SHIRAISHI Yasuyuki

写真a

Affiliation

School of Medicine, Endowed Research Laboratory for Arrhythmia Advanced Therapeutics Department of Cardiology (Shinanomachi)

Position

Project Assistant Professor (Non-tenured)/Project Research Associate (Non-tenured)/Project Instructor (Non-tenured) (None)

Related Websites

External Links

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、並行して「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

  • 博士(医学), Keio University, 2017.03

 

Research Areas 【 Display / hide

  • Life Science / Cardiology (Heart Failure)

  • Life Science / Cardiology (循環器救急)

  • 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

  • Heart Failure

  • 心臓突然死(Sudden Cardiac Death)

  • Personalized Medicine

  • Patient Centered Care

  • Patient Reported Outcome [PRO]

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Papers 【 Display / hide

  • Use of short-acting vs. long-acting loop diuretics after heart failure hospitalization

    Imaeda S, Shiraishi Y, Kohsaka S, Niimi N, Goda A, Nagatomo Y, Takei M, Saji M, Nakano S, Kohno T, Fukuda K, Yoshikawa T

    ESC Heart Failure  2022.06

    Research paper (scientific journal), Lead author, Accepted

  • 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 (ESC Heart Failure)  8 ( 1 ) 204 - 221 2020

    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.

  • Derivation and Validation of Clinical Prediction Models for Rapid Risk Stratification for Time-Sensitive Management for Acute Heart Failure.

    Shiraishi Y, Kohsaka S, Abe T, Nagai T, Goda A, Nishihata Y, Nagatomo Y, Saji M, Toyosaki Y, Takei M, Kitai T, Kohno T, Fukuda K, Matsue Y, Anzai T, Yoshikawa T

    Journal of Clinical Medicine (Journal of Clinical Medicine)  9 ( 11 ) 1 - 13 2020.10

    Research paper (scientific journal), Lead author, Accepted

     View Summary

    Early and rapid risk stratification of patients with acute heart failure (AHF) is crucial for appropriate patient triage and outcome improvements. We aimed to develop an easy-to-use, in-hospital mortality risk prediction tool based on data collected from AHF patients at their initial presentation. Consecutive patients’ data pertaining to 2006-2017 were extracted from the West Tokyo Heart Failure (WET-HF) and National Cerebral and Cardiovascular Center Acute Decompensated Heart Failure (NaDEF) registries (n = 4351). Risk model development involved stepwise logistic regression analysis and prospective validation using data pertaining to 2014-2015 in the Registry Focused on Very Early Presentation and Treatment in Emergency Department of Acute Heart Failure Syndrome (REALITY-AHF) (n = 1682). The final model included data describing six in-hospital mortality risk predictors, namely, age, systolic blood pressure, blood urea nitrogen, serum sodium, albumin, and natriuretic peptide (SOB-ASAP score), available at the time of initial triage. The model showed excellent discrimination (c-statistic = 0.82) and good agreement between predicted and observed mortality rates. The model enabled the stratification of the mortality rates across sixths (from 14.5% to <1%). When assigned a point for each associated factor, the integer score’s discrimination was similar (c-statistic = 0.82) with good calibration across the patients with various risk profiles. The models’ performance was retained in the independent validation dataset. Promptly determining in-hospital mortality risks is achievable in the first few hours of presentation; they correlate strongly with mortality among AHF patients, potentially facilitating clinical decision-making.

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  • Validation and Recalibration of Seattle Heart Failure Model in Japanese Acute Heart Failure Patients

    Shiraishi Y., Kohsaka S., Nagai T., Goda A., Mizuno A., Nagatomo Y., Sujino Y., Fukuoka R., Sawano M., Kohno T., Fukuda K., Anzai T., Shadman R., Dardas T., Levy W., Yoshikawa T.

    Journal of Cardiac Failure (Journal of Cardiac Failure)  25 ( 7 ) 561 - 567 2019.07

    Research paper (scientific journal), Lead author, Accepted,  ISSN  10719164

     View Summary

    © 2018 Elsevier Inc. Background: Precise risk stratification in heart failure (HF) patients enables clinicians to tailor the intensity of their management. The Seattle Heart Failure Model (SHFM), which uses conventional clinical variables for its prediction, is widely used. We aimed to externally validate SHFM in Japanese HF patients with a recent episode of acute decompensation requiring hospital admission. Methods and Results: SHFM was applied to 2470 HF patients registered in the West Tokyo Heart Failure and National Cerebral And Cardiovascular Center Acute Decompensated Heart Failure databases from 2006 to 2016. Discrimination and calibration were assessed with the use of the c-statistic and calibration plots, respectively, in HF patients with reduced ejection fraction (HFrEF; <40%) and preserved ejection fraction (HFpEF; ≥40%). In a perfectly calibrated model, the slope and intercept would be 1.0 and 0.0, respectively. The method of intercept recalibration was used to update the model. The registered patients (mean age 74 ± 13 y) were predominantly men (62%). Overall, 572 patients (23.2%) died during a mean follow-up of 2.1 years. Among HFrEF patients, SHFM showed good discrimination (c-statistic = 0.75) but miscalibration, tending to overestimate 1-year survival (slope = 0.78; intercept = −0.22). Among HFpEF patients, SHFM showed modest discrimination (c-statistic = 0.69) and calibration, tending to underestimate 1-year survival (slope = 1.18; intercept = 0.16). Intercept recalibration (replacing the baseline survival function) successfully updated the model for HFrEF (slope = 1.03; intercept = −0.04) but not for HFpEF patients. Conclusions: In Japanese acute HF patients, SHFM showed adequate performance after recalibration among HFrEF patients. Using prediction models to tailor the care for HF patients may improve the allocation of medical resources.

  • 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

     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.

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Reviews, Commentaries, etc. 【 Display / hide

  • 【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

  • 【循環器集中治療(Critical Care Cardiology)】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 ((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

    Lead author, Corresponding author,  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】(Part 1)総論 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 ((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

    Lead author, Last author, Corresponding author,  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。

  • 【心不全(第2版)上 -最新の基礎・臨床研究の進歩-】疫学 コホート研究「日本におけるコホート研究:WET-HF研究」

    白石 泰之, 香坂 俊

    日本臨床 ((株)日本臨床社)  76 ( 増刊9 心不全(上) ) 76 - 82 2018.12

    Lead author,  ISSN  0047-1852

  • 【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】(III章)慢性心不全「LVEFの保たれた心不全(HFpEF)患者の治療戦略」

    川久保 裕美子, 白石 泰之

    循環器内科学レビュー ((株)総合医学社)  2022-'23   140 - 147 2021.11

    Last author, Corresponding author,  ISSN  2436-6838

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Presentations 【 Display / hide

  • 心不全診療のジョーカー -Ivabradineによる心拍管理の色々-

    白石 泰之

    第28回 日本心臓リハビリテーション学会学術集会, 

    2022.06

    Public lecture, seminar, tutorial, course, or other speech

  • Heart rate variability as a good predictor of generalized anxiety burden

    Yuta Seki, Yoshinori Katsumata, Yasuyuki Shiraishi, Kazuki Sato, Keiichi Fukuda

    第68回 日本不整脈心電学会学術集会, 

    2022.06

    Oral presentation (general)

  • 肺高血圧を合併した心房中隔欠損症に対し、肺血管拡張薬導入後に閉鎖術を施行した1例

    山岡 広季, 白石 泰之, 平出 貴裕, 岸野 喜一, 猪原 拓, 湯浅 慎介, 福田 恵一

    第676回 日本内科学会関東地方会, 

    2022.03

    Oral presentation (general)

  • Recurrence of Myopericarditis Following mRNA-1273 COVID-19 Vaccination

    渡邊 桂子, 梅井 智彦, 都築 一平, 岸野 喜一, 白石 泰之, 猪原 拓, 湯浅 慎介, 福田 恵一

    第86回 日本循環器学会学術集会, 

    2022.03

    Oral presentation (general)

  • Phenotype of Pattern of Congestion Signs on Physical Examination in Patients with Acute Decompensated Heart Failure

    新美 望, 香坂 俊, 白石 泰之, 福田 恵一, 河野 隆志, 佐地 真育, 長友 祐司, 田中 寿一, 武井 眞, 中埜 信太郎, 吉川 勉

    第86回 日本循環器学会学術集会, 

    2022.03

    Oral presentation (general)

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

  • 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

    2022.04
    -
    Present

    Japan Agency for Medical Research and Development (AMED), 橋渡し研究プログラム・シーズA, Principal investigator

  • 心房細動患者に対する抗凝固療法による消化管出血性合併症の臨床像と重症度同定

    2021.04
    -
    2024.03

    Keio University, Grant-in-Aid for Scientific Research (C), No Setting

     View Summary

    心房細動の抗凝固療法は、脳卒中抑制効果と出血性合併症の安全性が証明されている新規経口抗凝固薬 (DOAC) が世界的に主流となってきている。我が国ではDOACを服用した心房細動患者の消化管出血発症率は年間 1.9% と高頻度であることが報告されているに留まり、本合併症発症時における薬剤の休薬・再開基準においては、さらなる実臨床での検証が急務であるとされている。本研究では、申請者自らが構築してきたレジストリシステムを発展的に活用し、日本人患者における抗凝固療法中の消化管出血の頻度、特徴、さらに出血イベントの予後に関する検証を行う。

  • 画像情報と深層学習を応用した心疾患患者の予後予測と革新的な治療戦略の開発

    2021.04
    -
    2022.03

    上原記念生命科学財団, 研究奨励金(新領域 4.0), Research grant, Principal investigator

  • Telemedicine Using Multi-Dementional Biological Sensors Information and Communication Technology in Combination With Artificial Intelligence

    2020.04
    -
    2023.03

    公益財団法人セコム科学技術振興財団, 挑戦的研究助成, Research grant, Principal investigator

  • 第二世代急性心不全患者予後予測システムの構築:画像情報とその深層学習の応用

    2019.04
    -
    2021.03

    日本循環器学会, 医師臨床研究助成, Research grant, Principal investigator

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Intellectual Property Rights, etc. 【 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

  • LECTURE SERIES, INTERNAL MEDICINE (CARDIOLOGY)

    2022

  • LECTURE SERIES, INTERNAL MEDICINE (CARDIOLOGY)

    2021

 

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

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Committee Experiences 【 Display / hide

  • 2020.10
    -
    Present

    関東甲信越支部 学術委員会 委員, 日本循環器学会