Details of a Researcher - Katsumata, Yoshinori

Papers - Katsumata, Yoshinori

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Incidence, clinical characteristics, and long-term outcome of the dilated phase of hypertrophic cardiomyopathy

Aizawa Y., Tanimoto Y., Hirata Y., Fujisawa T., Fukuoka R., Nakajima K., Katsumata Y., Nishiyama T., Kimura T., Yuasa S., Kohno T., Kohsaka S., Murata M., Maekawa Y., Furukawa Y., Takatsuki S., Fukuda K.

Keio Journal of Medicine (Keio Journal of Medicine) 68 ( 4 ) 87 - 94 2019

ISSN 00229717

© 2018 by The Keio Journal of Medicine. Some patients with hypertrophic cardiomyopathy (HCM) develop systolic dysfunction, called the dilated phase of HCM (d-HCM), which is associated with increased morbidity and mortality. We conducted a retrospective study using an HCM database to clarify the incidence, clinical characteristics, and long-term outcomes of d-HCM. We analyzed an HCM cohort consisting of 434 patients (273 with apical HCM and 161 with non-apical HCM; 18 had obstructive HCM, 16 had dilated HCM, and 127 had other HCM) diagnosed by echocardiography in our hospital between 1991 and 2010. The follow-up period was 8.4 ± 6.7 years. The mean age at final follow-up was 67 ± 14 years, and 304 patients (70%) were men. The mean age of the 16 d-HCM patients at the initial visit was 45 ± 17 years, the age at final follow-up was 59 ± 18 years, and 13 were men. Thirteen d-HCM patients developed atrial fibrillation and six patients developed ischemic stroke. Twelve d-HCM patients were implanted with cardiac devices: one pacemaker, nine implantable cardioverter-defibrillators, and two cardiac resynchronization therapy with defibrillator. Five patients died of progressive heart failure at the age of 61 ± 23 years. The age at the initial visit and final follow-up were lower and the NYHA class, brain natriuretic peptide levels, and left ventricular function at initial evaluation were worse in the d-HCM group. Univariate analysis demonstrated that a lower age at the initial visit was associated with d-HCM (hazard ratio 0.955/1 year increase; 95% CI 0.920–0.991, P = 0.015). In our HCM cohort, the incidence of d-HCM was 4%. A high prevalence of atrial fibrillation and cerebral infarction and poor prognosis were noted in this group, despite patients undergoing medication and device implantation.

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Decrease in membrane phospholipids unsaturation correlates with myocardial diastolic dysfunction

Yamamoto T., Endo J., Kataoka M., Matsuhashi T., Katsumata Y., Shirakawa K., Yoshida N., Isobe S., Moriyama H., Goto S., Yamashita K., Nakanishi H., Shimanaka Y., Kono N., Shinmura K., Arai H., Fukuda K., Sano M.

PLoS ONE (PLoS ONE) 13 ( 12 ) 2018.12

© 2018 Yamamoto et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Increase in saturated fatty acid (SFA) content in membrane phospholipids dramatically affects membrane properties and cellular functioning. We sought to determine whether exogenous SFA from the diet directly affects the degree of membrane phospholipid unsaturation in adult hearts and if these changes correlate with contractile dysfunction. Although both SFA-rich high fat diets (HFDs) and monounsaturated FA (MUFA)-rich HFDs cause the same degree of activation of myocardial FA uptake, triglyceride turnover, and mitochondrial FA oxidation and accumulation of toxic lipid intermediates, the former induced more severe diastolic dysfunction than the latter, which was accompanied with a decrease in membrane phospholipid unsaturation, induction of unfolded protein response (UPR), and a decrease in the expression of Sirt1 and stearoyl-CoA desaturase-1 (SCD1), catalyzing the conversion of SFA to MUFA. When the SFA supply in the heart overwhelms the cellular capacity to use it for energy, excess exogenous SFA channels to membrane phospholipids, leading to UPR induction, and development of diastolic dysfunction.

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Asymptomatic Cerebral Infarction During Catheter Ablation for Atrial Fibrillation: Comparing Uninterrupted Rivaroxaban and Warfarin (ASCERTAIN)

Kimura T., Kashimura S., Nishiyama T., Katsumata Y., Inagawa K., Ikegami Y., Nishiyama N., Fukumoto K., Tanimoto Y., Aizawa Y., Tanimoto K., Fukuda K., Takatsuki S.

JACC: Clinical Electrophysiology (JACC: Clinical Electrophysiology) 4 ( 12 ) 1598 - 1609 2018.12

ISSN 2405500X

© 2018 American College of Cardiology Foundation Objectives: This randomized study compared uninterrupted rivaroxaban therapy with warfarin therapy as prophylaxis against catheter ablation (CA)-induced asymptomatic cerebral infarction (ACI) and identified the risk factors of rivaroxaban. Background: The reported incidence of ACI during CA for atrial fibrillation (AF) remains at 10% to 30%, and periprocedural oral anticoagulation could affect this incidence. Methods: Patients with nonvalvular AF undergoing radiofrequency CA were randomly assigned to receive either uninterrupted rivaroxaban or warfarin as periprocedural anticoagulation therapy. CA was performed after at least 1 month of adequate anticoagulation. Cerebral magnetic resonance imaging (MRI) was performed within 2 weeks before and 1 day after CA to detect ACI. Results: A total 132 patients were enrolled; 127 (median: 60.0 years of age; 83.5% males; 64.6% incidence of paroxysmal AF) complied with the study protocol and were analyzed; 64 patients received rivaroxaban, and 63 patients received warfarin. The rates of CA-induced ACI in the rivaroxaban group (15.6% [10 of 64 patients]) were similar to those in the warfarin group (15.9% [10 of 63 patients]; p = 1.000). No thromboembolic events developed; no differences in major or nonmajor bleeding rates were observed between the 2 drug groups (3.1% vs. 1.6%, respectively, or 18.8% vs. 19.0%, respectively). Multiple regression analysis indicated that the presence of deep and subcortical white matter hyperintensity (p = 0.002; odds ratio [OR]: 5.323) and the frequency of cardioversions (p = 0.016; OR: 1.250) were associated with the incidence of ACI. Conclusions: No notable differences were found between the incidence of CA-induced ACI in the rivaroxaban group and that in the warfarin group in this randomized study.

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Sex-dependent phenotypic variability of an SCN5a mutation: Brugada syndrome and sick sinus syndrome

Aizawa Y., Fujisawa T., Katsumata Y., Kohsaka S., Kunitomi A., Ohno S., Sonoda K., Hayashi H., Hojo R., Fukamizu S., Nagase S., Ito S., Nakajima K., Nishiyama T., Kimura T., Kurita Y., Furukawa Y., Takatsuki S., Ogawa S., Nakazato Y., Sumiyoshi M., Kosaki K., Horie M., Fukuda K.

Journal of the American Heart Association (Journal of the American Heart Association) 7 ( 18 ) 2018.09

© 2018 The Authors. Background Brugada syndrome (BS) is known to be 9 times more prevalent in males than females. However, little is known about the development of sick sinus syndrome in female members with familial BS. Methods and Results Familial BS patients and family members, both from our institutions and collaborating sites that specialize in clinical care of BS, participated in this study. We collected information on their clinical and genetic background, along with the inheritance patterns of BS. Detailed information on each case with familial BS is described. A total of 7 families, including 25 BS patients (12 females and 13 males), were included. Seven were probands and 18 were family members. Ten out of the 12 female patients and none of the 13 male patients developed sick sinus syndrome. Sudden death or spontaneous ventricular fibrillation occurred in 7 out of 13 male patients and 2 out of 12 female patients. Conclusions Familial BS existed in which female patients developed sick sinus syndrome but male patients did not. Some of those female patients with sick sinus syndrome had unrecognized BS. Information should be collected not only regarding a family history of sudden death or BS, but also whether a pacemaker was implanted in female members.

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Improvement in the electrocardiograms associated with right ventricular hypertrophy after balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension

Nishiyama Takahiko, Takatsuki Seiji, Kawakami Takashi, Katsumata Yoshinori, Kimura Takehiro, Kataoka Masaharu, Tsuruta Hikaru, Itabashi Yuji, Murata Mitsushige, Yuasa Shinsuke, Aizawa Yoshiyasu, Fukuda Keiichi

IJC Heart and Vasculature (IJC Heart and Vasculature) 19 75 - 82 2018.06

ISSN 2352-9067

Background: Balloon pulmonary angioplasty (BPA) is a treatment option for patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods and results: In 60 patients with CTEPH, we examined the hemodynamic data before and after BPA. In addition, the sequential ECG findings for right ventricular hypertrophy (RVH) were assessed. The mean pulmonary arterial pressure (mPAP) decreased from 38 ± 11 to 20 ± 4 mm Hg (p < 0.05). The ROC analysis showed that the S waves in V5, R waves in V1 + S waves in V5, S waves in I, and QRS axis were significant predictors of an mPAP ≧ 30 mm Hg (AUC > 0.75, p < 0.01). The predictive values for the mPAP before the BPA were the S and R waves in lead V6, and P waves in lead II (33.417 + 0.078 × P in II − 0.10 × R in V6 + 0.012 × S in V6). The change in the mPAP (ΔmPAP) correlated with the change in the amplitudes of the ECGs: ΔS wave in lead I (R = 0.544, p < 0.001), ΔR in V1 + S in V5 (R = 0.476, p < 0.001), and ΔP wave in II (R = 0.511, p < 0.001). At 6 months of follow-up, the improvement in an R in V1 + S in V5 of ≧10 mm implied a better functional status. Conclusion: BPA therapy reduced the pulmonary arterial pressure in patients with CTEPH and was associated with an improvement in the ECG findings related to RVH.

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Prevalence and clinical characteristics of obstructive- and central-dominant sleep apnea in candidates of catheter ablation for atrial fibrillation in Japan

Kohno Takashi, Kimura Takehiro, Fukunaga Koichi, Yamasawa Wakako, Fujisawa Taishi, Fukuoka Ryoma, Nakajima Kazuaki, Kashimura Shin, Kunitomi Akira, Katsumata Yoshinori, Nishiyama Takahiko, Nishiyama Nobuhiro, Aizawa Yoshiyasu, Fukuda Keiichi, Takatsuki Seiji

International Journal of Cardiology (International Journal of Cardiology) 260 99 - 102 2018.06

ISSN 0167-5273

Introduction: We aimed to study the prevalence and types of sleep apnea (SA) as well as their clinical characteristics in atrial fibrillation (AF) ablation candidates in Japan. Methods: Before catheter ablation, 197 consecutive AF patients (age: 60 ± 9 years, body mass index; 25.0 ± 3.0) were evaluated with portable polygraphy. We compared the clinical characteristics, according to the severity of SA as well as its types, as defined by the presence of obstruction and the mixed vs. central apnea indices. Results: The mean apnea–hypopnea index (AHI) was 17.7 ± 11.9, with 135 AF patients having an AHI ≥10 (68.5%). Patients with an AHI ≥10 had a significantly higher body mass index, plasma brain natriuretic peptide (BNP) level, prevalence of hypertension, and larger left atrial size. Among patients with an AHI ≥10, the incidence of obstructive-dominant SA was 60.9% and that of central-dominant SA was 7.6%. The prevalence of hypertension was significantly higher in obstructive-dominant SA patients (obstructive vs. central: 48.3% vs. 20.0%, P = 0.038). The obstructive apnea index correlated with plasma BNP level and age, but the central and mixed apnea indices did not. Conclusions: The prevalence of SA was common in AF ablation candidates, even without an obesity epidemic, and the SA type was predominantly obstructive. Portable polygraphy was useful for detecting undiagnosed SA patients in AF ablation candidates.

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Response by Fujisawa et al to Letter Regarding Article, "pulmonary Artery Denervation by Determining Targeted Ablation Sites for Treatment of Pulmonary Arterial Hypertension"

Fujisawa Taishi, Kataoka Masaharu, Kawakami Takashi, Isobe Sarasa, Nakajima Kazuaki, Kunitomi Akira, Kashimura Shin, Katsumata Yoshinori, Nishiyama Takahiko, Kimura Takehiro, Nishiyama Nobuhiro, Aizawa Yoshiyasu, Murata Mitsushige, Fukuda Keiichi, Takatsuki Seiji

Circulation: Cardiovascular Interventions 11 ( 2 ) 2018.02

ISSN 1941-7640

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The Durability of Atrial Fibrillation Ablation Using an Oesophageal Temperature Cut-Off of 38 °C

Kimura Takehiro, Nishiyama Nobuhiro, Negishi Masachika, Nishiyama Ako, Takazawa Takako, Fujisawa Taishi, Nakajima Kazuaki, Kashimura Shin, Kunitomi Akira, Katsumata Yoshinori, Nishiyama Takahiko, Aizawa Yoshiyasu, Fukuda Keiichi, Takatsuki Seiji

Heart Lung and Circulation (Heart Lung and Circulation) 28 ( 7 ) 1050 - 1058 2018.01

ISSN 1443-9506

Background: A lower cut-off of the oesophageal temperature (ET) during catheter ablation of atrial fibrillation (AF) should be safer, but its durability may become in question. We evaluated an ET cut-off of 38 °C with an output of 25 W on the posterior wall. Methods: In 636 consecutive patients (age: 60 ± 10 years, male: 542, paroxysmal AF: 405, CHADS₂ score: 0.7 ± 0.9), an ET probe was utilised in 303 patients (259 pulmonary vein isolations [PVIs] and 44 simultaneous isolations of the posterior wall and all PVs box isolations [BOXIs]). When the ET increased to >38 °C, the radiofrequency delivery was switched off and the ablation point was tagged as an “EsoTag” by the CARTO™ system (Biosense Webster, Irvine, CA, USA). We analysed the characteristics of the ablation lesions at the EsoTags with respect to the dormant conduction, gaps in the redo-session, and ablation outcome. Results: EsoTags were identified in 94.6% of the left PVIs and all BOXIs, and dormant conduction at the EsoTags was identified in 12.0% and 6.8%, respectively. In 10,796 ablation points, the ablation at the EsoTags that were associated with dormant conduction had a significantly shorter duration, smaller force-time integral, and smaller Δimpedance. The duration of an ET of >38 °C was significantly and positively correlated with the body mass index and negatively with the left atrial appendage flow velocity. During the redo-sessions in a 10.5 ± 6.0 months of follow-up (PVI: 14.7%, BOXI: 11.4%), reconnections at the EsoTags with dormant conduction were observed only in two patients after the PVI. The AF survival rate did not significantly differ in the presence of dormant conduction at the EsoTags (83.1% vs. 75.0%, p = 0.696). There were no patients hospitalised for gastroparesis. Conclusions: Atrial fibrillation ablation utilising an oesophageal temperature cut-off of 38 °C might be safe and durable.

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Real-time analysis of the heart rate variability during incremental exercise for the detection of the ventilatory threshold

Shiraishi Yasuyuki, Katsumata Yoshinori, Sadahiro Taketaro, Azuma Koichiro, Akita Keitaro, Isobe Sarasa, Yashima Fumiaki, Miyamoto Kazutaka, Nishiyama Takahiko, Tamura Yuichi, Kimura Takehiro, Nishiyama Nobuhiro, Aizawa Yoshiyasu, Fukuda Keiichi, Takatsuki Seiji

Journal of the American Heart Association (Journal of the American Heart Association) 7 ( 1 ) 2018.01

ISSN 2047-9980

Background--It has never been possible to immediately evaluate heart rate variability (HRV) during exercise. We aimed to visualize the real-time changes in the power spectrum of HRV during exercise and to investigate its relationship to the ventilatory threshold (VT). Methods and Results--Thirty healthy subjects (29.1±5.7 years of age) and 35 consecutive patients (59.0±13.2 years of age) with myocardial infarctions underwent cardiopulmonary exercise tests with an RAMP protocol ergometer. The HRV was continuously assessed with power spectral analyses using the maximum entropy method and projected on a screen without delay. During exercise, a significant decrease in the high frequency (HF) was followed by a drastic shift in the power spectrum of the HRV with a periodic augmentation in the low frequency/HF (L/H) and steady low HF. When the HRV threshold (HRVT) was defined as conversion from a predominant high frequency (HF) to a predominant low frequency/HF (L/H), the VO₂ at the HRVT (HRVT-VO₂) was substantially correlated with the VO₂ at the lactate threshold and VT) in the healthy subjects (r=0.853 and 0.921, respectively). The mean difference between each threshold (0.65 mL/kg per minute for lactate threshold and HRVT, 0.53 mL/kg per minute for VT and HRVT) was nonsignificant (P > 0.05). Furthermore, the HRVT-VO₂ was also correlated with the VT-VO₂ in these myocardial infarction patients (r=0.867), and the mean difference was -0.72 mL/kg per minute and was nonsignificant (P > 0.05). Conclusions--A HRV analysis with our method enabled real-time visualization of the changes in the power spectrum during exercise. This can provide additional information for detecting the VT.

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Development of monomorphic ventricular tachycardia in a patient with fever-induced Brugada syndrome

Sato Y., Aizawa Y., Fujisawa T., Ito S., Katano K., Fuse N., Miyabe A., Osada K., Ishihara R., Tosaka A., Tamamura T., Mizumura T., Sugimura Y., Nakajima K., Katsumata Y., Nishiyama T., Kimura T., Furukawa Y., Takatsuki S., Kosaki K., Fukuda K.

Journal of Arrhythmia (Journal of Arrhythmia) 34 ( 4 ) 465 - 468 2018

ISSN 18804276

© 2018 The Authors. A 50-year-old woman visited the emergency department with a high fever due to pneumonia. Incessant monomorphic ventricular tachycardia occurred and was terminated by intravenous lidocaine. Her ECG during sinus rhythm demonstrated ST segment elevation suggestive of Brugada syndrome (BS). An intensive examination could not detect any structural disease, and typical coved-type ST elevation was unmasked by a pilsicainide injection leading to a diagnosis of BS. An ICD was implanted for secondary prevention of ventricular arrhythmia. The patient has been free from any recurrences of arrhythmia for 3 years.

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IL (interleukin)-10-STAT3-galectin-3 axis is essential for osteopontin-producing reparative macrophage polarization after myocardial infarction

Shirakawa K., Endo J., Kataoka M., Katsumata Y., Yoshida N., Yamamoto T., Isobe S., Moriyama H., Goto S., Kitakata H., Hiraide T., Fukuda K., Sano M.

Circulation (Circulation) 138 ( 18 ) 2021 - 2035 2018

ISSN 00097322

© 2018 American Heart Association, Inc. BACKGROUND: Both osteopontin (OPN) and galectin-3 have been implicated in phagocytic clearance of dead cells and reparative fibrosis during wound healing. CD206+ macrophages are involved in tissue repair through phagocytosis and fibrosis after myocardial infarction (MI). However, the relationship among OPN, galectin-3, and macrophage polarization in the context of MI remains unclear. METHODS: The time course of Spp1 (encoding OPN) expression in the heart after MI showed a strong activation of Spp1 on day 3 after MI. To identify where in the body and in which cells the transcriptional activity of Spp1 increased after MI, we analyzed EGFP (enhanced green fluorescent protein)-Spp1 knockin reporter mice on day 3 after MI. RESULTS: The transcriptional activity of Spp1 increased only in CD206+ macrophages in the infarct myocardium, and most of CD206+ macrophages have strong transcriptional activation of Spp1 after MI. The temporal expression pattern of Lgal3 (encoding galectin-3) in cardiac macrophages after MI was similar to that of Spp1, and OPN is almost exclusively produced by galectin-3hiCD206+ macrophages. Although both interleukin (IL)-4 and IL-10 were reported to promote CD206+ macrophage-mediated cardiac repair after MI, IL-10- but not IL-4-stimulated CD11b+Ly6G− cells could differentiate into OPN-producing galectin-3hiCD206+ macrophages and showed enhanced phagocytic ability. Inhibition of STAT3 tyrosine phosphorylation suppressed IL-10-induced expression of intracellular galectin-3 and transcriptional activation of Spp1. Knockdown of galectin-3 suppressed their ability to differentiate into OPN-producing cells, but not STAT3 activation. The tyrosine phosphorylation of STAT3 and the appearance rate of galectin-3hiCD206+ cells on cardiac CD11b+Ly6G− cells in Spp1 knockout mice were the same as those in wild-type mice. Spp1 knockout mice showed vulnerability to developing post-MI left ventricular chamber dilatation and the terminal deoxynucleo-tidyltransferase 2'-Deoxyuridine-5'-triphosphate nick-end labeling (TUNEL)-positive cells in the infarcted myocardium after MI remained higher in number in Spp1 knockout mice than in wild-type mice. CONCLUSIONS: OPN is almost exclusively produced by galectin-3hiCD206+ macrophages, which specifically appear in the infarct myocardium after MI. The IL-10-STAT3-galectin-3 axis is essential for OPN-producing reparative macrophage polarization after myocardial infarction, and these macrophages contribute to tissue repair by promoting fibrosis and clearance of apoptotic cells. These results suggest that galectin-3 may contribute to reparative fibrosis in the infarct myocardium by controlling OPN levels.

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Pulmonary Artery Denervation by Determining Targeted Ablation Sites for Treatment of Pulmonary Arterial Hypertension

Circulation: Cardiovascular Interventions 10 ( 10 ) 2017.10

ISSN 1941-7640

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Negative legacy of obesity

Shirakawa Kohsuke, Endo Jin, Katsumata Yoshinori, Yamamoto Tsunehisa, Kataoka Masaharu, Isobe Sarasa, Yoshida Naohiro, Fukuda Keiichi, Sano Motoaki

PLoS One 12 ( 10 ) 2017.10

ISSN 1932-6203

Obesity promotes excessive inflammation, which is associated with senescence-like changes in visceral adipose tissue (VAT) and the development of type 2 diabetes (T2DM) and cardiovascular diseases. We have reported that a unique population of CD44^hi CD62L^lo CD4⁺ T cells that constitutively express PD-1 and CD153 exhibit cellular senescence and cause VAT inflammation by producing large amounts of osteopontin. Weight loss improves glycemic control and reduces cardiovascular disease risk factors, but its long-term effects on cardiovascular events and longevity in obese individuals with T2DM are somewhat disappointing and not well understood. High-fat diet (HFD)-fed obese mice were subjected to weight reduction through a switch to a control diet. They lost body weight and visceral fat mass, reaching the same levels as lean mice fed a control diet. However, the VAT of weight reduction mice exhibited denser infiltration of macrophages, which formed more crown-like structures compared to the VAT of obese mice kept on the HFD. Mechanistically, CD153⁺ PD-1⁺ CD4⁺ T cells are long-lived and not easily eliminated, even after weight reduction. Their continued presence maintains a self-sustaining chronic inflammatory loop via production of large amounts of osteopontin. Thus, we concluded that T-cell senescence is essentially a negative legacy effect of obesity.

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A subtype of idiopathic ventricular fibrillation and its relevance to catheter ablation and genetic variants

Nishiyama Takahiko, Aizawa Yoshiyasu, Ito Shogo, Katsumata Yoshinori, Kimura Takehiro, Takatsuki Seiji

HeartRhythm Case Reports 3 ( 5 ) 271 - 275 2017.05

ISSN 2214-0271

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The absence of a left atrial appendage in a patient with paroxysmal atrial fibrillation with a persistent left superior vena cava

Katsumata Yoshinori, Kashimura Shin, Nishiyama Takahiko, Kimura Takehiro, Takatsuki Seiji

European Heart Journal Cardiovascular Imaging 18 ( 3 ) 374 2017.03

ISSN 2047-2404

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An RyR2 mutation found in a family with a short-coupled variant of torsade de pointes

Kimura Mai, Fujisawa Taishi, Aizawa Yoshiyasu, Matsuhashi Noritaka, Ito Shogo, Nakajima Kazuaki, Kashimura Shin, Kunitomi Akira, Katsumata Yoshinori, Nishiyama Takahiko, Kimura Takehiro, Nishiyama Nobuhiro, Yuasa Shinsuke, Takatsuki Seiji, Kosaki Kenjiro, Fukuda Keiichi

International Journal of Cardiology 227 367 - 369 2017.01

ISSN 0167-5273

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Effect of Compliance to Updated AHA/ACC Performance and Quality Measures Among Patients With Atrial Fibrillation on Outcome (from Japanese Multicenter Registry)

Inohara Taku, Kimura Takehiro, Ueda Ikuko, Ikemura Nobuhiro, Tanimoto Kojiro, Nishiyama Nobuhiro, Aizawa Yoshiyasu, Nishiyama Takahiko, Katsumata Yoshinori, Fukuda Keiichi, Takatsuki Seiji, Kohsaka Shun

American Journal of Cardiology 2017

ISSN 0002-9149

Performance measures (PMs) are used to accelerate translation of scientific evidence into clinical practice. However, it remains unknown how they are applied in the real world and whether the compliance to these metrics will lead to improved patient's outcome in atrial fibrillation (AF). Within the Japanese multicenter AF registry (n = 1,874), adherence of the AF PMs (based on 2016 American Heart Association/American College of Cardiology criteria) and its association with quality of life scaling and clinical outcomes was evaluated. The patient was deemed "adherent" when all applicable components of the PMs for outpatient settings (CHA₂DS₂-VASc risk score documentation [PM-4], anticoagulation prescribed [PM-5], and monthly international normalized ratio (INR) for warfarin treatment [PM-6]) were satisfied. The Atrial Fibrillation Effect on Quality of Life (AFEQT) questionnaire was assessed at baseline and 1 year. About a half of patients (46.1%) were adherent to the AF PMs. PMs were more frequently achieved in patients managed with rhythm control compared with rate control. The achievement rate for each component was 53.9% for PM-4, 85.6% for PM-5, and 90.3% for PM-6, respectively. Although AFEQT global scores at baseline were similar (median 79.2 [interquartile ranges 66.7 to 88.5] vs 77.1 [64.8 to 88.0], p = 0.227), AFEQT global scores at 1-year follow-up were significantly greater in adherence group than those in nonadherence group (89.2 [78.5 to 96.6] vs 86.7 [76.7 to 95.0], p = 0.021). This tendency was consistent regardless of therapeutic strategies. There remains an important opportunity to improve the quality of care in patients with AF. Adherence to the AF PMs might lead to the improvement of patient's quality of life.

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The effects of hydrogen gas inhalation on adverse left ventricular remodeling after percutaneous coronary intervention for ST-elevated myocardial infarction

Katsumata Yoshinori, Sano Fumiya, Abe Takayuki, Tamura Tomoyoshi, Fujisawa Taishi, Shiraishi Yasuyuki, Kohsaka Shun, Ueda Ikuko, Homma Koichiro, Suzuki Masaru, Okuda Shigeo, Maekawa Yuichiro, Kobayashi Eiji, Hori Shingo, Sasaki Junichi, Fukuda Keiichi, Sano Motoaki

Circulation Journal 81 ( 7 ) 940 - 947 2017

ISSN 1346-9843

Background: Hydrogen gas inhalation (HI) reduced infarct size and mitigated adverse left ventricular (LV) remodeling in a rat model of acute myocardial infarction (AMI). We designed a prospective, open-label, rater-blinded clinical pilot study in patients experiencing ST-elevated MI (STEMI). Methods and Results: The 20 patients with an initial diagnosis of STEMI were assigned to either an HI group (1.3% H2 with 26% oxygen) or a control group (26% oxygen). There were no HI-related severe adverse events. In the full analysis set, the cardiac salvage index as evaluated using cardiac magnetic resonance imaging at 7 days after primary percutaneous coronary intervention (PCI), showed no significant between-group difference (HI: 50.0±24.3%; control: 60.1±20.1%; P=0.43). However, the improvement from day 7 in the HI group was numerically greater than that in the control group in some of the surrogate outcomes at 6-month follow-up, including the LV stroke volume index (HI: 9.2±7.1 mL/m²; control: -1.4±7.2 mL/m²; P=0.03) and the LV ejection fraction (HI: 11.0%±9.3%; control: 1.7%±8.3%; P=0.11). Conclusions: The first clinical study has shown that HI during PCI is feasible and safe and may also promote LV reverse remodeling at 6 months after STEMI. The study was not powered to test efficacy and a further large-scale trial is warranted. (Clinical trials registration: UMIN00006825).

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Puncture of the Closed Coronary Sinus Ostium in a Patient With Coronary Sinus Atresia

Nakajima Kazuaki, Fujisawa Taishi, Kashimura Shin, Kunitomi Akira, Katsumata Yoshinori, Nishiyama Takahiko, Kimura Takehiro, Nishiyama Nobuhiro, Aizawa Yoshiyasu, Takatsuki Seiji

JACC: Clinical Electrophysiology 2016.12

ISSN 2405-500X

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Obesity accelerates T cell senescence in murine visceral adipose tissue

Shirakawa Kohsuke, Yan Xiaoxiang, Shinmura Ken, Endo Jin, Kataoka Masaharu, Katsumata Yoshinori, Yamamoto Tsunehisa, Anzai Atsushi, Isobe Sarasa, Yoshida Naohiro, Itoh Hiroshi, Manabe Ichiro, Sekai Miho, Hamazaki Yoko, Fukuda Keiichi, Minato Nagahiro, Sano Motoaki

Journal of Clinical Investigation 126 ( 12 ) 4626 - 4639 2016.12

ISSN 0021-9738

Chronic inflammation in visceral adipose tissue (VAT) precipitates the development of cardiometabolic disorders. Although changes in T cell function associated with visceral obesity are thought to affect chronic VAT inflammation, the specific features of these changes remain elusive. Here, we have determined that a high-fat diet (HFD) caused a preferential increase and accumulation of CD44^hiCD62LloCD4⁺ T cells that constitutively express PD-1 and CD153 in a B cell-dependent manner in VAT. These cells possessed characteristics of cellular senescence and showed a strong activation of Spp1 (encoding osteopontin [OPN]) in VAT. Upon T cell receptor stimulation, these T cells also produced large amounts of OPN in a PD-1-resistant manner in vitro. The features of CD153⁺PD-1⁺CD44hiCD4⁺ T cells were highly reminiscent of senescence-associated CD4⁺ T cells that normally increase with age. Adoptive transfer of CD153⁺PD-1⁺CD44hiCD4⁺ T cells from HFD-fed WT, but not Spp1-deficient, mice into the VAT of lean mice fed a normal diet recapitulated the essential features of VAT inflammation and insulin resistance. Our results demonstrate that a distinct CD153⁺PD-1⁺CD44hiCD4⁺ T cell population that accumulates in the VAT of HFD-fed obese mice causes VAT inflammation by producing large amounts of OPN. This finding suggests a link between visceral adiposity and immune aging.

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