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Utility of low-dose exercise echocardiography for predicting outcome in the patient with HFpEF

Research Project

Project/Area Number 17K01411
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field Medical systems
Research InstitutionTottori University

Principal Investigator

Haruki Nobuhiko  鳥取大学, 医学部, プロジェクト研究員 (70469394)

Co-Investigator(Kenkyū-buntansha) 加藤 雅彦  鳥取大学, 医学部, 教授 (40362884)
柳原 清孝  鳥取大学, 医学部, 助教 (50788180)
衣笠 良治  鳥取大学, 医学部, 講師 (60598944)
山本 一博  鳥取大学, 医学部, 教授 (90303966)
Project Period (FY) 2017-04-01 – 2020-03-31
Project Status Completed (Fiscal Year 2019)
Budget Amount *help
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2019: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2018: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2017: ¥3,120,000 (Direct Cost: ¥2,400,000、Indirect Cost: ¥720,000)
Keywords大動脈弁狭窄症 / 左房機能 / 左室駆出率が保持された心不全 / 心エコー図検査 / 低容量運動負荷心エコー図検査 / 高齢者心不全 / 検査・診断システム
Outline of Final Research Achievements

We investigated the incidence and related echocardiographic parameters especially left atrial (LA) function for worsening heart failure (WHF) after transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis and preserved left ventricular ejection. Among 53 patients in this study, 10 patients had experiehced WHF after TAVI. Compared to non-WHF patients, WHF patients showed higher E/A ratio and lower trans-aortic peak velocity and mean pressure gradient at baseline. Significant reduction in Maximum LA volume and BNP level, and increase in peal LA strain were noted only in non-WHF group. Changes in peal LA strain from baseline to 1 week after TAVI were significantly lower in WHF patients compared to non-WHF patients.

Academic Significance and Societal Importance of the Research Achievements

近年高齢者の心臓弁膜症が増加しており、大動脈弁狭窄症(AS)は心不全の原因となるが、根治治療である経カテーテル的大動脈弁移植術(TAVI)を行っても、約2割の症例で術後に心不全(HFpEF)を再発する症例が存在する。高額な医療費を投入してTAVI治療を行ったにもかかわらず、術後に心不全を繰り返し再入院を余儀なくされる症例が存在する事は、今後我が国の医療経済に対しても大きな問題をもたらすことが明白である。この研究結果から、心不全予防のためにTAVI治療を検討している症例に対して、術前の心エコー図検査で左房機能を評価することは、術後の心不全増悪リスクを低減することに繋がると考える。

Report

(4 results)
  • 2019 Annual Research Report   Final Research Report ( PDF )
  • 2018 Research-status Report
  • 2017 Research-status Report
  • Research Products

    (5 results)

All 2019 2018 2017

All Presentation (5 results)

  • [Presentation] Impact of Left Atrial Function on Worsening Heart Failure after Transcatheter Aortic Valve Implantation in Patients with Severe Aortic Stenosis2019

    • Author(s)
      春木伸彦
    • Organizer
      第82回日本循環器学会学術集会
    • Related Report
      2019 Annual Research Report
  • [Presentation] Comparison of Nutrition Status in Elderly Patients with Low- and High-pressure Gradient Severe Aortic Stenosis2019

    • Author(s)
      春木伸彦
    • Organizer
      第82回日本循環器学会学術集会
    • Related Report
      2019 Annual Research Report
  • [Presentation] Impact of Transcatheter Aortic Valve Implantation and Surgical Aortic Valve Replacement on Early Recovery of Left Atrial Structure and Function2019

    • Author(s)
      春木伸彦
    • Organizer
      第82回日本循環器学会学術集会
    • Related Report
      2019 Annual Research Report
  • [Presentation] Impact of Left Atrial Function on Worsening Heart Failure after Transcatheter Aortic Valve Implantation in Patients with Severe Aortic Stenosis2018

    • Author(s)
      Nobuhiko Haruki
    • Organizer
      第82回日本循環器学会学術集会
    • Related Report
      2017 Research-status Report
  • [Presentation] 重症大動脈弁狭窄症に対する経カテーテル的大動脈弁移植術後の心不全増悪2017

    • Author(s)
      春木伸彦
    • Organizer
      第21回日本心不全学会学術集会
    • Related Report
      2017 Research-status Report

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Published: 2017-04-28   Modified: 2021-02-19  

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