| Project/Area Number |
14571290
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Thoracic surgery
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| Research Institution | Kurume University |
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Principal Investigator |
AOYAGI Shigeaki Kurume university, School of medicine, MD, 医学部, 教授 (40098786)
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| Co-Investigator(Kenkyū-buntansha) |
HAYASHIDA Nobuhiko Kurume university, School of medicine, MD, 医学部, 講師 (30238141)
TAYAMA Eiki Kurume university, School of medicine, MD, 医学部, 助手 (90281542)
FUKUNAGA Shuji Kurume university, School of medicine, MD, 医学部, 講師 (90261073)
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| Project Period (FY) |
2002 – 2004
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| Project Status |
Completed (Fiscal Year 2004)
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| Budget Amount *help |
¥3,400,000 (Direct Cost: ¥3,400,000)
Fiscal Year 2004: ¥1,800,000 (Direct Cost: ¥1,800,000)
Fiscal Year 2003: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 2002: ¥1,000,000 (Direct Cost: ¥1,000,000)
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| Keywords | prosthetic valve dysfunction / pannus formation / aortic valve replacement / TGF-β1 / MDCT / immunohistological mechanism / 人工弁機能不全 / 血栓 / 術前診断 / 形質変換増殖因子 / 大動脈弁置換術 / TGF-β1 |
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| Research Abstract |
Objectives : Non-structual prosthetic valve dysfunction(PVD)due to thrombus and/or pannus is one of the major complications after prosthetic valve replacement. In this study, we elucidated histological and immunohistological mechanism of pannus formation. In addition, we evaluated usefulness of a multidetector-row computed tomography scanner (MDCT) for detecting causes of PVD.
Methdos. : Twenty-six patients with PVD(PVD group) and randomly selected 48 patients with normal prosthetic valve function (control group) were studied. The blood was analyzed for its prothrombin time-inter national normalized ratio(PT-INR) and expression of TGF-β1. Resected pannus of reoperative patients (n=11) were used for histological(HE,EVG Azan, Grocott's) and immunohistological(TGF-β1,α-SMA,CD34,vWF etc)staining. Eight patients with PVD were underwent MDCT for detecting pannus formation before reoperation.
Results : Expression of PVD group was significantly (p<0.05)grater than control group. PT-INR of PVD group was significantly (p<0.05)shorter than control group. We confirmed pannus formation was neointima with expression of TGF-β1, in the immunohistological study. We observed pannus formation detecting MDCT in 7 patients with PVD and these findings were confirmed during operation.
Conclusions : In adequate anticoaglant therapy is one of cause for PVD. The pannus formation after prosthetic valve replacement may be associated with a process of periannular tissue healing via the expression of TGF-β1. MDCT can be a useful diagnostic technique for anatomic and functional evaluation of PVD as a result of pannus formation.
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