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Article ; Online: Evaluation of Changes in Coronary Ischemia After Lipid-Lowering Therapy Using Computed Tomography Angiography.

Nishihara, Takahiro / Nakashima, Mitsutaka / Ichikawa, Keishi / Miyoshi, Toru

Circulation reports

2023 Volume 6, Issue 1, Page(s) 16–17

Language	English
Publishing date	2023-12-23
Publishing country	Japan
Document type	Journal Article
ISSN	2434-0790
ISSN (online)	2434-0790
DOI	10.1253/circrep.CR-23-0091
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Article: Impact of malnutrition on prognosis in patients with pulmonary arterial hypertension.

Nakashima, Mitsutaka / Akagi, Satoshi / Ejiri, Kentaro / Nakamura, Kazufumi / Ito, Hiroshi

Pulmonary circulation

2023 Volume 13, Issue 3, Page(s) e12286

Abstract: Pulmonary arterial hypertension is a life-threatening disease that coexists with right heart failure. We evaluated the relationship between malnutrition and prognosis in patients with pulmonary arterial hypertension, as malnutrition is known as a ... ...

Abstract	Pulmonary arterial hypertension is a life-threatening disease that coexists with right heart failure. We evaluated the relationship between malnutrition and prognosis in patients with pulmonary arterial hypertension, as malnutrition is known as a prognosis determinant in chronic heart failure. We retrospectively reviewed data of patients with pulmonary arterial hypertension before treatment. The Geriatric Nutritional Risk Index, Prognostic Nutritional Index, and Controlling Nutritional Status scores on the day of diagnosis were calculated to assess the nutritional status. Clinical endpoints were defined as composite outcomes of all-cause death or lung transplantation. Eighty patients were enrolled (mean age, 50 years; 23 men). The mean pulmonary arterial pressure was 47 ± 19 mmHg, Geriatric Nutritional Risk Index was 99.9 ± 12.0, and Prognostic Nutritional Index was 46.3 ± 10.0. The median Controlling Nutritional Status score was 2 (1-4). During the median 5.5-year follow-up period, 28 composite events occurred. Kaplan-Meier analysis demonstrated significant differences in the incidence of clinical endpoints between groups divided by each median Geriatric Nutritional Risk Index, Prognostic Nutritional Index, and Controlling Nutritional Status score (
Language	English
Publishing date	2023-09-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2638089-4
ISSN	2045-8940 ; 2045-8932
ISSN (online)	2045-8940
ISSN	2045-8932
DOI	10.1002/pul2.12286
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Article ; Online: Myocardial Late Iodine Enhancement Using Photon-Counting Computed Tomography in Patients With Hypertrophic Cardiomyopathy.

Nishihara, Takahiro / Miyoshi, Toru / Akagi, Noriaki / Nakashima, Mitsutaka / Nakamura, Kazufumi / Ito, Hiroshi

Circulation reports

2023 Volume 5, Issue 6, Page(s) 269–270

Language	English
Publishing date	2023-05-18
Publishing country	Japan
Document type	Journal Article
ISSN	2434-0790
ISSN (online)	2434-0790
DOI	10.1253/circrep.CR-23-0034
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Article ; Online: Prognostic value of metabolic dysfunction-associated steatotic liver disease over coronary computed tomography angiography findings: comparison with no-alcoholic fatty liver disease.

Nishihara, Takahiro / Miyoshi, Toru / Nakashima, Mitsutaka / Miki, Takashi / Toda, Hironobu / Yoshida, Masatoki / Ichikawa, Keishi / Osawa, Kazuhiro / Yuasa, Shinsuke

Cardiovascular diabetology

2024 Volume 23, Issue 1, Page(s) 167

Abstract: Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the proposed name change for non-alcoholic fatty liver disease (NAFLD). This study aimed to investigate the association of cardiovascular disease risk with MASLD and NAFLD ... ...

Abstract	Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the proposed name change for non-alcoholic fatty liver disease (NAFLD). This study aimed to investigate the association of cardiovascular disease risk with MASLD and NAFLD in patients who underwent clinically indicated coronary computed tomography angiography (CCTA). Methods: This retrospective study included 2289 patients (60% men; mean age: 68 years) with no history of coronary artery disease who underwent CCTA. The steatotic liver was defined as a hepatic-to-spleen attenuation ratio of < 1.0 on CT just before CCTA. MASLD is defined as the presence of hepatic steatosis along with at least one of the five cardiometabolic risk factors. Adverse CCTA findings were defined as obstructive and/or high-risk plaques. Major adverse cardiac events (MACE) encompassed composite coronary events, including cardiovascular death, acute coronary syndrome, and late coronary revascularization. Results: MASLD and NAFLD were identified in 415 (18%) and 368 (16%) patients, respectively. Adverse CCTA findings were observed in 40% and 38% of the patients with MASLD and with NAFLD, respectively. Adverse CCTA findings were significantly associated with MASLD (p = 0.007) but not NAFLD (p = 0.253). During a median follow-up of 4.4 years, 102 (4.4%) MACE were observed. MASLD was significantly associated with MACE (hazard ratio 1.82, 95% CI 1.18-2.83, p = 0.007), while its association with NAFLD was not significant (p = 0.070). By incorporating MASLD into a prediction model of MACE, including the risk score and adverse CCTA findings, global chi-squared values significantly increased from 87.0 to 94.1 (p = 0.008). Conclusions: Patients with MASLD are likely to have a higher risk of cardiovascular disease than those with NAFLD. Concurrent assessment of MASLD during CCTA improves the identification of patients at a higher risk of cardiovascular disease among those with clinically indicated CCTA.
MeSH term(s)	Humans ; Male ; Non-alcoholic Fatty Liver Disease/diagnostic imaging ; Non-alcoholic Fatty Liver Disease/complications ; Non-alcoholic Fatty Liver Disease/epidemiology ; Female ; Retrospective Studies ; Aged ; Middle Aged ; Computed Tomography Angiography ; Coronary Angiography ; Predictive Value of Tests ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/epidemiology ; Prognosis ; Risk Assessment ; Cardiometabolic Risk Factors ; Risk Factors
Language	English
Publishing date	2024-05-10
Publishing country	England
Document type	Journal Article ; Comparative Study ; Research Support, Non-U.S. Gov't
ZDB-ID	2093769-6
ISSN	1475-2840 ; 1475-2840
ISSN (online)	1475-2840
ISSN	1475-2840
DOI	10.1186/s12933-024-02268-1
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Article ; Online: Catheter-directed thrombolysis for critical hand ischemia with failed distal venous arterialization.

Nakashima, Mitsutaka / Toda, Hironobu / Ejiri, Kentaro / Ozawa, Susumu / Akagi, Satoshi / Nakamura, Kazufumi

Cardiovascular intervention and therapeutics

2023 Volume 39, Issue 1, Page(s) 95–96

MeSH term(s)	Humans ; Peripheral Vascular Diseases ; Ischemia/drug therapy ; Ischemia/etiology ; Catheters ; Thrombolytic Therapy ; Treatment Outcome
Language	English
Publishing date	2023-08-30
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2581654-8
ISSN	1868-4297 ; 1868-4300
ISSN (online)	1868-4297
ISSN	1868-4300
DOI	10.1007/s12928-023-00956-5
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Article ; Online: Relationship between patent foramen ovale anatomical features and residual shunt after patent foramen ovale closure.

Nakayama, Rie / Takaya, Yoichi / Akagi, Teiji / Takemoto, Rika / Haruna, Madoka / Nakashima, Mitsutaka / Miki, Takashi / Nakagawa, Koji / Toh, Norihisa / Nakamura, Kazufumi

Cardiovascular intervention and therapeutics

2024 Volume 39, Issue 2, Page(s) 200–206

Abstract: Transcatheter closure of patent foramen ovale (PFO) is an effective strategy for preventing recurrence of paradoxical embolism. However, PFO closure is often associated with residual shunt, which is a risk of recurrent stroke. This study aimed to ... ...

Abstract	Transcatheter closure of patent foramen ovale (PFO) is an effective strategy for preventing recurrence of paradoxical embolism. However, PFO closure is often associated with residual shunt, which is a risk of recurrent stroke. This study aimed to evaluate the relationship between the anatomical features of PFO and residual shunt. The degree of residual shunt and its relationship with the anatomical features of PFO were evaluated in 106 patients who underwent PFO closure at our institution between March 2011 and January 2022 and in whom contrast transthoracic echocardiography was performed 1 year later. The mean PFO tunnel length was 9.3 ± 3.6 mm and the mean PFO height was 3.2 ± 2.2 mm. Atrial septal aneurysm (ASA) was found in 37 patients. After PFO closure, residual shunt was observed in 28 patients (grade 1, n = 8; grade 2, n = 16; grade 3, n = 3; grade 4, n = 1). Univariate logistic analysis identified ASA to be associated with residual shunt (odds ratio 2.78, 95% confidence interval 1.14 to 6.79; p = 0.024). There was no association of residual shunt with the size of the PFO, the length of PFO tunnel, or the size of the device used for closure. Two of four patients with a large residual shunt of grade 3 or grade 4 were found to have device size mismatch. Residual shunt after PFO closure was observed in a quarter of patients and was related to the presence of ASA. A few patients had a large residual shunt due to the device size mismatch.
MeSH term(s)	Humans ; Foramen Ovale, Patent/surgery ; Foramen Ovale, Patent/complications ; Echocardiography ; Septal Occluder Device ; Treatment Outcome ; Cardiac Catheterization ; Stroke
Language	English
Publishing date	2024-01-24
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2581654-8
ISSN	1868-4297 ; 1868-4300
ISSN (online)	1868-4297
ISSN	1868-4300
DOI	10.1007/s12928-023-00979-y
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Article: Association of Oxidized Low-Density Lipoprotein in Nonalcoholic Fatty Liver Disease with High-Risk Plaque on Coronary Computed Tomography Angiography: A Matched Case-Control Study.

Nishihara, Takahiro / Miyoshi, Toru / Ichikawa, Keishi / Osawa, Kazuhiro / Nakashima, Mitsutaka / Miki, Takashi / Ito, Hiroshi

Journal of clinical medicine

2022 Volume 11, Issue 10

Abstract: Nonalcoholic fatty liver disease (NAFLD) is a risk factor for the development of atherosclerotic cardiovascular diseases (CVDs), and oxidative stress has been proposed as a shared pathophysiological condition. This study examined whether oxidized low- ... ...

Abstract	Nonalcoholic fatty liver disease (NAFLD) is a risk factor for the development of atherosclerotic cardiovascular diseases (CVDs), and oxidative stress has been proposed as a shared pathophysiological condition. This study examined whether oxidized low-density lipoprotein (LDL) is involved in the underlying mechanism that links coronary atherosclerosis and NAFLD. This study included 631 patients who underwent coronary computed tomography angiography (CTA) for suspected coronary artery disease. NAFLD was defined on CT images as a liver-to-spleen attenuation ratio of <1.0. Serum-malondialdehyde-modified LDL (MDA-LDL) and coronary CTA findings were analyzed in a propensity-score-matched cohort of patients with NAFLD (n = 150) and those without NAFLD (n = 150). This study analyzed 300 patients (median age, 65 years; 64% men). Patients with NAFLD had higher MDA-LDL levels and a greater presence of CTA-verified high-risk plaques than those without NAFLD. In the multivariate linear regression analysis, MDA-LDL was independently associated with NAFLD (β = 11.337, p = 0.005) and high-risk plaques (β = 12.487, p = 0.007). Increased MDA-LDL may be a mediator between NAFLD and high-risk coronary plaque on coronary CTA. Increased oxidative stress in NAFLD, as assessed using MDA-LDL, may be involved in the development of CVDs.
Language	English
Publishing date	2022-05-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11102838
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Article ; Online: The Fibrosis-4 Index Predicts Cardiovascular Prognosis in Patients With Severe Isolated Tricuspid Regurgitation.

Nakashima, Mitsutaka / Tanakaya, Machiko / Miyoshi, Toru / Saito, Takaaki / Katayama, Yusuke / Sakuragi, Satoru / Ito, Hiroshi

Circulation journal : official journal of the Japanese Circulation Society

2022 Volume 86, Issue 11, Page(s) 1777–1784

Abstract: Background: The fibrosis-4 (FIB-4) index is used to evaluate liver disease patients. It can also be used to evaluate the prognosis for heart disease patients; however, its ability to determine the prognosis of severe isolated tricuspid regurgitation (TR) ...

Abstract	Background: The fibrosis-4 (FIB-4) index is used to evaluate liver disease patients. It can also be used to evaluate the prognosis for heart disease patients; however, its ability to determine the prognosis of severe isolated tricuspid regurgitation (TR) patients is unclear. This study aimed to clarify the association between FIB-4 index scores and the cardiovascular prognosis for severe isolated TR patients.Methods and Results: This was a dual-center, retrospective study. From 2011 to 2019, 111 consecutive outpatients with severe isolated TR (mean age, 68.6 years; 53.2% male) were evaluated. Major adverse cardiovascular events (MACEs) were defined as the composite of cardiovascular death, hospitalization for heart failure, myocardial infarction, and stroke. The association between FIB-4 index scores and echocardiography was also evaluated. During a median follow up of 3.0 years, 24 patients were lost to follow up and 40 MACEs occurred. Baseline FIB-4 index scores for patients with MACEs were significantly higher than those for patients without MACEs. A multivariate analysis revealed that FIB-4 index scores are significantly associated with MACEs (hazard ratio, 1.89; 95% confidence interval, 1.01-3.54; P=0.046). A linear regression analysis indicated that FIB-4 index scores were correlated with echocardiographic parameters, including the left atrial volume index and left ventricular end-diastolic diameter. Conclusions: The FIB-4 index score may be a useful predictor of MACEs for patients with severe isolated TR.
MeSH term(s)	Humans ; Male ; Aged ; Female ; Tricuspid Valve Insufficiency/diagnostic imaging ; Retrospective Studies ; Prognosis ; Heart Failure ; Fibrosis
Language	English
Publishing date	2022-08-04
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2068090-9
ISSN	1347-4820 ; 1346-9843
ISSN (online)	1347-4820
ISSN	1346-9843
DOI	10.1253/circj.CJ-22-0109
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Article ; Online: Association between high oxidized high-density lipoprotein levels and increased pericoronary inflammation determined by coronary computed tomography angiography.

Ichikawa, Keishi / Miyoshi, Toru / Kotani, Kazuhiko / Osawa, Kazuhiro / Nakashima, Mitsutaka / Nishihara, Takahiro / Ito, Hiroshi

Journal of cardiology

2022 Volume 80, Issue 5, Page(s) 410–415

Abstract: Background: Impaired high-density lipoprotein (HDL) function is a risk factor for cardiac mortality. We aimed to investigate the association between oxidized HDL (oxHDL) and pericoronary adipose tissue (PCAT) attenuation, a novel imaging biomarker of ... ...

Abstract	Background: Impaired high-density lipoprotein (HDL) function is a risk factor for cardiac mortality. We aimed to investigate the association between oxidized HDL (oxHDL) and pericoronary adipose tissue (PCAT) attenuation, a novel imaging biomarker of pericoronary inflammation, by using coronary computed tomography angiography (CTA). Methods: A total of 287 outpatients with suspected coronary artery disease who had undergone both oxHDL measurement and coronary CTA were examined. PCAT attenuation values were assessed at the proximal 10-50 mm segments of the right coronary artery on coronary CTA. The presence of significant stenosis (luminal narrowing of >50 %) and high-risk plaque characteristics were also evaluated. Patients were then classified into tertiles according to their oxHDL level: low (n = 95), moderate (n = 96), and high (n = 96) groups. Results: PCAT attenuation in the high oxHDL group was significantly higher than that in other groups after adjusting for age and apolipoprotein-A-I. Multivariate linear regression analysis revealed that oxHDL was significantly associated with PCAT attenuation in the right coronary artery (β = 3.832, p < 0.001), whereas HDL cholesterol was not. Furthermore, subgroup analyses demonstrated that the association between oxHDL and PCAT attenuation remained significant in older patients (β = 6.367, p < 0.001) and in those with hypertension (β = 4.922, p < 0.011), dyslipidemia (β = 3.264, p = 0.010), diabetes mellitus (β = 4.284, p = 0.015), and significant stenosis (β = 3.075, p = 0.021). Conclusions: High oxHDL levels were significantly associated with increased pericoronary inflammation, as assessed using coronary CTA. Our results may explain the association between impaired HDL function and the development of coronary atherosclerosis.
MeSH term(s)	Adipose Tissue ; Aged ; Apolipoproteins ; Biomarkers ; Computed Tomography Angiography/methods ; Constriction, Pathologic ; Coronary Angiography/methods ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/etiology ; Coronary Vessels/diagnostic imaging ; Humans ; Inflammation ; Lipoproteins, HDL ; Plaque, Atherosclerotic
Chemical Substances	Apolipoproteins ; Biomarkers ; Lipoproteins, HDL
Language	English
Publishing date	2022-07-16
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	639364-0
ISSN	1876-4738 ; 0386-2887 ; 0914-5087
ISSN (online)	1876-4738
ISSN	0386-2887 ; 0914-5087
DOI	10.1016/j.jjcc.2022.06.015
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Article ; Online: Association of perivascular fat attenuation on computed tomography and heart failure with preserved ejection fraction.

Nishihara, Takahiro / Miyoshi, Toru / Nakashima, Mitsutaka / Ichikawa, Keishi / Takaya, Yoichi / Nakayama, Rie / Miki, Takashi / Ito, Hiroshi

ESC heart failure

2023 Volume 10, Issue 4, Page(s) 2447–2457

Abstract: Aims: Heart failure with a preserved ejection fraction (HFpEF) is associated with chronic inflammation. We aimed to investigate the association between pericoronary adipose tissue attenuation (PCATA) on coronary computed tomography angiography as a ... ...

Abstract	Aims: Heart failure with a preserved ejection fraction (HFpEF) is associated with chronic inflammation. We aimed to investigate the association between pericoronary adipose tissue attenuation (PCATA) on coronary computed tomography angiography as a novel noninvasive marker of pericoronary inflammation and the presence of HFpEF. Methods and results: This retrospective study included 607 outpatients (median age, 65 years; 50% male) who underwent both echocardiography and coronary computed tomography angiography. Patients with obstructive coronary artery disease were excluded from this study. PCATA was compared between patients with and without HFpEF, which was diagnosed according to the Heart Failure Association (HFA)-PEFF score. PCATA was assessed at the proximal 40-mm segments of all three major coronary arteries on coronary computed tomography angiography. Patients with HFpEF had higher PCATA in all coronary arteries compared to the control participants: left anterior descending artery (LAD), -65.2 ± 6.9 Hounsfield units (HU) vs. -68.1 ± 6.7 HU; left circumflex artery (LCX), -62.7 ± 6.8 HU vs. -65.4 ± 6.6 HU; and right coronary artery (RCA), -63.6 ± 8.5 HU vs. -65.5 ± 7.7 HU (P < 0.01). Multivariate logistic regression analysis, including conventional risk factors, revealed that PCATA per standard deviation in the LAD (odds ratio [OR], 1.449; 95% confidence interval [CI], 1.152-1.823), LCX (OR, 1.634; 95% CI, 1.283-2.081), and RCA (OR, 1.388; 95% CI, 1.107-1.740) were independently associated with HFpEF. The association between PCATA and HFpEF was mostly consistent across various patient clinical characteristics. The left ventricular mass and left atrial volume index showed a mild correlation with LAD-PCATA (ρ = 0.13 [P < 0.01] and ρ = 0.24 [P < 0.01]) and LCX-PCATA (ρ = 0.16 [P < 0.01] and ρ = 0.23 [P < 0.01]). Conclusions: High PCATA score was significantly associated with the presence of HFpEF. Our results suggest that inflammation in the pericoronary artery adipose tissue is one of the underlying mechanisms of HFpEF.
MeSH term(s)	Humans ; Male ; Aged ; Female ; Retrospective Studies ; Coronary Angiography/methods ; Heart Failure/diagnostic imaging ; Stroke Volume ; Tomography, X-Ray Computed/methods ; Adipose Tissue/diagnostic imaging ; Inflammation
Language	English
Publishing date	2023-05-31
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2814355-3
ISSN	2055-5822 ; 2055-5822
ISSN (online)	2055-5822
ISSN	2055-5822
DOI	10.1002/ehf2.14419
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