2025/01/11 更新

写真a

アサイ クニヤ
淺井 邦也
Asai Kuniya
所属
大学院医学研究科 循環器内科学分野 大学院教授
付属病院 循環器内科 大学院教授
職名
大学院教授
外部リンク

学位

  • 医学博士 ( 1999年2月   日本医科大学 )

研究キーワード

  • 虚血性心疾患

  • アポトーシス

  • 性差

  • 心筋症

  • 心不全

研究分野

  • その他 / その他

経歴

  • 日本医科大学大学院医学研究科   循環器内科学分野   大学院教授

    2022年10月 - 現在

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  • 日本医科大学付属病院   副院長

    2024年4月 - 現在

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  • 日本医科大学付属病院   循環器内科   部長

    2022年12月 - 現在

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  • 日本医科大学千葉北総病院   集中治療室   病院教授、副院長、部長

    2019年4月 - 現在

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  • 日本医科大学千葉北総病院   集中治療室   准教授、部長

    2018年4月 - 2019年3月

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所属学協会

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委員歴

  • 日本心不全学会   代議員  

    2024年10月   

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    団体区分:学協会

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  • 日本循環器学会   理事  

    2024年7月   

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    団体区分:学協会

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  • 日本脈管学会   理事  

    2023年10月 - 現在   

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  • 日本臨床生理学会   理事  

    2023年10月   

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    団体区分:学協会

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  • 日本心臓病学会   代議員  

    2020年11月 - 2024年10月   

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論文

  • Hepatic function markers as prognostic factors in patients with acute kidney injury undergoing continuous renal replacement therapy. 国際誌

    Takuya Nishino, Yoshiaki Kubota, Tetsuya Kashiwagi, Akio Hirama, Kuniya Asai, Masahiro Yasutake, Shinichiro Kumita

    Renal failure   46 ( 1 )   2352127 - 2352127   2024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)  

    Acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT), secondary to cardiovascular disease and sepsis, is associated with high in-hospital mortality. Although studies have examined cardiovascular disease and sepsis in AKI, the association between AKI and hepatic functional impairment remains unclear. We hypothesized that hepatic function markers would predict mortality in patients undergoing CRRT. We included 1,899 CRRT patients from a multi-centre database. In Phase 1, participants were classified according to the total bilirubin (T-Bil) levels on the day of, and 3 days after, CRRT initiation: T-Bil < 1.2, 1.2 ≤ T-Bil < 2, and T-Bil ≥ 2 mg/dL. In Phase 2, propensity score matching (PSM) was performed to examine the effect of a T-Bil cutoff of 1.2 mg/dL (supported by the Sequential Organ Failure Assessment score); creating two groups based on a T-Bil cutoff of 1.2 mg/dL 3 days after CRRT initiation. The primary endpoint was total mortality 90 days after CRRT initiation, which was 34.7% (n = 571). In Phase 1, the T-Bil, aspartate transaminase (AST), alanine transaminase (ALT), and AST/ALT (De Ritis ratio) levels at CRRT initiation were not associated with the prognosis, while T-Bil, AST, and the De Ritis ratio 3 days after CRRT initiation were independent factors. In Phase 2, T-Bil ≥1.2 mg/dL on day 3 was a significant independent prognostic factor, even after PSM [hazard ratio: 2.41 (95% CI; 1.84-3.17), p < 0.001]. T-Bil ≥1.2 mg/dL 3 days after CRRT initiation predicted 90-day mortality. Changes in hepatic function markers in acute renal failure may enable stratification of high-risk patients.

    DOI: 10.1080/0886022X.2024.2352127

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  • Long-term clinical outcomes after alcohol septal ablation for hypertrophic obstructive cardiomyopathy in Japan: a retrospective study.

    Junya Matsuda, Hitoshi Takano, Yoichi Imori, Kakeru Ishihara, Hideto Sangen, Yoshiaki Kubota, Jun Nakata, Hideki Miyachi, Yusuke Hosokawa, Shuhei Tara, Yukichi Tokita, Takeshi Yamamoto, Mitsunobu Kitamura, Morimasa Takayama, Kuniya Asai

    Heart and vessels   2024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)  

    Hypertrophic cardiomyopathy is characterized by significant left ventricular wall thickening, often leading to obstructive symptoms. Alcohol septal ablation (ASA) has emerged as an effective treatment for patients with hypertrophic obstructive cardiomyopathy (HOCM) who remain symptomatic despite maximal medical therapy. However, the detailed long-term effects of ASA in Japanese patients with HOCM remain unclear. Therefore, this study aimed to investigate the long-term effects of ASA for HOCM by evaluating changes in symptoms, pressure gradient, hemodynamics, prognosis, and predictive factors for cardiovascular events over time. In this retrospective study, we examined 239 highly symptomatic patients (age, 64 ± 13 years; median follow-up, 6.9 years) treated with ASA for drug-refractory HOCM between 1998 and 2021. Patients were assessed using transthoracic echocardiography, magnetic resonance imaging, and cardiac catheterization. Follow-up evaluations included clinical assessments, electrocardiography, and echocardiography. Data analysis included descriptive statistics, Kaplan-Meier analysis, and multivariate regression. ASA reduced the left ventricular outflow tract gradient from 90.5 ± 52.8 to 14.4 ± 17.1 mmHg (P < 0.01) and New York Heart Association (NYHA) class from 3 [2.5-3] to 1 [1-2] at 10 years after ASA (P < 0.01). The 30-day mortality rate following ASA was 1%. Overall, 31 patients (13%) died during the follow-up period. The survival rates at 1, 5, 10, and 15 years after ASA were 97.4%, 89.9%, 83.7%, and 77.6%, respectively. Multivariable analysis revealed NYHA functional class before ASA (odds ratio [OR], 3.09; 95% confidence interval [CI], 1.40-6.82; P = 0.005), beta-blocker use (OR, 0.25; 95% CI, 0.07-0.91; P = 0.036), and class Ia agent use (OR, 0.31; 95% CI, 0.13-0.75; P = 0.009) as independent predictors of all-cause mortality. This study demonstrated low periprocedural and long-term mortality rates following ASA in patients with HOCM, suggesting that ASA provides durable symptomatic relief and reduces left ventricular outflow tract obstruction in selected highly symptomatic patients with HOCM.

    DOI: 10.1007/s00380-024-02489-0

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  • Optimizing ablation sites for pulmonary vein isolation reconnections: A novel approach using an emphasis map combined with the peak frequency and local activation timing map. 国際誌

    Shuhei Okajima, Yuhi Fujimoto, Masato Hachisuka, Hiroshige Murata, Yoshiyasu Aizawa, Kenji Yodogawa, Kuniya Asai, Wataru Shimizu, Yu-Ki Iwasaki

    Heart rhythm   2024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: Although catheter ablation techniques for atrial fibrillation (AF) have advanced, some cases of reconnections after pulmonary vein (PV) isolation still exist. The diversity of the anatomic wall thickness and fiber orientation around the PVs might contribute to reconnections. OBJECTIVE: The purpose of this study was to investigate the utility of the emphasis map's emphasize settings to determine optimal ablation sites. METHODS: Patients undergoing AF ablation with the EnSite X system who had PV reconnections were included. The emphasis map (a combination of peak frequency and local activation timing [LAT] maps) was created to obtain the emphasize settings for indicating the optimal ablation site (Emphasis group). In another group, the ablation site was determined based on LAT mapping (LAT group). RESULTS: A total of 64 patients (age 69 ± 9 years; 50 males), and 109 PVs were found to be reconnected and analyzed. Gaps were observed at 55 and 68 points of the PV isolation in the Emphasis and LAT groups, respectively. The number of ablation points needed to successfully eliminate the gaps, and the total energy were markedly smaller (1.6 ± 1.1 vs. 6.3 ± 3.7, P <.001; 3541 ± 2060 J vs 5606 ± 3728 J, P = .001) in the Emphasis group than in the LAT group, respectively. The average optimal emphasize setting was 338 ± 67 Hz in the Emphasis group. CONCLUSION: Adjusting the emphasize settings visualized the optimal ablation site, and the number of ablation points needed to reisolate the PV might be markedly reduced.

    DOI: 10.1016/j.hrthm.2024.11.036

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  • The association between introduction of the micro-axial flow pump Impella in hospitals and in-hospital mortality in patients treated with extracorporeal membrane oxygenation: interrupted time-series analyses. 国際誌

    Jun Nakata, Hiroyuki Ohbe, Toru Takiguchi, Yuji Nishimoto, Mikio Nakajima, Yusuke Sasabuchi, Toshiaki Isogai, Hiroki Matsui, Takeshi Yamamoto, Shoji Yokobori, Kuniya Asai, Hideo Yasunaga

    Annals of intensive care   14 ( 1 )   151 - 151   2024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 micro-axial flow pump Impella, a new mechanical circulatory device for cardiogenic shock, is still only available in a limited number of hospitals, due to the facility certification requirements and insufficient evidence of the benefit of introducing Impella in hospitals. This study aimed to evaluate the impact of introducing Impella in hospitals on in-hospital mortality of patients treated with extracorporeal membrane oxygenation (ECMO). METHODS: Using a nationwide Japanese inpatient database, we identified patients who received ECMO during hospitalization between 1 April 2014 and 31 March 2021. A hospital-level propensity score-matched cohort was created matching hospitals that introduced Impella (exposure group) to those that did not introduce Impella (control group). The inclusion period in each hospital was divided into two time periods according to the time of Impella introduction in the exposure group and the corresponding hospital in the control group (before and after exposure). The primary outcome was in-hospital mortality. Uncontrolled and controlled interrupted time-series analyses involved before-after exposure comparison and exposure-control comparison. RESULTS: Out of 34,379 eligible patients, we created a matched cohort of 8351 patients from 86 hospitals with Impella introduction (exposure group) and 7230 patients from 86 hospitals without Impella introduction (control group). In-hospital mortality before and after exposure was 62.5% and 59.3, respectively, in the exposure group; and 66.8% and 63.7%, respectively, in the control group. Uncontrolled interrupted time-series analysis showed no significant level change or trend change in the before-after exposure comparison in both the exposure and the control groups. Controlled interrupted time-series analysis also showed no significant level change (-0.01%; 95% confidence intervals -5.36% to + 5.33%) or trend change (+ 0.10%, -0.30% to + 0.40%) after exposure in the exposure-control comparison. CONCLUSIONS: This nationwide inpatient database study showed no association between Impella introduction in hospitals and in-hospital mortality of patients who underwent ECMO. Because this study confined itself to analze of the impact of the introduction of Impella solely at the hospital level, further detailed studies are warranted to assess its efficacy at the patient level.

    DOI: 10.1186/s13613-024-01381-4

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  • Efficacy and safety of atrial fibrillation ablation in patients with aged 80 years or older.

    Kenji Yodogawa, Yu-Ki Iwasaki, Nobuaki Ito, Toshiki Arai, Masato Hachisuka, Yuhi Fujimoto, Kanako Hagiwara, Hiroshige Murata, Yoshiyasu Aizawa, Wataru Shimizu, Kuniya Asai

    Heart and vessels   2024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)  

    Atrial fibrillation (AF) is the most common cardiac arrhythmia observed in the elderly. Its prevalence rises with age, particularly in individuals over 80 years old. While catheter ablation has emerged as a first line therapy for the patients with symptomatic AF, evidence on its application in elderly patients remains controversial. This study aimed to assess safety and efficacy outcomes of AF ablation in patients aged ≥ 80 years. Consecutive 1327 patients who underwent a first pulmonary vein isolation (PVI) for AF were retrospectively analyzed. Patients aged ≥ 80 years (elderly group, n = 107) were compared with patients aged < 80 years (younger group, n = 1220). At 1-year follow-up, there was no significant difference in AF free rate between the elderly and the younger group (72.0% vs. 73.9%, P = 0.786). Regarding major complications, the elderly patients had a greater incidence of periprocedural stroke (1.9% vs. 0.1%, P = 0.018). The rates of cardiac tamponade, phrenic palsy, and vascular complications were not significantly different between the 2 groups. PVI for AF is effective in patients aged ≥ 80 years with a similar success rate, but periprocedural stoke risk was higher compared to the younger population.

    DOI: 10.1007/s00380-024-02458-7

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書籍等出版物

  • 心不全Q&A―プレホスピタルから慢性期まで―

    浅井邦也( 担当: 分担執筆 範囲: 欧州ガイドラインから学ぶ再入院予防のための患者教育)

    2013年 

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  • 循環器内科学

    浅井邦也( 範囲: 心不全)

    2010年 

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  • 血管内皮細胞をめぐる疾患

    ( 担当: 分担執筆 範囲: 血管収縮作動性物質)

    真興交易(株)医書出版部  2007年 

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  • Cardiovascular Physiology in the Genetically Engineered Mouse

    Vatner SF, Takagi G, Asai K, Shannon RP( 担当: 分担執筆 範囲: Cardiovascular Physiology in Mice: Conscious Measurements and Effects of Anesthesia.)

    Kluwer Academic Publishers  2001年 

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  • Cardiovascular Toxicology

    Vatner SF, Patrick TA, Kudej AB, Shen YT, Asai K( 担当: 分担執筆 範囲: Monitoring of cardiovascular dynamics in conscious animals.)

    Taylor & Francis Books  2001年 

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MISC

  • 心室細動に対して皮下植込み型除細動器が5回適切作動したが停止せず心肺停止に至った肥大型心筋症の1例

    福山曜, 岡英一郎, 細野陽介, 瀬崎あやの, 中島悠希, 田中匡成, 酒井伸, 福泉偉, 黄俊憲, 細川雄亮, 丸山光紀, 清水渉, 淺井邦也

    植込みデバイス関連冬季大会プログラム・抄録集(Web)   16th   2024年

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  • 冠攣縮性狭心症に伴う心停止蘇生後二次予防として,発作時の心電図所見から経静脈的除細動器の妥当性が示された2症例

    岡英一郎, 細野陽介, 瀬崎あやの, 中島悠希, 福山曜, 田中匡成, 酒井伸, 福泉偉, 黄俊憲, 細川雄亮, 丸山光紀, 清水渉, 淺井邦也

    植込みデバイス関連冬季大会プログラム・抄録集(Web)   16th   2024年

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  • 急性心不全患者における乳酸値の推移と短期予後の検討

    細川雄亮, 細野陽介, 瀬崎あやの, 福山曜, 中島悠希, 田中匡成, 酒井伸, 岡英一郎, 福泉偉, 黄俊憲, 丸山光紀, 浅井邦也

    日本集中治療医学会学術集会(Web)   51st   2024年

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  • 肥大閉塞性心筋症の長期改善に対する経皮的中隔心筋焼灼術時の術中心エコー所見の影響

    松田淳也, 時田祐吉, 星加りさ, 石原翔, 小林芹奈, 内山沙央里, 萩原かな子, 小野有希, 井守洋一, 久保田芳明, 小玉麻衣, 中田淳, 宮地秀樹, 太良修平, 山本剛, 高野仁司, 浅井邦也

    日本循環器学会学術集会(Web)   88th   2024年

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  • 心房細動を伴う肥大性心筋症患者における左心耳血栓症の発生率

    石原翔, 時田祐吉, 星加りさ, 内山沙央里, 小林芹奈, 萩原かな子, 松田淳也, 小野有希, 井守洋一, 久保田芳明, 小玉麻衣, 高野仁司, 浅井邦也

    日本循環器学会学術集会(Web)   88th   2024年

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受賞

  • 奨励賞

    2003年9月   日本医科大学  

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  • Scientific Conference on Molecular, cellular, and Integrated Physiological Approaches to the Failing Heart, AHA. New Investigator Award

    1999年8月   アメリカ心臓協会  

    浅井邦也

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共同研究・競争的資金等の研究課題

  • 3次元タギングMRIを用いた心不全の予後予測

    2014年4月 - 2016年

    文部科学省科学研究費 

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    担当区分:研究分担者 

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  • 治験の実施に関する研究[エプレレノン]

    2013年4月 - 2015年3月

    厚生労働科学研究(医療技術実用化総合研究事業(臨床研究・治験推進研究事業))研究事業費 

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    担当区分:研究代表者 

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  • 心不全進展過程における性ホルモンの役割

    研究課題/領域番号:12770363  2000年4月 - 2002年3月

    文部科学省科学研究費  科学研究費助成事業  奨励研究(A)

    浅井 邦也

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    担当区分:研究代表者 

    配分額:1800000円 ( 直接経費:1800000円 )

    1.心肥大モデル(マウス)の作成
    心肥大における性ホルモンの関与を検討するにあたり、いくつかの心肥大モデルを作成中である。心肥大の原因にはいくつかの異なったものがあり、各々において、その心肥大の伸展過程、メカニズムに差異があると考えられる。従って心不全伸展過程における性ホルモンの役割も、それぞれ異なる可能性がある。
    (1)圧負荷による心肥大
    大動脈縮窄術による心肥大。圧較差、約50-80mmHgで25-35%程度の心重量の増加を4-6週間で得る。
    (2)容量負荷による心肥大
    現在二つのモデルを作成中。一つは前下降枝の結札による心筋梗塞モデルとカテーテルを用いた大動脈弁損傷による大動脈弁閉鎖不全モデル
    (3)心肥大に関与するシグナルの直接刺激による心肥大モデル
    β刺激薬(イソプロテレノール、30μg/g/day)、α1刺激薬(フェニレフリン、100μg/g/day)、アンギオテンシンII(50ng/g/day)をminiosmotic pumpを用い2週間の持続投与。
    2.血行動態の測定
    (1)左室内圧の測定
    1.4Fのcatheter tip transducerを用い左室内圧、左室dP/dtを計測
    (2)心エコーによる計測
    壁厚、左室内径、%FS、およびLV massの測定を行っている。
    現時点では、心不全のモデルの作成、基礎データ収集段階であり、今後、卵巣摘出モデルおよび摘出後のエストロゲン治療群、雄におけるエストロゲン投与の効果を検討していく予定である。

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社会貢献活動

  • 江戸川区医師会循環器病研究会

    役割:講師

    江戸川区医師会  2012年4月 - 現在

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    種別:講演会

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