Development of a new non-invasive method to assess severity for pulmonary hypertension in cardiac rehabilitation

• Project/Area Number: 17K13047
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Rehabilitation science/Welfare engineering
• Research Institution: Tohoku University
• Principal Investigator: Akizuki Mina 東北大学, 大学病院, 理学療法士 (40772182)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥3,120,000 (Direct Cost: ¥2,400,000、Indirect Cost: ¥720,000); Fiscal Year 2019: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2018: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2017: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
• Keywords: 慢性血栓塞栓性肺高血圧症 / 肺動脈性肺高血圧症 / 呼気ガス分析 / 非侵襲的評価法 / リハビリテーション / 循環器・高血圧

Outline of Final Research Achievements

Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by organic thrombotic obstructions in the pulmonary arteries with reduced pulmonary vascular reserve.Moreover, RHC is required to diagnosis and hemodynamic assessment of pulmonary hypertension. However, RHC is invasive and imposes a heavy burden on patients if repeated.
The main findings are as follows: i) supine PETCO2 and ΔPETCO2 are useful for the evaluation of mean pulmonary arterial pressure, which is one of the parameters of CTEPH severity; ii) supine PETCO2 may help assess response to therapies.The this method is a useful non-invasive method for the evaluation of CTEPH severity　and assess response to therapies.

Academic Significance and Societal Importance of the Research Achievements

本研究により，呼気ガス分析指標である呼気終末二酸化炭素分圧 (PETCO2) が、CTEPHの重症度評価や治療効果判定に有用であることが判明した。
肺高血圧症の確定診断や治療効果判定には、侵襲的な右心カテーテル検査が必須であり、繰り返し施行することは患者負担が大きい。本研究結果より、姿勢変化を伴う呼気ガス分析が非侵襲的かつ簡易的に肺高血圧症の有無および重症度評価、治療効果判定に有用である可能性が示された。
これにより、患者負担が少ない簡易な肺高血圧症の検査法として、多くの医療施設で手軽に導入されることが期待できる。

Research Products

• [Journal Article] Usefulness of ventilatory gas analysis for the non-invasive evaluation of the severity of chronic thromboembolic pulmonary hypertension (2019)
  • Author(s): Akizuki M, Sugimura K, Aoki T, Kakihana T, Tatebe S, Yamamoto S, Sato H, Satoh K, Shimokawa H, Kohzuki M.
  • Journal Title: International Journal of Cardiology Volume: 296 Pages: 149-154
  • DOI: 10.1016/j.ijcard.2019.07.018
  • Peer Reviewed / Open Access
• [Journal Article] Non‐invasive screening using ventilatory gas analysis to distinguish between chronic thromboembolic pulmonary hypertension and pulmonary arterial hypertension (2019)
  • Author(s): Akizuki M, Sugimura K, Aoki T, Kakihana T, Tatebe S, Yamamoto S, Sato H, Satoh K, Shimokawa H, Kohzuki M.
  • Journal Title: Respirology Volume: 25 Issue: 4 Pages: 427-434
  • DOI: 10.1111/resp.13618
  • Peer Reviewed / Open Access
• [Presentation] Usefulness of ventilatory gas analysis for non-invasive differentiation between chronic thromboembolic pulmonary hypertension and pulmonary arterial hypertension (2019)
  • Author(s): Mina Akizuki
  • Organizer: ATS 2019 International Conference
  • Int'l Joint Research
• [Presentation] 慢性血栓塞栓性肺高血圧症の重症度評価における呼気ガス分析の有用性 (2018)
  • Author(s): 秋月三奈
  • Organizer: 第82回日本循環器学会学術集会
• [Presentation] Non-invasive Distinction Between Chronic Thromboembolic Pulmonary Hypertension and Pulmonary Arterial Hypertension Using Ventilatory Gas Analysis (2017)
  • Author(s): Mina Akizuki
  • Organizer: American Heart Association Scientific Sessions 2017
  • Int'l Joint Research