| Project/Area Number |
17K09527
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Cardiovascular medicine
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| Research Institution | Juntendo University |
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Principal Investigator |
Kasai Takatoshi 順天堂大学, 医学(系)研究科(研究院), 准教授 (60465036)
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| Project Period (FY) |
2017-04-01 – 2021-03-31
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| Project Status |
Completed (Fiscal Year 2020)
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| Budget Amount *help |
¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000)
Fiscal Year 2019: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2018: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2017: ¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000)
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| Keywords | 心不全 / 睡眠呼吸障害 / 体液貯留 / 体液シフト / 急性非代償性心不全 / 減塩 / 睡眠時無呼吸 |
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| Outline of Final Research Achievements |
First, we performed a randomized controlled trial (RCT) in order to investigate whether specific approaches to the fluid retention and its shift from the legs to the upper body can reduce severity of central sleep apnea (CSA) thorough the management of fluid retention and its shift, and thorough the alteration of arterial partial pressure of carbon dioxide levels in patients with acute decompensated heart failure (ADHF). We found that intensified low sodium diet can reduce severity of CSA in ADHF patients. In addition, we initially planned to conduct another RCT regarding effects of daytime leg compression stocking (CS). However, we had to use different CS with lower pressure, and perform a pilot study to investigate whether such CS with lower pressure can reduce daytime fluid retention in the legs. In a pilot study, we confirmed such CS with lower pressure could prevent daytime fluid retention in the legs as well as initially planned CS.
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| Academic Significance and Societal Importance of the Research Achievements |
体液貯留・体液シフト量に関してCSAに特化した報告は少なく、介入による効果の検証はほとんどない。したがって、体液貯留・体液シフトに対する特異的アプローチによるCSA軽減効果を検証した本研究の成果は独自性と新規性が高い。またADHFへの標準的治療に加え、減塩強化などのアプローチによって、CSAの軽症化を介してADHFそのものの予後改善につながる可能性がある。特に、現在、陽圧呼吸療法に変わる新たな治療法を模索している心不全に合併したCSAに対しての新たな治療法の確立につながる可能性があり、特にコストや侵襲に関する懸念が少ない介入による有効性を示せた点で社会的意義も十分にあるといえる。
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