今月の研究者

成井 浩司

成井 浩司

1)キャリア
1982年東海大学医学部卒業後,虎の門病院内科研修医。
1985年より東海大学第II内科勤務。
1988年より虎の門病院呼吸器科医員。
1992年シドニー大学コリン・サリバン教授のもと,CPAPの共同開発に携わる。
2003年より虎の門病院病院睡眠センターセンター長,呼吸器センター内科医長兼任。
2009年より虎の門病院睡眠呼吸器科部長。

2)研究分野
持続陽圧呼吸(CPAP)療法を中心とした睡眠時無呼吸症候群(SAS)の診療および,SASの診断・治療に関する研究を行っています。CPAP療法は今でこそ一般的となりましたが,私が研修医の頃にはSASの治療選択肢は外科的治療や気管切開に限られていました。私がシドニーからCPAP機器を日本に持ち帰り,当時の厚生労働省に働きかけ続けた結果,1998年にはCPAP療法が保険収載され,今では全国で治療が行えるようになりました。昨今,SASは高血圧や心不全といった循環器疾患との関連が注目されているため,循環器センターの医師とも協力し,日々の診療・研究にあたっています。

3)今後の豊富
CPAP療法を行っている患者さんは年々増えており,2017年現在,40万人前後となっています。治療の普及により,多くの国民のQOLが向上し,生活習慣病の1次予防,2次予防を介して国民の健康に寄与していると言えますが,実際にはSASの潜在患者数は500万人以上と言われています。多くの患者さんのニーズに応えるべく,今後はICTを活用したCPAPの遠隔管理が広まっていきます。これからも多くの患者さんに質の高い医療を提供するための研究と仕組み作りに尽力して参ります。

発表・論文

【発表・論文】

1.Comparison of clinical features and polysomnographic findings between men and women with sleep apnea. Yamakoshi S, Kasai T, Tomita Y, Takaya H, Kasagi S, Kawabata M, Narui K, Setoguchi Y. J Thorac Dis. 2016 Jan;8(1):145-51.

2.Relationship between sleep disordered breathing and diabetic retinopathy: Analysis of 136 patients with diabetes. Nishimura A, Kasai T, Tamura H, Yamato A, Yasuda D, Nagasawa K, Okubo M, Narui K, Mori Y. Diabetes Res Clin Pract. 2015 Aug;109(2):306-11.

3.Adaptive servo-ventilation in cardiac function and neurohormonal status in patients with heart failure and central sleep apnea nonresponsive to continuous positive airway pressure. Kasai T, Kasagi S, Maeno K, Dohi T, Kawana F, Kato M, Naito R, Ishiwata S, Ohno M, Yamaguchi T, Narui K, Momomura S. JACC Heart Fail. 2013 Feb;1(1):58-63.

4.Effects of obstructive sleep apnea and its treatment on signal-averaged P-wave duration in men. Maeno K, Kasagi S, Ueda A, Kawana F, Ishiwata S, Ohno M, Yamaguchi T, Narui K, Kasai T. Circ Arrhythm Electrophysiol. 2013 Apr;6(2):287-93.

5.Comparison between the apnea-hypopnea indices determined by the REMstar Auto M series and those determined by standard in-laboratory polysomnography in patients with obstructive sleep apnea. Ikeda Y, Kasai T, Kawana F, Kasagi S, Takaya H, Ishiwata S, Narui K. Intern Med. 2012;51(20):2877-85.

6.Relationship between atrial conduction delay and obstructive sleep apnea. Maeno K, Kasai T, Kasagi S, Kawana F, Ishiwata S, Ohno M, Yamaguchi T, Narui K. Heart Vessels. 2013 Sep;28(5):639-45.

7.Conversion from predominant central sleep apnea to obstructive sleep apnea following valvuloplasty in a patient with mitral regurgitation. Takahashi M, Kasai T, Dohi T, Maeno K, Kasagi S, Kawana F, Ishiwata S, Narui K. J Clin Sleep Med. 2011 Oct 15;7(5):523-5.

8.Change in cardio-ankle vascular index by long-term continuous positive airway pressure therapy for obstructive sleep apnea. Kato M, Kumagai T, Naito R, Maeno K, Kasagi S, Kawana F, Ishiwata S, Narui K, Kasai T. J Cardiol. 2011 Jul;58(1):74-82.

9.Effects of olmesartan on blood pressure and insulin resistance in hypertensive patients with sleep-disordered breathing. Dohi T, Narui K, Kasai T, Takaya H, Inoshita A, Maeno K, Kasagi S, Ishiwata S, Ohno M, Yamaguchi T, Momomura S. Heart Vessels. 2011 Nov;26(6):603-8.

10.Plasma pentraxin3 and arterial stiffness in men with obstructive sleep apnea. Kasai T, Inoue K, Kumagai T, Kato M, Kawana F, Sagara M, Ishiwata S, Ohno M, Yamaguchi T, Momomura S, Narui K. Am J Hypertens. 2011 Apr;24(4):401-7.

11.Evaluation of the apnea-hypopnea index determined by the S8 auto-CPAP, a continuous positive airway pressure device, in patients with obstructive sleep apnea-hypopnea syndrome. Ueno K, Kasai T, Brewer G, Takaya H, Maeno K, Kasagi S, Kawana F, Ishiwata S, Narui K. J Clin Sleep Med. 2010 Apr 15;6(2):146-51.

12.Effect of flow-triggered adaptive servo-ventilation compared with continuous positive airway pressure in patients with chronic heart failure with coexisting obstructive sleep apnea and Cheyne-Stokes respiration. Kasai T, Usui Y, Yoshioka T, Yanagisawa N, Takata Y, Narui K, Yamaguchi T, Yamashina A, Momomura SI; JASV Investigators. Circ Heart Fail. 2010 Jan;3(1):140-8.

13.Establishment of the cardio-ankle vascular index in patients with obstructive sleep apnea. Kumagai T, Kasai T, Kato M, Naito R, Maeno KI, Kasagi S, Kawana F, Ishiwata S, Narui K. Chest. 2009 Sep;136(3):779-786.

14.A case of obstructive sleep apnea with dissociation between apnea termination and arousal: Is this a hint for complex sleep apnea. Higuchi M, Kasai T, Kasagi S, Kawana F, Ishiwata S, Narui K. Sleep Med. 2009 Oct;10(9):1063-5.

15.Atrioventricular block during the phasic events of REM sleep in a patient with severe obstructive sleep apnea syndrome. Kawana F, Kasai T, Maeno K, Momomura S, Narui K. J Clin Sleep Med. 2008 Jun 15;4(3):257-9.

16.Bi-level positive airway pressure ventilation for treating heart failure with central sleep apnea that is unresponsive to continuous positive airway pressure. Dohi T, Kasai T, Narui K, Ishiwata S, Ohno M, Yamaguchi T, Momomura S. Circ J. 2008 Jul;72(7):1100-5.

17.Prognosis of patients with heart failure and obstructive sleep apnea treated with continuous positive airway pressure. Kasai T, Narui K, Dohi T, Yanagisawa N, Ishiwata S, Ohno M, Yamaguchi T, Momomura S. Chest. 2008 Mar;133(3):690-6.

18.Cardiac metastasis from lung adenocarcinoma causing atrioventricular block and left ventricular outflow tract obstruction. Kasai T, Kishi K, Kawabata M, Narui K, Momomura S, Yoshimura K. Chest. 2007 May;131(5):1569-72.

19.First experience of using new adaptive servo-ventilation device for Cheyne-Stokes respiration with central sleep apnea among Japanese patients with congestive heart failure: report of 4 clinical cases. Kasai T, Narui K, Dohi T, Takaya H, Yanagisawa N, Dungan G, Ishiwata S, Ohno M, Ymaguchi T, Momomura S. Circ J. 2006 Sep;70(9):1148-54.

20.Efficacy of nasal bi-level positive airway pressure in congestive heart failure patients with cheyne-stokes respiration and central sleep apnea. Kasai T, Narui K, Dohi T, Ishiwata S, Yoshimura K, Nishiyama S, Yamaguchi T, Momomura S. Circ J. 2005 Aug;69(8):913-21.

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