Effects of beta-blockers and renin-angiotensin system inhibitors on the prognosis of patients with heart failure with preserved ejection fraction -A multicenter registry

• Project/Area Number: 17K09517
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular medicine
• Research Institution: Nagoya City University
• Principal Investigator: Ohte Nobuyuki 名古屋市立大学, 医薬学総合研究院(医学), 教授 (10185332)
• Project Period (FY): 2017-04-01 – 2021-03-31
• Project Status: Completed (Fiscal Year 2020)
• Budget Amount: ¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000); Fiscal Year 2020: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2018: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2017: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
• Keywords: HFpEF / 前向き観察研究 / 左室駆出率 / β遮断薬 / レニンアンジオテンシン系阻害薬 / 心不全 / 心筋保護薬 / 多施設共同 / 前向き / registry / 観察研究 / RAS阻害薬 / HFｐEF / 予後

Outline of Final Research Achievements

EASY HFpEF Registry (prospective observational research) was to investigate the difference in the effectiveness of cardioprotective drugs such as b-blockers or RAS-inhibitors between the patients with left ventricular ejection fraction (LVEF) 40-60% and those with ³60%. The primary endpoint (total death and readmission due to heart failure) was increased with an LVEF increase. RAS-inhibitors reduced the event rate regardless of LVEF. The LVEF and RAS-inhibitors administration had no interaction on the endpoint occurrence. The original hypothesis was denied.

Academic Significance and Societal Importance of the Research Achievements

未だエビデンスに基づいた治療法の確立されていない左室駆出率の維持された心不全(HFpEF)に対する心筋保護薬の有効性を検証した。本コホートの予後に対して、左室駆出率そのものの関与が大きく（左室駆出率が高いほど予後が悪くなる）、加えてRAS系阻害薬の予後改善効果が左室駆出率にかかわらず認められた。予後に対し、RAS系阻害薬と左室駆出率の間に交互作用が認められた。HFpEFの予後は、左室駆出率に有意に依存し、RAS系阻害薬は予後改善効果を示す。