| Project/Area Number |
16K09463
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Cardiovascular medicine
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| Research Institution | Fujita Health University |
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Principal Investigator |
Ozaki Yukio 藤田医科大学, 医学部, 教授 (50298569)
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| Co-Investigator(Kenkyū-buntansha) |
渡邉 英一 藤田医科大学, 医学部, 教授 (80343656)
井澤 英夫 藤田医科大学, 医学部, 教授 (80402569)
皿井 正義 藤田医科大学, 大学病院, 教授 (10298531)
村松 崇 藤田医科大学, 医学部, 准教授 (40783759)
元山 貞子 藤田医科大学, 医学部, 教授 (30308902)
河合 秀樹 藤田医科大学, 医学部, 講師 (30778361)
外山 宏 藤田医科大学, 医学部, 教授 (90247643)
片田 和広 藤田医科大学, 医学部, 教授 (00101684)
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| Project Period (FY) |
2016-04-01 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2018: ¥130,000 (Direct Cost: ¥100,000、Indirect Cost: ¥30,000)
Fiscal Year 2017: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2016: ¥2,990,000 (Direct Cost: ¥2,300,000、Indirect Cost: ¥690,000)
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| Keywords | Acute Coronary Syndromes / Ruptured Fibrous Cap / Intact Fibrous Cap / OCT / Intravascular Ultrasound / Coronary CT Angiography / 急性冠症候群 / 冠動脈CT / プラークびらん / プラーク破綻 / 光干渉断層像 / 冠動脈内エコー / 循環器・高血圧 |
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| Outline of Final Research Achievements |
Atherosclerotic plaques associated with acute coronary syndromes (ACS) on histopathological characterisation demonstrate either ruptured fibrous caps (RFC-ACS) or intact fibrous caps (IFC-ACS). The latter lesions are often referred to as plaque erosions and are responsible for up to one-third of culprit lesions. A total of 66 patients either ACS or stable patients underwent CT-angiography, OCT, angioscopy, IVUS. Fibrous caps were significantly thinner in RFC-ACS than IFC-ACS and stable angina. Positive remodelling was more predominantly seen in RFC-ACS than IFC-ACS and stable angina. However, none of the specific CT-angiography features clearly distinguished IFC-ACS from stable lesions. In contrast to the situation with RFC-ACS, distinct culprit lesion characteristics associated with non-rupture related mechanisms are not identified by current CT angiography. Future technology including high resolution CT would overcome such limitations.
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| Academic Significance and Societal Importance of the Research Achievements |
JACSS研究によれば日本人の急性心筋梗塞(AMI)の院内死亡率は8％で、JCAD 研究では陳旧性心筋梗塞例は非梗塞例に比べて予後が悪いことが示されている。AMIの原因はプラーク破綻 (RFC-ACS)と、びらん(intact fibrous cap ACS [IFC-ACS])であるが、光干渉断層像OCT）、近赤外線断層像(NIRS)、冠動脈内エコー(IVUS)などは病態の解明に有用である。一方、冠動脈CTにより病態の把握が非侵襲的に行えれば、近年増加している急性冠症候群(ACS)を、低侵襲かつ低コストに診断でき、予防にも貢献できる可能性が本研究により示唆された。
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