中村 貴(ナカムラ タカシ)

医学科医学部講師

Last Updated :2024/09/14

■教員コメント

コメント

循環器救急一般についてコメント可能です。

■研究者基本情報

現在の研究分野(キーワード)

循環器救急一般についてコメント可能です。

■研究活動情報

論文

  • Masakazu Yasuda; Yoshitaka Iwanaga; Takao Kato; Toshiaki Izumi; Yasutaka Inuzuka; Takashi Nakamura; Yuki Miyaji; Takayuki Kawamura; Shigeru Ikeguchi; Moriaki Inoko; Takashi Kurita; Shunichi Miyazaki
    Open Heart 3 2 e000437  2016年07月 [査読有り]
     
    Background The presence of myocardial fibrosis by cardiac MRI has prognostic value in cardiac sarcoidosis, and localisation may be equally relevant to clinical outcomes. Objective We aimed to analyse cardiac damage and function in detail and explore the relationship with clinical outcomes in patients with cardiac sarcoidosis using cardiac MRI. Methods We included 81 consecutive patients with cardiac sarcoidosis undergoing cardiac MR. Left ventricular mass and fibrosis mass were calculated, and localisation was analysed using a 17-segment model. Participants underwent follow-up through 2015, and the development of major adverse cardiac events including ventricular tachyarrhythmias was recorded. Results Increased left ventricular fibrosis mass was associated with increased prevalence of ventricular tachyarrhythmias (p< 0.001). When localisation was defined as the sum of late gadolinium enhancement in the left ventricular basal anterior and basal anteroseptal areas, or the right ventricular area, it was associated with ventricular tachyarrhythmias (p< 0.001). Kaplan-Meier analysis during a median follow-up of 22.1â €..months showed that both the mass and localisation groupings for fibrosis were significantly associated with major adverse cardiac events or ventricular tachyarrhythmias and that when combined, the risk stratification was better than for each variable alone (p< 0.001, respectively). By Cox-proportional hazard risk analysis, the localisation grouping was an independent predictor for the both. Conclusions In patients with cardiac sarcoidosis, both fibrosis mass and its localisation to the basal anterior/anteroseptal left ventricle, or right ventricle was associated with the development of major adverse cardiac events or ventricular tachyarrhythmias. Cardiac MR with late gadolinium enhancement may be useful for improving risk stratification in patients with cardiac sarcoidosis.
  • Takashi Nakamura; Yoshitaka Iwanaga; Masakazu Yasuda; Takayuki Kawamura; Yuki Miyaji; Hanako Morooka; Shunichi Miyazaki
    INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 32 4 613 - 620 2016年04月 [査読有り]
     
    Myocardial fibrosis is frequently observed and may be associated with the prognosis in patients with hypertrophic cardiomyopathy (HCM); however, the clinical pathophysiological features, particularly in terms of fibrosis, of hypertrophic obstructive cardiomyopathy (HOCM) remain unclear. This study aimed to determine a role of local fibrosis in HOCM using cardiac magnetic resonance (CMR). 108 consecutive HCM patients underwent CMR. HOCM was defined as a left ventricular outflow tract (LVOT) pressure gradient a parts per thousand yen30 mmHg at rest. Myocardial mass and fibrosis mass by late gadolinium-enhancement CMR (LGE-CMR) were calculated and the distribution/pattern was analyzed using the AHA 17-segment model. LV ejection fraction (LVEF) was significantly higher in patients with HOCM (n = 19) than in those with nonobstructive HCM (n = 89) (P < 0.05). Both total myocardial and fibrosis masses in LV were similar in the two groups (P = 0.385 and P = 0.859, respectively). However, fibrosis in the basal septum was significantly less frequent in the HOCM group than in the nonobstructive HCM group (P < 0.01). The LVOT pressure gradient was significantly higher in the basal-septal non-fibrosis group than in the fibrosis group (23.6 +/- A 37.3 vs. 4.8 +/- A 11.4 mmHg, P < 0.01). Multivariate analysis revealed that basal-septal fibrosis was an independent negative predictor of LVOT obstruction in addition to the local wall thickness and LVEF as positive predictors in HCM patients. In conclusion, a significant association was observed between LVOT obstruction and basal septal fibrosis by LGE-CMR in HCM patients. In addition to negative impact of basal-septal fibrosis, basal-septal hypertrophy and preserved global LV contractility may be associated with the pathophysiological features of LVOT obstruction.
  • Takashi Nakamura; Yoshitaka Iwanaga; Yuki Miyaji; Ryuji Nohara; Takao Ishimura; Shunichi Miyazaki
    CARDIOVASCULAR DIABETOLOGY 15 54  2016年03月 [査読有り]
     
    Background: Gliptins should have beneficial effects beyond glycemic control, potentially on the pathophysiology of cardiovascular (CV) diseases, with some basic studies demonstrating this possibility. However, we are yet to answer whether there are any direct CV effects in the clinical setting. We aimed to examine the beneficial effects of sitagliptin in Japanese patients with diabetes and high CV risk for 12 months. Methods: This was a prospective, multicenter, observational study of 205 patients with type 2 diabetes. All participants had more than one major CV risk factor and were treated with sitagliptin for 12 months. At 3 or 12 months, we examined the effects of treatment on glycemic control, CV function (by electrocardiography, echocardiography, and reactive hyperemia-peripheral arterial tonometry), and CV biomarkers. Results: Patients were predominantly elderly (68.8 +/- 9.9 years) and male (71.5 %) and typically had more than three CV risk factors (79.2 %). Treatment with sitagliptin significantly reduced the hemoglobin A1c (HbA1c) level from 7.09 % +/- 0.81 % at baseline to 6.67 % +/- 0.69 % at 3 months and 6.68 % +/- 0.73 % at 12 months (both P < 0.001). The reduction in HbA1c was also in tandem with the decrease in the level of high-sensitive C-reactive protein throughout the study. Independent of the change in HbA1c, sitagliptin reduced systolic (-7.0 +/- 18.9 mmHg) and diastolic blood pressure (-5.1 +/- 11.7 mmHg) at 12 months, and this was associated with a decrease in urinary albumin. In contrast, there were no beneficial effects on cardiac and endothelial function or on the levels of serum B-type natriuretic peptide, high-sensitive troponin T, and urinary 8-hydroxy-2'-deoxyguanosine. Conclusions: In Japanese patients with diabetes and multiple CV risk factors, sitagliptin showed a decrease in blood pressure associated with an improvement in albuminuria in addition to glycemic control.
  • Yuki Miyaji; Yoshitaka Iwanaga; Takashi Nakamura; Masakazu Yasuda; Takayuki Kawamura; Shunichi Miyazaki
    INTERNAL MEDICINE 55 10 1261 - 1268 2016年 [査読有り]
     
    Objective Increased left ventricular mass (LVM) and LV fibrosis mass (LVFM) are characteristics of hypertrophic cardiomyopathy (HCM). Additionally, a substantial increase in the plasma B-type natriuretic peptide (BNP) level is observed. Therefore, we investigated the interrelationship and clinical significances of these parameters in a HCM cohort that underwent cardiac MRI (CMR). Methods Patients with HCM (n=109) receiving regular outpatient treatment underwent CMR and follow-up through 2015 from CMR examinations. The clinical outcome measures were all-cause mortality, admission for worsening heart failure, and ventricular tachycardia/fibrillation. Results The baseline body mass index (BMI), LV outflow tract (LVOT) obstruction, New York Heart Association (NYHA) class, and increased left atrial dimension (LAD) index were associated with the plasma BNP level. In the CMR analysis, LVM and LVFM indices significantly correlated with the BNP level (r=0.422 and 0.368, respectively), which were independent determinants according to a multivariate analysis (p=0.009 and 0.023, respectively). A Kaplan-Meier analysis during a median follow-up of 19.4 months showed that the baseline LVM or LVFM index was not associated with the clinical outcomes. However, the baseline BNP level was significantly associated with them (p<0.001). In addition, a multivariate Cox proportional hazard analysis showed that plasma BNP was an independent predictor for the clinical outcomes after adjusting for age, sex, LVM, and LVFM. Conclusion The LVM and LVFM are determinants of the BNP level independent of the BMI, LVOT obstruction, LAD, and NYHA class in patients with HCM. However, plasma BNP may be a more sensitive integrated-marker for the clinical outcomes than LVM or LVFM.

講演・口頭発表等

  • Different clinical significance of prolonged and fragmented QRS in hypertrophic cardiomyopathy  [通常講演]
    中村 貴; 岩永 善高; 宮崎 俊一
    American Heart Association Scientific Sessions 2016 2016年11月 ポスター発表
  • Impact of Elevated Cardiac Troponin And Increased Fibrosis on Clinical Manifestations in Hypertropic Cardiomyopathy  [通常講演]
    中村 貴; 岩永 善高; 宮崎 俊一
    American Heart Association Scientific Sessions 2014 2014年11月 ポスター発表
  • The Onset of Heart Failure is Associated With The Extent of LV Fibrosis in Hypertrophic Cardiomyopathy: Insights From Cardiac Magnetic Resonance Analysis  [通常講演]
    中村 貴; 宮崎 俊一
    American Heart Association Scientific Sessions 2013 2013年11月 Dallas, Texas, USA American Heart Association Scientific Sessions 2013
  • Pathological Mechanism of LV Outflow Obstruction in Hypertrophic Cardiomyopathy : Insights From Cardiac Magnetic Resonance Analysis  [通常講演]
    中村 貴; 宮崎 俊一
    American Heart Association Scientific Sessions 2013 2013年11月 Dallas, Texas, USA American Heart Association Scientific Sessions 2013
  • 左室-右房交通症を認めた高齢者の1例  [通常講演]
    宮地 佑希; 岩永 善高; 中村 貴; 山本 裕美; 宮崎 俊一
    第115回 日本循環器学会近畿地方会 2013年06月 京都市 第115回 日本循環器学会近畿地方会
  • 冠動脈瘤内血栓により心筋梗塞を発症した1例  [通常講演]
    八木 英次郎; 磯野 員理; 河村 尚幸; 渡邉 平太郎; 中村 貴; 上野 雅史; 生田 新一郎; 山本 裕美; 谷口 貢; 岩永 善高; 宮崎 俊一
    第115回 日本循環器学会近畿地方会 2013年06月 京都市 第115回 日本循環器学会近畿地方会
  • 僧房弁閉鎖不全の原因同定に苦慮した1例  [通常講演]
    長束 一紘; 山本 裕美; 河村 尚幸; 中村 貴; 岩永 善高; 宮崎 俊一
    第115回 日本循環器学会近畿地方会 2013年06月 第115回 日本循環器学会近畿地方会
  • 学生・初期研修医セッション 陳旧性心筋梗塞の加療中に完全房室ブロックが出現しMRI・PET-CTにて心サルコイドーシスと診断された1例  [通常講演]
    田中 寛樹; 安田 昌和; 八木 英次郎; 河村 尚幸; 中村 貴; 岩永 善高; 宮崎 俊一
    第114回 日本循環器学会近畿地方会 2012年12月 大阪国際会議場 第114回 日本循環器学会近畿地方会
  • 不安定狭心症で入院して偶然発見された心筋内脂肪腫の一症例  [通常講演]
    渡邉 平太郎; 小夫家 和宏; 宮地 佑希; 磯野 員理; 安田 昌和; 中村 貴; 諸岡 花子; 菅 竜也; 森本 啓介; 岩永 善高; 宮崎 俊一; 小林 直也
    第113回 日本循環器学会近畿地方会 2012年06月 大阪市 第113回 日本循環器学会近畿地方会
  • 完全左脚ブロック患者に生じた急性下壁心筋梗塞:補充調律時のQRS波とT波の興味ある心電図変化に関する考察  [通常講演]
    池田 智之; 谷口 貢; 安岡 良文; 安田 昌和; 中村 貴; 生田 新一郎; 岩永 善高; 栗田 隆志; 宮崎 俊一; 小林 直也
    第113回 日本循環器学会近畿地方会 2012年06月 大阪市 第113回 日本循環器学会近畿地方会
  • SES留置後3年半を経て発症したステント内血栓症に対して、血管内視鏡とOCTでの評価を行えた一症例  [通常講演]
    菅 竜也; 森本 啓介; 生田 新一郎; 植木 博之; 池田 智之; 中村 貴; 小林 直也; 小夫家 和宏; 谷口 貢; 岩永 善高; 宮崎 俊一
    第25回 日本冠疾患学会学術集会 2011年12月 大阪市 第25回 日本冠疾患学会学術集会
  • マムシ咬傷後に心尖部壁運動低下を来した症例  [通常講演]
    安田 昌和; 生田 新一郎; 小林 直也; 池田 智之; 中村 貴; 菅 竜也; 岩永 善高; 谷口 貢; 宮崎 俊一
    第111回 日本循環器学会近畿地方会 2011年11月 京都市 第111回 日本循環器学会近畿地方会
  • LMTが責任病変である3枝病変の急性心筋梗塞に対して、急性期に長期予後を考慮したPCIストラテジーを選択し、慢性期にCABGを施行した症例  [通常講演]
    磯野 員理; 森本 啓介; 宮地 佑希; 池田 智之; 中村 貴; 上野 雅史; 小林 直也; 谷口 貢; 宮崎 俊一
    第17回 日本心血管インターベンション治療学会 近畿地方会 (Japanese Association of Cardiovascular Intervention and Therapeutics 2011年10月 豊中市 第17回 日本心血管インターベンション治療学会 近畿地方会 (Japanese Association of Cardiovascular Intervention and Therapeutics
  • 院外心肺停止蘇生後の著明な低左心機能の急性心筋梗塞にelectrical stormを合併したため、補助循環、低体温療法を施行し救命しえた高齢者の一例  [通常講演]
    宮地 佑希; 森本 啓介; 安田 昌和; 池田 智之; 中村 貴; 小林 直也; 生田 新一郎; 宮崎 俊一
    第56回 日本集中治療医学会近畿地方会 2011年07月 大阪市北区 第56回 日本集中治療医学会近畿地方会

その他のリンク