| Project/Area Number |
17K15904
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Multi-year Fund |
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| Research Field |
General internal medicine(including psychosomatic medicine)
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| Research Institution | Japan Organization of Occupational Health and Safety (2018-2020)
Kyorin University (2017) |
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Principal Investigator |
Uechi Takahiro 独立行政法人労働者健康安全機構横浜労災病院(臨床病態研究センター), 臨床病態研究センター, 医長 (30725487)
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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 |
¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000)
Fiscal Year 2020: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2019: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2018: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2017: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
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| Keywords | 経頭蓋ドップラー検査 / ３次元経胸壁心エコー検査 / 非心原性失神 / ３次元経胸壁心臓超音波検査 / 3次元心臓超音波検査 / 失神 / 脳血流検査 / 自律機能検査 / ３次元心エコー / 脳血流測定 / 心臓超音波検査 / 再発予防 / プライマリーケア / 予防医学 / 経頭蓋エコー |
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| Outline of Final Research Achievements |
Previous studies have shown that transient loss of consciousness accounts for about 1% of cases of emergency patients, and 40% have no identified cause despite close examination. Syncope is classified into cardiogenic and non-cardiogenic. Non-cardiogenic syncope has a favorable prognosis, but its recurrence rate is as high as about 60%, and it has been suggested that it worsens the quality of life. However, the predictive factors for its recurrence are not clarified. In this study, transcranial doppler (TCD) and three-dimensional transthoracic echocardiography (3DTTE) examinations were performed on non-cardiogenic syncope patients who were referred to the emergency department of Kyorin University Hospital, and it was found that syncope was associated with recurrence in patients with high cerebral vascular resistance in the TCD test. It was also shown that the patients over 40 years of age with left ventricular dyssynchrony in the 3DTTE test were associated with more recurrent syncope.
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| Academic Significance and Societal Importance of the Research Achievements |
本研究では、TCD検査を用いて脳血管抵抗を測定し、3DTTE検査を用いて左室内非同期を測定することで、非心原性失神の再発予測の可能性を明らかとした。両検査ともに、ベッドサイドで行われることのできる検査であり、診断に要する時間が比較的短く、非侵襲的で、患者への負担も少ない。現在、両検査ともに救急外来での普及率は高くないが、今後、普及し、解析も自動化することが予想される。多くの施設で失神再発率を予測できるようになれば、広く失神診断ツールとして利用できる可能性が高い。また、再発する失神患者の病態ごとの治療戦略をたてることができるようになるため、再発患者に対しても有益であり、その社会的意義は大きい。
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