小宮山　伸之 コミヤマ ノブユキ

研究者基本情報

経歴

• 2002年- 2003年千葉大学 医学部附属病院 講師

所属学協会

日本脈管学会

委員歴

• 1999年日本脈管学会 評議員

研究活動情報

研究分野

• ライフサイエンス / 循環器内科学

研究キーワード

アンジオテンシン受容体拮抗剤 , vulnerable plaque , スタチン , カルシウム拮抗剤 , integrated backscatter , アンジオテンシンII受容体阻害剤 , LDLコレステロール

書籍等出版物

• 冠動脈血栓吸引、末梢保護
  循環器疾患最新の治療2012-2013 2012年05月
• 糖尿病におけるプラーク退縮と心血管事故の関連
  『PCIのストラテジー』、南江堂 2011年02月
• 硝酸薬／他の血管拡張薬
  循環器治療薬ファーストブック。南江堂 2010年04月
• 虚血性心疾患
  循環器治療薬ファーストブック。南江堂 2010年04月
• 冠動脈血栓溶解療法
  循環器疾患最新の治療 2010-2011。南江堂 2010年03月
• 狭心症、心筋梗塞
  内科確定診断 完全マスター。齋藤宣彦 編。メディカルビュー社 2009年05月
• 画像診断に必要な臨床的基礎知識。
  見て診て学ぶ 虚血性心疾患の画像診断、永井書店 2009年04月
• 急性心筋梗塞
  腹痛診療ナビ 2008年06月
• 大動脈解離
  腹痛診療ナビ 2008年06月
• 心タンポナーデ
  循環器症候群（第2版）II（日本臨牀 別冊） 2007年11月
• X線CT・MRI
  内科学。朝倉書店 2007年10月
• 成人の先天性心疾患の治療と看護
  心臓病の治療と看護、南江堂 2006年10月
• CABG後グラフトの経年変化とgraft diseaseの特徴
  IVUSマニュアル、中山書店 2006年09月
• IVUS elastographyで何がわかるか―その原理と限界
  冠動脈疾患のNew Concept。冠動脈疾患プロフェッション７、中山書店 2006年08月
• RF解析 attenuation-slope
  IVUSマニュアル、中山書店 2006年08月
• 循環器疾患による胸痛診断のための検査法とその所見
  胸痛診療のコツと落とし穴、中山書店 2005年06月
• 循環器疾患による胸痛の診断ポイント－病歴および理学的所見から
  胸痛診療のコツと落とし穴、中山書店 2005年06月
• 冠動脈バイパス術後造影で何がわかるか
  新・心臓病診療プラクティス４、文光堂 2005年05月
• 狭心症治療の秘訣について考えること
  循環器診療二頁の秘訣、金原出版 2004年08月
• BCAPS
  DATA UPDATE 循環系、先端医学社 2004年07月
• 胸部X線
  講義録 循環器学、メジカルビュー社 2004年05月
• 心臓カテーテル
  講義録 循環器学、メジカルビュー社 2004年05月

講演・口頭発表等

• CLIに対するチーム医療における血行再建術の適応決定
  第5回日本下肢救済・足病学会学術集会 2013年
• Hancock弁で三尖弁置換術を行い30年後に弁機能不全となり再手術をした一例
  第219回日本循環器学会関東甲信越地方会 2011年
• CTにて偏心性粥腫の炎症・破綻・偽性瘤化の短期間の経過を観察できた腹部大動脈瘤の一治験例
  第218回日本循環器学会関東甲信越地方会 2010年
• The latest outcome of patients with decompensated dilated cardiomyopathy (DCM) after discharged from our hospital, Saitama Medical University
  第14回日本心不全学会学術集会 2010年
• ST上昇型心筋梗塞患者における急性期心臓リハビリテーション期間中の炎症と血栓塞栓症に関するバイオマーカーの経時的変化
  第58回日本心臓病学会学術集会 2010年
• 心室再同期療法（CRT）患者における年齢と左室リードの位置が左室リバースリモデリングに与える影響
  第58回日本心臓病学会学術集会 2010年
• 左冠動脈前下行枝の閉塞による心筋梗塞を合併した若年性バージャー病の2症例
  第215回日本循環器学会関東甲信越地方会 2010年
• 感染性心内膜炎に続発した左室仮性瘤の2例
  第70回心臓血管放射線研究会 2010年
• Impact of pioglitazone on coronary atherosclerosis in patients with non- and early-diabetes: A prospective randomized study with intravascular ultrasound
  The 59th annual scientific session, American college of Cardiology 2010年
• Kato,R., Matsumoto,K., Hara,M., Tobiume,T., Ishida,H., Uenishi,M., Hotta,Y., Matsumura,M., Komiyama,N. and Nishimura,S
  第74回日本循環器学会学術集会 2010年
• Experience of Waon therapy to the severe heart failure in our hospital.
  第14回日本心不全学会学術集会 2010年
• 複数の波形を呈したプルキンエ起源心室頻拍の１例
  第217回日本循環器学会関東甲信越地方会 2010年
• Evaluation of cardiac function for the patients with atrial fibrillation – Comparison between the paroxysmal and persistent atrial fibrillation
  第74回日本循環器学会学術集会 2010年
• 虫垂癌の術後経過中に発見された右冠動脈周囲腫瘍と右房内Epithelioid hemangiomaの1例
  第215回日本循環器学会関東甲信越地方会 2010年
• CRT植え込み後もカテコラミン依存の高度心不全に対し和温療法が有効であった１例
  第58回日本心臓病学会学術集会 2010年
• CARTO mapでactivation mapを確認しえたLSPV内リエントリーの1例
  第215回日本循環器学会関東甲信越地方会 2010年
• 初期糖尿病患者の冠動脈硬化病変におけるピオグリタゾンの血管反応に対する効果について：血管内超音波による前向き無作為化比較試験
  第57回日本心臓病学会学術集会 2009年
• くも膜下出血を合併した急性上行大動脈解離の１例
  第212回日本循環器学会関東甲信越地方会 2009年
• Benefit of thrombus aspiration for myocardial infarction with ST-segment elevation: Analysis by biomarkers of thrombosis and inflammation
  Scientific Sessions 2009 of American Heart Association 2009年
• MDCTによる軽度～中等度狭窄病変と負荷心筋シンチグラフィによる虚血診断
  第57回日本心臓病学会学術集会 2009年
• Cost effect of fractional flow reserve measurement by pressure wire with diagnostic catheters.
  第18回日本心血管インターベンション治療学会 CVIT2009学術集会 2009年
• 心房中隔欠損により奇異性塞栓を起こし急性心筋梗塞を発症した若年男性の１例
  第214回日本循環器学会関東甲信越地方会 2009年
• Intravascular ultrasound assessment of drug eluting stent expansion for in-stent restenosis comparing to manufacturers compliance charts.
  第18回日本心血管インターベンション治療学会 CVIT2009学術集会 2009年
• 心電図上、陰性U波のみを認めた不安定狭心症の１例
  第211回日本循環器学会 関東甲信越地方会 2009年
• 冠動脈用ステントグラフトにより閉鎖しえた巨大腹腔動脈瘤の１例
  第213回日本循環器学会関東甲信越地方会 2009年
• Exercise tolerance and hemoglobin A1c during cardiac rehabilitation after acute myocardial infarction: Impact of gender.
  17th Asian Pacific Congress of Cardiology 2009年
• Impact of pioglitazone on serum lipid-profile and coronary plaque volume in patients with non- and early-diabetes: A prospective randomized IVUS study
  第73回日本循環器学会学術集会 2009年
• Behavior of biomarkers linking inflammation and thrombosis in the infarct-related coronary artery and systemic circulation after primary percutaneous coronary intervention for the treatment of ST-segment elevation myocardial infarction.
  The 59th annual scientific session, American college of Cardiology 2009年
• 冠動脈バイパス術周術期の難治性冠動脈スパスムに対して塩酸ファスジルが著効した一例
  第33回日本心血管インターベンション学会 関東甲信越地方会 2008年
• 当院における成人心房中隔欠損症に対する経皮的中隔閉鎖デバイス（Amplazer）の有効性と短期治療成績について
  第56回日本心臓病学会学術集会 2008年
• 通常CRP値正常例における高感度CRP値とLDLコレステロール値およびHDLコレステロール値との関係－一般健診受診者における検討
  第40回日本動脈硬化学会総会・学術集会 2008年
• ST上昇型心筋梗塞の梗塞責任冠動脈に対するコバルトクロムステントの治療成績
  第56回日本心臓病学会学術集会 2008年
• Intravscular ultrasound assessment of drug eluting stent expansion for the treatment of in-stent restenosis: Comparing to manufacturer’s compliance charts
  第72回日本循環器学会学術集会 2008年
• Initial experience of SPECT-CT in our hospital: Comparison with conventional SPECT
  第72回日本循環器学会学術集会 2008年
• 健診におけるＬＤＬコレステロールとＨＤＬコレステロールの測定意義について～高感度ＣＲＰ値との関係からの再考察～
  第36回日本総合健診学会 2008年
• 健診における携帯心電計使用の有効性の検討
  第36回日本総合健診学会 2008年
• 閉塞性血栓性血管炎に左前下行枝の完全閉塞による心筋梗塞を合併した一例。
  第49回日本脈管学会総会 2008年
• Ischemic preconditioning increases myocardial salvage evaluated by cardiac magnetic resonance in patients with acute myocardial infarction who underwent revascularization
  第72回日本循環器学会学術集会 2008年
• 心筋梗塞患者でのsalvageした心筋と先行する虚血症状との関連の調査
  第18回日本心血管画像動態学会 2008年
• 多枝冠動脈解離を発症した１例
  第208回日本循環器学会関東甲信越地方会 2008年
• Very late sirolimus-eluting stent thrombosis beyond 4 years after implantation.
  第18回日本心血管インターベンション治療学会 CVIT2009学術集会 2006年

作品

• 座談会 長期予後改善を目指す冠動脈疾患の治療戦略（内科）
   2007年10月
  URL:https://researchmap.jp/5380/works/24427596?lang=ja
• 厚生労働科学研究費補助 循環器病等総合研究事業「冠動脈不安定粥腫の同定とその効果的破綻予防、治療法の開発に関する多施設研究」
   2004年04月 - 2007年03月
  URL:https://researchmap.jp/5380/works/24427597?lang=ja

MISC

• 不安定プラークの血管内超音波所見と安定化
  月刊循環器CIRCULATION（医学出版） 3(1) 54-63 2013年01月
• Azelnidipine and Amlodipine Anti-Coronary Atherosclerosis Trial in Hypertensive Patients Undergoing Coronary Intervention by Serial Volumetric Intravascular Ultrasound Analysis in Juntendo University (ALPS-J)
  Takahiko Kojima, Katsumi Miyauchi, Takayuki Yokoyama, Ken Yokoyama, Takeshi Kurata, Satoru Suwa, Masaki Kawamura, Hiroshi Tamura, Shinya Okazaki, Kenji Inoue, Yasumasa Fujiwara, Masataka Sumiyoshi, Kosei Tanimoto, Yuji Nakazato, Shinichiro Yamagami, Takafumi Hiro, Nobuyuki Komiyama, Hiroyuki Daida
  CIRCULATION JOURNAL 75(5) 1071-1079 2011年05月
  DOI:10.1253/circj.CJ-11-0141
  Background: A previous study reported that amlodipine retarded coronary plaque progression in patients with coronary artery disease. The goal of this multicenter study was to determine which calcium-channel blockers (CCBs) other than amlodipine attenuated the progression of plaque volume (PV) accessed by intravascular ultrasound (IVUS). Methods and Results: ALPS-J was a prospective, randomized open-label study conducted at 5 centers. Patients who had hypertension and were scheduled for coronary intervention were enrolled. Subjects were randomly assigned to receive 16 mg/day of azelnidipine or 5 mg/day of amlodipine administered for 48 weeks. The primary endpoint was the percent change in coronary PV measured by IVUS. Between 2007 and 2009, 199 patients were enrolled; 115 had evaluable IVUS images at both baseline and after 48 weeks of treatment. Blood pressure significantly reduced to 128/68 mmHg at follow-up. The lipid profiles in the 2 groups were comparable (low-density lipoprotein cholesterol: 97 mg/di). The %change in PV showed a significant regression of -4.67 and -4.85% in the azelnidipine and amlodipine groups, respectively. The upper limit of the 95% confidence interval of the mean difference in %change PV between the 2 groups (0.18%, 95% confidence interval -4.62 to 4.98%) did not exceed the pre-defined non-inferiority margin of 6.525%. Conclusions: ALPS-J demonstrated that azelnidipine was not inferior to amlodipine for primary efficacy. In addition to standard medical therapy, dihydropyridine CCBs will retard PV progression in hypertensive patients. (Circ J 2011;75: 1071-1079)
• Azelnidipine and Amlodipine Anti-Coronary Atherosclerosis Trial in Hypertensive Patients Undergoing Coronary Intervention by Serial Volumetric Intravascular Ultrasound Analysis in Juntendo University (ALPS-J)
  Takahiko Kojima, Katsumi Miyauchi, Takayuki Yokoyama, Ken Yokoyama, Takeshi Kurata, Satoru Suwa, Masaki Kawamura, Hiroshi Tamura, Shinya Okazaki, Kenji Inoue, Yasumasa Fujiwara, Masataka Sumiyoshi, Kosei Tanimoto, Yuji Nakazato, Shinichiro Yamagami, Takafumi Hiro, Nobuyuki Komiyama, Hiroyuki Daida
  CIRCULATION JOURNAL 75(5) 1071-1079 2011年05月
  DOI:10.1253/circj.CJ-11-0141
  Background: A previous study reported that amlodipine retarded coronary plaque progression in patients with coronary artery disease. The goal of this multicenter study was to determine which calcium-channel blockers (CCBs) other than amlodipine attenuated the progression of plaque volume (PV) accessed by intravascular ultrasound (IVUS). Methods and Results: ALPS-J was a prospective, randomized open-label study conducted at 5 centers. Patients who had hypertension and were scheduled for coronary intervention were enrolled. Subjects were randomly assigned to receive 16 mg/day of azelnidipine or 5 mg/day of amlodipine administered for 48 weeks. The primary endpoint was the percent change in coronary PV measured by IVUS. Between 2007 and 2009, 199 patients were enrolled; 115 had evaluable IVUS images at both baseline and after 48 weeks of treatment. Blood pressure significantly reduced to 128/68 mmHg at follow-up. The lipid profiles in the 2 groups were comparable (low-density lipoprotein cholesterol: 97 mg/di). The %change in PV showed a significant regression of -4.67 and -4.85% in the azelnidipine and amlodipine groups, respectively. The upper limit of the 95% confidence interval of the mean difference in %change PV between the 2 groups (0.18%, 95% confidence interval -4.62 to 4.98%) did not exceed the pre-defined non-inferiority margin of 6.525%. Conclusions: ALPS-J demonstrated that azelnidipine was not inferior to amlodipine for primary efficacy. In addition to standard medical therapy, dihydropyridine CCBs will retard PV progression in hypertensive patients. (Circ J 2011;75: 1071-1079)
• Clinical trial PIGEON-MS
  CIRCULATION up-to-date 6(1) 74-77 2011年01月
• Clinical trial PIGEON-MS
   6(1) 74-77 2011年01月
• 書評。『チャートでわかる実践IVUS, OCT & FFR』
  内科 106(7) 102 2010年07月
• PCIにIVUSは本当に必要か？ Grey-scale IVUSはPCIに必要か？
  Coronary Intervention 6(3) 140-146 2010年03月
• この症例をどう治療するか？：多枝病変
  CIRCULATION up-to-date 5(3) 25-29 2010年03月
• 血管内エコーによりなにがわかるか
  レジデント 3(2) 43*47 2010年02月
• Pioglitazone induces regression of coronary atherosclerotic plaques in patients with type 2 diabetes mellitus or impaired glucose tolerance: A randomized prospective study using intravascular ultrasound
  Takashi Nakayama, Nobuyuki Komiyama, Masaki Yokoyama, Susumu Namikawa, Nakabumi Kuroda, Yoshio Kobayashi, Issei Komuro
  INTERNATIONAL JOURNAL OF CARDIOLOGY 138(2) 157-165 2010年01月
  DOI:10.1016/j.ijcard.2008.08.031
  Background: A large clinical trial clarified that pioglitazone reduces cardiovascular events in diabetic patients. However, effects of pioglitazone on structure of coronary atherosclerotic plaques have not been demonstrated. We examined whether pioglitazone reduces volumes of coronary atherosclerotic plaques using intravascular ultrasound (IVUS). Methods: Twenty-six consecutive patients with type 2 diabetes mellitus (DM) or impaired glucose tolerance (IGT) undergoing percutaneous coronary intervention (PCI) were enrolled. Echolucent plaques without significant stenosis were selected in IVUS video images at non-PCI-influenced coronary segments and volumetric analysis of the targeted plaques was performed. The patients were randomly assigned into 2 groups: pioglitazone group consisted of 13 patients taking pioglitazone 15 mg/day for initial 14 days after PCI and subsequent 30 mg/day during 6-month follow-up, and control group with 13 patients as control. The plaque volumes and some parameters such as plasma lipid profiles and high-sensitive C-reacting protein (hs-CRP) levels were compared between baseline and the follow-up in those groups. Results: In the pioglitazone group after 6 months, the plaque volume was significantly reduced (101.3 +/- 32.1 to 94.6 +/- 33.6 mm(3), -7.2%; p=0.0023), plasma triglyceride was significantly decreased (-14.9%) and high density lipoprotein cholesterol was substantially increased (+20.0%) without any significant change in low density lipoprotein cholesterol (LDL-C). Also, hs-CRP level tended to be decreased. However, no significant change in plaque volumes and those parameters was observed in the control group. Conclusions: Pioglitazone may induce regression of coronary atherosclerotic plaques without LDL-C reduction in patients with DM and IGT. (C) 2008 Elsevier Ireland Ltd. All rights reserved.
• Pioglitazone induces regression of coronary atherosclerotic plaques in patients with type 2 diabetes mellitus or impaired glucose tolerance: A randomized prospective study using intravascular ultrasound
  Takashi Nakayama, Nobuyuki Komiyama, Masaki Yokoyama, Susumu Namikawa, Nakabumi Kuroda, Yoshio Kobayashi, Issei Komuro
  INTERNATIONAL JOURNAL OF CARDIOLOGY 138(2) 157-165 2010年01月
  DOI:10.1016/j.ijcard.2008.08.031
  Background: A large clinical trial clarified that pioglitazone reduces cardiovascular events in diabetic patients. However, effects of pioglitazone on structure of coronary atherosclerotic plaques have not been demonstrated. We examined whether pioglitazone reduces volumes of coronary atherosclerotic plaques using intravascular ultrasound (IVUS). Methods: Twenty-six consecutive patients with type 2 diabetes mellitus (DM) or impaired glucose tolerance (IGT) undergoing percutaneous coronary intervention (PCI) were enrolled. Echolucent plaques without significant stenosis were selected in IVUS video images at non-PCI-influenced coronary segments and volumetric analysis of the targeted plaques was performed. The patients were randomly assigned into 2 groups: pioglitazone group consisted of 13 patients taking pioglitazone 15 mg/day for initial 14 days after PCI and subsequent 30 mg/day during 6-month follow-up, and control group with 13 patients as control. The plaque volumes and some parameters such as plasma lipid profiles and high-sensitive C-reacting protein (hs-CRP) levels were compared between baseline and the follow-up in those groups. Results: In the pioglitazone group after 6 months, the plaque volume was significantly reduced (101.3 +/- 32.1 to 94.6 +/- 33.6 mm(3), -7.2%; p=0.0023), plasma triglyceride was significantly decreased (-14.9%) and high density lipoprotein cholesterol was substantially increased (+20.0%) without any significant change in low density lipoprotein cholesterol (LDL-C). Also, hs-CRP level tended to be decreased. However, no significant change in plaque volumes and those parameters was observed in the control group. Conclusions: Pioglitazone may induce regression of coronary atherosclerotic plaques without LDL-C reduction in patients with DM and IGT. (C) 2008 Elsevier Ireland Ltd. All rights reserved.
• Pioglitazone induces regression of coronary atherosclerotic plaques in patients with type 2 diabetes mellitus or impaired glucose tolerance: A randomized prospective study using intravascular ultrasound
  Takashi Nakayama, Nobuyuki Komiyama, Masaki Yokoyama, Susumu Namikawa, Nakabumi Kuroda, Yoshio Kobayashi, Issei Komuro
  INTERNATIONAL JOURNAL OF CARDIOLOGY 138(2) 157-165 2010年01月
  DOI:10.1016/j.ijcard.2008.08.031
  Background: A large clinical trial clarified that pioglitazone reduces cardiovascular events in diabetic patients. However, effects of pioglitazone on structure of coronary atherosclerotic plaques have not been demonstrated. We examined whether pioglitazone reduces volumes of coronary atherosclerotic plaques using intravascular ultrasound (IVUS). Methods: Twenty-six consecutive patients with type 2 diabetes mellitus (DM) or impaired glucose tolerance (IGT) undergoing percutaneous coronary intervention (PCI) were enrolled. Echolucent plaques without significant stenosis were selected in IVUS video images at non-PCI-influenced coronary segments and volumetric analysis of the targeted plaques was performed. The patients were randomly assigned into 2 groups: pioglitazone group consisted of 13 patients taking pioglitazone 15 mg/day for initial 14 days after PCI and subsequent 30 mg/day during 6-month follow-up, and control group with 13 patients as control. The plaque volumes and some parameters such as plasma lipid profiles and high-sensitive C-reacting protein (hs-CRP) levels were compared between baseline and the follow-up in those groups. Results: In the pioglitazone group after 6 months, the plaque volume was significantly reduced (101.3 +/- 32.1 to 94.6 +/- 33.6 mm(3), -7.2%; p=0.0023), plasma triglyceride was significantly decreased (-14.9%) and high density lipoprotein cholesterol was substantially increased (+20.0%) without any significant change in low density lipoprotein cholesterol (LDL-C). Also, hs-CRP level tended to be decreased. However, no significant change in plaque volumes and those parameters was observed in the control group. Conclusions: Pioglitazone may induce regression of coronary atherosclerotic plaques without LDL-C reduction in patients with DM and IGT. (C) 2008 Elsevier Ireland Ltd. All rights reserved.
• Balance between interleukin-1β and interleukin-1 receptor antagonist in the development of atherosclerosis - A polymorphism in the interleukin-1 receptor antagonist
  Shinichiro Iida, Nobuyuki Komiyama
  Circulation Journal 73(8) 1401-1402 2009年08月
  DOI:10.1253/circj.CJ-09-0425
• Editorial. Balance between interleukin-1β and interleukin-1 receptor antagonist in the development of atherosclerosis. A polymorphism in the interleukin-1 receptor antagonist.
   73(8) 1401-1402 2009年08月
  DOI:10.1253/circj.CJ-09-0425
• Angioの臨床における位置づけ
  インナービジョン 24(5) 58-60 2009年04月
• Angio
   24(5) 58-60 2009年04月
• Editorial. Statin-induced structural changes in coronary plaques evaluated by intracoronary imaging
   73 628-629 2009年04月
  DOI:10.1253/circj.CJ-09-0067
• Editorial. Statin-induced structural changes in coronary plaques evaluated by intracoronary imaging
  Circ J 73 628-629 2009年04月
  DOI:10.1253/circj.CJ-09-0067
• 糖尿病合併例。Stent status 2009
  Coronary Intervention 5(1) 71-76 2009年03月
• 後藤論文に対するEditorial Comment
  心臓 41(3) 332-333 2009年03月
• PCI
   5(1) 71-76 2009年03月
• Editorial Comment
   41(3) 332-333 2009年03月
• PCI（バイパス術、薬物療法と対比しながら）。心筋梗塞・狭心症の二次予防
  Mebio 26(2) 92 2009年01月
• Pioglitazone induces regression of coronary atherosclerotic plaques in patients with type 2 diabetes mellitus or impaired glucose tolerance: A randomized prospective study using intravascular ultrasound
  Int J Cardiol 2008年10月
  DOI:10.1016/j.ijcard.2008.08.031
• Pioglitazone induces regression of coronary atherosclerotic plaques in patients with type 2 diabetes mellitus or impaired glucose tolerance: A randomized prospective study using intravascular ultrasound
  Int J Cardiol 2008; doi:10.1016/j.ijcard.2008.08.031 2008年08月
• ピオグリタゾンは糖尿病症例の冠動脈プラークを退縮させる
   2008年08月
• Debulking PCI (DCA、ロータブレータ)
  循環器疾患最新の治療 2008-2009。南江堂 2008年05月
• R-R間隔が異常な心電図モニター
  ハートナーシング 21(5) 64 2008年03月
• Feasibility and safety of granulocyte colony-stimulating factor treatment in patients with acute myocardial infarction
  Hiroyuki Takano, Hiroshi Hasegawa, Yoichi Kuwabara, Takashi Nakayama, Koki Matsuno, Yoshiya Miyazaki, Masashi Yamamoto, Yoshihide Fujimoto, Hisayuki Okada, Shinji Okubo, Miwa Fujita, Satoshi Shindo, Yoshio Kobayashi, Nobuyuki Komiyama, Noboru Takekoshi, Kamon Imai, Toshiharu Himi, Iwao Ishibashi, Issei Komuro
  INTERNATIONAL JOURNAL OF CARDIOLOGY 122(1) 41-47 2007年10月
  DOI:10.1016/j.ijcard.2006.11.016
  Background: This study examined feasibility and safety of granulocyte colony- stimulating factor ( G- CSF) treatment for patients with acute myocardial infarction ( AMI). Methods: Forty patients with AMI related with the left anterior descending coronary artery, who underwent successful percutaneous coronary intervention ( PCI), were randomized into G- CSF group ( n= 18) or Control group ( n= 22). G- CSF treatment was started within 24 h after PCI. Tc-99m- tetrofosmin single- photon emission computed tomography ( SPECT) was performed at 4 days and 6 months after AMI. SPECT data was analyzed for LV end- diastolic volume ( LVEDV), LV end- systolic volume ( LVESV), LV ejection fraction ( LVEF) and myocardial perfusion. Results: LVEF at 6 months was significantly better than that at 4 days in G- CSF group ( p= 0.013), but not changed in Control group ( p= 0.245). Although no significant difference was observed for LVEDV between the two groups, LVESV tended to be decreased only in G-CSF group. In G- CSF group, defect score ( DS) was significantly decreased from 4 days to 6 months after AMI. Restenosis rate at 6 months after AMI was not significantly different between the two groups. Conclusions: G- CSF treatment for patients with AMI was effective and did not have any clinical and angiographic adverse effects. (C) 2006 Elsevier Ireland Ltd. All rights reserved.
• Sternum fracture and haemorrhage after cardiopulmonary resuscitation
  Yurika Hotta, Tomomi Koizumi, Jiro Kawanami, Atsushi Sakamoto, Nobuyuki Komiyama, Shigeyuki Nishimura
  RESUSCITATION 74(3) 401-402 2007年09月
  DOI:10.1016/j.resuscitation.2007.04.003
• Sternum fracture and haemorrhage after cardiopulmonary resuscitation
  Yurika Hotta, Tomomi Koizumi, Jiro Kawanami, Atsushi Sakamoto, Nobuyuki Komiyama, Shigeyuki Nishimura
  RESUSCITATION 74(3) 401-402 2007年09月
  DOI:10.1016/j.resuscitation.2007.04.003
• 慢性冠動脈疾患の長期予後改善のために
  心臓 39(8) 697 2007年08月
• 座談会 長期予後改善を目指す冠動脈疾患の治療戦略
  内科 100(3) 537-548 2007年08月
• 高橋論文に対するEditorial Comment.
  心臓 39(5) 454-455 2007年05月
• 不安定狭心症。循環器病の救急診療マニュアル
  CIRCULATION up-to-date 2 171-180 2007年02月
• Cardiac resurrection after bone-marrow-derived mononuclear cell transplantation during left ventricular assist device support
  Satoshi Gojo, Shunei Kyo, Shigeyuki Nishimura, Nobuyuki Komiyama, Nobutaka Kawai, Masami Bessho, Hiroshige Sato, Toshihisa Asakura, Motonobu Nishimura, Kenji Ikebuchi
  ANNALS OF THORACIC SURGERY 83(2) 661-662 2007年02月
  DOI:10.1016/j.athoracsur.2006.06.074
  We describe a novel therapy of mononuclear cell transplantation combined with a left ventricular assist device (LVAD) for severe ischemic heart failure. Significant myocardial recovery by the LVAD rarely occurs in the severely failing heart. We undertook successful mononuclear cell transplantation in a patient who sustained an acute myocardial infarction that had resulted in the LVAD therapy. The heart regained good function after cell transplantation, and the LVAD was explanted 6 weeks later. These results suggest that this novel therapy could be an alternative to cardiac transplantation for severe ischemic heart failure.
• Cardiac resurrection after bone-marrow-derived mononuclear cell transplantation during left ventricular assist device support
  Satoshi Gojo, Shunei Kyo, Shigeyuki Nishimura, Nobuyuki Komiyama, Nobutaka Kawai, Masami Bessho, Hiroshige Sato, Toshihisa Asakura, Motonobu Nishimura, Kenji Ikebuchi
  ANNALS OF THORACIC SURGERY 83(2) 661-662 2007年02月
  DOI:10.1016/j.athoracsur.2006.06.074
  We describe a novel therapy of mononuclear cell transplantation combined with a left ventricular assist device (LVAD) for severe ischemic heart failure. Significant myocardial recovery by the LVAD rarely occurs in the severely failing heart. We undertook successful mononuclear cell transplantation in a patient who sustained an acute myocardial infarction that had resulted in the LVAD therapy. The heart regained good function after cell transplantation, and the LVAD was explanted 6 weeks later. These results suggest that this novel therapy could be an alternative to cardiac transplantation for severe ischemic heart failure.
• ACS治療にDESは妥当か。IVUS所見から
  Coronary Intervention 3(1) 26-31 2007年01月
• 静脈グラフト。PCI治療のためのKey words
  Heart View 10 206-207 2006年11月
• Retrospective ECG-gated left ventriculography using multislice CT following left ventricular bolus injection and evaluation of its utility and motion artifact at every cardiac phase
  Nobusada Funabashi, Nobuyuki Komiyama, Hideyuki Kato, Hideo Umekita, Miki Asano, Issei Komuro
  International Journal of Cardiology 113(1) 132-138 2006年10月
  DOI:10.1016/j.ijcard.2005.08.044
  Following left ventricular bolus injection of contrast material, multislice CT scanning was performed. With retrospective ECG-gated reconstruction, we could acquire volume data for the heart at any cardiac phase and selectively depict only the left ventricle and aorta with maximum intensity projection. Temporal resolution of multislice CT was not sufficient to eliminate motion artifact except just before atrial contraction periods. © 2005 Elsevier Ireland Ltd. All rights reserved.
• Retrospective ECG-gated left ventriculography using multislice CT following left ventricular bolus injection and evaluation of its utility and motion artifact at every cardiac phase
  Nobusada Funabashi, Nobuyuki Komiyama, Hideyuki Kato, Hideo Umekita, Miki Asano, Issei Komuro
  International Journal of Cardiology 113(1) 132-138 2006年10月
  DOI:10.1016/j.ijcard.2005.08.044
  Following left ventricular bolus injection of contrast material, multislice CT scanning was performed. With retrospective ECG-gated reconstruction, we could acquire volume data for the heart at any cardiac phase and selectively depict only the left ventricle and aorta with maximum intensity projection. Temporal resolution of multislice CT was not sufficient to eliminate motion artifact except just before atrial contraction periods. © 2005 Elsevier Ireland Ltd. All rights reserved.
• 再狭窄はどのような治療をすればよいですか？ Q＆Aからはじめよう冠動脈疾患マスターブック
  HEART nursing 255 243-250 2006年10月
• 血管内超音波―組織性状診断を目的として― 冠動脈病変―基礎から臨床へ―
  Medical Practice 23(10) 1733-1738 2006年10月
• 薬剤師のための臨床講座 虚血性心疾患
  Pharmavision 10(10) 2-8 2006年10月
• 血管内超音波イメージング。冠動脈イメージングの臨床応用をめぐるトピックス
  メディカル・ビュー・ポイント（MVP） 27(10) 1-2 2006年09月
• Feasibility and safety of granulocyte colony-stimulating factor treatment in patients with acute myocardial infarction
   2006年08月
• IVUSの使い方。ACS。
  TOPIC 2006 Syllabus 94-97 2006年07月
• 心タンポナーデ。循環管理Q＆A
  救急・集中治療 17 205-209 2006年06月
• ＩＶＵＳでみる不安定プラーク
  臨床医のための循環器診療(5) 50-53 2006年05月
• 冠動脈イメージングの新技術。Attenuation-slope.
  Heart View 10(3) 336-339 2006年03月
• Stent deformity caused by coronary artery spasm
  Toshihiko Yoshida, Yoshio Kobayashi, Takashi Nakayama, Nakabumi Kuroda, Nobuyuki Komiyama, Issei Komuro
  Circulation Journal 70(6) 800-801 2006年
  DOI:10.1253/circj.70.800
  Previous studies have shown that coronary stents have radial strength above the pressure induced by coronary artery spasm. This case report describes a stent deformity caused by coronary artery spasm during percutaneous coronary intervention.
• Valsartan cardio-renal protection in patients undergoing coronary angiography complicated with chronic renal insufficiency (VAL-CARP) trial: Rationale and design
  Naofumi Ikeda, Shigeyuki Nishimura, Shunei Kyo, Nobuyuki Komiyama, Kazuo Matsumoto, Tsutomu Inoue, Hiromichi Suzuki
  Circulation Journal 70(5) 548-552 2006年
  DOI:10.1253/circj.70.548
  Background: Despite an increase in the frequency of coronary angiography (CAG) in Japan, the exact incidence of contrast-induced nephropathy (CIN) remains unknown in the Japanese population, especially in patients with chronic renal insufficiency. In addition, the nature of pharmacological interventions that would benefit the patients before or after procedures such as coronary bypass graft (CABG) and percutaneous coronary intervention (PCI) has not been fully investigated. Methods: In the trial 500 patients with renal insufficiency (defined as a glomerular filtration rate (GFR) of between 89 and 30 ml·min-1·(1.73 m-2) following CAG will be randomly assigned to receive either valsartan, an angiotensin receptor blocker or angiotensin converting enzyme (ACE) inhibitor plus valsartan.1 The primary end-point is a change in the GFR of patients, which will be followed up for 3 years, including following CABG surgery or PCI. The incidence of cardiac events as well as the adverse effects of pharmacological intervention will be evaluated. In addition, the incidence of renal artery stenosis at the time of CAG will be reported also however, the patients with renal artery stenosis will be excluded from the present study. Conclusion: The present study will provide data on: 1) the exact incidence and course of renal function of CIN after CAG and 2) the comparative therapeutic benefit of pharmacological intervention with valsartan alone or with valsartan and an ACE inhibitor in combination in patients with coexisting coronary artery diseases and chronic renal insufficiency, regardless of whether they receive CABG or PCI. In addition to these studies, an estimate of the incidence of renal artery stenosis in these patients will be demonstrated.
• Stent deformity caused by coronary artery spasm
  Toshihiko Yoshida, Yoshio Kobayashi, Takashi Nakayama, Nakabumi Kuroda, Nobuyuki Komiyama, Issei Komuro
  Circulation Journal 70(6) 800-801 2006年
  DOI:10.1253/circj.70.800
  Previous studies have shown that coronary stents have radial strength above the pressure induced by coronary artery spasm. This case report describes a stent deformity caused by coronary artery spasm during percutaneous coronary intervention.
• Valsartan cardio-renal protection in patients undergoing coronary angiography complicated with chronic renal insufficiency (VAL-CARP) trial: Rationale and design
  Naofumi Ikeda, Shigeyuki Nishimura, Shunei Kyo, Nobuyuki Komiyama, Kazuo Matsumoto, Tsutomu Inoue, Hiromichi Suzuki
  Circulation Journal 70(5) 548-552 2006年
  DOI:10.1253/circj.70.548
  Background: Despite an increase in the frequency of coronary angiography (CAG) in Japan, the exact incidence of contrast-induced nephropathy (CIN) remains unknown in the Japanese population, especially in patients with chronic renal insufficiency. In addition, the nature of pharmacological interventions that would benefit the patients before or after procedures such as coronary bypass graft (CABG) and percutaneous coronary intervention (PCI) has not been fully investigated. Methods: In the trial 500 patients with renal insufficiency (defined as a glomerular filtration rate (GFR) of between 89 and 30 ml·min-1·(1.73 m-2) following CAG will be randomly assigned to receive either valsartan, an angiotensin receptor blocker or angiotensin converting enzyme (ACE) inhibitor plus valsartan.1 The primary end-point is a change in the GFR of patients, which will be followed up for 3 years, including following CABG surgery or PCI. The incidence of cardiac events as well as the adverse effects of pharmacological intervention will be evaluated. In addition, the incidence of renal artery stenosis at the time of CAG will be reported also however, the patients with renal artery stenosis will be excluded from the present study. Conclusion: The present study will provide data on: 1) the exact incidence and course of renal function of CIN after CAG and 2) the comparative therapeutic benefit of pharmacological intervention with valsartan alone or with valsartan and an ACE inhibitor in combination in patients with coexisting coronary artery diseases and chronic renal insufficiency, regardless of whether they receive CABG or PCI. In addition to these studies, an estimate of the incidence of renal artery stenosis in these patients will be demonstrated.
• クリニカル・クイズ 循環器疾患
  Japan Clipping Today 8-10 2005年10月
• どのようなプロセスで難治性心不全に陥るか 虚血性心筋症
  Heart View 47-52 2005年10月
• Plasma low-density lipoprotein reduction and structural effects on coronary atherosclerotic plaques by atorvastatin as clinically assessed with intravascular ultrasound radio-frequency signal analysis: A randomized prospective study
  M Yokoyama, N Komiyama, BK Courtney, T Nakayama, S Namikawa, N Kuriyama, T Kuizumi, M Nameki, PJ Fitzgerald, Komuro, I
  AMERICAN HEART JOURNAL 150(2) 287e1-287e7 2005年08月
  DOI:10.1016/j.ahj.2005.03.059
  Background Plaque stabilization by statins is important for reduction of cardiovascular events but has not been demonstrated enough in vivo. We examined whether statins clinically alter the structure of coronary atherosclerotic plaques using intravascular ultrasound (IVUS) radio-frequency (RF) signal analysis. Methods Fifty consecutive patients undergoing percutaneous coronary intervention were enrolled. Intravascular ultrasound radio-frequency signals were acquired from non-percutaneous coronary intervention-targeted echolucent plaques. The patients were randomly assigned into 2 groups: group S in = 25) taking atorvastatin 10 mg/d and group C (n = 25) as control. After 6-month follow-up, IVUS-RF signals were sampled at the some plaque sites. Several regions of interest were placed on each plaque. Intravascular ultrasound radio-frequency parameters were blindly calculated in all regions of interests (group 5, n = 148; group C, n = 191). Targeted plaque volumes were also measured. Those data were compared between baseline and follow-up. Results in group S after 6 months, plasma low-density lipoprotein level was significantly decreased (133 13 to 87 29 mg/dL, P <.0001), integrated backscatter of IVUS-RF signals was substantially increased (-53.8 +/- 4.5 to -51.2 +/- 4 9 dB, P <.0001), and plaque volume was significantly reduced, whereas no change was demonstrated in group C. Conclusions These results suggest that statins alter properties as well as volumes of coronary plaques within 6 months, which may be related to plasma low-density lipoprotein reduction. Intravascular ultrasound radio-frequency signal analysis may be useful to evaluate the effects of drugs on stabilization of coronary atherosclerotic plaques.
• クリニカル・クイズ 循環器疾患
  Japan Clipping Today 8-10 2005年08月
• 図解で理解！ 心臓手術のオモテとウラ 経皮的冠動脈形成術
  ハートナーシング 4-7 2005年08月
• Cardiovascular circulation and hepatic perfusion of pigs in 4-dimensional films evaluated by 256-slice cone-beam computed tomography
  Nobusada Funabashi, Katsuya Yoshida, Hiroyuki Tadokoro, Keiichi Nakagawa, Nobuyuki Komiyama, Kenichi Odaka, Takanori Tsunoo, Shinichiro Mori, Shuji Tanada, Masahiro Endo, Issei Komuro
  Circulation Journal 69(5) 585-589 2005年05月
  DOI:10.1253/circj.69.585
  Background: In both cardiac and hepatic disorders it is desirable to accurately visualize the direction and scale of blood flow in the whole organ in pulsating 3-dimensional (D) images, which are known as 4-D images. Methods and Results: The present study used 256-slice cone-beam computed tomography (CT) (Athena, Sony-Toshiba) at one rotation per second and a section thickness of 0.5 mm to show the dynamics of cardiovascular circulation and hepatic perfusion by contrast injection in 4-D films of pigs. Four pigs (20 kg each) were anesthetized with isoflurane. The distal tips of the catheters were positioned in the inferior vena cava (IVC) (pigs 1-3) and in the proper hepatic artery (pig 4). Volumetric scanning and injection of contrast material were started simultaneously and continued for 25 s with image reconstruction at 1-s intervals. In pigs 1-3, 4-D filming revealed the dynamics of cardiovascular circulation, first in the IVC, followed by the right ventricle and pulmonary artery, then the left ventricle, left atrium, pulmonary vein, and finally, the right heart disappeared and only the left heart and aorta remained visible. In pig 4, the hepatic arterial trees, followed by the venous trees, could be easily visualized in turn on the 4-D images. Conclusions: This technology successfully demonstrated cardiovascular circulation and hepatic perfusion in 4-D and will have clinical applicability.
• スタチンによる冠動脈プラークの安定化
  呼と循 49-55 2005年04月
• 血管内超音波とOCTでみる再狭窄病変
  Heart View 20-25 2005年04月
• 42) 経食道エコー,CT検査により冠動脈瘤が診断され剖検により確認された化膿性心膜炎の一例(第191回日本循環器学会関東甲信越地方会)
  井藤 葉子, 高野 博之, 佐野 雅則, 船橋 伸禎, 桑原 洋一, 小宮山 伸之, 吉田 勝哉, 小室 一成
  Circulation journal : official journal of the Japanese Circulation Society 68(0) 2004年10月
  Permalink:http://ci.nii.ac.jp/naid/110002698989
• 78) うつ病増悪を契機に発症し,動脈閉塞様症状を呈した両側腸骨静脈血栓症の一例(第191回日本循環器学会関東甲信越地方会)
  上原 孝紀, 本城 祐子, 長谷川 洋, 船橋 伸禎, 小宮山 伸之, 桑原 洋一, 吉田 勝哉, 小室 一成
  Circulation journal : official journal of the Japanese Circulation Society 68(0) 2004年10月
  Permalink:http://ci.nii.ac.jp/naid/110002699024
• 不安定プラークの診断
  小宮山伸之
  呼と循 937-946 2004年09月
  DOI:10.11477/mf.1404100363
• Usefulness of rapid quantitative measurement of myoglobin and troponin T in early diagnosis of acute myocardial infarction
  Masashi Yamamoto, Nobuyuki Komiyama, Tomomi Koizumi, Mizuo Nameki, Yutaka Yamamoto, Tomohiko Toyoda, Tomonobu Okuno, Kaoru Tateno, Kouichi Sano, Toshiharu Himi, Nehiro Kuriyama, Susumu Namikawa, Masaki Yokoyama, Issei Komuro
  Circulation Journal 68(7) 639-644 2004年07月
  DOI:10.1253/circj.68.639
  Background: New equipment, the Cardiac Reader™, which can measure blood concentrations of troponin T (T) and myoglobin (M) in only 15 min at the bedside was evaluated for early diagnosis of acute myocardial infarction (AMI). Methods and Results: A total of 34 consecutive patients with AMI who came to hospital within 24 h after onset were studied. Blood samples were collected from the patients at admission and 6, 12, 24, 48 h after onset to qualitatively and quantitatively measure T, M and creatine kinase-MB fraction. There were 20 patients with positive results by qualitative troponin T test and 29 with positive results by quantitative test. Of the patients who visited hospital within 3 h of onset, 17% were positive by the qualitative test and 67% cases had positive results in the quantitative test. The patients were divided into 2 groups according to the flow grade in the infarct-related coronary artery. In the TIMI 0-1 group (n=28), serum myoglobin concentrations were higher than in the TIMI 3-4 group (n=6) at admission and at their peak. Conclusion: The rapid quantitative test of T and M is useful for early diagnosis of AMI and as an indicator of its severity, which can be evaluated from the myoglobin concentration in the hyper-acute phase.
• 画像診断による心機能評価法。V. 維持血液透析療法、尿毒症の病態論
  小宮山伸之
  日本臨牀 92-95 2004年06月
• 心臓血管領域におけるイメージングの進歩。心血管造影検査。
  小宮山伸之
  Clinical Engineering 103-108 2004年06月
• Assessment of myocardial perfusion and fatty acid metabolism in a patient with Churg-Strauss syndrome associated with eosinophilic heart disease
  Nobuaki Shikama, Tomoo Nakagawa, Yasuo Takiguchi, Nobuyuki Aotsuka, Yoichi Kuwabara, Nobuyuki Komiyama, Takashi Terano, Akira Hirai
  Circulation Journal 68(6) 595-598 2004年06月
  DOI:10.1253/circj.68.595
  Churg-Strauss syndrome is characterized by asthma, eosinophilia and systemic necrotizing vasculitis cardiac involvement (ie, eosinophilic heart disease) is the major cause of morbidity and mortality, although there are no reports of an association between left ventricular dysfunction because of eosinophilic heart disease and myocardial blood flow or myocardial fatty acid metabolism. A patient presented with Churg-Strauss syndrome associated with eosinophilic heart disease that had progressed to dilated cardiomyopathy. Coronary angiography, thallium-201 (201T1) and iodine-123 β-methyl-iodophenyl pentadecanoic acid (123I BMIPP) myocardial single photon emission computed tomography (SPECT) were performed to evaluate left ventricular dysfunction. Although coronary angiography was normal and 201T1 SPECT showed no apparent image defect, 123I BMIPP SPECT showed diffuse decreased accumulation, excepting the apex. The left ventricular dysfunction in patients with eosinophilic heart disease is associated with impaired myocardial fatty acid metabolism rather than with impaired myocardial blood flow.
• 72) I型心室中隔欠損症に感染性心内膜炎を併発しvalsalva洞動脈瘤破裂をきたした一例(第190回日本循環器学会関東甲信越地方会)
  浜 義之, 前川潤平, 前川, 浪川 進, 中川 敬一, 桑原 洋一, 吉田 勝哉, 小室 一成, 小宮山 伸之
  Circulation journal : official journal of the Japanese Circulation Society 68(0) 2004年04月
  Permalink:http://ci.nii.ac.jp/naid/110002690119
• 冠動脈疾患をIVUS最新技術で診る
  小宮山伸之
  分子心血管病 348-354 2004年04月
• Comparison of the effects of beta blockers and calcium antagonists on cardiovascular events after acute myocardial infarction in Japanese subjects
  H Yasue, H Ogawa, H Kawano
  AMERICAN JOURNAL OF CARDIOLOGY 93(8) 969-973 2004年04月
  DOI:10.1016/j.amjcard.2004.01.006
  The efficacy of beta blockers in managing patients with post-acute myocardial infarction (AMI) was established based on randomized controlled trials predating the era of modern therapy in Western populations. We compared the effects of 6 blockers on cardiovascular events with those of calcium antagonists in Japanese post-AMI patients on modern reperfusion therapy by performing a multicenter, prospective, randomized, open-blind end point study. Five hundred forty-five patients were assigned to the p-blocker group and 545 patients to the calcium antagonist group. The mean follow-up period was 455 days. There was no significant difference in the incidence of cardiovascular death (0.7% vs 1.1%), reinfarction (0.9% vs 1.3%), uncontrolled unstable angina (11.0% vs 10.6%), and nonfatal stroke (0.7% vs 0.2%) between the 2 groups. However, the incidences of heart failure and coronary spasm were significantly higher in the beta-blocker group than in the calcium antagonist group (4.2% vs 1.1%, p = 0.001; 1.2% vs 0.2%, p = 0.027, respectively). We conclude that the cardiovascular event rate is substantially lower in Japanese post-AMI patients receiving modern therapy than in those reported in the West, and that there are no significant differences in the cardiovascular event rate between the p-blocker and calcium antagonist groups. (C) 2004 by Excerpta Medica, Inc.
• 糖尿病における冠動脈硬化症の特徴
  小宮山伸之
  内分泌・糖尿病科 383-390 2004年04月
• Comparison between Nicorandil and Magnesium as an Adjunct Cardioprotective Agent to Percutaneous Coronary Intervention in Acute Anterior Myocardial Infarction
  Mizuo Nameki, Iwao Ishibashi, Yoshiya Miyazaki, Yoshiaki Sakai, Susumu Namikawa, Nehiro Kuriyama, Nobuyuki Komiyama, Kouichi Tsunoda, Yoshiaki Masuda, Issei Komuro
  Circulation Journal 68(3) 192-197 2004年03月
  DOI:10.1253/circj.68.192
  Background: It has been reported that both nicorandil and magnesium have a cardioprotective effect in experimental ischemia-reperfusion models. In the present study, the cardioprotective effects of nicorandil and magnesium as an adjunct to reperfusion therapy in patients with acute myocardial infarction (AMI) were compared. Methods and Results: Forty consecutive patients with AMI caused by occlusion of anterior descending coronary artery were randomized into 3 groups: (1) Group N: nicorandil was given as 4mg iv and 4mg ic before reperfusion, followed by continuous infusion at 4mg/h for 24h (2) Group M: magnesium was administered at 10 mmol iv before reperfusion, followed by continuous infusion at 0.4 mmol/h for 24 h and (3) Group C: neither nicorandil nor magnesium was given. Left ventriculography was performed immediately after reperfusion and 3 months later. There was no significant change in regional wall motion (RWM) in either Group C or M, whereas that of group N improved significantly. The change in RWM in Group N was significantly greater than in Group C (Group N: 0.92±0.92, Group M: 0.44±0.80, Group C: -0.01±0.65, p< 0.05). Conclusions: The early administration of nicorandil as an adjunct to reperfusion is useful for cardioprotection in AMI, but magnesium is not.
• 奇異な剥離形態を示した左室内巨大壁在血栓症の一例(第188回日本循環器学会関東甲信越地方会)
  白井 和佳子, 和田 浩, 大門 雅夫, 堀 泰彦, 竹田 隆一, 永井 敏雄, 桑原 洋一, 小宮山 伸之, 吉田 勝哉, 小室 一成, 平出 明
  Circulation journal : official journal of the Japanese Circulation Society 67(0) 2003年10月
  Permalink:http://ci.nii.ac.jp/naid/110002688981
• 10)プレドニゾロンが奏功した慢性心筋炎の一例
  福島 賢一, 舘野 馨, 高野 博之, 小室 一成, 高橋 聖尚, 豊崎 哲也, 小泉 智三, 小宮山 伸之, 鹿島 健三
  Circulation journal : official journal of the Japanese Circulation Society 67(0) 2003年04月
  Permalink:http://ci.nii.ac.jp/naid/110002666465
• 39)末梢血単核球細胞移植が有効であった重症閉塞性動脈硬化症の一例
  鶴 有希子, 南野 徹, 川田 貴之, 舘野 馨, 永井 敏雄, 小宮山 伸之, 吉田 勝哉, 小室 一成, 清水 直美, 浅井 隆善, 増田 敏久
  Circulation journal : official journal of the Japanese Circulation Society 67(0) 2003年04月
  Permalink:http://ci.nii.ac.jp/naid/110002666604
• 1) 血管内超音波検査にてプラークの断裂像を認めた左主幹部冠動脈瘤の1例
  田村 典子, 栗原 勲, 大沼 徳吉, 小宮山 伸之, 山本 豊, 山本 雅史, 行木 瑞雄, 小泉 智三, 栗山 根廣, 浪川 進, 横山 正樹, 大門 雅夫, 船橋 伸禎, 吉田 勝哉, 小室 一成
  Circulation journal : official journal of the Japanese Circulation Society 66(0) 2002年10月
  Permalink:http://ci.nii.ac.jp/naid/110002687806
• 29)血管内超音波画像においてgiant lipid poolを有した冠動脈狭窄病変に対してPTCAを施行した一例(日本循環器学会 第181回関東甲信越地方会)
  栗山 根廣, 横山 正樹, 吉田 俊彦, 浪川 進, 行木 瑞雄, 小泉 智三, 山本 雅史, 小室 一成, 小宮山 伸之, 山本 豊
  Circulation journal : official journal of the Japanese Circulation Society 66(0) 2002年04月
  Permalink:http://ci.nii.ac.jp/naid/110002692267
• 54)早期診断が可能であった典型的動脈狭窄所見を持たない大動脈炎症候群の1例(日本循環器学会 第182回関東甲信越地方会)
  山崎 道子, 高野 博之, 宮内 秀行, 大門 雅夫, 土方 康義, 船橋 伸禎, 永井 敏夫, 小宮山 伸之, 吉田 勝哉, 渡辺 滋, 小室 一成
  Circulation journal : official journal of the Japanese Circulation Society 66(0) 2002年04月
  Permalink:http://ci.nii.ac.jp/naid/110002692399
• 55)高度房室ブロックを合併した特発性肺動脈拡張症の一例(日本循環器学会 第182回関東甲信越地方会)
  伊藤 薫, 栗原 勲, 大沼 徳吉, 豊田 智彦, 大門 雅夫, 米沢 真頼, 松本 泰典, 行木 瑞雄, 船橋 伸禎, 小宮山 伸之, 吉田 勝哉, 小室 一成
  Circulation journal : official journal of the Japanese Circulation Society 66(0) 2002年04月
  Permalink:http://ci.nii.ac.jp/naid/110002692400
• 再灌流療法を施行した心筋梗塞早期におけるdipyridamole負荷Tc-^<99>m心筋SPECTの臨床的意義の検討 : その経過およびI-^<123>BMIPP心筋SPECTとの比較.
  木ノ下 敬彦, 桑原 洋一, 鹿間 毅, 松野 公紀, 黒田 徹, 粟生田 輝, 藤井 清孝, 小宮山 伸之, 増田 善昭
  千葉医学雑誌 77(4) 207-212 2001年08月
  Permalink:http://ci.nii.ac.jp/naid/110004664724
  【目的】血行再建に成功した心筋梗塞早期にdipyridamole負荷Tc-99m心筋SPECTを施行し,可逆的集積低下出現の意義を心筋血流および脂肪酸代謝障害領域との関連および経過により検討する。【方法】完全血行再建を施行し得た初回心筋梗塞23例を対象とした。平均3,8病日にdipyridamole負荷Tc-99m心筋SPECTを施行し,負荷時および安静時SPECT像の欠損を14領域のtotal defect score (TDS)にて半定量的に評価した。平均7.2病日に施行したBMIPPシンチも同様に評価した。6ヵ月後に血管造影で再狭窄を認めない症例の一部に対してdipyridamole負荷Tc-99m心筋SPECTを再検した。【結果】負荷時のTDS(13.1±9.5)は安静時のTDS(9.1±8.9)より有意に大(P<0.001)であり,BMIPPのTDS(13.8±8.2)と同程度であった。6ヵ月後の再検を行った6症例においては,負荷時TDSは急性期11.5±2.9から慢性期8.2±4.9へと有意に低下し,安静時の慢性期TDS(6.8±6.2)と有意差は消失した。【結語】完全血行再建を施行した急性心筋梗塞において,早期dipyridamole負荷時Tc-99m心筋SPECTの可逆的欠損領域はBMIPPの欠損領域と同等であり,急性冠血流低下による心筋障害の領域に重なることが示された。またこの領域は経過とともに著明に減少し,急性期冠血行再建療法によりsalvageされた心筋領域を描出していると考えられた。
• 血清thrombomodulin濃度は,冠動脈病変進展と逆相関し,tumor necrosis factor α,ホモシステイン,およびVCAM-1濃度とは正の相関がある.
  山本 雅史, 渡邉 滋, 小宮山 伸之, 宮崎 彰, 増田 善昭
  千葉医学雑誌 77(4) 231-240 2001年08月
  Permalink:http://ci.nii.ac.jp/naid/110004664727
  冠動脈の動脈硬化の進展と各種動脈硬化促進因子の血清濃度との関係を調べ,第一にトロンボモデュリン(TM)が,冠動脈硬化の進展に比例して上昇するのではなく,内皮機能障害が進むことでTM産生能も低下する仮説を調べた。第二に,TM,VCAM-1,ホモシステイン(HC),TNF-αが相互に作用しあっている可能性の傍証として各種分子の血清濃度の相関関係を検討した。経皮経管冠動脈形成術(PTCA)を施行した48例(男性36例,女性12例,平均年齢59±8歳)に対し,空腹時の動脈血採血をヘパリン注射前に行った。冠動脈硬化の進展の指標として,1)病変枝数,2)Gensiniscore,および3)Coronary extent scoreを用いた。病変枝数で群分けした場合では,いずれの物質の血清濃度も群間で有意差は認められなかった。Gensini scoreが40未満の群と40以上の群で分けた場合では,Gensini scoreが40以上の群でHbAlcは有意に高く,TMは有意に低かった。Coronary extent score(狭窄箇所数)が1箇所の群と,2〜4箇所の群および5箇所以上の群で分けた場合では,群間有意差を認めた物質はTMのみであり,狭窄箇所数の増加に連れて血清濃度が低下する傾向にあった。また,TM,VCAM-1,HC,TNF-αの間には,互いに強い相関が認められた。この結果の説明として,病変の進展とともに血管内皮機能が障害されてTM産生が低下したと考えられる。また,HCとTMの間の強い相関は,HCが血管内皮細胞にダメージを与えてTMの遊離や発現を促している可能性を示唆している。同様に,HCがVCAM-1の発現に関与している可能性や,TNF-αが血管内皮細胞におけるTMの発現を促している可能性が考えられた。
• 心筋梗塞患者の経皮的冠動脈形成術成功例における運動療法の効果 : 運動耐容能と左室機能について
  小泉 智三, 小宮山 伸之, 中里 毅, 山本 豊, 増田 善昭
  日本臨床生理学会雑誌 = Japanese journal of applied physiology 30(6) 305-310 2000年12月
  Permalink:http://ci.nii.ac.jp/naid/10009073113
• 第49回米国心臓学会(ACC)
  小宮山 伸之
  循環器専門医 : 日本循環器学会専門医誌 8(2) 349-351 2000年09月
  Permalink:http://ci.nii.ac.jp/naid/110002936735
• SIII-7 血管内超音波法における高周波信号解析による冠動脈硬化病変の組織性状診断 : 視覚的画像評価との比較と実時間解析システム
  小宮山 伸之, 増田 善昭, 大島 祥男, コートニィ ブライアン, ヨック ポール, フィッツジェラルド ピーター
  Japanese circulation journal 64(0) 2000年03月
  Permalink:http://ci.nii.ac.jp/naid/110002569371
• P660 ステント過拡張が慢性期の内膜増殖に及ぼす影響について : IVUSによる検討
  栗山 根廣, 黒田 央文, 奥野 友信, 木ノ下 敬彦, 山本 雅史, 増田 善昭, 小林 欣夫, 山本 豊, 小宮山 伸之
  Japanese circulation journal 64(0) 2000年03月
  Permalink:http://ci.nii.ac.jp/naid/110002571425

受賞

• 2010年 Moderated complex case competition. Endovascular intervention I (Transcatheter Cardiovascular Therapeutics Asia Pacific 2010)
• 2010年 Moderated complex case competition. Endovascular intervention I (Transcatheter Cardiovascular Therapeutics Asia Pacific 2010)
• 1996年 Cardiovascular Medicine Award for Excellence in Clinical Research (Stanford University School of Medicine)

競争的資金

• ２型糖尿病患者におけるアログリプチンの冠動脈プラークに及ぼす影響に関する研究
  研究期間：2011年  
• 冠動脈硬化症を合併した糖尿病症例におけるロスバスタチンによる冠循環機能改善効果の検討
  ：その他の研究制度
  研究期間：2007年 - 2009年  
• Effect of rosuvastatin on microcirculation of coronary artery in patients with type 2 diabetes.
  ：The Other Research Programs
  研究期間：2007年 - 2009年  
• メタボリック症候群を合併した安定狭心症患者におけるピオグリタゾンによる冠動脈粥腫退縮効果の検討
  研究期間：2006年  
• 急性冠症候群におけるピオグリタゾンによる冠動脈粥腫安定化の検討
  研究期間：2006年  
• 血管内超音波法を用いたヒト血管組織性状診断アルゴリズムを開発
  ：受託研究
  研究期間：2004年  
• 血管内超音波法を用いたヒト血管組織性状診断アルゴリズムを開発
  ：受託研究
  研究期間：2004年