Research Achievements - Original paper -

Coconut Atrium Causing Restrictive Physiology in the Right Ventricle

Wakaki Tomitaka, Sato Wakana, Suzuki Mayu, Watanabe Hiroyuki

Internal Medicine ( 一般社団法人 日本内科学会 )  advpub ( 0 )   2023.12  [Refereed]

Research paper (journal)   Domestic Co-author

<p>We herein report a 61-year-old woman with a history of mitral valve replacement for rheumatic fever who presented with crural edema and ascites. Computed tomography showed massive left atrial (LA) calcification involving the interatrial septum, termed "coconut atrium." Catheterization revealed not only pulmonary artery hypertension but also a large V-wave in the pulmonary artery wedge pressure waveform and a dip-and-plateau pattern of right ventricular pressure. Three-dimensional transthoracic echocardiography confirmed the early attainment of peak LA volume and a decreased LA expansion index. Stiff LA syndrome due to coconut LA results in the development of restrictive right ventricular physiology. </p>

DOI PubMed CiNii Research

Pathological Analysis of Medial and Intimal Calcification in Lower Extremity Artery Disease: Impact of Hemodialysis

Tsukasa Kato, Sho Torii, Norihito Nakamura, Kazuki Aihara, Yuta Terabe, Osamu Iida, Takahiro Tokuda, Tatsuya Nakama, Yo Kawahara, Junichi Miyamoto, Takafumi Saito, Norihiko Kamioka, Tsutomu Murakami, Takeshi Ijichi, Makoto Natsumeda, Shigemitsu Tanaka, Yohei Ohno, Gaku Nakazawa, Hiroyuki Watanabe, and Yuji Ikari

JACC: Advances ( JACC: Advances )  2 ( 9 )   2023.11  [Refereed]

Research paper (journal)   Domestic Co-author

DOI

Superiority of the Combination of Input and Output Parameters to the Single Parameter for Lesion Size Estimation

Hidehiro Iwakawa, Masateru Takigawa, Junji Yamaguchi, Claire A Martin, Masahiko Goya, Tasuku Yamamoto, Miki Amemiya, Takashi Ikenouchi, Miho Negishi, Iwanari Kawamura, Kentaro Goto, Takatoshi Shigeta, Takuro Nishimura, Tomomasa Takamiya, Susumu Tao, Shinsuke Miyazaki , Hiroyuki Watanabe, Tetsuo Sasano

Circulation Journal ( Circulation Journal )  87 ( 12 ) 1757 - 1764   2023.10  [Refereed]

Research paper (journal)   Domestic Co-author

<b><i>Background:</i></b> For lesion size prediction, each input parameter, including ablation energy (AE), and output parameter, such as impedance, is individually used. We hypothesize that using both parameters simultaneously may be more optimal.

<b><i>Methods and Results:</i></b> Radiofrequency applications at a range of power (30–50 W), contact force (10 g and 20 g), duration (10–60 s), and catheter orientation with normal saline (NS)- or half-normal saline (HNS)-irrigation were performed in excised porcine hearts. The correlations, with lesion size of AE, absolute impedance drop (∆Imp-drop), relative impedance drop (%Imp-drop), and AE*%Imp-drop were examined. Lesion size was analyzed in 283 of 288 lesions (NS-irrigation, n=142; HNS-irrigation, n=141) without steam pops. AE*%Imp-drop consistently showed the strongest correlations with lesion maximum depth (NS-irrigation, ρ=0.91; HNS-irrigation, ρ=0.94), surface area (NS-irrigation, ρ=0.87; HNS-irrigation, ρ=0.86), and volume (NS-irrigation, ρ=0.94; HNS-irrigation, ρ=0.94) compared with the other parameters. Moreover, compared with AE alone, AE*%Imp-drop significantly improved the strength of correlation with lesion maximum depth (AE vs. AE*%Imp-drop, ρ=0.83 vs. 0.91, P<0.01), surface area (ρ=0.73 vs. 0.87, P<0.01), and volume (ρ=0.84 vs. 0.94, P<0.01) with NS-irrigation. This tendency was also observed with HNS-irrigation. Parallel catheter orientation showed a better correlation with lesion depth and volume using ∆Imp-drop, %Imp-drop, and AE*%Imp-drop than perpendicular orientation.

<b><i>Conclusions:</i></b> The combination of input and output parameters is more optimal than each single parameter for lesion prediction.

DOI Repository PubMed CiNii Research

Successful treatment of lead-related superior vena cava syndrome in combination with transvenous lead extraction and venous stenting

Hidehiro Iwakawa, Tomohito Suzuki, Ken Terata, Hiroyuki Watanabe

Journal of Arrhythmia ( Journal of Arrhythmia )  39 ( 5 ) 813 - 815   2023.09  [Refereed]

Research paper (journal)   Domestic Co-author

DOI

Asymmetric remodeling between the left and right atria in patients with advanced interatrial block and atrial fibrillation

Ryota Kaimori, Hidehiro Iwakawa, Nobuhiro Suzuki, Mako Aokawa, Haruwo Tashiro, Ken Terata, Hiroyuki Watanabe

Journal of Electrocardiology ( Journal of Electrocardiology )  80   63 - 68   2023.05  [Refereed]

Research paper (journal)   Domestic Co-author

BACKGROUND: Advanced interatrial block (A-IAB) on electrocardiography (ECG) represents the conduction delay between the left and right atria. We investigated the association of A-IAB with left and right atrial (LA/RA) remodeling in patients with atrial fibrillation (AF). METHODS: We enrolled 74 patients who underwent ECG, cardiac computed tomography (CCT), and echocardiography during sinus rhythm before catheter ablation of AF. A-IAB was defined as P-wave duration ≥120 ms with a biphasic morphology in leads III and aVF or notched morphology in lead II. We compared the maximum and minimum LA/RA volume indices (max and min LAV/RAVI), LA/RA expansion index (LAEI/RAEI), and total, passive, and active LA/RA emptying fraction (LAEF/RAEF) between patients with and without A-IAB. RESULTS: Of the 74 patients (mean age, 64.3 ± 9.6 years), 35 (47%) showed A-IAB. Patients with A-IAB had a significantly higher likelihood of hypertension and left ventricular diastolic dysfunction than those without. Patients with A-IAB had significantly larger max (69.2 [60.7-79.7]mL/m2 vs. 60.9 [50.4-68.3]mL/m2, P < 0.01) and min (44.0 [37.2-52.1]mL/m2 vs. 34.1 [29.2-43.5]mL/m2, P < 0.01) LAVI than those without. The max and min RAVI were not significantly different between groups. LAEI (55.1 [48.2-78.5]% vs. 72.1 [57.8-84.8]%, P < 0.05), total LAEF (35.5 [32.5-44.0]% vs. 41.9 [36.6-45.9]%, P < 0.05), and passive LAEF (12.2 [10.0-14.4]% vs. 15.5 [11.2-19.6]%, P < 0.05) were significantly lower in patients with A-IAB than without. CONCLUSIONS: A-IAB was associated with LA, but not RA enlargement, in patients with AF. A-IAB may indicate LA functional remodeling in the reservoir and conduit phases.

DOI PubMed

Status of adult outpatients with congenital heart disease in Japan: The Japanese Network of Cardiovascular Departments for Adult Congenital Heart Disease Registry

Yao A.

Journal of Cardiology ( Journal of Cardiology )  80 ( 6 ) 525 - 531   2022.12  [Refereed]

Research paper (journal)   Domestic Co-author

DOI Repository

Utility of P-wave abnormalities for distinguishing embolic stroke from non-embolic stroke

Iwakawa H.

International Journal of Cardiology ( International Journal of Cardiology )  368   72 - 77   2022.12  [Refereed]

Research paper (journal)   Domestic Co-author

DOI

Comparison of Radiofrequency and Cryoballoon Pulmonary Vein Ablation for the Early and Late Recurrence of Atrial Fibrillation

Terata K.

Internal Medicine ( Internal Medicine )  61 ( 22 ) 3315 - 3322   2022.11  [Refereed]

Research paper (journal)   Domestic Co-author

<p><b>Objective </b>Early recurrence (ER) after pulmonary vein isolation (PVI) for atrial fibrillation (AF) is expected to resolve within the recommended 3-month blanking period, irrespective of the ablation device used. To compare the occurrence and relationship of AF within the blanking period and subsequent late recurrence (LR) with radiofrequency (RF) and cryoballoon (CB) ablation. </p><p><b>Methods </b>A retrospective analysis of 294 patients (mean age=62±9, 70.0% male) undergoing PVI for drug-refractory paroxysmal AF was done. After categorizing the patients into the RF group (n=152) and the CB group (n=142), a group-wise comparison was done to investigate the impact of ER on LR throughout a 2-year follow-up. </p><p><b>Results </b>The groups were similar regarding the occurrence of ER (RF=22.4%, CB=24.6%, p=0.62), while LR was significantly higher in the RF group (p=0.003). ER was associated with LR in the RF group (p<0.01) but not in the CB group (p=0.08), while a significant independent association with an increased LR risk was observed [hazard ratio (HR) 6.12; 95% confidence interval (CI) 3.56-10.51, p<0.01]. RF ablation also significantly increased the risk of LR (HR=2.93; 95% CI=1.64-5.23, p<0.01). </p><p><b>Conclusion </b>A recurrence of atrial arrhythmia is more frequent with RF-PVI than with CB-PVI for patients with paroxysmal AF. ER and RF-ablation are strong predictors for LR after the 3-month blanking period. </p>

DOI PubMed CiNii Research

Utility of Superb Microvascular Imaging in the Assessment of Foot Perfusion in Patients with Critical Limb Ischemia

Suto Y.

Diagnostics ( Diagnostics )  12 ( 11 )   2022.11  [Refereed]

Research paper (journal)   Domestic Co-author

DOI Repository

Narrow QRS complex tachycardia with and without ventriculoatrial block: What is the mechanism?

Iwakawa H.

Heart Rhythm ( Heart Rhythm )  19 ( 11 ) 1907 - 1909   2022.11  [Refereed]

Research paper (journal)   Domestic Co-author

DOI

Female Reproductive Events and Subclinical Atherosclerosis of the Brain and Carotid Arteriopathy: the Ohasama Study

Sato Wakana, Nomura Kyoko, Satoh Michihiro, Hara Azusa, Tsubota-Utsugi Megumi, Murakami Takahisa, Asayama Kei, Tatsumi Yukako, Kobayashi Yuki, Hirose Takuo, Inoue Ryusuke, Totsune Tomoko, Kikuya Masahiro, Hozawa Atsushi, Metoki Hirohito, Imai Yutaka, Watanabe Hiroyuki, Ohkubo Takayoshi

Ｊｏｕｒｎａｌ　ｏｆ　Ａｔｈｅｒｏｓｃｌｅｒｏｓｉｓ　ａｎｄ　Ｔｈｒｏｍｂｏｓｉｓ ( 一般社団法人 日本動脈硬化学会 )  advpub ( 0 )   2022.10  [Refereed]

Research paper (journal)   Domestic Co-author

<p><b>Aims: </b>Few studies have investigated the subclinical atherosclerotic changes in the brain and carotid artery, and in East Asian populations. We sought to investigate whether gravidity, delivery, the age at menarche and menopause and estrogen exposure period are associated with subclinical atherosclerosis of the brain and carotid arteriopathy.<b> </b></p><p><b>Methods: </b>This cross-sectional study formed part of a cohort study of Ohasama residents initiated in 1986. Brain atherosclerosis and carotid arteriopathy were diagnosed as white matter hyperintensity (WMH) and lacunae evident on brain magnetic resonance imaging (MRI) and carotid intimal media thickness (IMT) or plaque revealed by ultrasound, respectively. The effect of the reproductive events on brain atherosclerosis and carotid arteriopathy was investigated using logistic regression and general linear regression models after adjusting for covariates.<b> </b></p><p><b>Results: </b>Among 966 women aged ≥ 55 years in 1998, we identified 622 and 711 women (mean age: 69.2 and 69.7 years, respectively) who underwent either MRI or carotid ultrasound between 1992–2008 or 1993–2018, respectively. The highest quartile of gravidity (≥ 5 vs. 3) and delivery (≥ 4 vs. 2), and the highest and second highest (3 vs. 2) quartiles of delivery were associated with an increased risk of WMH and carotid artery plaque, respectively. Neither of age at menarche, menopause, and estrogen exposure period estimated by subtracting age at menarche from age at menopause was associated with atherosclerotic changes of brain and carotid arteries.<b> </b></p><p><b>Conclusions: </b>Higher gravidity and delivery are associated with subclinical atherosclerosis of the brain and carotid plaque.</p>

DOI Repository CiNii Research

Carotid Artery Revascularization Improves Cardiac Sympathetic Nerve Activity in Patients With Carotid Artery Stenosis

Kato T.

Cardiology Research ( Cardiology Research )  13 ( 5 ) 289 - 296   2022.10  [Refereed]

Research paper (journal)   Domestic Co-author

DOI Repository

Asymptomatic Coarctation of the Aorta in Adults with Preserved Exercise Capacity: A Case Report

Tashiro Haruwo, Sato Wakana, Seki Katsuhito, Ono Yuto, Kato Tsukasa, Sato Teruki, Watanabe Hiroyuki

Internal Medicine ( 一般社団法人 日本内科学会 )  advpub ( 0 )   2022.09  [Refereed]

Research paper (journal)   Domestic Co-author

<p>We herein report a case of coarctation of the aorta (CoA) in an asymptomatic adult who had a preserved exercise capacity. A 56-year-old man with mild hypertension exhibited left ventricular hypertrophy on an electrocardiogram during an annual medical checkup. Echocardiography showed a bicuspid aortic valve and cor triatriatum sinister, and subsequent computed tomography revealed CoA with developed collaterals. Cardiopulmonary exercise testing showed a good exercise capacity. He refused surgical repair and has been asymptomatic for five years. This case is of special interest, as CoA is usually rarely noticed during adulthood if there are no severe congenital anomalies, and in addition, this patient had good exercise capacity. </p>

DOI CiNii Research

Wide QRS complex tachycardia and alternating bundle branch block aberration: What is the mechanism?

Iwakawa H.

Journal of Arrhythmia ( Journal of Arrhythmia )  38 ( 3 ) 478 - 481   2022.06  [Refereed]

Research paper (journal)  

DOI Repository

Bilateral deep vein thrombosis in pregnancy as first manifestation of an anomalous inferior vena cava

Kato T.

Journal of Echocardiography ( Journal of Echocardiography )    2022.03  [Refereed]

Research paper (journal)   Domestic Co-author

DOI

Echocardiographic Assessment of Left Ventricular Diastolic Function for Beginners

IINO Takako, WATANABE Hiroyuki

Choonpa Igaku ( The Japan Society of Ultrasonics in Medicine )  49 ( 2 ) 97 - 104   2022.03  [Refereed]  [Invited]

Research paper (journal)   Domestic Co-author

<p>Left ventricular (LV) diastolic dysfunction is associated with worse outcomes in many cardiovascular diseases. Echocardiography is the primary imaging modality used for the assessment of LV diastolic function. Noninvasive estimation of LV filling pressure is an important role of echocardiography. However, echocardiographic parameters have fundamental limitations in the diagnosis of LV diastolic dysfunction as they are significantly influenced by various hemodynamic factors. In this article, we demonstrate the diagnostic approach of LV diastolic dysfunction and pitfalls in echocardiographic diagnosis for beginners.</p>

DOI CiNii Research

Sudden and severe cardiotoxicity induced with pembrolizumab, its clinical course, therapeutic intervention, and outcome

Matsumoto.T

International Cancer Conference Journal   11 ( 1 ) 81 - 86   2022.01  [Refereed]

Research paper (journal)   Domestic Co-author

DOI

Lead dislodgement after a very long-term period of cardiac implantable electronic device implantation

Hidehiro Iwakawa,Ken Terata,Takayuki Yamanaka,Haruwo Tashiro,Hiroyuki Watanabe

Journal of arrhythmia   37 ( 6 ) 1570 - 1571   2021.12  [Refereed]

Research paper (journal)  

A 74-year-old man was admitted for a second replacement of a transvenous implantable cardioverter-defibrillator (ICD) generator at 15 years after implantation. Postoperatively, electrocardiographic monitoring showed atrial lead malfunction. Chest X-ray revealed that the tip of the active fixation atrial lead was dislocated. We present a case of atrial lead dislodgement after a very long-term period of an ICD implantation.

DOI

Clinical implications of antegrade diastolic pulmonary artery flow in adults

Umeta Y.

Journal of Cardiology ( Journal of Cardiology )  78 ( 6 ) 542 - 549   2021.12  [Refereed]

Research paper (journal)   Domestic Co-author

DOI

Large non-coronary sinus of Valsalva aneurysm: A case report of an unusual cause of angina pectoris

Iwakawa H.

European Heart Journal - Case Reports ( European Heart Journal - Case Reports )  4 ( 5 ) 1 - 6   2021.09  [Refereed]

Research paper (journal)   Domestic Co-author

DOI