KEIO RESEARCHERS INFORMATION SYSTEM

Profile Summary 【 Display / hide 】

Profile Summary 【 Display / hide 】

• 医学の進歩に伴い、個々の心不全患者さんの病態の理解が深まり、がん治療と同様な個別化医療の実現を目指すとともに、患者のニーズに合わせた「患者中心の医療」を実践するための現代的な枠組み構築にも力を注いでいます。

Academic Degrees 【 Display / hide 】

Academic Degrees 【 Display / hide 】

• 博士（医学）, Keio University, 2017.03

Research Areas 【 Display / hide 】

Research Areas 【 Display / hide 】

• Life Science / Cardiology (Heart Failure)

• Life Science / Cardiology (腫瘍循環器学)

• Life Science / Sports sciences (心臓リハビリテーション)

Research Keywords 【 Display / hide 】

Research Keywords 【 Display / hide 】

• Heart Failure

• Personalized Medicine

• Patient Centered Care

• Patient Reported Outcome [PRO]

• 腫瘍循環器学（Onco-Cardiology）

display all >>

Books 【 Display / hide 】

Books 【 Display / hide 】

• 心不全診療Controversy

  河野隆志, 白石泰之（共編）, 中外医学社, 2023.10,  Page： 262

• 心不全治療薬の考え方, 使い方（改訂2版）

  齋藤秀輝, 鍋田 健, 柴田 龍宏（共著）, 中外医学社, 2023.10,  Page： 331

  Scope: 3章 利尿薬：1. ループ利尿薬 および 2. サイアザイド系利尿薬

• 最新主要文献とガイドラインでみる 循環器内科学レビュー 2022-'23

  清水 渉（共著）, 総合医学社, 2021.11,  Page： 413

  Scope: III章 慢性心不全：LVEFの保たれた心不全（HFpEF）患者の治療戦略

• 循環器診療エッセンシャル

  永井 利幸（共著）, 南江堂, 2022.03,  Page： 260

  Scope: 治療編：エビデンスを踏まえた治療アプローチ「4. 急性心不全」

• 心不全診療アップグレード

  佐藤 幸人（共著）, 日本医事新報社, 2021.03,  Page： 283

  Scope: 1章 心不全の疫学データの読み方・考え方

display all >>

Papers 【 Display / hide 】

Papers 【 Display / hide 】

• Rationale and protocol of the LAQUA-HF trial: a factorial randomised controlled trial evaluating the effects of neurohormonal and diuretic agents on health-status reported outcomes in heart failure patients

  Shiraishi Y, Ikemura N, Urashima M, Kohno T, Nakano S, Tanaka T, Nagatomo Y, Ikoma T, Ono T, Numasawa Y, Sakamoto M, Nishikawa K, Takei M, Hakuno D, Nakamaru R, Ueda I, Kohsaka S

  BMJ open （BMJ Open)  14 （ 2 ） e076519 2024.02

  Research paper (scientific journal), Lead author, Accepted

  　View Summary

  Introduction The current guidelines strongly recommend early initiation of multiple classes of cardioprotective drugs for patients with heart failure with reduced ejection fraction to improve prognosis and health status. However, evidence on the optimal sequencing of approved drugs is scarce, highlighting the importance of individualised treatment plans. Registry data indicate that only a portion of these patients can tolerate all four recommended classes, underscoring the need to establish the favoured sequence when using these drugs. Additionally, the choice between long-acting and short-acting loop diuretics in the present era remains uncertain. This is particularly relevant given the frequent use of angiotensin receptor-neprilysin inhibitor and sodium-glucose cotransporter 2 inhibitor, both of which potentiate natriuretic effects. Methods and analysis In a prospective, randomised, open-label, blinded endpoint method, LAQUA-HF (Long-acting vs short-acting diuretics and neurohormonal Agents on patients' QUAlity-of-life in Heart Failure patients) will be a 2×2 factorial design, with a total of 240 patients randomised to sacubitril/valsartan versus dapagliflozin and torsemide versus furosemide in a 1:1 ratio. Most enrolment sites have participated in an ongoing observational registry for consecutive patients hospitalised for heart failure involved dedicated study coordinators, and used the same framework to enrol patients. The primary endpoint is the change in patients' health status over 6 months, defined by the Kansas City Cardiomyopathy Questionnaire. Additionally, clinical benefit at 6 months defined as a hierarchical composite endpoint will be assessed by the win ratio as the secondary endpoint. Ethics and dissemination The medical ethics committee Keio University in Japan has approved this trial. All participants provide written informed consent prior to study entry. The results of this trial will be disseminated in one main paper and additional papers on secondary endpoints and subgroup analyses. Trial registration number UMIN000045229

  PDF1

  • Access to Document (DOI)

• Improved prediction of sudden cardiac death in patients with heart failure through digital processing of electrocardiography.

  Shiraishi Y, Goto S, Niimi N, Katsumata Y, Goda A, Takei M, Saji M, Sano M, Fukuda K, Kohno T, Yoshikawa T, Kohsaka S

  EP Europace : Journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 25 （ 3 ） 922 - 930 2023.01

  Research paper (scientific journal), Lead author, Corresponding author, Accepted,  ISSN  1099-5129

  　View Summary

  Aims: Available predictive models for sudden cardiac death (SCD) in heart failure (HF) patients remain suboptimal. We assessed whether the electrocardiography (ECG)-based artificial intelligence (AI) could better predict SCD, and also whether the combination of the ECG-AI index and conventional predictors of SCD would improve the SCD stratification among HF patients.
  
  Methods and results: In a prospective observational study, 4 tertiary care hospitals in Tokyo enrolled 2559 patients hospitalized for HF who were successfully discharged after acute decompensation. The ECG data during the index hospitalization were extracted from the hospitals' electronic medical record systems. The association of the ECG-AI index and SCD was evaluated with adjustment for left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) class, and competing risk of non-SCD. The ECG-AI index plus classical predictive guidelines (i.e. LVEF ≤35%, NYHA Class II and III) significantly improved the discriminative value of SCD [receiver operating characteristic area under the curve (ROC-AUC), 0.66 vs. 0.59; P = 0.017; Delong's test] with good calibration (P = 0.11; Hosmer-Lemeshow test) and improved net reclassification [36%; 95% confidence interval (CI), 9-64%; P = 0.009]. The Fine-Gray model considering the competing risk of non-SCD demonstrated that the ECG-AI index was independently associated with SCD (adjusted sub-distributional hazard ratio, 1.25; 95% CI, 1.04-1.49; P = 0.015). An increased proportional risk of SCD vs. non-SCD with an increasing ECG-AI index was also observed (low, 16.7%; intermediate, 18.5%; high, 28.7%; P for trend = 0.023). Similar findings were observed in patients aged ≤75 years with a non-ischaemic aetiology and an LVEF of >35%.
  
  Conclusion: To improve risk stratification of SCD, ECG-based AI may provide additional values in the management of patients with HF.

  PDF1

  • Access to Document (DOI)

• Catheter ablation for patients with atrial fibrillation and heart failure with reduced and preserved ejection fraction: insights from the KiCS-AF multicentre cohort study

  Shiraishi Y, Kohsaka S, Ikemura N, Kimura T, Katsumata Y, Tanimoto K, Suzuki M, Ueda I, Fukuda K, Takatsuki S

  EP Europace : Journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 25 （ 1 ） 83 - 91 2022.06

  Research paper (scientific journal), Lead author, Accepted,  ISSN  1099-5129

  　View Summary

  Aims: The usefulness of catheter ablation (CA) for atrial fibrillation (AF) across a broad spectrum of heart failure (HF) patients remains to be established. We assessed the association of CA with both health-related quality of life (QoL) and cardiovascular events among HF patients with reduced and preserved left ventricular ejection fraction (LVEF) in an 'all-comer' outpatient-based AF registry.
  
  Methods and results: Of 3303 patients with AF consecutively enrolled in a retrospective multicentre registry that mandated the Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) questionnaire at registration and 1-year follow-up, we extracted data from 530 patients complicating clinical HF. The association between CA and both 1-year change in AFEQT Overall Summary (AFEQT-OS) scores and 2-year composite clinical outcomes (including all-cause death, stroke, and HF hospitalization) was assessed by multivariable analyses. The median duration of AF was 108 days (52-218 days), and 83.4% had LVEF >35%. Overall, 75 patients (14.2%) underwent CA for AF within 1-year after registration. At 1-year follow-up, 67.2% in the ablation group showed clinically meaningful improvements of ≥ 5 points in AFEQT-OS score than 47.8% in the non-ablation group {adjusted odds ratio, 2.03 [95% confidence interval (CI): 1.13-3.64], P = 0.017}. Furthermore, the composite endpoint of all-cause death, stroke, and HF hospitalization occurred less frequently in the ablation group than the non-ablation group [adjusted hazard ratio, 0.27 (95% CI: 0.09-0.86), P = 0.027].
  
  Conclusion: Among AF-HF patients, CA was associated with improved QoL and lower risk of cardiovascular events against drug therapy alone, even for patients with mildly reduced and preserved LVEF.

  PDF1

  • Access to Document (DOI)

• Assessment of physical activity using waist-worn accelerometers in hospitalized heart failure patients and its relationship with Kansas City Cardiomyopathy Questionnaire

  Shiraishi Y, Niimi N, Goda A, Takei M, Kimura T, Kohno T, Kawana M, Fukuda K, Kohsaka S

  Journal of Clinical Medicine （Journal of Clinical Medicine)  10 （ 18 ）  2021.09

  Research paper (scientific journal), Lead author, Corresponding author, Accepted,  ISSN  2077-0383

  　View Summary

  The health benefits of physical activity have been widely recognized, yet there is limited information on associations between accelerometer-related parameters and established patient-re-ported health status. This study investigated the association between the waist-worn accelerometer measurements, cardiopulmonary exercise testing (CPX), and results of the Kansas City Cardiomy-opathy Questionnaire (KCCQ) in heart failure (HF) patients hospitalized for acute decompensation. A total of 31 patients were enrolled and wore a validated three-axis accelerometer for 2 weeks and completed the short version of the KCCQ after removing the device. Daily step counts, exercise time (metabolic equivalents × hours), and %sedentary time (sedentary time/device-equipped time) were measured. Among the measured parameters, the best correlation was observed between %seden-tary time and the KCCQ overall and clinical summary scores (r = −0.65 and −0.65, each p < 0.001). All of the individual domains of the KCCQ (physical limitation, symptom frequency, and quality of life), with the exception of the social limitation domain, showed moderate correlations with %sed-entary time. Finally, oxygen consumption assessed by CPX demonstrated only weak associations with the accelerometer-measured parameters. An accelerometer could complement the KCCQ results in accurately assessing the physical activity in HF patients immediately after hospitalization, albeit its correlation with CPX was at most moderate.

  • Access to Document (DOI)

• Time-sensitive approach in the management of acute heart failure

  Shiraishi Y, Kawana M, Nakata J, Sato N, Fukuda K, Kohsaka S

  ESC Heart Failure 8 （ 1 ） 204 - 221 2021.02

  Research paper (scientific journal), Lead author, Accepted

  　View Summary

  Acute heart failure (AHF) has become a global public health burden largely because of the associated high morbidity, mortality, and cost. The treatment options for AHF have remained relatively unchanged over the past decades. Historically, clinical congestion alone has been considered the main target for treatment of acute decompensation in patients with AHF; however, this is an oversimplification of the complex pathophysiology. Within the similar clinical presentation of congestion, significant differences in pathophysiological mechanisms exist between the fluid accumulation and redistribution. Tissue hypoperfusion is another vital characteristic of AHF and should be promptly treated with appropriate interventions. In addition, recent clinical trials of novel therapeutic strategies have shown that heart failure management is ‘time sensitive’ and suggested that treatment selection based on individual aetiologies, triggers, and risk factor profiles could lead to better outcomes. In this review, we aim to describe the specifics of the ‘time-sensitive’ approach by the clinical phenotypes, for example, pulmonary/systemic congestion and tissue hypoperfusion, wherein patients are classified based on pathophysiological conditions. This mechanistic classification, in parallel with the comprehensive risk assessment, has become a cornerstone in the management of patients with AHF and thus supports effective decision making by clinicians. We will also highlight how therapeutic modalities should be individualized according to each clinical phenotype.

  • Access to Document (DOI)

display all >>

Reviews, Commentaries, etc. 【 Display / hide 】

Reviews, Commentaries, etc. 【 Display / hide 】

• 【心腎連関を再考する】貧血を治す：循環器内科の立場から

  白石 泰之

  Heart View ((株)メジカルビュー社)  27 ( 6 ) 583 - 589 2023.06

  ISSN  1342-6591

  　View Summary

  ＜文献概要＞Point 1.血行動態が崩れていて,ほかに手がないなら赤血球輸血 2.血行動態が安定していて,鉄欠乏があれば鉄剤投与 3.体液量を適正にしても,Hb<9g/dLで心不全コントロールが難しいときにESA製剤(を考えてもよい)

• 【今だからこそ聞きたい心不全診療のこと。】心不全研究のプール解析で注意すべき点　LVEF spectrumって何?

  白石 泰之

  循環器ジャーナル ((株)医学書院)  71 ( 2 ) 252 - 258 2023.04

  ISSN  2432-3284

  　View Summary

  ＜文献概要＞POINT　・複数の試験を集めたプール解析は,データが増えることで検出力が上がり,より信頼度の高い結果を得ることができる.・特定の解析集団での治療効果などを見るためには,各集団での被験者数・イベント数が十分確保されていることがポイントとなる.

• 【循環器学2021年の進歩】心不全診療の進歩 ～心不全の新規薬物療法と心筋再生医療への期待～

  白石 泰之, 福田 恵一

  循環器専門医 ((一社)日本循環器学会)  30   88 - 94 2021.08

  Lead author,  ISSN  0918-9599

• 【心不全急性期治療の循環管理】時間軸に基づく急性心不全治療

  白石 泰之

  INTENSIVIST（特集: 循環器集中治療 Critical Care Cardiology） ((株)メディカル・サイエンス・インターナショナル)  13 ( 1 ) 17 - 27 2021.01

  ISSN  1883-4833

  　View Summary

  ＜文献概要＞心不全診療にかかる医療面および社会・経済面での負担は莫大であり,今後しばらくは増えることはあっても減ることはない。心不全は増悪と好転を繰り返しながら慢性的に進行する症候群であり,安定期(慢性期)と増悪期(急性期)でその治療に対する考え方は異なる。心不全の急性期治療の選択肢はここ四半世紀で大きな変化はないが,ほかの循環器救急疾患と同様に「時間軸」の重要性が徐々に認識され,日本を含む世界の心不全診療ガイドラインのなかで早期診断・早期介入が強調されるに至っている。心不全急性期においては,うっ血と組織低灌流という2つの病態に対して的確な把握と対応をし,すみやかに血行動態を安定化させ,その後の慢性期治療(予後改善をめざした)へつなげていくことが肝要である。

• 【心不全の疫学】心不全予後予測スコアとその使い方 ～効果的かつ効率的な医療を実践するために～

  白石 泰之

  Hospitalist（特集: 心不全） ((株)メディカル・サイエンス・インターナショナル)  6 ( 4 ) 793 - 805 2018.12

  ISSN  2188-0409

  　View Summary

  ＜文献概要＞Summary　●心不全患者数は向こう10〜20年間は増加の一途をたどり,さらに患者の高齢化が劇的に進んでいる。日本の心不全患者の入院期間は依然として世界標準よりも長いが(15日前後),長期予後は欧米諸国に比べると良好である。●年齢や血圧,尿素窒素,血中ナトリウム濃度,そしてBNP/NT-proBNP値などが心不全患者における単独の強力な予後予測因子である。●心不全リスクモデルのなかで,GWTG-HF Risk ScoreあるいはSeattle Heart Failure Model, MAGGIC Heart Failure Risk Scoreは,日本人における当てはまりが確認されており,実際に臨床現場で使用することも可能である。●いかに熟練の医師といえども,心不全患者の予後予測は困難な場合も多く,リスクモデルによる客観的な予後予測は有用である。予後予測(リスク評価)は医療者,患者の治療方針あるいは意思決定の支柱であり,効果的かつ効率的な医療の実践のためには,リスクモデルを用いた評価が不可欠である。

display all >>

Presentations 【 Display / hide 】

Presentations 【 Display / hide 】

• Improved prediction of sudden cardiac death in patients with heart failure through digital processing of electrocardiography

  Shiraishi Y, Kohsaka S, Nakamaru R, Kohno T, Yoshikawa T, Ieda M

  第88回 日本循環器学会学術集会, 

  2024.03

  , 

  Symposium, workshop panel (public)

• Risk-based Approach in Heart Failure

  白石 泰之

  第27回 日本心不全学会学術集会, 

  2023.10

  , 

  Symposium, workshop panel (nominated)

• 総務・将来構想委員会企画［若手立案セッション］ 核心に迫る心不全薬物治療の真髄2：sGC刺激薬（Pros/Cons）

  白石 泰之

  第71回 日本心臓病学会学術集会, 

  2023.09

  , 

  Symposium, workshop panel (nominated)

• 患者中心の心不全診療 ～繰り返す心不全入院を防ぐ～

  白石 泰之

  第71回 日本心臓病学会学術集会, 

  2023.09

  , 

  Symposium, workshop panel (nominated)

• 観察研究からランダム化比較試験へ ～Pragmatic trial への挑戦～

  白石 泰之

  第70回 日本心臓病学会学術集会, 

  2022.09

  , 

  Symposium, workshop panel (nominated)

display all >>

Research Projects of Competitive Funds, etc. 【 Display / hide 】

Research Projects of Competitive Funds, etc. 【 Display / hide 】

• 新規心不全薬の効果比較：薬物反応性および機序解明に向けた統合オミックス解析の実施

  2023.04

  -

  Present

  慶應義塾, 学事振興資金, Research grant, Principal investigator

• 心不全患者に対する、身体診察動画とAIを用いた非侵襲的うっ血評価技術の開発

  2023.04

  -

  Present

  日本学術振興会, 科学研究費助成事業, 若手研究, Research grant, Principal investigator

• 心血管疾患に対する、運動支援プログラムに関する研究開発

  2022.10

  -

  Present

  AMED, 循環器疾患・糖尿病等生活習慣病対策実用化研究事業, 生活習慣病の予防・診断・治療のための医療機器開発に関する研究, Commissioned ｒesearch, Coinvestigator(s)

• 性差を考慮した疾患の予防、診断及び治療法の開発研究

  2023.04

  -

  Present

  AMED, ⼥性の健康の包括的⽀援実⽤化研究事業, Research grant, Coinvestigator(s)

• 運動支援プログラムを含む遠隔生体情報モニタリング基盤の開発研究

  2022.12

  -

  Present

  明治安田厚生事業団 , 若手研究者のための健康科学研究助成, Principal investigator

display all >>

Intellectual Property Rights, etc. 【 Display / hide 】

Intellectual Property Rights, etc. 【 Display / hide 】

• 医用情報処理装置、医用情報処理方法、医用情報処理プログラム、及び医用情報処理システム（心電図機械学習を用いた心血管疾患の診療支援システム）

  Date applied： 特願2020-167287  2020.10 

  Date announced： 特開2022-059494  2022.04 

  Patent, Joint

Awards 【 Display / hide 】

Awards 【 Display / hide 】

• 第86回 日本循環器学会学術集会 Young Investigator's Award: Clinical Research

  2022.03

  Type of Award： Award from Japanese society, conference, symposium, etc.

• 第38回 東京CCU研究会 殊勲賞

  2018.12

  Type of Award： Award from Japanese society, conference, symposium, etc.

• 第13回 日本心臓リハビリテーション学会学術集会 Young Investigator's Award

  2016.09

  Type of Award： Award from Japanese society, conference, symposium, etc.

• 第33回 東京CCU研究会 最優秀演題賞

  2013.12

  Type of Award： Award from Japanese society, conference, symposium, etc.

Courses Taught 【 Display / hide 】

Courses Taught 【 Display / hide 】

• THEORETICAL ISSUES IN CANCER MEDICATION NURSING

  2024

• LECTURE SERIES, INTERNAL MEDICINE (CARDIOLOGY)

  2024

• LECTURE SERIES, INTERNAL MEDICINE (CARDIOLOGY)

  2023

• がん看護学（大学院修士・博士課程）講義

  2023

  腫瘍循環器学

• LECTURE SERIES, INTERNAL MEDICINE (CARDIOLOGY)

  2022

display all >>

Courses Previously Taught 【 Display / hide 】

Courses Previously Taught 【 Display / hide 】

• 内科学（循環器）

  慶應義塾大学

  2021.04

  -

  Present

  , 

  Undergraduate (specialized), Lecture, Within own ｆaculty

• 医学概論（修士課程）

  慶應義塾大学大学院

  2020.04

  -

  2021.03

  , 

  Lecture

Memberships in Academic Societies 【 Display / hide 】

Memberships in Academic Societies 【 Display / hide 】

• 日本内科学会, 

  2010.04

  -

  Present

• 日本循環器学会, 

  2011.04

  -

  Present

• 日本心臓病学会, 

  2012.04

  -

  Present

• 日本心不全学会, 

  2016.04

  -

  Present

• 日本心臓リハビリテーション学会, 

  2017.04

  -

  Present

display all >>

Committee Experiences 【 Display / hide 】

Committee Experiences 【 Display / hide 】

• 2023.04

  -

  Present

  心不全診療ガイドライン2025作成班 協力員, 日本循環器学会

• 2020.10

  -

  Present

  関東甲信越支部 学術委員会 委員, 日本循環器学会