Effects of percutaneous coronary intervention and coronary artery bypass grafting on coronary flow reserve

• Project/Area Number: 16K10264
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Radiation science
• Research Institution: Hokkaido University
• Principal Investigator: Naya Masanao 北海道大学, 大学病院, 講師 (20455637)
• Research Collaborator: Manabe Osamu
• Project Period (FY): 2016-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000); Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2017: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000); Fiscal Year 2016: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
• Keywords: 冠血流予備能 / 冠動脈疾患 / 経皮的冠動脈形成術 / 冠動脈バイパス術 / 生活習慣病 / PET / SYNTAXスコア / 循環器 / 放射線

Outline of Final Research Achievements

This study clarified the subjects below to evaluate the effective treatment for coronary artery disease based on coronary flow reserve (CFR). 1. Development of noninvasive CFR measurement: we developed the scan protocol and data analysis to estimate CFR by using O15-water PET /CT. 2. Effects of optical medical therapy on CFR: Because the rate of achievement of optical medical therapy was high as 71% at baseline, the CFR did not change at 6 months. 3. Effects of coronary revascularization: Among 72 patients with coronary artery disease, 28 and 20 patients underwent percutaneous coronary intervention and coronary artery bypass grafting, respectively. The CFR less than 2.0 or the SYNTAX score more than and equal to 23 are associated with increase in CFR by coronary revascularization.

Academic Significance and Societal Importance of the Research Achievements

本研究では、3大死亡原因である心疾患を対象に、高いエビデンスレベルにすべく前向き介入観察試験を企画実行した。本研究の意義は、冠動脈疾患に対してガイドラインに従った治療によって、冠血流予備能を指標に2.0未満の患者に対して冠血行再建術の冠血流予備能に対する改善度を明らかにした点にある。今後、SYNTAXスコアに加えてこの非侵襲的CFRガイドによる治療により、心疾患の予後改善および医療費削減に貢献すると考えられ、社会的意義が大きい。

Research Products

• [Journal Article] Effects of coronary revascularization on global coronary flow reserve in stable coronary artery disease (2018)
  • Author(s): Aikawa Tadao、Naya Masanao、Obara Masahiko、Manabe Osamu、Magota Keiichi、Koyanagawa Kazuhiro、Asakawa Naoya、Ito Yoichi M、Shiga Tohru、Katoh Chietsugu、Anzai Toshihisa、Tsutsui Hiroyuki、Murthy Venkatesh L、Tamaki Nagara
  • Journal Title: Cardiovascular Research Volume: 115 Issue: 1 Pages: 119-129
  • DOI: 10.1093/cvr/cvy169
  • NAID: 120006546754
  • Peer Reviewed / Open Access
• [Journal Article] PET/CT scanning with 3D acquisition is feasible for quantifying myocardial blood flow when diagnosing coronary artery disease (2017)
  • Author(s): Osamu Manabe, Masanao Naya, Aikawa Tadao, Masahiko Obara, Keiichi Magota, Markus Kroenke, Noriko Oyama-Manabe, Kenji Hirata, Daiki Shinyama, Chietsugu Katoh, and Nagara Tamaki
  • Journal Title: EJNMMI Research Volume: 1 Issue: 1 Pages: 52-52
  • DOI: 10.1186/s13550-017-0296-x
  • NAID: 120006331857
  • Peer Reviewed / Open Access
• [Presentation] 核医学的手法を用いた虚血性心疾患の治療戦略 (2019)
  • Author(s): 納谷昌直
  • Organizer: 日本循環器学会総会
• [Presentation] CFRを極める (2019)
  • Author(s): 納谷昌直
  • Organizer: Friends Live
• [Presentation] 冠動脈疾患患者において血清TBARSは冠微小循環障害の予測因子である (2018)
  • Author(s): 納谷昌直
  • Organizer: 日本核医学会総会
• [Presentation] Clinical values of 15O-water PET in the detection of multi-vessel disease (2018)
  • Author(s): Kazunori Omote, Masanao Naya, Tadao Aikawa, Toshiyuki Nagai, Kazuhiro Koyanagawa, Hirokazu Komoriyama, Yoshiya Kato, Yusuke Tokuda, Naoya Asakawa, Toshihisa Anzai
  • Organizer: FRIENDSLIVE
• [Presentation] 核医学的手法を用いた虚血性心疾患の治療戦略 (2018)
  • Author(s): 納谷昌直
  • Organizer: 日本循環器学会総会
• [Presentation] Clinical applications of coronary flow reserve in patients with coronary artery disease (2017)
  • Author(s): Masanao Naya
  • Organizer: 日本心臓核医学会総会
• [Presentation] 重症冠動脈疾患診断における定量的心筋血流量の意義：MRIと15O標識水PET/CTでの評価 (2016)
  • Author(s): 相川忠夫
  • Organizer: 日本心臓核医学総会
  • Place of Presentation: アスト津（三重県津市）