Survay for Utility of Electrocardiogram as an Index for Identifying the Risk of Cardiovascular Events for Inhabitants in the Great East Japan Earthquake disaster area

• Project/Area Number: 17K09520
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular medicine
• Research Institution: Iwate Medical University
• Principal Investigator: Tanaka Fumitaka 岩手医科大学, 医学部, 准教授 (80405761)
• Project Period (FY): 2017-04-01 – 2021-03-31
• Project Status: Completed (Fiscal Year 2020)
• Budget Amount: ¥2,990,000 (Direct Cost: ¥2,300,000、Indirect Cost: ¥690,000); Fiscal Year 2019: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2017: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
• Keywords: 心肥大 / コホート研究 / 慢性腎臓病 / 心血管疾患 / 心電図 / 左室肥大 / 生活習慣病 / 不整脈 / 循環器 / 自然災害

Outline of Final Research Achievements

A total of 7206 participants at least 40 years of age who were free from cardiovascular events in a general population were followed for the incidence of cardiovascular events. A total of 1886 (26.2%) had CKD, of which 1471 (78.0%) had a preserved eGFR. After an average 11.3 years of follow-up, the adjusted hazard ratio for the incidence of cardiovascular events significantly increased for ECG-LVH according to the Sokolow Lyon voltage among participants with CKD, in contrast to those without CKD. The inclusion of any ECG-LVH parameters improved the accuracy of reclassification in any risk prediction model based on the eGFR, UACR, or Framingham 10-year risk score in the CKD participants (all P values <0.040). In conclusion, in patients with CKD stage 1 to 5, ECG-LVH is useful for predicting the risk of future cardiovascular events and adds prognostic information to traditional cardiovascular risk assessments.

Academic Significance and Societal Importance of the Research Achievements

東日本大震災の甚大な被害地域の住民が負った多大なる心的ストレスが、循環器疾患発症リスクと関連することがこれまでの疫学研究から明らかにされている。今回得られた解析結果より、心電図の左室肥大所見が、特にCKD患者において、震災関連の循環器疾患予防の上で高リスクに相当する被災地域居住者を安価かつ簡便に特定できる可能性が明らかになった。
また、ECG所見と血液、尿所見という既存の危険因子との組み合わせによる評価が、被災地域コホートの循環器疾患発症の高リスク特定に寄与することが明らかになったことで、循環器疾患を未然に予防する上で有用な情報となる可能性がある。

Research Products

• [Journal Article] Additional prognostic value of electrocardiographic left ventricular hypertrophy in traditional cardiovascular risk assessments in chronic kidney disease (2020)
  • Author(s): Tanaka Fumitaka、Komi Ryosuke、Nakamura Motoyuki、Tanno Kozo、Onoda Toshiyuki、Ohsawa Masaki、Sakata Kiyomi、Omama Shinichi、Ogasawara Kuniaki、Ishibashi Yasuhiro、Yonekura Yuki、Itai Kazuyoshi、Kuribayashi Toru、Kikuchi Yawara、Ishigaki Yasushi、Okayama Akira、Asahi Koichi
  • Journal Title: Journal of Hypertension Volume: 38 Issue: 6 Pages: 1149-1157
  • DOI: 10.1097/hjh.0000000000002394
  • Peer Reviewed
• [Journal Article] Sex differences in the influence of elevated serum uric acid levels for cardiovascular risk in the general population with normal renal function (2020)
  • Author(s): Yuki Matsuura, Fumitaka Tanaka, Toshie Segawa, Kozo Tanno, Kiyomi Sakata, Masaki Ohsawa, Shinichi Omama, Kuniaki Ogasawara, Koichi Asahi, Motoyuki Nakamura
  • Journal Title: Journal of Iwate Medical Association Volume: 72 Pages: 145-155
  • NAID: 130007940850
  • Peer Reviewed / Open Access
• [Journal Article] The Value of a Cystatin C-based Estimated Glomerular Filtration Rate for Cardiovascular Assessment in a General Japanese Population: Results from the Iwate Tohoku Medical Megabank Project. (2020)
  • Author(s): Osaki T, Satoh M, Tanaka F, Tanno K, Takahashi Y, Nasu T, Sakata K, Morino Y, Sobue K, Sasaki M.
  • Journal Title: J Epidemiol Volume: 30 Pages: 260-267
  • NAID: 130007852130
  • Peer Reviewed / Open Access
• [Journal Article] Association between high-sensitivity cardiac troponin T and future cardiovascular incidence in a general Japanese population: results from the Tohoku medical megabank project. (2019)
  • Author(s): Takahashi Y, Satoh M, Ohmomo H, Tanaka F, Osaki T, Tanno K, Nasu T, Sakata K, Morino Y, Sobue K, Sasaki M
  • Journal Title: Biomarkers Volume: 24 Pages: 566-573
  • Peer Reviewed
• [Journal Article] 糖尿病患者の脳卒中発症における血圧高値の寄与 (2019)
  • Author(s): 田中文隆
  • Journal Title: 血圧 Volume: ２６ Pages: 8-9
• [Journal Article] Association between high-sensitivity cardiac troponin T and future cardiovascular incidence in a general Japanese population: Results from the Tohoku Medical Megabank Project.in a general Japanese population (2019)
  • Author(s): Takahashi Y, Satoh M, Ohmomo H, Tanaka F, Osaki T, Tanno K, Nasu T, Sakata K, Morino Y, Sobue K, Sasaki M.
  • Journal Title: Biomarkers Volume: in press Pages: 1-26
  • Peer Reviewed
• [Journal Article] Prognostic Value of Electrocardiographic Left Ventricular Hypertrophy on Cardiovascular Risk in a Non-Hypertensive Community-Based Population. (2018)
  • Author(s): Tanaka K, Tanaka F, Onoda T, Tanno K, Ohsawa M, Sakata K, Omama S, Ogasawara K, Ishibashi Y, Itai K, Kuribayashi T, Okayama A, Nakamura M
  • Journal Title: Am J Hypertens Volume: ３１ Pages: 895-901
  • Peer Reviewed
• [Journal Article] Burden of high blood pressure as a contributing factor to stroke in the Japanese community-based diabetic population. (2018)
  • Author(s): Komi R, Tanaka F, Omama S, Ishibashi Y, Tanno K, Onoda T, Ohsawa M, Tanaka K, Okayama A, Nakamura M
  • Journal Title: Hypertens Res Volume: 41 Pages: 531-538
  • Peer Reviewed
• [Journal Article] Ability of B-Type Natriuretic Peptide Testing to Predict Cardioembolic Stroke in the General Population ― Comparisons With C-Reactive Protein and Urinary Albumin ― (2018)
  • Author(s): Nakamura M, Ishibashi Y, Tanaka F, Omama S, Onoda T, Takahashi T, Takahashi S, Tanno K, Ohsawa M, Sakata K, Koshiyama M, Ogasawara K, Okayama A; Iwate-KENCO Study Group.
  • Journal Title: Circulation Journal Volume: 82 Issue: 4 Pages: 1017-1025
  • DOI: 10.1253/circj.CJ-17-1124
  • NAID: 130006528570
  • ISSN: 1346-9843, 1347-4820
  • Peer Reviewed / Open Access
• [Journal Article] Prognostic value of electrocardiographic left ventricular hypertrophy on cardiovascular risk in a non-hypertensive community-based population. (2018)
  • Author(s): Tanaka K, Tanaka F, Onoda T, Tanno K, Ohsawa M, Sakata K, Omama S, Ogasawara K, Ishibashi Y, Itai K, Kuribayashi T, Okayama A, Nakamura M; Iwate-Kenco Study Group.
  • Journal Title: Am J Hypertens Volume: - Issue: 8 Pages: 895-901
  • DOI: 10.1093/ajh/hpy055
  • Peer Reviewed
• [Journal Article] Burden of high blood pressure as a contributing factor to stroke in the Japanese community-based diabetic population. (2018)
  • Author(s): Komi R, Tanaka F, Omama S, Ishibashi Y, Tanno K, Onoda T, Ohsawa M, Tanaka K, Okayama A, Nakamura M; Iwate-Kenco Study Group.
  • Journal Title: Hypertens Res. Volume: - Issue: 7 Pages: 531-538
  • DOI: 10.1038/s41440-018-0042-4
  • Peer Reviewed / Open Access
• [Journal Article] Long-term effects of the 2011 Japan earthquake and tsunami on incidence of fatal and nonfatal myocardial infarction. (2017)
  • Author(s): Nakamura M, Tanaka K, Tanaka F, Matsuura Y, Komi R, Niiyama M, Kawakami M, Koeda Y, Sakai T, Onoda T, Itoh T; Northern Iwate Heart Registry Consortium.
  • Journal Title: Am J Cardiol Volume: 120 Issue: 3 Pages: 352-358
  • DOI: 10.1016/j.amjcard.2017.05.002
  • Peer Reviewed / Open Access
• [Journal Article] Temporal Trends in the Incidence and Clinical Features of Acute Myocardial Infarction in a Japanese Rural Area From 2006 to 2014 (2017)
  • Author(s): Nakamura M, Tanaka F, Segawa T, Takahashi T, Matsuura Y, Sakai T, Nishiyama O, Niiyama M, Onoda T, Koshiyama M; (on behalf of Northern Iwate Heart Disease Registry Consortium).
  • Journal Title: Circulation Journal Volume: 81 Issue: 12 Pages: 1854-1861
  • DOI: 10.1253/circj.CJ-17-0201
  • NAID: 130006219153
  • ISSN: 1346-9843, 1347-4820
  • Peer Reviewed / Open Access
• [Presentation] 日本高血圧学会2019年血圧値分類別の脳心血管疾患罹患リスクの検討 中年男性の解析結果 (2020)
  • Author(s): 大澤 正樹, 丹野 高三, 板井 一好, 米倉 祐貴, 小笠原 邦昭, 大間々 真一, 田中 文隆, 小野田 敏行, 栗林 徹, 岡山 明
  • Organizer: 第56回日本循環器病予防学会学術集会
• [Presentation] 降圧薬服用中の高血圧患者の大血管障害リスクの指標とは 血圧を超えたアルブミン尿の有用性 (2020)
  • Author(s): 菊池 調, 田中 文隆, 中村 元行, 旭 浩一
  • Organizer: 第63回日本腎臓学会学術総会
• [Presentation] 地域における腎専門医初診までのかかりつけ医での慢性腎臓病の管理と腎機能推移 (2020)
  • Author(s): 松浦 佑樹, 田中 文隆, 菊池 調, 佐藤 直幸, 野田 晴也, 赤坂 祐一郎, 高橋 今日子, 渡邊 収司, 旭 浩一
  • Organizer: 第63回日本腎臓学会学術総会
• [Presentation] 降圧薬物療法中の高血圧例の大血管障害リスクの指標とは？-血圧を超えたアルブミン尿の有用性 (2020)
  • Author(s): 菊池 調, 田中文隆, 丹野高三, 大澤正樹, 坂田清美, 大間々真一, 小笠原邦明, 岡山明, 中村元行, 旭 浩一
  • Organizer: 第63回日本腎臓学会学術総会
• [Presentation] Hypertension Enhances the Association between Body Mass Index Categories and the Risk of Incident Cardiovascular Disease in Chronic Kidney Disease. (2019)
  • Author(s): 田中文隆, 丹野高三, 大澤正樹, 坂田清美, 石橋靖宏, 岡山明, 中村元行
  • Organizer: 第83回日本循環器学会学術集会
• [Presentation] Prognostic Value of Electrocardiographic Left Ventricular Hypertrophy on Cardiovascular Risk in Chronic Kidney Disease. (2019)
  • Author(s): 古味良亮, 田中文隆, 丹野高三, 大澤正樹, 坂田清美, 石橋靖宏, 岡山明, 中村元行
  • Organizer: 第83回日本循環器学会学術集会
• [Presentation] Preserved Glomerular Filtration Rate and Albuminuria Significantly Contributes to Higher Risks of Death and Cardiovascular Diseases, Especially in Diabetic Individuals. (2019)
  • Author(s): 大澤正樹, 丹野高三, 森野禎浩, 伊藤智範, 田中文隆, 腰山誠, 岡山明
  • Organizer: 第83回日本循環器学会学術集会
• [Presentation] Hypertension Enhances the Association between Body Mass Index and the Risk of Incident Cardiovascular Disease in Chronic Kidney Disease (2019)
  • Author(s): 田中 文隆,古味 良亮, 大澤 正樹, 小野田 敏行, 丹野 高三,小笠原 邦昭, 坂田 清美, 岡山 明, 中村 元行
  • Organizer: 第83回日本循環器学会学術集会
• [Presentation] Prognostic Value of Electrocardiographic Left Ventricular Hypertrophy on Cardiovascular Risk in Chronic Kidney Disease (2019)
  • Author(s): 古味 良亮, 田中 文隆,大澤 正樹, 小野田 敏行, 丹野 高三,小笠原 邦昭, 坂田 清美, 岡山 明, 中村 元行
  • Organizer: 第83回日本循環器学会学術集会
• [Presentation] 12誘導心電図のRV5またはRV6電位の評価はCKDの心血管疾患発症リスクを特定する～岩手県北沿岸地域コホート研究～ (2018)
  • Author(s): 田中 文隆,古味 良亮, 大澤 正樹, 小野田 敏行, 丹野 高三,小笠原 邦昭, 坂田 清美, 岡山 明, 中村 元行
  • Organizer: 第61回日本腎臓学会学術総会
• [Presentation] Impact of blood pressure as a contributing factor to stroke in the community-based diabetic population. (2018)
  • Author(s): 古味良亮, 田中文隆, 丹野高三, 大澤正樹, 坂田清美, 石橋靖宏, 岡山明, 中村元行.
  • Organizer: 第82回日本循環器学会
• [Presentation] Prognostic value of electrocardiographic left ventricular hypertrophy on cardiovascular risk in a non-hypertensive community-based population (2018)
  • Author(s): 田中健太郎, 田中文隆, 大澤正樹, 丹野高三, 小野田敏行, 坂田清美, 大間々真一, 石橋靖宏, 小笠原邦昭, 板井一好, 岡山明, 中村元行.
  • Organizer: 第82回日本循環器学会
• [Presentation] Sex-specific association of serum uric acid on the incidence of cardiovascular events in community-dwelling people with the low cardiovascular risk. (2018)
  • Author(s): 松浦佑樹, 田中文隆, 丹野高三, 大澤正樹, 坂田清美, 岡山明, 中村元行.
  • Organizer: 第82回日本循環器学会
• [Presentation] Plasma B-type Natriuretic Peptide level is useful to predict incidence for both types of heart failure with and without left ventricular systolic dysfunction in the general population . (2017)
  • Author(s): Komi R, Tanaka F, Satoh K, Matsuura Y, TannoK, Ohsawa M, Onoda T, Sakata K, Ogasawara K, Okayama A, Okayama A, Nakamura M.on behalf of Iwate KENCO study group, Iwate, Japan.
  • Organizer: America Heart Association 2017.
  • Int'l Joint Research
• [Presentation] Additional value of B-type Natriuretic Peptide to electrocardiography on the prediction of atherosclerotic cardiovascular disease in a population-based sample. . (2017)
  • Author(s): Komi R, Tanaka F, Tanaka K, Onoda T, Tanno K, Ohsawa M, Itai K, Sakata K, Omama S, Ishibashi Y, Kuribayashi T, Okayma A, Nakamura, M.On behalf of Iwate-Kenco Study Group :
  • Organizer: America Heart Association 2017.
  • Int'l Joint Research
• [Presentation] Sex-specific differences in the association between serum uric acid and the incidence of cardiovascular events in the general population. (2017)
  • Author(s): Matsuura Y, Segawa T, Tanaka F, Komi R, Tanno K, Ohsawa M, Ishibashi Y, Omama S, Sakata K, Okayama A, Nakamura M.
  • Organizer: America Heart Association 2017.
  • Int'l Joint Research
• [Presentation] ：心血管ハイリスク群で高尿酸血症は循環器疾患発症リスクを増大させるか?一般住民での観察研究. (2017)
  • Author(s): 松浦佑樹, 瀬川利恵, 田中文隆, 石橋靖宏, 大澤正樹, 坂田清美, 中村元行.
  • Organizer: 第114回日本内科学会.
• [Presentation] 尿蛋白を加味したCKD定義別の心血管疾患発症リスクの比較：一般住民での検討 (2017)
  • Author(s): 松浦佑樹, 田中文隆, 瀬川利恵, 渡邊收司, 赤坂祐一郎, 岡山明, 中村元行.
  • Organizer: 第60回日本腎臓学会