Effects of novel respiratory physiotherapy on exercise tolerance in hospitalized patients with heart failure

• Project/Area Number: 16K16442
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Rehabilitation science/Welfare engineering
• Research Institution: Kitasato University
• Principal Investigator: Hamazaki Nobuaki 北里大学, 大学病院, 主任 (40448973)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000); Fiscal Year 2018: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2017: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2016: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
• Keywords: 心不全 / 呼吸筋力 / リハビリテーション / 慢性心不全 / 吸気筋力 / 患者取り込み開始 / 倫理審査承認済 / 国際誌への報告 / 国際学会への報告 / 患者取り込みの準備 / 研究モニタリングシステムの設置済 / アウトカム測定精度の向上 / 研究内容修正の倫理審査中 / 入院期慢性心不全 / 吸気筋トレーニング / 運動耐容能 / 自律神経活動

Outline of Final Research Achievements

We investigated the influences of respiratory muscle strength on exercise tolerance and prognosis in patients who were admitted for heart failure (HF) treatment. As the results, we found that patients with HF and respiratory muscle weakness (RMW) likely had breathlessness during exercise and had a significant decrease in exercise tolerance. Moreover, HF patients with RMW at hospital discharge showed significantly higher mortality as compared to those without RMW. Conversely, we also found that increased respiratory muscle strength following cardiac rehabilitation was significantly associated with improved exercise tolerance and reduced risk of re-hospitalization.
From these research results, two papers were accepted for publication in English journals. Besides, four presentations were awarded by several congresses.

Academic Significance and Societal Importance of the Research Achievements

臨床において呼吸筋力は簡便に測定できる。心不全患者の呼吸筋力が健常者の70%程度に低下することは先行研究で明らかとなっていた。
我々の研究結果から、心不全患者における呼吸筋力測定が患者のリスク層別化や治療の効果判定に有用であることが明らかとなった。また、呼吸筋力の向上を目的としたリハビリテーションが、患者の運動耐容能を向上するばかりでなく予後を改善する可能性も示された。

Research Products

• [Journal Article] Prevalence and prognosis of respiratory muscle weakness in heart failure patients with preserved ejection fraction. (2020)
  • Author(s): Nobuaki Hamazaki,Kentaro Kamiya,Ryota Matsuzawa,Kohei Nozaki,Takafumi Ichikawa,Shinya Tanaka,Takeshi Nakamura,Masashi Yamashita,Emi Maekawa,Chiharu Noda,Minako Yamaoka-Tojo,Atsuhiko Matsunaga,Takashi Masuda,Junya Ako
  • Journal Title: Respiratory medicine Volume: 161 Pages: 105834-105834
  • DOI: 10.1016/j.rmed.2019.105834
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Short-Term Change in Gait Speed and Clinical Outcomes in Older Patients With Acute Heart Failure (2019)
  • Author(s): Shinya Tanaka,Kentaro Kamiya,Nobuaki Hamazaki,Ryota Matsuzawa,Kohei Nozaki,Takeshi Nakamura,Masashi Yamashita,Emi Maekawa,Chiharu Noda,Minako Yamaoka-Tojo,Atsuhiko Matsunaga,Takashi Masuda,Junya Ako
  • Journal Title: Circulation Journal Volume: 83 Issue: 9 Pages: 1860-1867
  • DOI: 10.1253/circj.CJ-19-0136
  • NAID: 130007695043
  • ISSN: 1346-9843, 1347-4820
  • Year and Date: 2019-08-23
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Prognostic value of instrumental activity of daily living in initial heart failure hospitalization patients aged 65ツ?years or older. (2019)
  • Author(s): Masashi Yamashita,Kentaro Kamiya,Nobuaki Hamazaki,Ryota Matsuzawa,Kohei Nozaki,Takafumi Ichikawa,Takeshi Nakamura,Emi Maekawa,Minako Yamaoka-Tojo,Atsuhiko Matsunaga,Junya Ako
  • Journal Title: Heart and vessels Volume: 35 Issue: 3 Pages: 273-278
  • DOI: 10.1007/s00380-019-01490-2
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Respiratory muscle weakness increases dead-space ventilation ratio aggravating ventilation-perfusion mismatch during exercise in patients with chronic heart failure. (2019)
  • Author(s): Hamazaki N, Masuda T, Kamiya K, Matsuzawa R, Nozaki K, Maekawa E, Noda C, Yamaoka-Tojo M, Ako J
  • Journal Title: Respiratory Volume: 24(2) Issue: 2 Pages: 154-161
  • DOI: 10.1111/resp.13432
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Papillary light reflex as a new prognostic marker in patients with heart failure. (2019)
  • Author(s): Nozaki K, Kamiya K, Matsue Y, Hamazaki N, Matsuzawa R, Tanaka S, Maekawa E, Kishi T, Matsunaga A, Masuda T, Izumi T, Ako J
  • Journal Title: J Cardiac Fail Volume: 25(3) Issue: 3 Pages: 156-163
  • DOI: 10.1016/j.cardfail.2018.09.009
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Office-Based Physical Assessment in Patients Aged 75 Years and Older with Cardiovascular Disease (2019)
  • Author(s): Matsuzawa Ryota、Kamiya Kentaro、Hamazaki Nobuaki、Nozaki Kohei、Tanaka Shinya、Maekawa Emi、Matsunaga Atsuhiko、Masuda Takashi、Ako Junya
  • Journal Title: Gerontology Volume: 65 Issue: 2 Pages: 128-135
  • DOI: 10.1159/000493527
  • Peer Reviewed / Open Access
• [Journal Article] Prognostic usefulness of arm circumference and nutritional screening tools in older patients with cardiovascular disease (2018)
  • Author(s): Nakamura T.、Kamiya K.、Matsunaga A.、Hamazaki N.、Matsuzawa R.、Nozaki K.、Tanaka S.、Yamashita M.、Maekawa E.、Noda C.、Yamaoka-Tojo M.、Masuda T.、Ako J.
  • Journal Title: Nutr Metab Cardiovasc Dis Volume: in press Issue: 7 Pages: 743-748
  • DOI: 10.1016/j.numecd.2018.02.015
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Incremental Value of Objective Frailty Assessment to Predict Mortality in Elderly Patients Hospitalized for Heart Failure (2018)
  • Author(s): TANAKA SHINYA、KAMIYA KENTARO、HAMAZAKI NOBUAKI、MATSUZAWA RYOTA、NOZAKI KOHEI、MAEKAWA EMI、NODA CHIHARU、YAMAOKA-TOJO MINAKO、MATSUNAGA ATSUHIKO、MASUDA TAKASHI、AKO JUNYA
  • Journal Title: Journal of Cardiac Failure Volume: 24 Issue: 11 Pages: 723-732
  • DOI: 10.1016/j.cardfail.2018.06.006
  • Peer Reviewed
• [Journal Article] SARC-F questionnaire identifies physical limitations and predicts post discharge outcomes in elderly patients with cardiovascular disease (2018)
  • Author(s): Shinya Tanaka, Kentaro Kamiya, Nobuaki Hamazaki, Ryota Matsuzawa, Kohei Nozaki, Yuta Ichinosawa, Manae Harada, Takeshi Nakamura, Emi Maekawa, Chiharu Noda, Minako Yamaoka-Tojo, Atsuhiko Matsunaga, Takashi Masuda, Junya Ako
  • Journal Title: Journal of Cachexia, Sarcopenia and Muscle Clinical Reports Volume: 1 Pages: 1-11
  • 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] Sarcopenia: prevalence and prognostic implications in elderly patients with cardiovascular disease (2017)
  • Author(s): Kentaro Kamiya, Nobuaki Hamazaki, Ryota Matsuzawa, Kohei Nozaki, Shinya Tanaka, Yuta Ichinosawa, Emi Maekawa, Chiharu Noda, Minako Yamaoka-Tojo, Atsuhiko Matsunaga, Takashi Masuda, Junya Ako
  • Journal Title: Journal of Cachexia, Sarcopenia and Muscle Clinical Reports Volume: 2 Pages: 1-13
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Association between chronic kidney disease and physical activity level in patients with ischemic heart disease (2017)
  • Author(s): Ryota Matsuzawa, Takashi Masuda, Kentaro Kamiya, Nobuaki Hamazaki, Kohei Nozaki, Shinya Tanaka, Emi Maekawa, Junya Ako
  • Journal Title: Renal Replacement Therapy Volume: 3 Issue: 1 Pages: 1-9
  • DOI: 10.1186/s41100-017-0109-8
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Prognostic Value of Psoas Muscle Area and Density in Patients Who Undergo Cardiovascular Surgery (2017)
  • Author(s): Masashi Yamashita, Kentaro Kamiya, Atsuhiko Matsunaga, Tadashi Kitamura, Nobuaki Hamazaki, Ryota Matsuzawa, Kohei Nozaki, Shinya Tanaka, Takeshi Nakamura, Emi Maekawa, Takashi Masuda, Junya Ako, Kagami Miyaji
  • Journal Title: Canadian Journal of Cardiology Volume: 33 Issue: 12 Pages: 1652-1659
  • DOI: 10.1016/j.cjca.2017.10.009
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Effects of acute phase intensive electrical muscle stimulation in frail elderly patients with acute heart failure (ACTIVE-EMS) (2017)
  • Author(s): Shinya Tanaka, Kentaro Kamiya, Yuya Matsue, Yonezawa R, Saito H, Nobuaki Hamazaki, Ryota Matsuzawa, Kohei Nozaki, Wakaume K, Endo Y, Emi Maekawa, Minako Yamaoka-Tojo, Shiono T, Inomata T, Takashi Masuda, Junya Ako
  • Journal Title: Clin Cardiol Volume: 40 Issue: 12 Pages: 1189-1196
  • DOI: 10.1002/clc.22845
  • Peer Reviewed / Open Access / Int'l Joint Research
• [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] Low ankle brachial index is associated with the magnitude of impaired walking endurance in patients with heart failure (2016)
  • Author(s): Shinya Tanaka, Kentaro Kamiya, Takashi Masuda, Nobuaki Hamazaki, Ryota Matsuzawa, Kohei Nozaki, Emi Maekawa, Chiharu Noda, Minako Yamaoka-Tojo, Atsuhiko Matsunaga, Junya Ako
  • Journal Title: International Journal of Cardiology Volume: 224 Pages: 400-405
  • DOI: 10.1016/j.ijcard.2016.09.060
  • Peer Reviewed
• [Journal Article] Prognostic Usefulness of Arm and Calf Circumference in Patients with 65 Years of Age with Cardiovascular Disease (2016)
  • Author(s): Kentaro Kamiya, Takashi Masuda, Yuya Matsue, Nobuaki Hamazaki, Ryota Matsuzawa, Shinya Tanaka, Kohei Nozaki, Emi Maekawa, Chiharu Noda, Minako Yamaoka-Tojo, Atsuhiko Matsunaga, Junya Ako
  • Journal Title: The American journal of cardiology Volume: 119(2) Issue: 2 Pages: 186-191
  • DOI: 10.1016/j.amjcard.2016.09.040
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Presentation] 慢性心不全患者に対する運動療法の効果に腎機能の低下は影響するか？ (2020)
  • Author(s): 濱崎伸明
  • Organizer: 第10回日本腎臓リハビリテーション学会学術集会
  • Invited
• [Presentation] Change in respiratory muscle strength predicts clinical events in patients with chronic heart failure (2019)
  • Author(s): Nobuaki Hamazaki, Takashi Masuda, Kentaro Kamiya, Ryota Matsuzawa, Kohei Nozaki, Takafumi Ichikawa, Minoru Tabata, Emi Maekawa, Chiharu Noda, Minako Yamaoka-Tojo, Atsuhiko Matsunaga, Junya Ako
  • Organizer: ESC Congress 2019 (Nursing and Allied Health Professions Investigator Award 受賞演題)
  • Int'l Joint Research
• [Presentation] 心疾患患者における呼吸機能評価の臨床的意義 (2019)
  • Author(s): 濱崎伸明
  • Organizer: 第4回日本心血管理学療法学会 第6回日本糖尿病理学療法学会 合同学術大会
  • Invited
• [Presentation] Change in respiratory muscle strength predicts clinical events in patients with chronic heart failure (2019)
  • Author(s): Hamazaki N, Masuda T, Kamiya K, Matsuzawa R, Nozaki K, Ichikawa T, Tabata M, Maekawa E, Noda C, Yamaoka-Tojo M, Matsunaga A, Ako J
  • Organizer: European Society of Cardiology Congress 2019
  • Int'l Joint Research
• [Presentation] Increased respiratory muscle strength as a contributor to improvement of exercise tolerance following cardiac rehabilitation in patients with chronic heart failure (2018)
  • Author(s): Hamazaki N, Kamiya K, Matsuzawa R, Nozaki K, Ichikawa T, Tanaka S, E Maekawa , Masuda T
  • Organizer: JRCD-PT 2018, English Session
  • Int'l Joint Research
• [Presentation] Respiratory muscle weakness as a predictor of all-cause mortality in chronic heart failure patients with preserved ejection fraction (2018)
  • Author(s): Hamazaki N, Masuda T, Kamiya K, Matsuzawa R, Nozaki K, Maekawa E, Noda C, Yamaoka-Tojo M, Ako J
  • Organizer: The 24th Annual Meeting of the Japanese Association of Cardiac Rehabilitation
  • Int'l Joint Research
• [Presentation] 長期集中治療が必要な心疾患患者に対する早期リハビリテーションの実際 (2018)
  • Author(s): 濱崎 伸明
  • Organizer: 日本心臓リハビリテーション学会第3回関東甲信越支部地方会
  • Invited
• [Presentation] Respiratory muscle weakness predicts all-cause mortality in chronic heart failure patients with preserved left ventricular ejection fraction (2018)
  • Author(s): Nobuaki Hamazaki, Takashi Masuda, Kentaro Kamiya, Ryota Matsuzawa, Kohei Nozaki, Shinya Tanaka, Minoru Tabata, Emi Maekawa, Chiharu Noda, Minako Yamaoka-Tojo, Junya Ako
  • Organizer: EuroPrevent 2018, Moderated Poster Session
  • Int'l Joint Research
• [Presentation] Increased respiratory muscle strength contributes to improvement of exercise tolerance following cardiac rehabilitation in patients with chronic heart failure (2018)
  • Author(s): Nobuaki Hamazaki, Takashi Masuda, Kentaro Kamiya, Ryota Matsuzawa, Kohei Nozaki, Shinya Tanaka, Takafumi Ichikawa, Minoru Tabata, Emi Maekawa, Chiharu Noda, Minako Yamaoka-Tojo, Junya Ako
  • Organizer: EuroPrevent 2018, Moderated Poster Session
  • Int'l Joint Research
• [Presentation] Pulmonary function is an independent determinant for chronotropic incompetence during exercise in patients with chronic heart failure (2017)
  • Author(s): Nobuaki Hamazaki, Takashi Masuda, Kentaro Kamiya, Ryota Matsuzawa, Kohei Nozaki, Shinya Tanaka, Minoru Tabata, Emi Maekawa, Chiharu Noda, Minako Yamaoka-Tojo, Junya Ako
  • Organizer: European Society of Cardiology Congress 2017
  • Place of Presentation: Barcelona, Spain
  • Year and Date: 2017-08-26
  • Int'l Joint Research
• [Presentation] Optimal Cut-off Value of Inspiratory Muscle Strength to Predict Exercise Intolerance in Patients with Chronic Heart Failure (2017)
  • Author(s): Nobuaki Hamazaki, Kentaro Kamiya, Ryota Matsuzawa, Kohei Nozaki, Shinya Tanaka, Emi Maekawa, Takashi Masuda
  • Organizer: The 52nd Congress of Japanese Society of Physical Therapy
  • Place of Presentation: 幕張メッセ・千葉・千葉
  • Year and Date: 2017-05-12
• [Presentation] Increase in Leg Strength after Outpatient Cardiac Rehabilitation Contributes to Improvement of Gait Speed in Patients Aged 75 Years or Older with Cardiovascular Disease (2017)
  • Author(s): Nobuaki Hamazaki, Kentaro Kamiya, Ryota Matsuzawa, Kohei Nozaki, Shinya Tanaka, Emi Maekawa, Takashi Masuda
  • Organizer: The 52nd Congress of Japanese Society of Physical Therapy
  • Place of Presentation: 幕張メッセ・千葉・千葉
  • Year and Date: 2017-05-12
• [Presentation] 入院期心不全患者に対する呼吸筋トレーニングの安全性と効果 (2017)
  • Author(s): 濱崎伸明, 増田卓, 神谷健太郎, 松沢良太, 野崎康平, 田中伸弥, 前川 恵美, 野田千春, 東條美奈子, 阿古潤哉
  • Organizer: 日本心臓リハビリテーション学会 第１回関東甲信越支部地方会
  • Place of Presentation: 大宮ソニックシティ・埼玉・さいたま
• [Presentation] Effect of supervised aerobic exercise on respiratory function in patients with chronic heart failure (2017)
  • Author(s): Nobuaki Hamazaki, Takashi Masuda, Kentaro Kamiya, Ryota Matsuzawa, Kohei Nozaki, Shinya Tanaka, Minoru Tabata, Emi Maekawa, Chiharu Noda, Minako Yamaoka-Tojo, Junya Ako
  • Organizer: Japanese Association of Cardiac Rehabilitation 2017 International Session
  • Place of Presentation: 長良川国際会議場・岐阜・岐阜
  • Int'l Joint Research
• [Presentation] Respiratory muscle weakness is an independent determinant for decreased parasympathetic activity in patients with chronic heart failure (2016)
  • Author(s): Nobuaki Hamazaki, Takashi Masuda, Kentaro Kamiya, Ryota Matsuzawa, Kohei Nozaki, Shinya Tanaka, Yumi Kamada, Kanae Yabu, Takeshi Nakamura, Minoru Tabata, Emi Maekawa, Chiharu Noda, Minako Yamaoka-Tojo, Junya Ako
  • Organizer: American Heart Association Scientific Sessions 2016
  • Place of Presentation: New Orleans, Louisiana
  • Year and Date: 2016-11-12
  • Int'l Joint Research
• [Presentation] Supervised aerobic exercise after hospital discharge improves pulmonary and respiratory muscle function in patients with chronic heart failure (2016)
  • Author(s): Nobuaki Hamazaki, Takashi Masuda, Kentaro Kamiya, Ryota Matsuzawa, Kohei Nozaki, Shinya Tanaka, Yumi Kamada, Kanae Yabu, Takeshi Nakamura, Minoru Tabata, Emi Maekawa, Chiharu Noda, Minako Yamaoka-Tojo, Junya Ako
  • Organizer: American Heart Association Scientific Sessions 2016
  • Place of Presentation: New Orleans, Louisiana
  • Year and Date: 2016-11-12
  • Int'l Joint Research
• [Presentation] Respiratory Muscle Weakness Increases Dead-space Ventilation Ratio Aggravating Ventilation-perfusion Mismatch during Exercise in Patients with Chronic Heart Failure (2016)
  • Author(s): Nobuaki Hamazaki, Takashi Masuda, Kentaro Kamiya, Ryota Matsuzawa, Kohei Nozaki, Shinya Tanaka, Kanae Yabu, Takeshi Nakamura, Minoru Tabata, Emi Maekawa, Chiharu Noda, Minako Yamaoka-Tojo, Junya Ako
  • Organizer: European Society of Cardiology Congress 2016
  • Place of Presentation: Rome, Italy
  • Year and Date: 2016-08-27
  • Int'l Joint Research
• [Presentation] 重複障害を有する患者に対する心臓リハビリテーション―理学療法士の役割― (2016)
  • Author(s): 濱崎伸明，増田卓，神谷健太郎，松沢良太，野崎康平，田中伸弥，河野真理，五十嵐亜希子，岩村貴美，前川恵美，松永篤彦，阿古潤哉
  • Organizer: 第22回日本心臓リハビリテーション学会学術集会
  • Place of Presentation: 東京国際フォーラム・東京
  • Year and Date: 2016-07-16
  • Invited
• [Presentation] Dead-space ventilation ratio as a determinant for exercise intolerance in chronic heart failure (2016)
  • Author(s): Nobuaki Hamazaki, Takashi Masuda, Kentaro Kamiya, Ryota Matsuzawa, Kohei Nozaki, Shinya Tanaka, Takami Iwamura, Mari Kawano, Akiko Igarashi, Ayako Akiyama, Kanae Yabu, Takeshi Nakamura, Emi Maekawa, Chiharu Noda, Minako Yamaoka-Tojo, Junya Ako
  • Organizer: Japanese Association of Cardiac Rehabilitation 2016 International Session
  • Place of Presentation: 東京国際フォーラム・東京
  • Int'l Joint Research
• [Book] PDCA理論で学ぶ内部障害理学療法―呼吸疾患編 (エキスパート理学療法) (2018)
  • Author(s): 福井勉、山田英司、森沢知之、野村卓生、松木良介、大浦啓輔、澁川武志、平岩康之、堀健太郎、齊藤正和、舟見敬成、濱崎伸明、神谷健太郎、田屋雅信、竹村仁、溝口桂、森本信三、浅田史成、河辺信秀、永嶋道浩、林久恵、伊藤沙夜香、平木幸治
  • Total Pages: 213
  • Publisher: ヒューマン・プレス
  • ISBN: 9784908933196
• [Book] 運動療法エビデンスレビュー : 臨床・研究に役立つ評価指標・基準値・介入のエビデンスをこの一冊に凝縮 (2018)
  • Author(s): 神谷 健太郎、松永 篤彦、小林主献、堀田一樹、松本卓也、山本周平、濱崎伸明、米澤隆介、市川毅、前川恵美、松沢良太、忽那俊樹、阿部義史、南里佑太、鎌田裕実、澁谷真香、野崎康平、田中伸弥、木村雅彦
  • Total Pages: 401
  • Publisher: 文光堂
  • ISBN: 9784830645655