below median hsCRP level without SCIs, those with above median hsCRP level and SCIs at baseline had a higher risk for clinical stroke events ( HR: 7.32, 95% CI: 2.17 to 24.76, P = 0.001), although those with below median hsCRP level and SCIs ( HR: 2.46, 95% CI: 0.64 to 9.47, P = 0.19) and those with above median hsCRP level without SCIs ( HR: 1.11, 95% CI: 0.22 to 5.55, P = 0.90) did not have significant risks. Conclusion - High-sensitivity C-reactive protein is a risk factor for clinical stroke events in addition to silent cerebral infarcts in Japanese older hypertensives, indicating that the risk for clinical stroke events increases with preexisting hypertensive target organ damage in the brain and additionally with ongoing low-grade inflammation.
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Hypertens Res 30(2) 143-149 2007年
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Circulation journal : official journal of the Japanese Circulation Society 70 262-262 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 660-660 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 670-670 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 160-160 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 172-172 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 173-173 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 159-159 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 179-179 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 177-178 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 173-173 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 160-160 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 159-160 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 528-528 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 454-455 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 435-435 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 37-37 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 480-480 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 229-229 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 294-294 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 293-293 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 684-684 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 624-625 2006年3月1日
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Circulation journal : official journal of the Japanese Circulation Society 70 609-609 2006年3月1日
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HYPERTENSION 47(2) 139-140 2006年2月
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Circulation J 70 210-210 2006年
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Hypertens Res 29(9) 695-702 2006年
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Hypertens Res 29(8) 581-587 2006年
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-
日本学術振興会 科学研究費助成事業 2022年4月 - 2027年3月
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日本学術振興会 科学研究費助成事業 2020年4月 - 2025年3月
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日本学術振興会 科学研究費助成事業 2020年7月 - 2023年3月
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日本学術振興会 科学研究費助成事業 2019年4月 - 2023年3月
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日本学術振興会 科学研究費助成事業 2018年4月 - 2023年3月