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受容体多型性解析による拡張型心筋症におけるβ遮断薬に対する反応多様性の機序解明

Research Project

Project/Area Number 16790428
Research Category

Grant-in-Aid for Young Scientists (B)

Allocation TypeSingle-year Grants
Research Field Circulatory organs internal medicine
Research InstitutionOsaka City University

Principal Investigator

竹本 恭彦  大阪市立大学, 大学院医学研究科, 助手 (20364002)

Project Period (FY) 2004 – 2005
Project Status Completed (Fiscal Year 2005)
Budget Amount *help
¥2,900,000 (Direct Cost: ¥2,900,000)
Fiscal Year 2005: ¥1,400,000 (Direct Cost: ¥1,400,000)
Fiscal Year 2004: ¥1,500,000 (Direct Cost: ¥1,500,000)
Keywords拡張型心筋症 / アドレナリンβ受容体遮断薬 / レスポンダー / 冠血流予備能 / 局所心筋運動不均一性
Research Abstract

近年心不全は増加傾向であり、その主要原因疾患である拡張型心筋症に対し有効であるアドレナリンβ受容体遮断薬療法が注目されている。しかしながら、アドレナリンβ受容体遮断薬に対する著効例と無効例が存在することが本治療法の問題点である。この反応性の差異を生じる機序を解明すべく以下の観点から検討を行った。(1)冠血流予備能:拡張型心筋症では健常者より冠血流予備能は低下しているが、アドレナリンβ受容体遮断薬療法により低下していた冠血流予備能が改善することを証明し、Journal of the American College of Cardiology 2005 45(2):318-319において報告した。(2)心筋運動不均一性:拡張型心筋症においては局所心筋運動の不均一性があり、心拍出が非効率となり心不全を生じる。アドレナリンβ受容体遮断薬療法により局所心筋運動不均一性が改善され、左室全体の心拍出非効率性も改善されることを証明し、Journal of the American College of Cardiology 2005 45(3)supplement A:289A、日本心不全学会誌、において報告した。また、欧米人の拡張型心筋症例において心不全発症危険因子と報告されているα_<2c>、Del322-325、β_1Ser49、β_1Arg389といったアドレナリン受容体多型は日本人の拡張型心筋症例では心不全発症危険因子ではないことを証明し、British Journal of Clinical Pharmacology 2005 60(4):414-417において報告した。今回証明したアドレナリンβ受容体遮断薬療法が拡張型心筋症に対し有効性を生じる機序や拡張型心筋症から心不全を生じる機序から、アドレナリンβ受容体遮断薬に対する反応性の差異を生じる機序がある程度解明できたものと考える。今後さらに症例とデータを重ね検討を進める。

Report

(2 results)
  • 2005 Annual Research Report
  • 2004 Annual Research Report
  • Research Products

    (25 results)

All 2006 2005 Other

All Journal Article (14 results) Book (11 results)

  • [Journal Article] Early Recovery of Impaired Coronary Flow Reserve by Carvedilol Therapy in Patients With Idiopathic Dilated Cardiomyopathy : A Serial Transthoracic Doppler Echocardiographic Study2005

    • Author(s)
      Kenichi Sugioka
    • Journal Title

      Journal of the American College of Cardiology 45(2)

      Pages: 318-319

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Acute improvement of atrial mechanical stunning after Electrical cardioversion of persistent atrial fibrillation : comparison between biatrial and single Atrial pacing2005

    • Author(s)
      Masahiko Takagi
    • Journal Title

      Heart 91

      Pages: 58-63

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Comparison of Accurate Measurement of Left Ventricular Mass in Patients With Hypertrophied Hearts by Real-Time Three-Dimensional Echocardiography Versus Magnetic Resonance Imaging2005

    • Author(s)
      Hiroki Oe
    • Journal Title

      The American Journal of Cardiology 95

      Pages: 1263-1267

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Non-invasive Assessment of Myocardial Ischemia Using New Real-Time Three-Dimensional Dobutamine Stress Echocardiography : Comparison With Conventional Two-Dimensional Methods2005

    • Author(s)
      Yoshiki Matsumura
    • Journal Title

      European Heart Journal 26

      Pages: 1625-1632

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Usefulness of Left Atrial Volume in Predicting First Congestive Heart Failure in Patients【greater than or equal】65 Years of Age With Well-Preserved Left Ventricular Systolic Function2005

    • Author(s)
      Yasuhiko Takemoto
    • Journal Title

      The American Journal of Cardiology 96

      Pages: 832-836

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Analysis of the Interaction Between Segmental Relaxation Patterns and Global Diastolic Function by Strain Echocardiography2005

    • Author(s)
      Yasuhiko Takemoto
    • Journal Title

      Journal of the American Society of Echocardiography 18

      Pages: 901-906

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Impaired Coronary Circulation in Patients With Apical Hypertrophic Cardiomyopathy : Noninvasive Analysis by Transthoracic Doppler Echocardiography2005

    • Author(s)
      Ken Yoshida
    • Journal Title

      Echocardiography 22(9)

      Pages: 723-729

    • Related Report
      2005 Annual Research Report
  • [Journal Article] No Positive Association Between Adrenergic Receptor Variants of _2cDel322-325,_1Ser49,_1Arg389 And the Risk For Heart Failure in the Japanese Population2005

    • Author(s)
      Shinpei Nonen
    • Journal Title

      British Journal of Clinical Pharmacology 60(4)

      Pages: 414-417

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Early Recovery of Impaired Coronary Flow Reserve by Carvedilol Therapy in Patients With Idiopathic Dilated Cardiomyopathy : A Serial Transthoracic 〜.2005

    • Author(s)
      Kenichi Sugioka, et al.
    • Journal Title

      Journal of the American College of Cardiology 45(2)

      Pages: 318-319

    • Related Report
      2004 Annual Research Report
  • [Journal Article] Estimation of Myocardial Ischemia by Diastolic Strain Analysis in Exercise Stress Echocardiography : Comparison With Exercise Thalium201SPECT

    • Author(s)
      Hong Zhu
    • Journal Title

      Journal of Cardiology In press

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Coronary Flow Velocity Reserve Measurement in Three Major Coronary Arteries Using Transthoracic Doppler Echocardiography

    • Author(s)
      Eriko Murata
    • Journal Title

      Echocardiography In press

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Automated Three-Dimensional Analysis of Mitral Annular Dynamics in Patients with Myocardial Infarction Using Automated Mitral Annular Tracking Method

    • Author(s)
      Yasuhiko Takemoto
    • Journal Title

      Echocardiography In press

    • Related Report
      2005 Annual Research Report
  • [Journal Article] Cut-off Value of Coronary Flow Velocity Reserve by Transthoracic Doppler Echocardiography for the Assessment of Significant Donor Left Anterior Descending Artery Stenosis in Patients With Spontaneously Visible Collaterals

    • Author(s)
      Shinichi Iwata
    • Journal Title

      The American Journal of Cardiology In press

    • Related Report
      2005 Annual Research Report
  • [Journal Article] No positive association between adrenergic receptor variants of alpha2c Del322-325, beta1Ser49, beta1Arg389 and the risk for heart failure in 〜.

    • Author(s)
      Shinpei Nonen
    • Journal Title

      British Journal of Clinical Pharmacology (In press)

    • Related Report
      2004 Annual Research Report
  • [Book] Junior:循環器疾患カンファランス2006

    • Author(s)
      竹本 恭彦
    • Total Pages
      6
    • Publisher
      日本医事新報社
    • Related Report
      2005 Annual Research Report
  • [Book] 臨床心臓病学:狭心症診断2006

    • Author(s)
      竹本 恭彦
    • Total Pages
      5
    • Publisher
      文光堂
    • Related Report
      2005 Annual Research Report
  • [Book] 臨床心臓病学:大動脈解離2006

    • Author(s)
      竹本 恭彦
    • Total Pages
      6
    • Publisher
      文光堂
    • Related Report
      2005 Annual Research Report
  • [Book] 臨床心臓病学:大動脈解離治療2006

    • Author(s)
      竹本 恭彦
    • Total Pages
      3
    • Publisher
      文光堂
    • Related Report
      2005 Annual Research Report
  • [Book] 臨床心臓病学:Valsalva洞動脈瘤破裂2006

    • Author(s)
      竹本 恭彦
    • Total Pages
      4
    • Publisher
      文光堂
    • Related Report
      2005 Annual Research Report
  • [Book] 心エコー:心不全の病態生理2005

    • Author(s)
      竹本 恭彦
    • Total Pages
      5
    • Publisher
      文光堂
    • Related Report
      2005 Annual Research Report
  • [Book] 新心臓病診療プラクティス冠動脈疾患を診るI:左室壁運動、左室機能評価2005

    • Author(s)
      竹本 恭彦
    • Total Pages
      6
    • Publisher
      文光堂
    • Related Report
      2005 Annual Research Report
  • [Book] Cardiovascular Med-Surg:大動脈弁疾患のエコー2005

    • Author(s)
      竹本 恭彦
    • Total Pages
      6
    • Publisher
      メディカルレビュー社
    • Related Report
      2005 Annual Research Report
  • [Book] 心エコー:左室拡張能の心エコー指標2005

    • Author(s)
      竹本 恭彦
    • Total Pages
      9
    • Publisher
      文光堂
    • Related Report
      2005 Annual Research Report
  • [Book] 循環器フィジカル・イグザミネーションの実際2005

    • Author(s)
      吉川 純一
    • Total Pages
      278
    • Publisher
      文光堂
    • Related Report
      2005 Annual Research Report
  • [Book] 心エコーを用いた拡張機能の評価法アップデート2005

    • Author(s)
      竹本 恭彦
    • Total Pages
      4
    • Publisher
      日本心不全学会
    • Related Report
      2005 Annual Research Report

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Published: 2004-04-01   Modified: 2016-04-21  

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