|Tetsuya Matoba||Last modified date：2022.07.11|
Lecturer / Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences / Angiocardiology / Kyushu University Hospital
|1.||Tetsuya Matoba 1, H. Fujita 2, T. Kohro 3, T. Kabutoya 4, Y. Ohba 4, Y. Imai 4, K. Kario 4, A. Kiyosue 5, Y. Mizuno 5, M. Nakayama 6, K. Nochioka 6, Y. Miyamoto 7, Y. Iwanaga 7, Y. Nakao 7, T. Iwai 7, K. Tsujita 8, T. Nakamura 9, H. Sato 10, Y. Nakano 1, H. Tsutsui 1, R. Nagai 11
(1) Kyushu University, Cardiovascular Medicine, Fukuoka, Japan; (2) Jichi Medical University Saitama Medical Center, Cardiology, Saitama, Japan; (3) Jichi Medical University, Medical Informatics, Tochigi, Japan; (4) Jichi Medical University, Cardiology, Tochigi, Japan; (5) University of Tokyo Hospital, Cardiology, Tokyo, Japan; (6) Tohoku University Graduate School of Medicine, Medical Informatics, Sendai, Japan; (7) National Cerebral and Cardiovascular Center Hospital, Cerebral and Cardiovascular Disease Information, Osaka, Japan; (8) Kumamoto University Hospital, Cardiovascular Center, Kumamoto, Japan; (9) Kumamoto University Hospital, Medical Informatics, Kumamoto, Japan; (10) Precision, Tokyo, Japan; (11) Jichi Medical University, Tochigi, Japan, Clinical Deep Data Accumulation System (CLIDAS) reveals Real-World Medical Therapy and Prognosis of Japanese patients after Percutaneous Coronary Intervention, 日本循環器学会学術集会, 2022.03, Background: Direct utilization of electronic medical records is an ideal approach to develop medical database to analyze real-world patient characteristics, medical and interventional therapeutics, and the prognosis of the patients with cardiovascular diseases; however, the lack of standard data format has hampered this approach. We have developed the Standard Export datA forMAT (SEAMAT) standards under a support from the Japanese Circulation Society for the export and the exchange of multimodal electronic data including cardiac catheterization and percutaneous coronary intervention (PCI) reports, electrocardiogram, and echocardiogram.
Methods: We developed the Clinical Deep Data Accumulation System (CLIDAS) that accumulates multimodal data through the SEAMAT and the standardized structured medical information exchange (SS-MIX) in the hospital information system including patient characteristics, laboratory data, prescriptions, heart rate and blood pressure at discharge, and long-term prognosis. We implemented the CLIDAS in 6 university hospitals and the national cerebral and cardiovascular center in Japan. We accumulated data from patients who underwent PCI during April 2014 and March 2020 in participating hospitals. The primary outcome was the first occurrence of a composite of cardiovascular death, stroke, myocardial infarction.
Results: Among 10126 consecutive patients, 77% were male, and the baseline age was 70±11. The index PCI was performed for acute coronary syndrome in 43% of the patients. The database identified comorbidity including hypertension, diabetes, dyslipidemia, chronic kidney disease and peripheral artery disease, the use of lipid-lowering drugs, beta blockers and antiplatelets and their doses. The median follow-up period was 850 days. The primary analysis reveals the real-world medical therapies among patients after PCI and their associations with long-term prognosis..
|2.||Tetsuya Matoba1, Isashi Baba1, Tomohiro Minakawa2, Yu Sakurai3, Hidetaka Akita3, Jun K. Yamashita2, Hiroyuki Tsutsui1 1 Department of Cardiovascular Medicine, Kyushu University. 2 Department of Cell Growth and Differentiation, Center for iPS Cell Research and Application (CiRA), Kyoto University. 3 Laboratory of Pharmacology and Toxicology, Graduate School of Pharmaceutical Science, Chiba University. , Efficacy of microRNA Delivery by Lipid and Polymeric Nanoparticles, Pacifichem 2021 , 2021.12.|
|3.||Tetsuya Matoba, Kazuo Sakamoto, Hiroyuki Tsutsui.
, Management of Cardiogenic shock in Acute Myocardial Infarction, The 19th International Symposium on Atherosclerosis (ISA 2021), 2021.10, The in-hospital mortality rate of acute myocardial infarction (AMI) has been decreased to 4-5% owing to the spread of coronary care unit (CCU) and the generalization of emergency coronary reperfusion therapy. However, a recent report from the Japanese circulation society (JCS) cardiovascular shock registry (2012-2015), a prospective, observational, multicenter, cohort study that accumulated 979 cardiovascular shock patients among 82 JCS certified teaching hospitals, revealed that the 30-day mortality of acute coronary syndrome (ACS) with cardiogenic shock was as high as 34%, which remains as a challenge in emergency cardiovascular medicine.
Management of cardiogenic shock in AMI includes early coronary reperfusion with primary percutaneous coronary intervention (PCI) and mechanical circulatory support; intra-aortic balloon pump, veno-arterial extracorporeal membrane oxygenation, and percutaneous left ventricular assist device (pLVAD or Impella) that had shown the clinical benefit for cardiogenic shock. Since a comprehensive management of cardiogenic shock state as well as early reperfusion therapy is vitally important for the treatment of AMI with cardiogenic shock (Killip class IV), functionally sufficient medical facilities and experienced medical staff are indispensable in order to increase the chance of survival of the patients with Killip class IV AMI.
Our recent analysis in the Japanese registry of all cardiac and vascular diseases-diagnosis procedure combination (JROAD-DPC) database (year 2012-2016), 30-day mortality of Killip class IV AMI patients (n=21823) was 42.3%. A multivariate analysis identified age, female gender, admission by ambulance, deep coma, and cardiac arrest as personal factors that were independently associated with higher 30-day mortality, and the number of JCS board certified members as institutional factors that were independently associated with lower mortality in Killip class IV patients.
Current guidelines state that patients with suspected STEMI should be transported to a PCI capable center. To further seek better survival of AMI patients with cardiogenic shock, establishing cardiac shock center in the local community may be effective, in which JCS board certified members manage critically ill patients in cooperation with interventional cardiologists, emergency physicians, and intensive care physicians.
|4.||Tetsuya Matoba, Gentaro Ikeda, Jun-ichiro Koga, Hiroyuki Tsutsui, Kensuke Egashira, Targeting Cyclophilin D and Inflammation with Nano-medicines in Myocardial Ischemia-Reperfusion Injury, 3rd Annual 2019 International Hawaii Cardiovascular Symposium, 2019.02, Aims: The opening of mitochondrial permeability transition pore (mPTP) and inflammation may cooperatively progress myocardial ischemia-reperfusion (IR) injury; however, clinical trials of cardioprotection with cyclosporine A (CsA) or anti-inflammatory agents ended with neutral results. In this pre-clinical study, we examined the ischemic time-dependent contribution of the 2 mechanisms, and tested the therapeutic effects of nanoparticle-mediated medicine that targets mPTP opening and inflammation in the mouse model of myocardial IR injury.
Methods and Results: We employed mice lacking cyclophilin D (CypD, a key molecule for mPTP opening) and CCR2 (a receptor for monocyte chemoattractant protein-1) and found that CypD contributed to progression of myocardial IR injury caused by shorter durations of ischemia (30-45 minutes), whereas CCR2 contributed to IR injury caused by longer durations of ischemia (60-90 minutes). Double deficiency of CypD and CCR2 showed larger cardioprotection over single deficiency regardless of the durations of ischemia. CypD deficiency induced production of interleukin-1β proteins and recruitment of Ly6Chigh inflammatory monocytes in the IR-injured myocardium despite the reduction in the infarction, whereas CCR2-deficiency markedly inhibited these inflammations. Anti-interleukin-1β treatment reduced the recruitment of monocytes to the myocardium, resulted in smaller infarct size in CypD-deficient mice. Then we engineered poly (lactic-co-glycolic acid) nanoparticle containing CsA (CsA-NP) that inhibits mPTP opening and pitavastatin (Pitava-NP) that reduces monocyte-mediated inflammation. Simultaneous treatment with CsA-NP and Pitava-NP at the time of reperfusion presented a remarkable reduction in infarct size after IR injury with 30 or 60 minutes of ischemia.
Conclusions: The mechanism of myocardial IR injury differs depending on the durations of ischemia. Simultaneous targeting to mitochondrial injury and inflammation with nano-medicines is a promising strategy that provides a solution for myocardial IR injury..
|5.||Yusuke Akiyama, Tetsuya Matoba, Yasushi Mukai, Daisuke Furukawa, Keiji Oi, Shunji Hayashidani, Toyokazu Uwatoku, Hiroyuki Tsutsui, Responses to Acetylcholine in Stented Target Vessel in Comparison to Non-Target Vessel in Patients after Percutaneous Coronary Intervention, American Heart Association Scientific Session, 2017.11.|
|6.||Tetsuya Matoba, Kazuo Sakamoto, Masahiro Mohri, Yasuyuki Tsujita, Masao Yamasaki, Yasushi Ueki, Nobuhiro Tanaka, Yohei Hokama, Motoki Fukutomi, Katsutaka Hashiba, Rei Fukuhara, Yasushi Ueki, Satoru Suwa, Hirohide Matsuura, Eizo Tachibana, Takahiro Nakashima, Hayato Hosoda, Yoshio Tahara, Michikazu Nakai, Kunihiro Nishimura, Naohiro Yonemoto, Ken Nagao, The Impact of Institutional Characteristics on the Prognosis of Acute Myocardial Infarction with Cardiogenic Shock: Analysis from the JROAD/JROAD-DPC, 日本循環器学会学術集会, 2018.06.|
|7.||Tetsuya Matoba, Primary PCI for STEMI with cardiogenic shock in Japan, 日本心血管インターベンション治療学会CVIT学術集会・TSCI-CVIT Jointシンポジウム, 2017.07.|
|8.||的場 哲哉, 1. Imaging and Targeting Inflammation in Acute Myocardial Infarction., The 10th Congress of the Asian-Pacific Society of Atherosclerosis and Vascular Diseases (APSAVD), 2016.07.|
|9.||的場 哲哉, Novel Nanoparticle-mediated Medicine for Myocardial Ischemia-Reperfusion Injury Simultaneously Targeting Mitochondrial Injury and Myocardial Inflammation., European Society of Cardiology (ESC) Congress 2016, 2017.08.|
|10.||的場 哲哉, Treatment of Myocardial Ischemia-Reperfusion Injury by Nanoparticle-Mediated Targeting Mitochondria and Inflammation., New Frontiers in Cell death Signaling and Heart Failure, 2017.02.|
|11.||的場 哲哉, Decision Making for Anticoagulation in AF: Combining Global and Asian Studies to Clinical Practices, 2015 Taiwan Society of Cardiology Annual Meeting, 2015.05.|
|12.||Tetsuya Matoba, Murine Model of Atherosclerotic Plaque Destabilization and Rupture in ApoE-Deficient Mice, 日本動脈硬化学会総会・学術集会, 2013.07.|
|13.||Tetsuya Matoba, Pathophysiology of Atherosclerotic Plaque Destabilization and Rupture, The 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC 2013), 2013.07, [URL].|
|14.||Tetsuya Matoba, Critical Role of Inflammatory Monocytes in Atherosclerotic Plaque Destabilization and Rupture, The 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC 2013), 2013.07, [URL].|
|15.||Tetsuya Matoba, Critical Role of Inflammatory Monocytes in Atherosclerotic Plaque Destabilization and Rupture in ApoE-Deficient Mice, International Society of Heart Research Japanese Section, 2013.06.|
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