2023/12/07 更新

写真a

タニ ケンイチ
谷 憲一
tani kenichi
所属
千葉北総病院 集中治療室 助教
職名
助教
外部リンク

経歴

  • 日本医科大学千葉北総病院   集中治療室   助教

    2023年4月 - 現在

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  • 日本医科大学多摩永山病院   循環器内科   助教

    2022年4月 - 2023年3月

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  • 国立病院機構 静岡医療センター   循環器内科

    2020年10月 - 2022年3月

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  • 日本医科大学千葉北総病院   集中治療室   助教代理

    2019年10月 - 2020年10月

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  • 八丈島町立病院   内科   非常勤医師

    2019年4月 - 2019年9月

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  • 日本医科大学千葉北総病院   集中治療室   専攻医

    2017年10月 - 2019年3月

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  • 日本医科大学千葉北総病院   循環器内科   専攻医

    2016年4月 - 2017年9月

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  • 日本医科大学千葉北総病院   初期研修医

    2014年4月 - 2016年3月

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▼全件表示

論文

  • Timing and Degree of Acute Kidney Injury in Patients Requiring Non-Surgical Intensive Care.

    Akihiro Shirakabe, Hirotake Okazaki, Masato Matsushita, Yusaku Shibata, Shota Shigihara, Suguru Nishigoori, Tomofumi Sawatani, Kenichi Tani, Kazutaka Kiuchi, Nobuaki Kobayashi, Kuniya Asai

    Circulation journal : official journal of the Japanese Circulation Society   87 ( 10 )   1392 - 1402   2023年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The degree and timing of acute kidney injury (AKI) on admission and during hospitalization in patients requiring non-surgical intensive care remain unclear.Methods and Results: In this study, 3,758 patients requiring intensive care were analyzed retrospectively. AKI was defined based on the ratio of serum creatinine concentrations recorded at each time point (i.e., on admission and during the first 5 days in the intensive care unit and during hospitalization) to those measured at baseline. Patients were grouped by combining AKI severity (RIFLE class) and timing (i.e., from admission to 5 days [A-5D]; from 5 days to hospital discharge [5D-HD]) as follows: No-AKI; New-AKI (no AKI to Class R [risk; ≥1.5-fold increase in serum creatinine], I [injury; ≥2.0-fold increase in serum creatinine], and F [failure; ≥3.0-fold increase in serum creatinine or receiving dialysis during hospitalization]); Stable-AKI (Class R to R; Class I to I); and Worsening-AKI (Class R to I or F; Class I to F). Multivariate logistic regression analysis indicated that 730-day mortality was independently associated with Class R, I, and F on admission; Class I and F during the 5D-H period; and New-AKI and Worsening-AKI during A-5D and 5D-HD. CONCLUSIONS: AKI on admission, even Class R, was associated with a poor prognosis. An increase in RIFLE class during hospitalization was identified as an important factor for poor prognosis in patients requiring intensive care.

    DOI: 10.1253/circj.CJ-23-0320

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  • The prognostic impact of the serum heart-type fatty acid-binding protein level in patients with sepsis who were admitted to the non-surgical intensive-care unit.

    Kenichi Tani, Akihiro Shirakabe, Nobuaki Kobayashi, Hirotake Okazaki, Masato Matsushita, Yusaku Shibata, Shota Shigihara, Tomofumi Sawatani, Yusuke Otsuka, Tsutomu Takayasu, Miwako Asano, Akiko Nomura, Noritake Hata, Kuniya Asai, Wataru Shimizu

    Heart and vessels   36 ( 11 )   1765 - 1774   2021年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Ongoing myocardial damage at the acme of the sepsis status has not been sufficiently evaluated. The clinical data of 160 sepsis patients who require intensive care and 127 outpatients with chronic heart failure (HF) were compared as a retrospective cohort study. Thereafter, the sepsis patients were divided into 3 groups according to the serum heart-type fatty acid-binding protein (H-FABP) quartiles [low H-FABP = Q1 (n = 39), middle H-FABP = Q2/Q3 (n = 81), and high H-FABP = Q4 group (n = 40)]. The H-FABP level was measured within 15 min of admission. The serum H-FABP levels in the sepsis patients [26.6 (9.3-79.0) ng/ml] were significantly higher than in the choric HF patients [6.6 (4.6-9.7) ng/ml]. A Kaplan-Meier curve showed that the survival rate of the high-H-FABP group was significantly lower than that of the middle- and low-H-FABP groups. The multivariate Cox regression analysis for the 365-day mortality showed that the high-H-FABP group (hazard ratio: 6.544, 95% confidence interval [CI] 2.026-21.140; p = 0.002) was an independent predictor of the 365-day mortality. The same trend in the prognostic impact was significantly (p = 0.015) observed in the cohort that had not been suffering from the cardiac disease before admission. The serum H-FABP level was an independent predictor of the 365-day mortality in the patients who were emergently hospitalized in the intensive-care unit due to sepsis. Ongoing myocardial damage was detected in the majority of patients with sepsis, suggesting that ongoing myocardial damage might be a candidate predictor of adverse outcomes in sepsis patients.

    DOI: 10.1007/s00380-021-01865-4

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  • Clinical Significance of the Fibrosis-4 Index in Patients with Acute Heart Failure Requiring Intensive Care.

    Akihiro Shirakabe, Hirotake Okazaki, Masato Matsushita, Yusaku Shibata, Shota Shigihara, Suguru Nishigoori, Tomofumi Sawatani, Kenichi Tani, Kazutaka Kiuchi, Yusuke Otsuka, Masanori Atsukawa, Norio Itokawa, Taeang Arai, Nobuaki Kobayashi, Kuniya Asai, Wataru Shimizu

    International heart journal   62 ( 4 )   858 - 865   2021年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The Fibrosis-4 (FIB4) index could indicate the liver fibrosis in patients with chronic hepatic diseases. It was calculated using the following formula: (age × aspartate aminotransferase [U/L]) / (platelet count [103/μL] × √alanine aminotransferase [U/L]). However, the clinical impact of the FIB4 index in the acute phase of acute heart failure (AHF) has not been sufficiently investigated.A total 1,468 AHF patients were analyzed. The median FIB4 index was 2.71 [1.85-4.22]. The patients were divided into three groups according to the quartiles of their FIB4 index (low-FIB4 [Q1, ≤ 1.847], middle-FIB4 [Q2/Q3, 1.848-4.216], and high-FIB4 [Q4, ≥ 4.216] groups). A Kaplan-Meier curve analysis showed that the prognosis, such as all-cause mortality and HF events within 365 days, was significantly poorer in the high-FIB4 group than in the middle-FIB4 and low-FIB4 groups. A multivariate Cox regression model identified high FIB4 index as an independent predictor of 365-day all-cause death (hazard ratio (HR): 1.660, 95% CI: 1.136-2.427) and HF events (HR: 1.505, 95% CI: 1.145-1.978). The multivariate logistic regression analysis showed that the high plasma volume status (PVS) (Q4, odds ratio [OR]: 2.099, 95% CI: 1.429-3.082), low systolic blood pressure (SBP) (< 100 mmHg, OR: 3.825, 95% CI: 2.504-5.840), and low left ventricular ejection fraction (< 40%, OR: 1.321, 95% CI: 1.002-1.741) were associated with a high FIB4 index.A high FIB4 index can predict adverse outcomes in AHF patients, which indicate that congestive liver and liver hypoperfusion occur due to low cardiac output in the acute phase of AHF.

    DOI: 10.1536/ihj.20-793

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  • Prognostic Impact of Plasma Xanthine Oxydoreductase(XOR) on Admission and Time-Dependent Changes during Hospitalization in Patients with Acute Heart Failure(和訳中)

    岡崎 大武, 白壁 章宏, 松下 誠人, 大塚 悠介, 谷 憲一, 西郡 卓, 鴫原 祥太, 村瀬 貴代, 中村 敬志, 小林 宣明, 畑 典武, 浅井 邦也, 清水 渉

    日本循環器学会学術集会抄録集   85回   OJ57 - 2   2021年3月

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    記述言語:英語   出版者・発行元:(一社)日本循環器学会  

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  • 急性心不全患者における入院時の血漿Xanthine Oxydoreductase(XOR)と入院中の経時的変化が予後へ及ぼす影響(Prognostic Impact of Plasma Xanthine Oxydoreductase(XOR) on Admission and Time-Dependent Changes during Hospitalization in Patients with Acute Heart Failure)

    岡崎 大武, 白壁 章宏, 松下 誠人, 大塚 悠介, 谷 憲一, 西郡 卓, 鴫原 祥太, 村瀬 貴代, 中村 敬志, 小林 宣明, 畑 典武, 浅井 邦也, 清水 渉

    日本循環器学会学術集会抄録集   85回   OJ57 - 2   2021年3月

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    記述言語:英語   出版者・発行元:(一社)日本循環器学会  

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  • Time-dependent changes in plasma xanthine oxidoreductase during hospitalization of acute heart failure. 国際誌

    Hirotake Okazaki, Akihiro Shirakabe, Masato Matsushita, Yusaku Shibata, Shota Shigihara, Tomofumi Sawatani, Kenichi Tani, Kazutaka Kiuchi, Yusuke Otsuka, Takayo Murase, Takashi Nakamura, Nobuaki Kobayashi, Noritake Hata, Kuniya Asai, Wataru Shimizu

    ESC heart failure   8 ( 1 )   595 - 604   2021年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIMS: The aim of present study is to evaluate the clinical significance of the time-dependent changes in xanthine oxidoreductase (XOR) activity during hospitalization for acute heart failure (AHF). METHODS AND RESULTS: A total of 229 AHF patients who visited to emergency room were prospectively enrolled, and 187 patients were analysed. Blood samples were collected within 15 min of admission (Day 1), after 48-72 h (Day 3), and between Days 7 and 21 (Day 14). The AHF patients were divided into two groups according to the XOR activity on Day 1: the high-XOR group (≥100 pmol/h/mL, n = 85) and the low-XOR group (<100 pmol/h/mL, n = 102). The high-XOR patients were assigned to two groups according to the rate of change in XOR from Day 1 to Day 14: the decreased group (≥50% decrease; n = 70) and the non-decreased group (<50% decrease; n = 15). The plasma XOR activity significantly decreased on Days 3 and 14 [23.6 (9.1 to 63.1) pmol/h/mL and 32.5 (10.2 to 87.8) pmol/h/mL, respectively] in comparison with Day 1 [78.5 (16.9 to 340.5) pmol/h/mL]. A Kaplan-Meier curve indicated that the prognosis, including heart failure (HF) events (all-cause death and readmission by HF) within 365 days, was significantly poorer in the low-XOR patients than in the high-XOR patients and was also significantly poorer in the non-decreased group than in the decreased group. CONCLUSIONS: The plasma XOR activity was rapidly decreased by the appropriate treatment of AHF. Although high-XOR activity on admission was not associated with increased HF events in AHF, high-XOR activity that was not sufficiently reduced during appropriate treatment was associated with increased HF events.

    DOI: 10.1002/ehf2.13129

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  • Importance of the Corrected Calcium Level in Patients With Acute Heart Failure Requiring Intensive Care.

    Akihiro Shirakabe, Kazutaka Kiuchi, Nobuaki Kobayashi, Hirotake Okazaki, Masato Matsushita, Yusaku Shibata, Shota Shigihara, Tomofumi Sawatani, Kenichi Tani, Yusuke Otsuka, Kuniya Asai, Wataru Shimizu

    Circulation reports   3 ( 1 )   44 - 54   2020年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: Serum calcium (Ca) concentrations in the acute phase of acute heart failure (AHF) have not been not sufficiently investigated. Methods and Results: This study enrolled 1,291 AHF patients and divided them into 3 groups based on original and corrected Ca concentrations: (1) hypocalcemia (both original and corrected Ca ≤8.7 mg/dL; n=651); (2) pseudo-hypocalcemia (original and corrected Ca ≤8.7 and >8.7 mg/dL, respectively; n=300); and (3) normal/hypercalcemia (both original and corrected Ca >8.7 mg/dL; n=340). AHF patients were also divided into 2 groups based on corrected Ca concentrations: (1) corrected hypocalcemia (corrected Ca ≤8.7 mg/dL; n=651); and (2) corrected normal/hypercalcemia (corrected Ca >8.7 mg/dL; n=640). Of the 951 patients with original hypocalcemia (≤8.7 mg/dL), 300 (31.5%) were classified as corrected normal/hypercalcemia after correction of Ca concentrations by serum albumin. The prognoses in the pseudo-hypocalcemia, low albumin, and corrected normal/hypercalcemia groups, including all-cause death within 730 days, were significantly poorer than in the other groups. Multivariate Cox regression analysis showed that classification into the pseudo-hypocalcemia, hypoalbumin, and corrected normal/hypercalcemia groups independently predicted 730-day all-cause death (hazard ratios [95% confidence intervals] of 1.497 [1.153-1.943], 2.392 [1.664-3.437], and 1.294 [1.009-1.659], respectively). Conclusions: Corrected normal/hypercalcemia was an independent predictor of prognosis because this group included patients with pseudo-hypocalcemia, which was affected by the serum albumin concentration.

    DOI: 10.1253/circrep.CR-20-0068

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  • Plasma xanthine oxidoreductase (XOR) activity in patients who require cardiovascular intensive care.

    Yusaku Shibata, Akihiro Shirakabe, Hirotake Okazaki, Masato Matsushita, Hiroki Goda, Shota Shigihara, Kazuhiro Asano, Kazutaka Kiuchi, Kenichi Tani, Takayo Murase, Takashi Nakamura, Nobuaki Kobayashi, Noritake Hata, Kuniya Asai, Wataru Shimizu

    Heart and vessels   35 ( 10 )   1390 - 1400   2020年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Hyperuricemia is known to be associated with adverse outcomes in cardiovascular intensive care patients, but its mechanisms are unknown. A total of 569 emergency department patients were prospectively analyzed and assigned to intensive care (ICU group, n = 431) or other departments (n = 138). Uric acid (UA) levels were significantly higher in the intensive care patients (6.3 [5.1-7.6] mg/dl vs. 5.8 [4.6-6.8] mg/dL). The plasma xanthine oxidoreductase (XOR) activity in the ICU group (68.3 [21.2-359.5] pmol/h/mL) was also significantly higher than that in other departments (37.2 [15.1-93.6] pmol/h/mL). Intensive care patients were divided into three groups according to plasma XOR quartiles (Q1, low-XOR, Q2/Q3, normal-XOR, and Q4, high-XOR group). A multivariate logistic regression model showed that lactate (per 1.0 mmol/L increase, OR 1.326; 95%, CI 1.166-1.508, p < 0.001) and the Acute Physiology and Chronic Health Evaluation II score (per 1.0 point increase, OR 1.095, 95% CI 1.034-1.160, p = 0.002) were independently associated with the high-XOR group. In-hospital mortality was significantly higher in the high-XOR group (n = 28, 26.2%) than in the normal- (n = 11, 5.1%) and low- (n = 9, 8.3%) XOR groups. The high-XOR group (vs. normal-XOR group) was independently associated with the in-hospital mortality (OR 2.934; 95% CI 1.170-7.358; p = 0.022). Serum UA levels and plasma XOR activity were high in patients admitted to intensive care. The enhanced XOR activity may be one of the mechanisms under which hyperuricemia was associated with adverse outcomes in patients requiring cardiovascular intensive care.

    DOI: 10.1007/s00380-020-01608-x

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  • The prognostic impact of the uric acid level in patients who require cardiovascular intensive care - is serum uric acid a surrogate biomarker for critical patients in the non-surgical intensive care unit? 国際誌

    Yusaku Shibata, Akihiro Shirakabe, Hirotake Okazaki, Masato Matsushita, Tomofumi Sawatani, Saori Uchiyama, Kenichi Tani, Nobuaki Kobayashi, Toshiaki Otsuka, Noritake Hata, Kuniya Asai, Wataru Shimizu

    European heart journal. Acute cardiovascular care   9 ( 6 )   636 - 648   2020年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The prognostic impact of hyperuricemia and the factors that induce hyperuricemia in cardiovascular intensive care patients remain unclear. METHODS AND RESULTS: A total of 3257 emergency department patients were screened, and data for 2435 patients who were admitted to an intensive care unit were analyzed. The serum uric acid level was measured within 15 min of admission. The patients were assigned to a low-uric acid group (uric acid ⩽7.0 mg/dl, n=1595) or a high-uric acid group (uric acid >7.0 mg/dl, n=840) according to their uric acid level on admission. Thereafter, the patients were divided into four groups according to the quartiles of their serum uric acid level (Q1, Q2, Q3 and Q4), and uric acid levels and Acute Physiology and Chronic Health Evaluation II (APACHE II) score. A Kaplan-Meier curve showed a significantly lower 365-day survival rate in a high-uric acid group than in a low-uric acid group, and in Q3 than in Q1 or Q2 and in Q4 than in the other groups. The multivariate logistic regression model for 30-day mortality identified Q4 (odds ratio: 1.856, 95% confidence interval (CI) 1.140-3.022; p=0.013) as an independent predictor of 30-day mortality. The area under the receiver-operating characteristic curve values of the serum uric acid level and APACHE II score for the prediction of 30-day mortality were 0.648 and 0.800, respectively. The category-free net reclassification improvement and integrated discrimination improvement showed that the calculated risk shifted to the correct direction by adding the serum uric acid level to the APACHE II score (0.204, 95% CI 0.065-0.344; p=0.004, and 0.015, 95% CI 0.005-0.025; p=0.004, respectively). The prognosis, including the 365-day mortality, among patients with a high uric acid level and a high APACHE II score was significantly poorer in comparison with other patients. CONCLUSION: The serum uric acid level, which might be elevated by the various critical stimuli on admission, was an independent predictor in patients who were emergently hospitalized in the intensive care unit. The serum uric acid level is therefore useful as a surrogate biomarker for critical patients in the intensive care unit.

    DOI: 10.1177/2048872618822473

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  • Mechanisms of Urgently Presenting Acute Heart Failure.

    Masato Matsushita, Akihiro Shirakabe, Nobuaki Kobayashi, Hirotake Okazaki, Yusaku Shibata, Hiroki Goda, Shota Shigihara, Kazuhiro Asano, Kenichi Tani, Kazutaka Kiuchi, Fumitaka Okajima, Noritake Hata, Kuniya Asai, Wataru Shimizu

    International heart journal   61 ( 2 )   316 - 324   2020年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The mechanisms of urgently presenting acute heart failure (AHF) are not clear. We evaluated the serum catecholamine values of AHF patients immediately after admission. A total of 1,475 AHF patients were screened, and 484 who were admitted from their homes and in whom serum catecholamine could be evaluated immediately after admission were analyzed. The patients were divided into three groups according to the time interval from the onset of symptoms to admission (OA): < 3 hours (early-OA group; n = 283), 3-24 hours (middle-OA group; n = 142), and ≥24 hours (late-OA group; n = 59). In the early-OA group, the systolic blood pressure (SBP) was significantly higher, orthopnea was more frequent, the pH value was significantly decreased, and the use of noninvasive positive-pressure ventilation was required significantly more often than in the other groups. The serum noradrenaline level was significantly increased in the early-OA group (1.96 [1.02-3.60] ng/mL) than in the middle-OA (1.49 [0.73-3.41] ng/mL) and late-OA (1.40 [0.91-2.42] ng/mL) groups, and the adrenaline level was significantly increased in the early-OA group (0.36 [0.13-1.17] ng/mL) than in the late-OA (0.22 [0.09-0.52] ng/mL) group. A multivariate logistic regression model indicated the early-OA group was independently associated with the SBP > 140 mmHg (odds ratio [OR]: 2.219, 95% CI: 1.375-3.581), midnight/early morning admission (OR: 3.158, 95% CI: 2.048-4.868), and high serum catecholamine value (adrenaline > 0.96 ng/mL, noradrenaline > 3.39 ng/mL, and dopamine > 0.21 ng/mL) (OR 2.091, 95% CI: 1.161-3.767). In conclusion, urgently presented AHF might be induced by an endogenous catecholamine surge, which causes an excessive rise in blood pressure leading to increased after-overload and volume-shift lung congestion.

    DOI: 10.1536/ihj.19-523

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  • Prognostic impact of new-onset atrial fibrillation associated with worsening heart failure in aging patients with severely decompensated acute heart failure. 国際誌

    Kazutaka Kiuchi, Akihiro Shirakabe, Nobuaki Kobayashi, Hirotake Okazaki, Masato Matsushita, Yusaku Shibata, Hiroki Goda, Shota Shigihara, Kazuhiro Asano, Kenichi Tani, Noritake Hata, Kuniya Asai, Wataru Shimizu

    International journal of cardiology   302   88 - 94   2020年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUNDS: The prevalence of atrial fibrillation (AF) has been increasing in aging societies. The prognostic impact of AF associated with worsening heart failure (HF) remains obscure. METHODS AND RESULTS: We analyzed 1170 acute heart failure (AHF) patients who required intensive care. Patients were assigned to two groups according to the prevalence of AF: no episode of AF (n = 940) and pre-existing AF (Group-1, n = 230). Patients with no episode of AF (n = 940) were further divided into two groups according to presence of new-onset of AF after admission (Group-2a, n = 258) or not (Group-2b, n = 682). Kaplan-Meier curve analysis showed that prognosis, including all-cause mortality and HF-events within 1000 days, was significantly poorer in the Group-1 compared to the Group-2b. However, a multivariate Cox regression model showed that the Group-1 was not an independent predictor of 1000-day mortality and HF-events. Furthermore, Kaplan-Meier curve analysis showed that prognosis, including all-cause mortality and HF-events within 1000 days, was significantly poorer in the Group-2a than in the Group-2b. A multivariate Cox regression model revealed that the Group-2a was an independent predictor of 1000-day mortality (HR: 1.403, 95% CI: 1.018-1.934) and HF-events (HR: 1.352, 95% CI: 1.071-1.708). A multivariate logistic regression model showed that only age (≥75 years old) was independently associated with new-onset of AF after admission (odds ratio: 1.556, 95% CI: 1.130-2.143). CONCLUSIONS: New-onset AF associated with worsening HF increases with age and is independently-associated with adverse outcome in patients with AHF.

    DOI: 10.1016/j.ijcard.2019.09.020

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  • Relation of Low Triiodothyronine Syndrome Associated With Aging and Malnutrition to Adverse Outcome in Patients With Acute Heart Failure. 国際誌

    Kuniya Asai, Akihiro Shirakabe, Kazutaka Kiuchi, Nobuaki Kobayashi, Hirotake Okazaki, Masato Matsushita, Yusaku Shibata, Hiroki Goda, Shota Shigihara, Kazuhiro Asano, Kenichi Tani, Fumitaka Okajima, Noritake Hata, Wataru Shimizu

    The American journal of cardiology   125 ( 3 )   427 - 435   2020年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Low triiodothyronine (T3) syndrome has recently been evaluated as a prognostic marker of acute heart failure (AHF). However, in which cases low T3 syndrome typically leads to adverse outcomes remain unclear. Of 1,432 AHF patients screened, 1,190 were enrolled. Euthyroidism was present in 956 patients (80.3%), who were divided into 2 groups: the normal group (n = 445, FT3 ≥1.88 µIU/L) and low-FT3 group (n = 511, FT3 <1.88 µIU/L). The survival rates and event-free rates within 365 days were significantly lower in the low-FT3 group than in the normal group. A multivariate Cox regression model showed that the low-FT3 group was an independent predictor of 365-day mortality (hazard ratio [HR] 1.429, 95% confidence interval [CI] 1.013 to 2.015) and HF events (HR 1.349, 95% CI 1.047 to 1.739). The multivariate logistic regression analysis revealed that age (per 10-year old increase, odds ratio [OR]: 1.186, 95% CI: 1.046 to 1.345) and prognostic nutritional index (PNI; per 1-point increase, OR: 1.067, 95% CI: 1.046 to 1.089) were independently associated with the low-FT3 group. The prognosis in patients with a low PNI and over 75 years old, including all-cause death within 365 days, was significantly poorer in the low-FT3 group than in the normal group. In conclusion, adverse outcomes were predicted by the presence of low T3. AHF patients with low T3 syndrome are strongly associated with aging and malnutrition. Low T3 syndrome complicated with older age and malnutrition is likely to lead to adverse outcomes in patients with AHF.

    DOI: 10.1016/j.amjcard.2019.10.051

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  • Clinical Approach to Shortening Length of Hospital Stay in Elderly Patients With Acute Heart Failure Requiring Intensive Care.

    Akihiro Shirakabe, Kuniya Asai, Toshiaki Otsuka, Nobuaki Kobayashi, Hirotake Okazaki, Masato Matsushita, Yusaku Shibata, Hiroki Goda, Shota Shigihara, Kazuhiro Asano, Kazutaka Kiuchi, Kenichi Tani, Tatsuhiro Nishiwaki, Noritake Hata, Wataru Shimizu

    Circulation reports   2 ( 2 )   95 - 103   2020年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: The length of hospital stay (LOHS) after acute heart failure (AHF) is too long in Japan. The clinical approach to shortening LOHS is an urgent issue in the aging Japanese society. Methods and Results: Of 1,473 AHF patients screened, 596 patients >75 years old were enrolled. They were divided by LOHS: <28 days (<28-day group, n=316) and ≥28 days (≥28-day group, n=280). Systolic blood pressure and serum hemoglobin were significantly higher and serum blood urea nitrogen and creatinine significantly lower in the <28-day group than in the ≥28-day group. Non-invasive positive pressure ventilation (NPPV) use was significantly more frequent in the <28-day group than in the ≥28-day group. Furthermore, newly initiated tolvaptan in <12 h was significantly more frequent in the <28-day group than in the ≥28-day group (P=0.004). On multivariate logistic regression analysis, newly initiated tolvaptan in <12 h (OR, 2.574; 95% CI: 1.146-5.780, P=0.022) and NPPV use (OR, 1.817; 95% CI: 1.254-2.634, P=0.002) were independently associated with the <28-day group. The same result was found after propensity score matching for LOHS. Conclusions: LOHS was prolonged in patients with severe HF but could be shortened by early tolvaptan treatment.

    DOI: 10.1253/circrep.CR-19-0132

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  • Plasma Xanthine Oxidoreductase (XOR) Activity in Cardiovascular Disease Outpatients.

    Masato Matsushita, Akihiro Shirakabe, Hirotake Okazaki, Yusaku Shibata, Hiroki Goda, Shota Shigihara, Kazuhiro Asano, Kenichi Tani, Kazutaka Kiuchi, Takayo Murase, Takashi Nakamura, Tsutomu Takayasu, Miwako Asano, Fumitaka Okajima, Nobuaki Kobayashi, Noritake Hata, Kuniya Asai, Wataru Shimizu

    Circulation reports   2 ( 2 )   104 - 112   2020年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: The mechanisms of the increased plasma xanthine oxidoreductase (XOR) activity in outpatients with cardiovascular disease were unclear. Methods and Results: A total of 372 outpatients were screened, and 301 outpatients with cardiovascular disease were prospectively analyzed. Blood samples were collected from patients who visited a daily cardiovascular outpatient clinic. Patients with diabetes mellitus (DM) were significantly more likely to be classified into the high-XOR group (≥100 pg/h/mL; 50%) than the low-XOR group (<100 pmol/h/mL; 28.7%). On multivariate logistic regression analysis, DM (OR, 2.683; 95% CI: 1.441-4.996) was independently associated with high plasma XOR activity in all cohorts. In the diabetic cardiovascular disease patients (n=100), median body mass index (BMI) in the high-XOR group (28.0 kg/m2; IQR, 25.2-29.4 kg/m2, n=32) was significantly higher than in the low-XOR group (23.6 kg/m2; IQR, 21.2-25.7 kg/m2, n=68), and BMI was independently associated with high plasma XOR activity (OR, 1.340; 95% CI: 1.149-1.540). Plasma hydrogen peroxide was significantly higher in DM patients with high plasma XOR activity and obesity (>22 kg/m2) than in other patients. Conclusions: DM with obesity is one of the mechanisms of XOR enhancement in cardiovascular disease. The increase of XOR is a possible pathway for the production of reactive oxygen species in obese cardiovascular disease patients with DM.

    DOI: 10.1253/circrep.CR-19-0116

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  • Characteristics of Patients with an Abnormally Decreased Plasma Xanthine Oxidoreductase Activity in Acute Heart Failure Who Visited the Emergency Department. 査読 国際誌

    Akihiro Shirakabe, Hirotake Okazaki, Masato Matsushita, Yusaku Shibata, Hiroki Goda, Shota Shigihara, Kazuhiro Asano, Kennichi Tani, Kazutaka Kiuchi, Takayo Murase, Takashi Nakamura, Nobuaki Kobayashi, Noritake Hata, Kuniya Asai, Wataru Shimizu

    Cardiology   145 ( 8 )   473 - 480   2020年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The factors associated with a low plasma xanthine oxidoreductase (XOR) activity were not elucidated in patients with acute heart failure (AHF). METHODS: Two-hundred and twenty-nine AHF patients who visited the emergency department were prospectively analyzed. AHF patients were divided into 3 groups according to the plasma XOR quartiles (Q1 = low-XOR group [n = 57], Q2/Q3 = middle-XOR group [n = 115], and Q4 = high-XOR group [n = 57]). The prognostic nutritional index (PNI) and the controlling nutritional status (CONUT) score were evaluated. RESULTS: The multivariate logistic regression model showed that the nutritional status (PNI: OR 1.044, 95% CI 1.000-1.088; CONUT: OR 3.805, 95% CI 1.158-12.498), age, and serum creatinine level were independently associated with a low plasma XOR activity. The Kaplan-Meier curve showed a significantly lower incidence of heart failure events in the low-XOR group than in the middle + high-XOR group (hazard ratio, HR 1.648, 95% CI 1.061-2.559). In particular, a low XOR activity with an increased serum creatinine level (>1.21 mg/dL) was independently associated with heart failure events (HR 1.937, 95% CI 1.199-3.130). CONCLUSION: A low plasma XOR activity was associated with malnutrition, renal dysfunction, and aging in AHF. A low XOR activity complicated with renal dysfunction leads to adverse long-term outcomes.

    DOI: 10.1159/000508037

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  • Prognostic Value of Both Plasma Volume Status and Nutritional Status in Patients With Severely Decompensated Acute Heart Failure. 国際誌

    Akihiro Shirakabe, Kuniya Asai, Nobuaki Kobayashi, Hirotake Okazaki, Masato Matsushita, Yusaku Shibata, Hiroki Goda, Shota Shigihara, Kazuhiro Asano, Kenichi Tani, Kazutaka Kiuchi, Noritake Hata, Wataru Shimizu

    CJC open   1 ( 6 )   305 - 315   2019年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Plasma volume status (PVS) has been evaluated recently as a prognostic marker of acute heart failure (AHF). However, whether evaluating PVS alone is sufficient remains unclear. METHODS: Of 675 patients with AHF screened, 601 were enrolled. The PVS, prognostic nutritional index (PNI) (lower = worse), and Controlling Nutritional Status (CONUT) score (higher = worse) were evaluated. Patients were divided into 2 groups according to PVS value (low- or high-PVS group) and were further subdivided into 4 groups (low- or high-PVS/CONUT group and low- or high-PVS/PNI group). RESULTS: A Kaplan-Meier curve showed a significantly lower survival rate in the high-PVS group than in the low-PVS group, the high-PVS/high-CONUT group than in the high-PVS/low-CONUT group, and the high-PVS/low-PNI group than in the high-PVS/high-PNI group. A multivariate Cox regression model showed that high PVS (hazard ratio [HR], 1.642; 95% confidence interval [CI], 1.049-2.570) and high PVS/high CONUT (HR, 2.076; 95% CI, 1.147-3.757) and high PVS/low PNI (HR, 2.094; 95% CI, 1.166-3.761) were independent predictors of 365-day mortality. CONCLUSIONS: An adverse outcome was predicted by the evaluation of PVS; furthermore, a malnutrition status with a high PVS leads to an adverse outcome. The simultaneous evaluation of nutrition status and PVS is essential to predict an AHF outcome.

    DOI: 10.1016/j.cjco.2019.10.001

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  • Gender Differences in the Social Determinants of the Long-term Prognosis for Severely Decompensated Acute Heart Failure in Patients over 75 Years of Age.

    Masato Matsushita, Akihiro Shirakabe, Nobuaki Kobayashi, Hirotake Okazaki, Yusaku Shibata, Hiroki Goda, Saori Uchiyama, Kenichi Tani, Kazutaka Kiuchi, Noritake Hata, Kuniya Asai, Wataru Shimizu

    Internal medicine (Tokyo, Japan)   58 ( 20 )   2931 - 2941   2019年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Objective The aim of present study was to elucidate the gender differences in social determinants among patients with acute heart failure (AHF). Methods A total of 1,048 AHF patients were enrolled, and the 508 AHF patients who were ≥75 years old and the 540 patients who were <75 years old were evaluated as the elderly and non-elderly cohorts, respectively. Participants who met one of the three marital status-, offspring-, and living status-related criteria were considered socially vulnerable, and subjects were thus classified into socially vulnerable and non-socially vulnerable groups by gender in both the non-elderly and elderly cohorts. Social vulnerability was significantly more common in the elderly cohort (n=246, 48.4%) than in the non-elderly cohort (n=197, 36.5%) and significantly more common in the elderly women (n=157, 69.4%) than in the elderly men (n=89, 31.5%). Kaplan-Meier curves showed that the survival rate of the socially vulnerable group was significantly poorer than that of the non-socially vulnerable group in the elderly male cohort (p=0.010). Social vulnerability was an independent predictor of the 1,000-day mortality in the elderly male cohort (hazard ratio: 1.942, 95% confidence interval: 1.102-3.422) but not in the elderly female cohort according to a multivariate analysis. Conclusion Social vulnerability was shown to be more common in elderly female AHF patients than in elderly men, although it was associated with a poor prognosis in elderly men. Reinforcing the social structure of elderly male AHF patients might help improve their prognosis.

    DOI: 10.2169/internalmedicine.2757-19

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  • Comparison of Coronary Culprit Lesion Morphology Determined by Optical Coherence Tomography and Relation to Outcomes in Patients Diagnosed with Acute Coronary Syndrome During Winter -vs- Other Seasons. 国際誌

    Junsuke Shibuya, Nobuaki Kobayashi, Kuniya Asai, Masafumi Tsurumi, Yusaku Shibata, Saori Uchiyama, Hirotake Okazaki, Hiroki Goda, Kenichi Tani, Akihiro Shirakabe, Masamichi Takano, Wataru Shimizu

    The American journal of cardiology   124 ( 1 )   31 - 38   2019年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Patients diagnosed with acute coronary syndrome (ACS) during winter have worse outcomes; however, mechanisms driving this trend are unclear. We examined coronary culprit lesion morphologies using optical coherence tomography (OCT). Features and outcomes were retrospectively compared between patients admitted with ACS in winter (W-ACS; n = 390) and in other seasons (O-ACS; n = 1,027). Angiography and OCT results were analyzed in patients who underwent OCT examination (173 patients in W-ACS and 450 in O-ACS). On initial angiography, minimum lumen diameter was smaller (median; 0.12 mm vs 0.25 mm, p = 0.021) and Thrombolysis in myocardial infarction flow grade was worse (Thrombolysis in myocardial infarction 0/1; 57% vs 44%, p = 0.005) in W-ACS. OCT performed before coronary interventions or just after intracoronary thrombectomy showed that plaque rupture (56% vs 46%) and calcified nodules (8% vs 5%) were more prevalent, and plaque erosion (37% vs 49%) was less prevalent in W-ACS (p = 0.039 for all 3 variables). At 2-year follow-up for all admitted ACS patients, Kaplan-Meier estimates showed higher cardiac mortality in W-ACS (11.8% vs 8.3%, p = 0.043). Multivariate Cox proportional hazard analysis showed that patients in W-ACS group had a 1.5-fold increased risk of cardiac death within 2 years after adjusting for traditional cardiovascular risk factors (hazard ratio, 1.54 [95% confidence interval, 1.06 to 2.23]; p = 0.024). In conclusion, patients diagnosed with ACS during winter had worse angiographic results and OCT revealed less plaque erosion (more plaque rupture or calcified nodules) at the culprit lesions, which may be partly associated with worse cardiac mortality within 2 years.

    DOI: 10.1016/j.amjcard.2019.03.045

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  • 腎細胞癌に対しニボルマブ、イピリムマブ投与2週間後に重症筋無力症、筋炎、心筋炎を発症し全経過12日で死亡した77歳男性例

    荒川 将史, 戸田 諭補, 小澤 明子, 谷 憲一, 浅井 邦也, 山崎 峰雄, 木村 和美

    臨床神経学   59 ( 7 )   471 - 471   2019年7月

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    記述言語:日本語   出版者・発行元:(一社)日本神経学会  

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  • Hyperuricemia complicated with acute kidney injury is associated with adverse outcomes in patients with severely decompensated acute heart failure. 国際誌

    Akihiro Shirakabe, Hirotake Okazaki, Masato Matsushita, Yusaku Shibata, Hiroki Goda, Saori Uchiyama, Kenichi Tani, Kazutaka Kiuchi, Nobuaki Kobayashi, Noritake Hata, Kuniya Asai, Wataru Shimizu

    International journal of cardiology. Heart & vasculature   23   100345 - 100345   2019年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The relationship between the serum level of uric acid (UA) and the acute kidney injury on admission in patients with acute heart failure (AHF) remain unclear. METHODS AND RESULTS: A total of 1326 AHF patients were screened, and data for 1047 patients who were admitted to the intensive-care unit were analyzed. The patients were assigned to a low-UA group (UA ≤ 7.0 mg/dl, n = 569) or a high-UA group (UA > 7.0 mg/dl, n = 478) according to their UA level at admission. Acute kidney injury (AKI) at admission was defined based on the ratio of the serum creatinine value recorded on admission to the baseline creatinine value: no-AKI (n = 736) or AKI (n = 311). The patients were therefore assigned to four groups: low-UA/no-AKI (n = 428), high-UA/no-AKI (n = 308), low-UA/AKI (n = 141) and high-UA/AKI (n = 170). The high-UA patients were significantly more frequent in the AKI group than in the non-AKI group among all patients and the non-chronic kidney injury (CKD) cohort. A Kaplan-Meier curve showed a significantly lower 365-day survival rate in the high-UA/AKI group than in the other groups. The multivariate Cox regression model identified only high-UA/AKI as an independent predictor of 365-day mortality (hazard ratio [HR]: 2.511, 95% confidence interval [CI] 1.671-3.772 in all AHF patients, HR: 1.884, 95% CI 1.022-3.473 in non-CKD patients and HR: 3.546, 95% CI 2.136-5.884 in CKD patients). CONCLUSION: An elevated serum UA level complicated with AKI was an independent predictor of mortality in patients with severely decompensated AHF.

    DOI: 10.1016/j.ijcha.2019.03.005

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  • Plasma xanthine oxidoreductase activity in patients with decompensated acute heart failure requiring intensive care. 査読 国際誌

    Okazaki H, Shirakabe A, Matsushita M, Shibata Y, Sawatani T, Uchiyama S, Tani K, Murase T, Nakamura T, Takayasu T, Asano M, Kobayashi N, Hata N, Asai K, Shimizu W

    ESC heart failure   6 ( 2 )   336 - 343   2019年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1002/ehf2.12390

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  • Clinical Features of Acute Heart Failure During Sleep - Prognostic Impact of a Prodrome in Patients With Severely Decompensated Acute Heart Failure Admitted at Midnight or Early Morning.

    Masato Matsushita, Akihiro Shirakabe, Nobuaki Kobayashi, Hirotake Okazaki, Yusaku Shibata, Hiroki Goda, Saori Uchiyama, Kenichi Tani, Kazutaka Kiuchi, Noritake Hata, Kuniya Asai, Wataru Shimizu

    Circulation reports   1 ( 2 )   61 - 70   2019年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: The features of sleep-associated acute heart failure (AHF) patients admitted at midnight or early morning (M/E) are unclear. Methods and Results: Of 1,268 AHF patients screened, 932 were analyzed, and divided into 2 groups by admission time (M/E group, 23:00-06:59, n=399; daytime group, 07:00-22:59, n=533). Those in the M/E group were further divided by the presence of a prodrome: with (n=176; prodrome group) or without (n=223; sudden onset group). The median time from symptom onset to hospitalization was significantly shorter in the M/E group (98 min; range, 65-170 min) than in the daytime group (123 min; range, 68-246 min). The 365-day HF event rate in the M/E group was significantly lower than that of the daytime group. On multivariate logistic regression modeling the M/E group was independently associated with a better outcome than the daytime group (OR, 0.673; 95% CI: 0.500-0.905). In the M/E group, the 365-day HF event rate was significantly lower in the prodrome group than in the sudden onset group. On multivariate logistic regression modeling, inclusion in the prodrome group was independently associated with a better outcome (OR, 0.544; 95% CI: 0.338-0.877). Conclusions: AHF patients admitted during sleeping hours were not sicker than those admitted during the daytime. The absence of a prodrome, however, might be associated with future repeated HF events.

    DOI: 10.1253/circrep.CJ-18-0014

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  • Impact of Accumulated Serum Uric Acid on Coronary Culprit Lesion Morphology Determined by Optical Coherence Tomography and Cardiac Outcomes in Patients with Acute Coronary Syndrome. 査読

    Kobayashi N, Asai K, Tsurumi M, Shibata Y, Okazaki H, Shirakabe A, Goda H, Uchiyama S, Tani K, Takano M, Shimizu W

    Cardiology   141 ( 4 )   190 - 198   2018年

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    掲載種別:研究論文(学術雑誌)  

    DOI: 10.1159/000496053

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  • 閉塞性下肢動脈硬化症患者は下肢の筋力と関係するか

    宮國 知世, 小宮山 英徳, 高野 雅充, 谷 憲一, 澤谷 倫史, 池田 健, 松下 誠人, 栗原 理, 村上 大介, 小林 宣明, 畑 典武, 宮内 靖史, 清野 精彦, 清水 渉

    日本心血管インターベンション治療学会抄録集   26回   MO084 - MO084   2017年7月

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    記述言語:英語   出版者・発行元:(一社)日本心血管インターベンション治療学会  

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  • 長軸方向のねじれをコバルトクロムエベロリムス溶出性ステントに認めた2症例

    澤谷 倫史, 小宮山 英徳, 高野 雅充, 小林 宣明, 清野 精彦, 宮内 靖史, 村上 大介, 松下 誠人, 栗原 理, 池田 健, 宮國 知世, 谷 憲一, 清水 渉

    日本心血管インターベンション治療学会抄録集   26回   MP010 - MP010   2017年7月

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    記述言語:英語   出版者・発行元:(一社)日本心血管インターベンション治療学会  

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  • 正常腎機能と慢性腎不全症例の造影剤投与による腎微小血管抵抗反応に関する比較検討

    谷 憲一, 澤谷 倫史, 宮國 知世, 池田 健, 栗原 理, 松下 誠人, 小宮山 英徳, 村上 大介, 高野 雅充, 宮内 靖史, 清野 精彦, 清水 渉

    日本心血管インターベンション治療学会抄録集   26回   MO336 - MO336   2017年7月

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    記述言語:英語   出版者・発行元:(一社)日本心血管インターベンション治療学会  

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  • ガイドライナーを用いたBuddy Wireテクニック

    小宮山 英徳, 高野 雅充, 村上 大介, 小林 宣明, 栗原 理, 松下 誠人, 池田 健, 宮國 知世, 澤谷 倫史, 谷 憲一, 宮内 靖史, 清野 精彦, 清水 渉

    日本心血管インターベンション治療学会抄録集   26回   MP144 - MP144   2017年7月

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    記述言語:英語   出版者・発行元:(一社)日本心血管インターベンション治療学会  

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  • 新しい試み 4Frガイドカテーテルを用いた非閉塞型血管内視鏡の有効性と安全性

    松下 誠人, 高野 雅充, 谷 憲一, 澤谷 倫史, 宮國 知世, 柴田 祐作, 栗原 理, 小宮山 英徳, 小林 宣明, 村上 大介, 宮内 靖史, 清野 精彦, 清水 渉

    心臓血管内視鏡   2 ( Suppl. )   s48 - s48   2016年9月

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    記述言語:日本語   出版者・発行元:日本心臓血管内視鏡学会  

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  • プラークの観察 BMIと冠動脈硬化 血管内視鏡からの検討

    谷 憲一, 栗原 理, 高野 雅充, 水野 杏一, 柴田 祐作, 松下 誠人, 小宮山 英徳, 加藤 活人, 宗像 亮, 村上 大介, 岡松 健太郎, 畑 典武, 清野 精彦, 清水 渉

    心臓血管内視鏡   2 ( Suppl. )   s61 - s61   2016年9月

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    記述言語:日本語   出版者・発行元:日本心臓血管内視鏡学会  

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▼全件表示

MISC

  • 腎細胞癌に対しニボルマブ、イピリムマブ投与2週間後に重症筋無力症、筋炎、心筋炎を発症し全経過12日で死亡した77歳男性例

    荒川 将史, 戸田 諭補, 小澤 明子, 谷 憲一, 浅井 邦也, 山崎 峰雄, 木村 和美

    臨床神経学   59 ( 7 )   471 - 471   2019年7月

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    記述言語:日本語   出版者・発行元:(一社)日本神経学会  

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  • 高齢者に対する最適な心不全治療-レジストリから見えてくる課題とは?(Social Determinants are Crucial Factors in the Long-term Prognosis of Acute Heart Failure in Male Gender over 75-Years of Age)

    白壁 章宏, 松下 誠人, 小林 宣明, 岡崎 大武, 柴田 祐作, 合田 浩紀, 内山 沙央里, 谷 憲一, 浅井 邦也, 清水 渉

    日本循環器学会学術集会抄録集   83回   SY05 - 4   2019年3月

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    記述言語:英語   出版者・発行元:(一社)日本循環器学会  

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  • The Prognostic Impact of Hyperuricemia and the Factors That Induce Hyperuricemia in Intensive Care Patients are Obscured(和訳中)

    柴田 祐作, 白壁 章宏, 岡崎 大武, 松下 誠人, 合田 浩紀, 内山 沙央里, 谷 憲一, 小林 宣明, 畑 典武, 浅井 邦也, 清水 渉

    日本循環器学会学術集会抄録集   83回   PJ012 - 2   2019年3月

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    記述言語:英語   出版者・発行元:(一社)日本循環器学会  

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  • 重症心筋炎合併筋炎に対して血漿交換療法が著効を示した1例

    戸田 諭補, 小澤 明子, 荒川 将史, 谷 憲一, 浅井 邦也, 山崎 峰雄, 木村 和美

    神経治療学   35 ( 6 )   S259 - S259   2018年11月

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    記述言語:日本語   出版者・発行元:(一社)日本神経治療学会  

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