| Project/Area Number |
16K10665
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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 surgery
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| Research Institution | Wakayama Medical University |
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Principal Investigator |
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| Project Period (FY) |
2016-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥3,640,000 (Direct Cost: ¥2,800,000、Indirect Cost: ¥840,000)
Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2017: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2016: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
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| Keywords | 大動脈プラーク / シスタチンC / 下行大動脈 / 弓部大動脈瘤 / 脳梗塞 / 胸部大動脈瘤 / LDL / シスタチンＣ |
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| Outline of Final Research Achievements |
During surgery for aortic arch aneurysm, aortic plaque in the descending aorta should be evaluated. Surgeons should be aware of cerebral embolism due to retrograde femoral perfusion. Cystatin C is known to be a useful marker of renal dysfunction with a role as biomarkers for severity of coronary artery disease. In the absence of a suitable biomarker for aortic plaque in the descending aorta, we examine cystatin C as a candidate. Enrolled were 75 patients that underwent surgery for aortic arch aneurysm. Serum cystatin C value was evaluated preoperatively. Aortic plaque volume was calculated from preoperative enhanced computed tomography. Cystatin C positively correlated with soft plaque volume. In patients without chronic kidney disease, the soft plaque volume was higher in patients with higher cystatin C levels than in patients with normal levels.Preoperative serum cystatin C level could be a biomarker of aortic plaque in the descending aorta in patients with aortic arch aneurysm.
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| Academic Significance and Societal Importance of the Research Achievements |
従来、大動脈プラークに対するバイオマーカーに関しては十分な検討がされていなかった。しかし、本研究により弓部大動脈瘤症例においてシスタチンC値が下行大動脈のプラークのバイオマーカーとなることが明らかとなった。これにより、弓部大動脈瘤症例において術前シスタチンC値が高値である症例では下行大動脈のソフトプラーク量が多いと予測され、かかる症例では大腿動脈送血を回避することで下行大動脈のソフトプラーク散布による逆行性脳塞栓を未然に防止することができるのではないかと考えられる。本研究の成果は弓部大動脈瘤術後の脳合併症の新たな予防対策の一つとして寄与すると考えられる。
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