Attempt to improve the diagnostic accuracy of angiographic PVL after TAVI and investigation of the relationship between device and host.

• Project/Area Number: 17K09505
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular medicine
• Research Institution: Yamaguchi University
• Principal Investigator: TATEISHI Hiroki 山口大学, 医学部附属病院, 助教 (20793342)
• Co-Investigator(Kenkyū-buntansha): 和田 靖明 山口大学, 医学部附属病院, 講師 (50448297) ; 有吉 亨 山口大学, 医学部附属病院, 臨床・衛生検査技師 (60750627) ; 岡村 誉之 山口大学, 医学部附属病院, 講師 (70380011)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000); Fiscal Year 2019: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2018: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2017: ¥2,990,000 (Direct Cost: ¥2,300,000、Indirect Cost: ¥690,000)
• Keywords: 大動脈弁狭窄 / TAVI / PVL / 大動脈造影 / 心臓超音波検査 / MSCT / 大動脈弁狭窄症 / 人工弁周囲逆流（PVL) / ビデオデンシトメトリー / 大動脈弁閉鎖不全症

Outline of Final Research Achievements

The clinical robustness of contrast-videodensitometric (VD) assessment of aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI) has been demonstrated. We sought to use preprocedural multi-slice computed tomography (MSCT) to optimize the angiographic projection in order to improve the feasibility of VD assessment. Introduction of a computed tomography guided angiographic image acquisition has significantly impacted the analyzability of the angiographic VD assessment of post-TAVI AR.
Furthermore, we aimed to investigate the relationship between intraprocedural angiographic and echocardiographic aortic regurgitation (AR) severity following transcatheter aortic valve implantation (TAVI) and the predictability of outcomes of both techniques. The present study demonstrates the intra-procedural inter-technique consistency and the prognostic value of the videodensitometirc assessment.

Academic Significance and Societal Importance of the Research Achievements

本研究によりビデオデンシトメトリーを用いた大動脈造影上のPVL重症度診断法は客観的かつ再現性があり、予後予測可能であるきわめて有用な診断法と言え、この正確な診断法を基にPVLの予測因子の検索が可能となる。
また、同時に本研究で作成した大動脈造影撮像プロトコル、ビデオデンシトメトリーによる診断法を用いて、日本、オランダ、カナダ、ブラジル、ドイツで多施設共同研究を行い、各種人工弁におけるTAVI後のPVLの重症度分布を報告することが可能となっている。

Research Products

• [Int'l Joint Research] Erasmus medical center/Academic medical center(オランダ)
• [Int'l Joint Research] McGill University Health Centre(カナダ)
• [Int'l Joint Research] University of Sao Paulo Medical School/Hospital Israelita Albert Einstein(ブラジル)
• [Int'l Joint Research] The Heart Center, Segeberger Kliniken/Heart Center Leipzig(ドイツ)
• [Journal Article] Quantitative Assessment of Acute Regurgitation Following TAVR: A Multicenter Pooled Analysis of 2,258 Valves (2020)
  • Author(s): Rodrigo Modolo, Chun Chin Chang, Mohammad Abdelghani, Hideyuki Kawashima, Masafumi Ono, Hiroki Tateishi, Yosuke Miyazaki, Osama Soliman, Yoshinobu Onuma, Nicolas M Van Mieghem, Patrick W Serruys et al.
  • Journal Title: JACC cardiovascular intervention Volume: 13 Issue: 11 Pages: 1303-1311
  • DOI: 10.1016/j.jcin.2020.03.002
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Quantitative aortography assessment of aortic regurgitation. Insight into a novel technique. (2020)
  • Author(s): Modolo R, Chang CC, Onuma Y, Schultz C, Tateishi H, Abdelghani M, Miyazaki Y, Aben JP, Rutten MCM, Pighi M, El Bouziani A, van Mourik M, Lemos PA, Wykrzykowska JJ, Brito FS Jr, Sahyoun C, Piazza N, Eltchaninoff H, Soliman O, Abdel-Wahab M, Van Mieghem NM, de Winter RJ, Serruys PW.
  • Journal Title: Eurointervention Volume: - Issue: 9 Pages: e738-e756
  • DOI: 10.4244/eij-d-19-00879
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Quantitative aortography for assessing aortic regurgitation after transcatheter aortic valve implantation: results of the multicentre ASSESS-REGURGE Registry. (2019)
  • Author(s): Modolo R, Chang CC, Tateishi H, Miyazaki Y, Pighi M, Abdelghani M, Roos MA, Wolff Q, Wykrzykowska JJ, de Winter RJ, Piazza N, Richardt G, Abdel-Wahab M, Soliman OII, Onuma Y, Van Mieghem NM, Serruys PW.
  • Journal Title: Eurointervention Volume: 15 Issue: 5 Pages: 420-426
  • DOI: 10.4244/eij-d-19-00362
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Inter-Technique Consistency and Prognostic Value of Intra-Procedural Angiographic and Echocardiographic Assessment of Aortic Regurgitation After Transcatheter Aortic Valve Implantation (2018)
  • Author(s): Tateishi H, Miyazaki Y, Okamura T, Abdelghani M, Modolo R, Wada Y, Okuda S, Omuro A, Ariyoshi T, Fujii A, Oda T, Fujimura T, Nanno T, Mikamo A, Soliman OII, Onuma Y, Hamano K, Yano M, Serruys PW.
  • Journal Title: Circulation Journal Volume: 82 Issue: 9 Pages: 2317-2325
  • DOI: 10.1253/circj.CJ-17-1376
  • NAID: 130007438843
  • ISSN: 1346-9843, 1347-4820
  • Year and Date: 2018-08-24
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Role of Computed Tomography in Planning the Appropriate X-Ray Gantry for Quantitative Aortography of Post-transcatheter Aortic Valve Implantation Regurgitation (2018)
  • Author(s): Tateishi H, Miyazaki Y, Okamura T, Modolo R, Abdelghani M, Soliman OII, Oda T, Mikamo A, Onuma Y, Hamano K, Yano M, Serruys PW.
  • Journal Title: Circulation Journal Volume: 82 Issue: 7 Pages: 1943-1950
  • DOI: 10.1253/circj.CJ-17-1375
  • NAID: 130007410618
  • ISSN: 1346-9843, 1347-4820
  • Year and Date: 2018-06-25
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] The role of computed tomography in planning the appropriate X-Ray gantry for quantitative aortographic assessment of post-TAVI regurgitation. (2018)
  • Author(s): Hiroki Tateishi, Yosuke Miyazaki, Takayuki Okamura, Rodrigo Modolo, Mohammad Abdelghani, Osama I.I. Soliman, Tetsuro Oda, Akihito Mikamo, Yoshinobu Onuma, Patrick W. Serruys, Kimikazu Hamano, Masafumi Yano
  • Journal Title: Circulation Journal Volume: 印刷中
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Inter-technique Consistency and Prognostic Value of Intra-Procedural Angiographic and Echocardiographic Assessments of Aortic Regurgitation after Transcatheter Aortic Valve Implantation. (2018)
  • Author(s): Hiroki Tateishi, Yosuke Miyazaki, Takayuki Okamura, Mohammad Abdelghani, Rodrigo Modolo, Yasuaki Wada, Shinichi Okuda, Ayumi Omuro, Toru Ariyoshi, Ayano Fujii, Tetsuro Oda, Tatsuhiro Fujimura, Takuma Nanno, Akihito Mikamo, Osama I.I. Soliman, Yoshinobu Onuma, Kimikazu Hamano, Masafumi Yano, Patrick W. Serruys.
  • Journal Title: Circulation Jounal Volume: 印刷中
  • NAID: 130007438843
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Presentation] Frailty Scale in Patients who Underwent TAVI Correlate with Physical Function, but not Nutritional Status and Muscle Mass (2020)
  • Author(s): Hiroki Tateishi et al.
  • Organizer: 日本循環器学会 2020 採択済み
• [Presentation] An assessment of the predictors of hemodynamic deterioration after TAVI insight from the intraprocedural multimodality study (2019)
  • Author(s): Hiroki Tateishi, Yosuke Miyazaki, Takayuki Okamura et al.
  • Organizer: CVIT 2019
• [Presentation] An attempt to reduce contrast volume for the contrast videodensitometric post-transcatheter aortic valve implantation aortic regurgitation assessment (2019)
  • Author(s): Hiroki Tateishi, Yosuke Miyazaki, Takayuki Okamura et al.
  • Organizer: CVIT 2019
• [Presentation] Clinical significance of pre-procedural nutrition assessment in the geriatric patients who underwent TAVI (2019)
  • Author(s): Hiroki Tateishi et al.
  • Organizer: 心不全学会 2019
• [Presentation] Completion of inter-technique comparison of intra-procedural post-TAVI aortic regurgitation assessments. (2018)
  • Author(s): Hiroki Tateishi
  • Organizer: Euro PCR 2018
  • Int'l Joint Research
• [Presentation] Completion of inter-technique comparison of intra-procedural post-TAVI aortic regurgitation assessments. (2018)
  • Author(s): Hiroki Tateishi
  • Organizer: London Valves 2018
  • Int'l Joint Research
• [Presentation] Videodensitometric assessment of aortic regurgitation:correlation with echocardiography and magnetic resonance imaging. (2018)
  • Author(s): Hiroki Tateishi
  • Organizer: CVIT 2018
• [Presentation] 経カテーテル的大動脈弁植え込み術後に生じる 人工弁周囲逆流の血行動態、大動脈造影、 心臓超音波検査上における重症度診断の比較検討 (2018)
  • Author(s): Hiroki Tateishi
  • Organizer: J-TVT 2018
• [Presentation] ビデオデンシトメトリー法によるTAVI後人工弁周囲逆流の重症度の人工弁間比較検討 (2018)
  • Author(s): Hiroki Tateishi
  • Organizer: ストラクチャークラブライブデモンストレーション2018
• [Presentation] Completion of inter-technique comparison of intra-procedural post-TAVI aortic regurgitation assessments (2018)
  • Author(s): Hiroki Tateishi, Takayuki Okamura, Yasuaki Wada, Shinichi Okuda, Ayano Fujii, Ayumi Omuro, Toru Ariyoshi, Tetsuro Oda, Yoriomi Hamada, Akihito Mikamo, Kimikazu Hamano, Masafumi Yano
  • Organizer: EuroPCR 2018
  • Int'l Joint Research
• [Presentation] Inter-modal and clinical validation of intra-procedural echocardiographic and angiographic assessments of aortic regurgitation after TAVI. (2017)
  • Author(s): Hiroki Tateishi, Takayuki Okamura, Yasuaki Wada, Shinichi Okuda, Ayano Fujii, Yosuke Miyazaki, Mohammad Abdelghani, Ayumi Omuro, Toru Ariyoshi, Tetsuro Oda, Tatsuhiro Fujimura, Yoshinobu Onuma, Patrick W Serruys, Akihito Mikamo, Kimikazu Hamano, Masafumi Yano
  • Organizer: EuroPCR 2017
  • Int'l Joint Research
• [Presentation] TAVI後人口弁周囲逆流の大動脈造影と心臓超音波上の重症度評価の比較・相関とアウトカムへの影響の検討 (2017)
  • Author(s): Hiroki Tateishi, Takayuki Okamura, Yasuaki Wada, Shinichi Okuda, Ayumi Omuro, Toru Ariyoshi, Ayano Fujii, Tetsuro Oda, Tatsuhiro Fujimura, Akihito Mikamo, Kimikazu Hamano, Masafumi Yano
  • Organizer: CVIT 2017
  • Int'l Joint Research
• [Presentation] A comparison between the prognostic predictability of the echocardiographic assessment of the paravalvular leak immediately after TAVI and at discharge. (2017)
  • Author(s): Hiroki Tateishi, Takayuki Okamura, Yasuaki Wada, Shinichi Okuda, Ayano Fujii, Ayumi Omuro, Toru Ariyoshi, Tetsuro Oda, Tatsuhiro Fujimura, Akihito Mikamo, Kimikazu Hamano, Masafumi Yano
  • Organizer: London Valves 2017
  • Int'l Joint Research