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11. Deep learning approach for analyzing chest x-rays to predict cardiac events in heart failure

Author

Kusunose, Kenya, Hirata, Yukina, Yamaguchi, Natsumi, Kosaka, Yoshitaka, Tsuji, Takumasa, Kotoku, Jun’ichi, Sata, Masataka, Kusunose, Kenya, Hirata, Yukina, Yamaguchi, Natsumi, Kosaka, Yoshitaka, Tsuji, Takumasa, Kotoku, Jun’ichi, and Sata, Masataka

Abstract

Background: A deep learning (DL) model based on a chest x-ray was reported to predict elevated pulmonary artery wedge pressure (PAWP) as heart failure (HF). Objectives: The aim of this study was to (1) investigate the role of probability of elevated PAWP for the prediction of clinical outcomes in association with other parameters, and (2) to evaluate whether probability of elevated PAWP based on DL added prognostic information to other conventional clinical prognostic factors in HF. Methods: We evaluated 192 patients hospitalized with HF. We used a previously developed AI model to predict HF and calculated probability of elevated PAWP. Readmission following HF and cardiac mortality were the primary endpoints. Results: Probability of elevated PAWP was associated with diastolic function by echocardiography. During a median follow-up period of 58 months, 57 individuals either died or were readmitted. Probability of elevated PAWP appeared to be associated with worse clinical outcomes. After adjustment for readmission score and laboratory data in a Cox proportional-hazards model, probability of elevated PAWP at pre-discharge was associated with event free survival, independent of elevated left atrial pressure (LAP) based on echocardiographic guidelines (p < 0.001). In sequential Cox models, a model based on clinical data was improved by elevated LAP (p = 0.005), and increased further by probability of elevated PAWP (p < 0.001). In contrast, the addition of pulmonary congestion interpreted by a doctor did not statistically improve the ability of a model containing clinical variables (compared p = 0.086). Conclusions: This study showed the potential of using a DL model on a chest x-ray to predict PAWP and its ability to add prognostic information to other conventional clinical prognostic factors in HF. The results may help to enhance the accuracy of prediction models used to evaluate the risk of clinical outcomes in HF, potentially resulting in more informed clinical decis

Published
2023

12. Artificial intelligence-assisted interpretation of systolic function by echocardiogram

Author

Yamaguchi, Natsumi, Kosaka, Yoshitaka, Haga, Akihiro, Sata, Masataka, Kusunose, Kenya, Yamaguchi, Natsumi, Kosaka, Yoshitaka, Haga, Akihiro, Sata, Masataka, and Kusunose, Kenya

Abstract

Objective: Precise and reliable echocardiographic assessment of left ventricular ejection fraction (LVEF) is needed for clinical decision-making. Recently, artificial intelligence (AI) models have been developed to estimate LVEF accurately. The aim of this study was to evaluate whether an AI model could estimate an expert read of LVEF and reduce the interinstitutional variability of level 1 readers with the AI-LVEF displayed on the echocardiographic screen. Methods: This prospective, multicentre echocardiographic study was conducted by five cardiologists of level 1 echocardiographic skill (minimum level of competency to interpret images) from different hospitals. Protocol 1: Visual LVEFs for the 48 cases were measured without input from the AI-LVEF. Protocol 2: the 48 cases were again shown to all readers with inclusion of AI-LVEF data. To assess the concordance and accuracy with or without AI-LVEF, each visual LVEF measurement was compared with an average of the estimates by five expert readers as a reference. Results: A good correlation was found between AI-LVEF and reference LVEF (r=0.90, p<0.001) from the expert readers. For the classification LVEF, the area under the curve was 0.95 on heart failure with preserved EF and 0.96 on heart failure reduced EF. For the precision, the SD was reduced from 6.1±2.3 to 2.5±0.9 (p<0.001) with AI-LVEF. For the accuracy, the root-mean squared error was improved from 7.5±3.1 to 5.6±3.2 (p=0.004) with AI-LVEF. Conclusions: AI can assist with the interpretation of systolic function on an echocardiogram for level 1 readers from different institutions.

Published
2023

15. 心収縮予備能に対する心房細動カテーテルアブレーションの効果 : 下肢陽圧負荷心エコー図法を用いた検討

Author

Ishii, Nao, Kusunose, Kenya, Shono, Ayu, Matsumoto, Kensuke, Nishio, Susumu, Yamaguchi, Natsumi, Hirata, Yukina, Matsuura, Tomomi, Ise, Takayuki, Yamaguchi, Koji, Yagi, Shusuke, Fukuda, Daiju, Yamada, Hirotsugu, Soeki, Takeshi, Wakatsuki, Tetsuzo, and Sata, Masataka

Subjects
Cardiac Reserve, Echocardiography, atrial fibrillation, left atrial function, Preload Stress
Abstract

The effects of catheter ablation on exercise tolerance and quality of life in patients with atrial fibrillation (AF) have been reported. We assessed cardiac function in more detail using the leg positive pressure (LPP) technique and found that contractile reserve is particularly important in relation to exercise tolerance and prognosis. In this study, we used the LPP technique to examine changes in contractile reserve immediately after ablation and 6 months later. We prospectively enrolled patients who underwent catheter ablation for AF at 2 institutes. We performed LPP stress echocardiography 2 to 3 days after (FU-1) and 6 months after (FU-2) ablation to examine changes in cardiac function indexes. The primary end point was improvement in contractile reserve. Ultimately, 109 patients (mean age 67.4 ± 9.6 years; 70% men) underwent 2 sessions of LPP stress echocardiography. The median CHA2DS2-VASC score was 2 (interquartile range 13). From FU-1 to FU-2, the change in the stroke volume index after the LPP maneuver increased in patients with paroxysmal and persistent AF with low CHA2DS2-VASC scores (both p

Published
2022

16. Isoproterenol loading transesophageal echocardiography in atrial fibrillation

Author

Takahashi, Tomonori, primary, Kusunose, Kenya, additional, Hayashi, Shuji, additional, Zheng, Robert, additional, Yamaguchi, Natsumi, additional, Morita, Sae, additional, Hirata, Yukina, additional, Nishio, Susumu, additional, Saijo, Yoshihito, additional, Ise, Takayuki, additional, Yamaguchi, Koji, additional, Yagi, Shusuke, additional, Yamada, Hirotsugu, additional, Soeki, Takeshi, additional, Wakatsuki, Tetsuzo, additional, and Sata, Masataka, additional

Published
2022
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19. Effects of Radiofrequency Catheter Ablation on Cardiac Reserve Using Preload Stress Echocardiography in Paroxysmal and Persistent Atrial Fibrillation

Author

Ishii, Nao, primary, Kusunose, Kenya, additional, Shono, Ayu, additional, Matsumoto, Kensuke, additional, Nishio, Susumu, additional, Yamaguchi, Natsumi, additional, Hirata, Yukina, additional, Matsuura, Tomomi, additional, Ise, Takayuki, additional, Yamaguchi, Koji, additional, Yagi, Shusuke, additional, Fukuda, Daiju, additional, Yamada, Hirotsugu, additional, Soeki, Takeshi, additional, Wakatsuki, Tetsuzo, additional, and Sata, Masataka, additional

Published
2022
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22. Voluntary running exercise after focal cerebral ischemia ameliorates dendritic spine loss and promotes functional recovery

Author

Yamaguchi, Natsumi, primary, Sawano, Toshinori, additional, Fukumoto, Kae, additional, Nakatani, Jin, additional, Inoue, Shota, additional, Doe, Nobutaka, additional, Yanagisawa, Daijiro, additional, Tooyama, Ikuo, additional, Nakagomi, Takayuki, additional, Matsuyama, Tomohiro, additional, and Tanaka, Hidekazu, additional

Published
2021
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23. Comparative distribution of Arcadlin/Protocadherin‐8 mRNA in the intact and ischemic brains of adult mice.

Author

Inoue, Yosuke, Sawano, Toshinori, Yamaguchi, Natsumi, Inoue, Shota, Takayama, Akinori, Nakazawa, Shuma, Inagaki, Shinobu, Nakatani, Jin, and Tanaka, Hidekazu

Abstract

The structural plasticity of dendritic spines serves as the adaptive capabilities of the central nervous system to various stimuli. Among these stimuli, cerebral ischemia induces dynamic alterations in neuronal network activity. Arcadlin/Paraxial protocadherin/Protocadherin‐8 (Acad), a regulator of dendritic spine density, is strongly induced by activating stimuli to the neurons. However, the detailed distribution of Acad in normal and ischemic adult brains remains unclear. We comprehensively described Acad expression patterns in normal and ischemic adult brains by in situ hybridization histochemistry. We found that intact adult brains expressed Acad in the piriform cortex, dentate gyrus, hippocampal CA3, entorhinal cortex, amygdala, and hypothalamus. Acad expression was dramatically upregulated in the piriform cortex, olfactory area, dentate gyrus, entorhinal cortex, prefrontal cortex, insular cortex, amygdala, and septohippocampal nucleus 4 h after cerebral ischemia. Cerebral ischemia induced widespread neuronal activation, which was required for Acad upregulation. Our data suggested the involvement of Acad in the adaptive plasticity and remodeling of the neuronal network in the limbic and paralimbic systems. [ABSTRACT FROM AUTHOR]

Published
2022
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24. Cardiac reserve by 6-minute walk stress echocardiography in systemic sclerosis

Author

Arase, Miharu, primary, Kusunose, Kenya, additional, Morita, Sae, additional, Yamaguchi, Natsumi, additional, Hirata, Yukina, additional, Nishio, Susumu, additional, Okushi, Yuichiro, additional, Ise, Takayuki, additional, Tobiume, Takeshi, additional, Yamaguchi, Koji, additional, Fukuda, Daiju, additional, Yagi, Shusuke, additional, Yamada, Hirotsugu, additional, Soeki, Takeshi, additional, Wakatsuki, Tetsuzo, additional, and Sata, Masataka, additional

Published
2021
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34. 全身性強皮症における6分間歩行負荷心エコー図検査での左室予備能の評価

Author

Arase, Miharu, Kusunose, Kenya, Morita, Sae, Yamaguchi, Natsumi, Hirata, Yukina, Nishio, Susumu, Okushi, Yuichiro, Ise, Takayuki, Tobiume, Takeshi, Yamaguchi, Koji, Fukuda, Daiju, Yagi, Shusuke, Yamada, Hirotsugu, Soeki, Takeshi, Wakatsuki, Tetsuzo, and Sata, Masataka

Subjects
exercise echocardiography, left ventricular diastolic dysfunction, systemic sclerosis, pulmonary hypertension
Abstract

Objectives There is a high prevalence of left ventricular diastolic dysfunction (LVDD) in systemic sclerosis (SSc) which is associated with high mortality. Thus, early detection of LVDD could be important in management of SSc. We hypothesised that exercise echocardiography in SSc patients with normal resting haemodynamics may expose early phase LVDD, which could affect its prognosis, defined as cardiovascular death and unplanned hospitalisation for heart failure. Methods Between January 2014 and December 2018, we prospectively enrolled 140 patients with SSc who underwent 6-minute walk (6MW) stress echocardiographic studies with normal range of estimated mean pulmonary arterial pressure (mPAP) (1.4 mm Hg/L/min) and impaired pulmonary vascular reserve (ΔmPAP/ΔCO>3.0 mm Hg/L/min) had worse outcomes compared with those without these abnormalities (p

Published
2021

35. Usefulness of measurement of proximal phalanx length by using ultrasonography in newborn infants.

Author

Yamaguchi, Natsumi, Yasui, Toshiyuki, Kaji, Takashi, Sogawa, Eishi, Yoshida, Atsuko, Yonetani, Naoto, and Irahara, Minoru

Subjects
*PHALANGES, *NEWBORN infants, *BIRTH weight, *ULTRASONIC imaging, *LENGTH measurement
Abstract

The purpose of this study was to compare digit lengths and proximal phalanx lengths in newborn infants by using ultrasonography (USG) and to examine sex differences between the ratio of the second digit (2D) and fourth digit (4D) of digit length and that of proximal phalanx length and the associations of digit length and proximal phalanx length with birth weight and birth height. Sixty newborn infants (28 males and 32 females) were recruited. Digit lengths were measured by using a transparent ruler and proximal phalanx lengths were measured by using USG. There were significant correlations between digit length and proximal phalanx length in the left and right hands. There was no significant correlation between 2D:4D ratios of digit lengths and 2D:4D ratios of proximal phalanx lengths measured by using USG. In males, birth height was significantly associated with right fourth proximal phalanx length and with left second and fourth proximal phalanx lengths. Birth weight was significantly associated with proximal phalanx length in males. Proximal phalanx length measured by using USG was significantly associated with digit length in newborn infants. Hormonal exposure before birth may be involved in the associations of proximal phalanx length with birth weight and height in males.Impact statementWhat is already known on this subject? The ratio of the second digit (2D) and fourth digit (4D) has been used postnatally to provide a retrospective indication of the foetal hormonal environment. Digit lengths have been measured by using a direct method, photocopies, digital scans and radiographs, but the results of a study on measurement of digit lengths by using ultrasonography (USG) have not been reported.What do the results of this study add? Proximal phalanx length measured by using USG was significantly associated with digit length in newborn infants. In males, birth height was significantly associated with right fourth proximal phalanx length and with left second and fourth proximal phalanx lengths. Birth weight was significantly associated with proximal phalanx length in males.What are the implications of these findings for clinical practice and/or further research? Measurement of proximal phalanx length by using USG may be useful for a study on gender differences in foetal development and the foetal hormonal environment. Hormonal exposure before birth may be involved in the associations of proximal phalanx length with birth weight and height in males. [ABSTRACT FROM AUTHOR]

Published
2021
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37. A cooperative support model for cancer therapy and employment balance: from focus-group interviews of health and business professionals

Author

TAKAHASHI, Miho, primary, UETAKE, Chika, additional, NAKAYAMA, Naoko, additional, EURA, Akiko, additional, YAMAGUCHI, Natsumi, additional, KAMEDA, Yui, additional, MUTO, Go, additional, ENDO, Motoki, additional, KAWAMATA, Kayo, additional, FUJII, Tomoko, additional, OKA, Hiroyuki, additional, and MATSUDAIRA, Ko, additional

Published
2019
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48. A Study on Primary Succession of Periphyton on Concrete Containing Amino Acid

Author

KOZUKI, Yasunori, primary, SATO, Kazuhiro, additional, NAKANISHI, Takashi, additional, NISHIMURA, Hirokazu, additional, TARA, Chizuru, additional, TABOHASHI, Tatsuru, additional, ISHIDA, Tatsunori, additional, NAKATA, Hiroko, additional, MIZUGUCHI, Yuta, additional, NOGAMI, Fumiko, additional, YAMAGUCHI, Natsumi, additional, and YAMANAKA, Ryoichi, additional

Published
2011
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50. Impact of Water Quality Variation on Mussel (Mytilus galloprovincialis) Biomass in Semi-enclosed Port.

Author

Yamanaka, Ryoichi, Miyoshi, Machi, Kozuki, Yasunori, Nogami, Fumiko, Ishida, Tatsunori, Yamaguchi, Natsumi, Tanaka, Chihiro, Matsumoto, Hidemasa, and Goto, Kotaro

Abstract

The article presents information on a study which examined the water quality threshold and generation mechanism inducing mussel drop-off in Amagasaki Port, a semi-enclosed port in the Osaka Bay, Japan. It discusses variation of mussel biomass as well as the relationship between temperature variation and mussel drop-off. Water quality loggers were used to measure the time-series of water temperature and salinity.

Published
2011

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