Comprehensive cardiac rehabilitation is useful for suppressing the increase of elderly heart failure patients with cognitive impairment

• Project/Area Number: 15K01389
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Rehabilitation science/Welfare engineering
• Research Institution: Kitasato University
• Principal Investigator: Yamaoka-Tojo Minako 北里大学, 医療衛生学部, 教授 (80327345)
• Research Collaborator: Aoyama Akihiro ; Kariya Hidenori ; Fujiyoshi Kazuhiro ; Ako Junya
• Project Period (FY): 2015-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000); Fiscal Year 2018: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2017: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2016: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2015: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
• Keywords: 心臓リハビリテーション / 血管内皮機能 / 認知機能 / フレイル / 振動性加速度トレーニング / 微小循環 / 心不全 / 疾病管理 / 循環器病予防 / 認知機能低下 / 糖尿病 / 動脈硬化 / 高齢者 / 循環器病予防医学 / 慢性心不全 / 歩行機能

Outline of Final Research Achievements

Comprehensive cardiac rehabilitation improved vascular endothelial function, autonomic nervous function, and microcirculuration in the tissue, especially with acceleration training that can be safely performed even in elderly cardiovascular disease patients who are in a flail state. We also developed our exercise program for elderly patients with cardiovascular disease (Aoyama A, Yamaoka-Tojo M, et al. Int Heart J. in press). Furthermore, for heart failure patients with impaired cognitive function, it has been shown that cardiac rehabilitation improved vascular endothelial function and cognitive impairment (under submission preparation).

Academic Significance and Societal Importance of the Research Achievements

多疾患有病者である高齢慢性心不全患者の認知機能と血管内皮機能を標的とした心臓リハビリテーションの効果を検討した報告はない。包括的心臓リハビリテーションは、心事故による救急発生を減少させ、再発・重症化による莫大な医療コストを軽減するのみならず、患者・家族・社会全体の労務負担を軽減することに直結することが期待される。本研究課題で得られた成果は、心臓リハビリテーションを基軸とした地域連携疾病管理の新たなエビデンスとなり、超高齢社会における生涯コストを抑制するなど、我が国が直面している医療崩壊の危機を救うことにつながり、健康長寿延伸に大きく貢献できるなど、さらなる波及効果をもたらすものと考えられる。

Research Products

• [Journal Article] Acute effects of whole-body vibration training on endothelial function and cardiovascular responses in elderly patients with cardiovascular disease: a single-arm pilot study. (2019)
  • Author(s): Aoyama A, Yamaoka-Tojo M, Obara S, Shimizu E, Fujiyoshi K, Noda C, Matsunaga A, Ako J.
  • Journal Title: Int Heart J Volume: 印刷中
  • Peer Reviewed / Open Access
• [Journal Article] Impaired flow-mediated dilation and severity and vulnerability of culprit plaque in patinets with coronary artery disease. (2019)
  • Author(s): Nemoto T, Minami Y, Yamaoka-Tojo M, Sato T, Muramatsu Y, Kakizaki R, Fujiyoshi K, Hashimoto T, Meguro K, Shimohama T, Tojo T, Ako J.
  • Journal Title: Int Heart J Volume: 印刷中
  • Peer Reviewed / Open Access
• [Journal Article] Endothelial Dysfunction Is Associated with Cognitive Impairment of Elderly Cardiovascular Disease Patients (2018)
  • Author(s): Fujiyoshi K, Yamaoka-Tojo M, Minami Y, Kutsuna T, Obara S, Kakizaki R, Nemoto T, Hashimoto T, Namba S, Shimohama T, Tojo T, Ako J.
  • Journal Title: International Heart Journal Volume: 59 Issue: 5 Pages: 1034-1040
  • DOI: 10.1536/ihj.17-610
  • NAID: 130007490474
  • ISSN: 1349-2365, 1349-3299
  • Year and Date: 2018-09-01
  • Peer Reviewed / Open Access
• [Journal Article] Excessive SBP elevation during moderate exercise discriminates patients at high risk of developing left ventricular hypertrophy from hypertensive patients. (2017)
  • Author(s): Tanaka S, Masuda T, Kamada Y, Hamazaki N, Kamiya K, Ogura MN, Maekawa E, Noda C, Yamaoka-Tojo M, Ako J.
  • Journal Title: J Hypertens. Volume: 印刷中 Issue: 6 Pages: 1291-1298
  • DOI: 10.1097/hjh.0000000000001700
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Gait speed has comparable prognostic capability to six-minute walk distance in older patients with cardiovascular disease. (2017)
  • Author(s): Kamiya K, Hamazaki N, Matsue Y, Mezzani A, Corra U, Matsuzawa R, Nozaki K, Tanaka S, Maekawa E, Noda C, Yamaoka-Tojo M, Matsunaga A, Masuda T, Ako J.
  • Journal Title: Eur J Prev Cardiol. Volume: 印刷中 Issue: 2 Pages: 212-219
  • DOI: 10.1177/2047487317735715
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Rationale and design of a multicenter placebo-controlled double-blind randomized trial to evaluate the effect of empagliflozin on endothelial function: the EMBLEM trial. (2017)
  • Author(s): Tanaka A, Shimabukuro M, Okada Y, Taguchi I, Yamaoka-Tojo M, Tomiyama H, Teragawa H, Sugiyama S, Yoshida H, Sato Y, Kawaguchi A, Ikehara Y, Machii N, Maruhashi T, Shima KR, Takamura T, Matsuzawa Y, Kimura K, Sakuma M, Oyama JI, Inoue T, Higashi Y, Ueda S, Node K; EMBLEM Trial Investigators.
  • Journal Title: Cardiovasc Diabetol. Volume: 印刷中 Issue: 1 Pages: 48-48
  • DOI: 10.1186/s12933-017-0532-8
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Endothelial function for cardiovascular disease prevention and management. (2017)
  • Author(s): Minako Yamaoka-Tojo
  • Journal Title: International Journal of Clinical Cardiology Volume: 4 Issue: 3 Pages: 1-11
  • DOI: 10.23937/2378-2951/1410103
  • Peer Reviewed / Open Access
• [Journal Article] 生活習慣病患者において最大歩行速度の低値は血管内皮機能障害に関連する． (2017)
  • Author(s): 苅谷英紀、松永篤彦、牧野彰宏、金子善恵、清水絵里香、伊藤博祐、遠原真一、忽那俊樹、東條美奈子、阿古潤哉．
  • Journal Title: 日循予防誌（JJCDP） Volume: 52 Pages: 29-35
  • Peer Reviewed
• [Journal Article] Utility of SARC-F for assessing physical function in elderly patients with cardiovascular disease. (2017)
  • Author(s): Tanaka S, Kamiya K, Hamazaki N, Matsuzawa R, Nozaki K, Maekawa E, Noda C, Yamaoka-Tojo M, Matsunaga A, Masuda T, Ako J.
  • Journal Title: J Am Med Dir Assoc. Volume: 18 Issue: 2 Pages: 176-181
  • DOI: 10.1016/j.jamda.2016.10.019
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Effects on bone metabolism markers and arterial stiffness by switching to rivaroxaban from warfarin in patients with atrial fibrillation. (2017)
  • Author(s): Namba S, Yamaoka-Tojo M, Kakizaki R, Nemoto T, Fujiyoshi K, Hashikata T, Kitasato L, Hashimoto T, Kameda R, Meguro K, Shimohama T, Tojo T, Ako J.
  • Journal Title: Heart Vessels. Volume: 印刷中 Issue: 8 Pages: 983-983
  • DOI: 10.1007/s00380-017-0966-7
  • Peer Reviewed / Open Access
• [Journal Article] Ezetimibe enhances and stabilizes anticoagulant effect of warfarin. (2016)
  • Author(s): Hashikata T, Yamaoka-Tojo M, Kakizaki R, Nemoto T, Fujiyoshi K, Namba S, Kitasato L, Hashimoto T, Ishii S, Kameda R, Shimohama T, Tojo T, Ako J.
  • Journal Title: Heart Vessels. (in press) Volume: X
  • Peer Reviewed / Open Access
• [Journal Article] 入院早期に評価したShort Performance Batteryは心不全で入院した後期高齢者の退院時における歩行能力を予測する． (2016)
  • Author(s): 田中伸弥、増田 卓、神谷健太郎、濱崎伸明、松沢良太、野崎康平、岩村貴美、河野真理、五十嵐亜希子、青山晃大、中村岳史、藪 香苗、前川恵美、東條美奈子、阿古潤哉．
  • Journal Title: 日循予防誌（JJCDP） Volume: 51 Pages: 1-9
  • Peer Reviewed
• [Journal Article] Teneligliptin, a novel dipeptidyl peptidase-4 inhibitor, ameliorates left ventricular function accompanied by improvement of endothelial dysfunction. (2016)
  • Author(s): Hashikata T, Yamaoka-Tojo M, Fujiyoshi K, Kakizaki R, Nemoto T, Namba S, Kitasato L, Hashimoto T, Kameda R, Maekawa E, Shimohama T, Tojo T, Ako J.
  • Journal Title: Heart Vessels. (in press) Volume: X
  • Peer Reviewed / Open Access
• [Journal Article] Neointimal coverage of zotarolimus-eluting stent at 1, 2, and 3 months’ follow-up: an optical coherence tomography study. (2016)
  • Author(s): Hashikata T, Tojo T, Namba S, Kitasato L, Hashimoto T, Kameda R, Shimohama T, Yamaoka-Tojo M, Ako J.
  • Journal Title: Heart Vessels. Volume: 2 Issue: 2 Pages: 206-11
  • DOI: 10.1007/s00380-014-0598-0
  • Peer Reviewed / Open Access
• [Journal Article] Low Stroke Rate of Carotid Stenosis Under the Guideline-Oriented Medical Treatment Compared With Surgical Treatment (2016)
  • Author(s): SatoK, Fujiyoshi K, Hoshi K, Noda C, Yamaoka-Tojo M, Ako J, Kumabe T.
  • Journal Title: International Heart Journal Volume: 57 Issue: 1 Pages: 80-86
  • DOI: 10.1536/ihj.15-196
  • NAID: 130005121004
  • ISSN: 1349-2365, 1349-3299
  • Peer Reviewed / Open Access
• [Journal Article] Long-term warfarin therapy and biomarkers for osteoporosis and atherosclerosis. (2015)
  • Author(s): Sayaka Namba, Minako Yamaoka-Tojo, Takehiro Hashikata, Yuki Ikeda, Lisa Kitasato, Takuya Hashimoto, Takao Shimohama, Taiki Tojo, Naonobu Takahira, Takashi Masuda, Junya Ako.
  • Journal Title: BBA Clin. Volume: 4 Pages: 76-80
  • DOI: 10.1016/j.bbacli.2015.08.002
  • Peer Reviewed / Open Access
• [Presentation] 心不全患者の疾患管理状態に関わらずフレイルの合併は運動耐容能の低下に関与する． (2017)
  • Author(s): 清水絵里香、東條美奈子、青山晃大、遠原真一、高橋由美、野田千春、阿古潤哉．
  • Organizer: 第21回日本心不全学会学術集会
• [Presentation] 維持期心血管疾患患者における慢性腎臓病ステージと左室心筋重量係数の経時的変化． (2017)
  • Author(s): 青山晃大、東條美奈子、清水絵里香、高橋由美、野田千春、松永篤彦、阿古潤哉．
  • Organizer: 第21回日本心不全学会学術集会
• [Presentation] Cardiac rehabilitation improves cognitive function in elderly patients with cardiovascular disease. (2017)
  • Author(s): Fujiyoshi K, Yamaoka-Tojo M, Minami Y, Kutsuna T, Obara S, Takahashi Y, Sekine E, Aoyama A, Katsura A, Kakizaki R, Nemoto t, Namba S, Hashimoto T, Ynagisawa T, noda C, Meguro K, Shimohama T, Tojo T, Ako J.
  • Organizer: European Society of Cardiology 2017
  • Int'l Joint Research
• [Presentation] Low renal function is associated with poor physical function and exercise capacity in patients with chronic cardiovascular disease. (2017)
  • Author(s): Aoyama A, Yamaoka-Tojo M, Obara S, Kutsuna T, Fujiyoshi K, Sekine E, Takahashi Y, Noda C, Matsunaga A, Ako J.
  • Organizer: European Society of Cardiology 2017
  • Int'l Joint Research
• [Presentation] 高齢者心不全の病態コントロール, 心不全フレイルの改善方法. (2017)
  • Author(s): 東條美奈子
  • Organizer: パネルディスカッション３, 第23回日本心臓リハビリテーション学会学術集会
  • Invited
• [Presentation] 高齢心血管疾患患者における認知機能障害とreactive hyperemia peripheral arterial tonometry (RH-PAT)による血管内皮機能との関係 (2016)
  • Author(s): 藤吉和博、東條美奈子、柿崎良太、根本照世志、橋本拓弥、難波早弥香、亀田良、南尚賢、目黒健太郎、下浜孝郎、東條大輝、阿古潤哉．
  • Organizer: 脳心血管抗加齢研究会2016
  • Place of Presentation: 東京・秋葉原UDX（東京都千代田区）
  • Year and Date: 2016-12-18
• [Presentation] High daily physical activity is associated with subsequent prevented decreasing left ventricular diastolic function in patients with ischemic heart disease. (2016)
  • Author(s): Kariya H, Kutsuna T, Obara S, Takahashi Y, Sekine E, Noda C, Matsunaga A, Yamaoka-Tojo M, Ako J.
  • Organizer: The 20th Annual Scientific Meeting of the Japanese Heart Failure Society
  • Place of Presentation: ロイトン札幌（北海道札幌市）
  • Year and Date: 2016-10-07
• [Presentation] 心臓リハビリテーションからみた血管病予後改善効果 (2016)
  • Author(s): 東條美奈子
  • Organizer: 第64回日本心臓病学会学術集会
  • Place of Presentation: 東京国際フォーラム（東京都千代田区）
  • Year and Date: 2016-09-23
  • Invited
• [Presentation] 高齢心疾患患者の歩行機能およびバランス機能と前頭葉機能の関連． (2016)
  • Author(s): 藤吉和博、東條美奈子、忽那俊樹、遠原真一、関根恵美子、高橋由美、難波早弥香、前川恵美、野田千春、増田卓、阿古潤哉．
  • Organizer: 第22回日本心臓リハビリテーション学会
  • Place of Presentation: 東京国際フォーラム（東京都千代田区）
  • Year and Date: 2016-07-17
• [Presentation] 再入院予防を目指す心臓リハビリテーションを考える (2016)
  • Author(s): 東條美奈子
  • Organizer: 第22回日本心臓リハビリテーション学会
  • Place of Presentation: 東京国際フォーラム（東京都千代田区）
  • Year and Date: 2016-07-16
  • Invited
• [Presentation] 認知機能が低下した心不全患者の心臓リハビリテーション (2016)
  • Author(s): 東條美奈子
  • Organizer: 第22回日本心臓リハビリテーション学会
  • Place of Presentation: 東京国際フォーラム（東京都千代田区）
  • Year and Date: 2016-07-16
  • Invited
• [Presentation] 心臓リハビリテーションによる血管内皮機能改善効果 (2016)
  • Author(s): 東條美奈子
  • Organizer: 第48回日本動脈硬化学会総会・学術集会
  • Place of Presentation: 京王プラザ（東京都新宿区）
  • Year and Date: 2016-07-15
  • Invited
• [Presentation] 循環器疾患の一次予防と二次予防．日本循環器学会委員会セッション（予防委員会）日本循環器学会や新設した予防委員会の役割と目指す場所． (2016)
  • Author(s): 東條美奈子．
  • Organizer: The 80th Annual Scientific Meeting of the Japanese Circulation Society
  • Place of Presentation: 宮城県仙台市（東北大学百年記念会館）
  • Year and Date: 2016-03-18
  • Invited
• [Presentation] Rivaroxaban reduces circulating levels of osteopontin accompanyied by improvement in vascular endothelial function in atrial fibrillation patients. (2015)
  • Author(s): 10.Namba S, Yamaoka-Tojo M, Fujiyoshi K, Hashikata T, Kitasato L, Hashimoto T, Meguro K, Shimohama T, Tojo T, Ako J.
  • Organizer: ESC 2015
  • Place of Presentation: Rondon, UK
  • Year and Date: 2015-08-29
  • Int'l Joint Research
• [Presentation] 心不全患者の入院早期に評価した10m快適歩行時の最高心拍数は、心不全再入院と心臓死の予測因子となる． (2015)
  • Author(s): 前川恵美、増田卓、田中伸弥、野崎康平、松沢良太、濱崎伸明、神谷健太郎、五十嵐亜希子、河野真里、岩村貴美、野田千春、猪又孝元、東條美奈子、阿古潤哉．
  • Organizer: 第21回日本心臓リハビリテーション学会学術集会
  • Place of Presentation: 福岡県福岡市（福岡国際会議場）
  • Year and Date: 2015-07-19
• [Presentation] 維持期高齢虚血性心疾患患者に対する監視型リハビリテーションの運動機能への効果． (2015)
  • Author(s): 4.遠原真一、忽那俊樹、苅谷英紀、牧野彰宏、関根恵美子、高橋由美、木村雅彦、野田千春、東條美奈子、松永篤彦、増田卓、阿古潤哉．
  • Organizer: 第21回日本心臓リハビリテーション学会学術集会
  • Place of Presentation: 福岡県福岡市（福岡国際会議場）
  • Year and Date: 2015-07-19
• [Presentation] 入院期にフレイルを合併した高齢心不全患者では退院後の運動耐容能の回復が著しく阻害される． (2015)
  • Author(s): 6.野崎康平、増田卓、神谷健太郎、濱崎伸明、松沢良太、田中伸弥、岩村貴美、河野真里、五十嵐亜希子、前川恵美、野田千春、東條美奈子、阿古潤哉．
  • Organizer: 第21回日本心臓リハビリテーション学会学術集会
  • Place of Presentation: 福岡県福岡市（福岡国際会議場）
  • Year and Date: 2015-07-19