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Establishment and application of the physiological biomarkers in older people at the end-of-life

Research Project

Project/Area Number 18K07440
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 52010:General internal medicine-related
Research InstitutionJichi Medical University (2019-2021)
The University of Tokyo (2018)

Principal Investigator

Yasuhiro Yamaguchi  自治医科大学, 医学部, 教授 (60376473)

Co-Investigator(Kenkyū-buntansha) 山本 寛  地方独立行政法人東京都健康長寿医療センター(東京都健康長寿医療センター研究所), 東京都健康長寿医療センター研究所, 研究員 (10361487)
石井 正紀  東京大学, 医学部附属病院, 講師 (20724438)
長瀬 隆英  東京大学, 医学部附属病院, 教授 (40208004)
Project Period (FY) 2018-04-01 – 2022-03-31
Project Status Completed (Fiscal Year 2021)
Budget Amount *help
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2020: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2018: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywords呼吸リズム / 睡眠時無呼吸 / 心不全 / 心房細動 / 加齢 / 慢性心不全 / 虚血性心疾患 / 胃運動 / 終末期 / 傾眠
Outline of Final Research Achievements

First, we extracted stable respiratory signals of oronasal thermistor before sleep onset with closed eyes, using polysomnography. Then, we quantified breathing irregularities using Shannon entropy S. The values of Shannon entropy S of airflow signals in subjects with heart diseases, including the past history of ischemic heart diseases, atrial fibrillation, and chronic heart failure, were significantly higher than in those without heart diseases. Our findings suggested that even those without the clinical diagnosis of heart failure can show breathing irregularities compared to those without heart diseases. Furthermore, those with the higher values of Shannon entropy S experienced cardiovascular events significantly more frequently after the polysomnography test than those with the lower values among those with heart diseases. Meanwhile, the values of Shannon entropy S of airflow signals decreased with age among those without heart diseases.

Academic Significance and Societal Importance of the Research Achievements

呼吸リズムは、非侵襲的に測定できる生理学的指標でありながら、その定量法や臨床的意義の研究は、ほとんどみられない。本研究では、同一患者内での再現性も評価することで、その測定法の一つを提案することができた。さらに、重症の心不全患者は、チェーンストークス呼吸を中心とする呼吸リズムの異常を呈することは既にしられていたが、我々は、臨床的に心不全と診断されていない患者も、すでに呼吸リズムの不規則性を示すことを明らかにした。これらの知見の応用は、心不全の早期発見につながりうるだけでなく、心疾患と呼吸リズムとの連関を通してそれらの病態解明の端緒になると期待される。

Report

(5 results)
  • 2021 Annual Research Report   Final Research Report ( PDF )
  • 2020 Research-status Report
  • 2019 Research-status Report
  • 2018 Research-status Report
  • Research Products

    (7 results)

All 2021 2020 2019 2018

All Journal Article (2 results) (of which Peer Reviewed: 2 results) Presentation (5 results) (of which Int'l Joint Research: 1 results)

  • [Journal Article] Breathing irregularities before sleep onset on polysomnography in patients with heart diseases2021

    • Author(s)
      Okamoto S, Ishii M, Hibi S, Akishita M, Yamaguchi Y.
    • Journal Title

      Sleep and Breathing

      Volume: - Issue: 2 Pages: 605-612

    • DOI

      10.1007/s11325-021-02403-2

    • Related Report
      2021 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Polysomnographic features of low arousal threshold in overlap syndrome involving obstructive sleep apnea and chronic obstructive pulmonary disease2019

    • Author(s)
      Yamaguchi Y, Shiota S, Kusunoki Y, Hamaya H, Ishii M, Kodama Y, Akishita M, Kida K, Takahashi K, Nagase T, Fukuchi Y
    • Journal Title

      Sleep Breath.

      Volume: 印刷中 Issue: 4 Pages: 1095-1100

    • DOI

      10.1007/s11325-019-01786-7

    • Related Report
      2018 Research-status Report
    • Peer Reviewed
  • [Presentation] Breathing irregularities before sleep onset on polysomnography in patients with heart diseases2021

    • Author(s)
      Okamoto S, Ishii M, Hibi S, Akishita M, Yamaguchi Y.
    • Organizer
      The 25th Congress of the Asian Pacific Society of Respirology
    • Related Report
      2021 Annual Research Report
    • Int'l Joint Research
  • [Presentation] 睡眠呼吸障害を持つ軽度心不全患者の安静閉眼覚醒時における呼吸リズムに関する検討2020

    • Author(s)
      岡本宗史、日比慎一郎、石井正紀、秋下雅弘、山口泰弘
    • Organizer
      第60回日本呼吸器学会学術講演会
    • Related Report
      2020 Research-status Report
  • [Presentation] 睡眠時無呼吸に続くあえぎ様呼吸と持続陽圧呼吸療法アドヒアランスの関連2018

    • Author(s)
      山口泰弘、日比慎一郎、濱谷広頌、石井正紀、秋下雅弘
    • Organizer
      日本呼吸器学会学術講演会
    • Related Report
      2018 Research-status Report
  • [Presentation] 非がん疾患のエンド・オブ・ライフケア:系統的レビューから2018

    • Author(s)
      山口泰弘
    • Organizer
      日本老年医学会学術集会
    • Related Report
      2018 Research-status Report
  • [Presentation] 高齢2型糖尿病患者におけるCOPD診断の有用性とCOPDリスク因子に関する検討2018

    • Author(s)
      石井正紀、山口泰弘、小川純人、秋下雅弘、井村満男
    • Organizer
      日本老年医学会学術集会
    • Related Report
      2018 Research-status Report

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Published: 2018-04-23   Modified: 2023-01-30  

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