The impact of endothelial function following cardiac resynchronization therapy

• Project/Area Number: 17K01437
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Medical engineering assessment
• Research Institution: Oita University
• Principal Investigator: Yufu Kunio 大分大学, 医学部, 准教授 (00437930)
• Project Period (FY): 2017-04-01 – 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 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2018: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
• Keywords: 心臓再同期療法 / 血管内皮機能 / 冠微小循環 / 脳心血管イベント / 冠血流予備能 / 予後 / 冠血管予備能

Outline of Final Research Achievements

The baseline peripheral endothelial function could predict the long-term outcome of Cardiac resynchronization therapy (CRT). The results also suggest that improvement of coronary microcirculation might be associated with the better baseline endothelial function.
The assessment of coronary flow reserve (CFR) predicts the outcome in responders to CRT. Preservation of coronary circulation flow might underlie one of the mechanisms for a better response to CRT in responders.
The factors for major adverse cerebral and cardiovascular events (MACCE) during long follow-up period were distinctively different between responders and non-responders. The patients with depressed e-GFR are suggested to have poor prognosis even if they are responder to CRT.

Academic Significance and Societal Importance of the Research Achievements

四肢血管内皮機能・冠血流予備能が心臓再同期療法後慢性期のresponderかnon-responderかを術前予測する一助になると考えられた。四肢血管内皮機能・冠血流予備能のある程度保たれた患者を中心に同手術をおこなうことで不要な手術を減らすことになり臨床面・医療経済的に非常に有益と思われた。心臓再同期療法のresponderであってもそれは一過性のことがあり冠血流予備能の悪い患者では長期的に心不全コントロールを行うよう心がけることで心不全再入院を予知し予防することができる。また術前腎機能低下を伴うresponderでは長期的な観察を厳密に行い心・脳・血管イベントの予防に努めるべきである。

Research Products

• [Journal Article] Impact of Mobile Cloud Electrocardiography System on Door-to-Balloon Time in Patients With Acute Coronary Syndrome in Oita Prefecture (2019)
  • Author(s): Yufu Kunio、Shimomura Tsuyoshi、Fujinami Mami、Nakashima Tatsunori、Saito Shotaro、Ayabe Reika、Kawano Kyoko、Ishii Yumi、Okada Norihiro、Akioka Hidefumi、Teshima Yasushi、Sakamoto Teruo、Nakagawa Mikiko、Takahashi Naohiko
  • Journal Title: Circulation Reports Volume: 1 Issue: 6 Pages: 241-247
  • DOI: 10.1253/circrep.CR-19-0020
  • NAID: 130007662193
  • ISSN: 2434-0790
  • Year and Date: 2019-06-10
  • Peer Reviewed
• [Journal Article] Assessment of coronary flow reserve predicts long-term outcome of responders to cardiac resynchronization therapy (2019)
  • Author(s): .Yufu K, Kondo H, Shinohara T, Ishii Y, Yoshimura S, Abe I, Saito S, Fukui A, Okada N, Akioka H, Teshima Y, Nakagawa M, Takahashi N.
  • Journal Title: Heart and Vessels Volume: 34 Issue: 5 Pages: 763-770
  • DOI: 10.1007/s00380-018-1308-0
  • Peer Reviewed
• [Presentation] 老年者における心臓再同期療法レスポンダーの長期予後規定因子 (2020)
  • Author(s): 高野 正幸、油布 邦夫、安部 一太郎、近藤 秀和、福井 暁、 篠原 徹二、中川 幹子、高橋 尚彦
  • Organizer: 第30回日本老年医学会九州地方会
• [Presentation] Longer R-R' interval in left precordial leads is predictive of clinical response to CRT in patients with LBBB (2020)
  • Author(s): Yano Y, Nakagawa M, Yufu K, Takahashi N, et al.
  • Organizer: 第84回日本循環器学会学術集会
• [Presentation] Ⅰ度房室ブロックのCRTの一例 (2019)
  • Author(s): 油布邦夫
  • Organizer: CRT ACTIVATE Round Table Discussion in Oita
• [Presentation] SnchAV機能を固定調節に切り替えたⅠ度房室ブロックを伴うCRTの症例 (2019)
  • Author(s): 廣田慧 （共同演者 油布邦夫）
  • Organizer: 第11回植込みデバイス関連冬季大会