Mechanism of cardio-renal interaction in atrial fibrillation

• Project/Area Number: 18K08099
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Kanazawa University
• Principal Investigator: Kato Takeshi 金沢大学, 附属病院, 助教 (90456418)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Project Status: Completed (Fiscal Year 2021)
• Budget Amount: ¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000); Fiscal Year 2020: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
• Keywords: 心房細動 / 慢性腎臓病 / カテーテルアブレーション

Outline of Final Research Achievements

The population of atrial fibrillation is growing with aging of Japanese society. Atrial fibrillation causes renal dysfunction, however, the underlying mechanism was unknown. We have demonstrated that catheter ablation for atrial fibrillation improves renal function. The independent predictors of the improvement were young age and small left atrium. These results suggests that decreased renal blood flow caused by impaired atrial contraction would be the major cause of atrial fibrillation-induced renal dysfunction.

Academic Significance and Societal Importance of the Research Achievements

心房細動は社会の高齢化に伴って増加している不整脈で、脳梗塞や心不全の原因となる。心房細動が存在すると腎機能が悪化するが、腎機能の悪化に伴って予後が不良になることが知られている。また、心房細動患者には抗凝固療法が必要になることが多いが、腎機能が悪いと出血などの合併症の発生率が高くなる。我々は、本研究で心房細動に対して早期にカテーテルアブレーションを行うことで腎機能悪化を予防できることを示した。現代社会で求められている、健康寿命の増進や医療資源・財源の有効活用に資するものと考える。

Research Products

• [Journal Article] Impact of sinus rhythm maintenance on major adverse cardiac and cerebrovascular events after catheter ablation of atrial fibrillation: insights from AF frontier ablation registry (2021)
  • Author(s): Usuda Keisuke, Kato Takeshi, Tsuda Toyonobu, et al. On behalf of the AF Ablation Frontier Registry
  • Journal Title: Heart and Vessels Volume: 37 Issue: 2 Pages: 327-336
  • DOI: 10.1007/s00380-021-01929-5
  • Peer Reviewed
• [Journal Article] CKDと心房細動の深い関係 (2020)
  • Author(s): 加藤武史
  • Journal Title: 臨床医のための循環器診療 Volume: 32 Pages: 25-26
• [Presentation] 糖尿病と心房細動の深い関係 (2020)
  • Author(s): 加藤武史
  • Organizer: 日本糖尿病合併症学会
  • Invited
• [Presentation] Left atrial volume index predicts improvement in renal function after catheter ablation of atrial fibrillation (2019)
  • Author(s): Usuda K, Kato T, et al.
  • Organizer: European Society of Cardiology
  • Int'l Joint Research
• [Presentation] Age and left atrial dimension predicts renal function improvement after catheter ablation for atrial fibrillation (2019)
  • Author(s): Usuda K, Kato T, et al.
  • Organizer: 日本不整脈心電学会
• [Presentation] Benefits of Ablating Atrial Fibrillation in Heart Failure (2019)
  • Author(s): Kato T
  • Organizer: Chinese Society of Cardiology
  • Int'l Joint Research / Invited
• [Book] 不整脈診療ロジック×プラクティス (2020)
  • Author(s): 加藤 武史、松尾 征一郎
  • Total Pages: 392
  • Publisher: 南江堂
  • ISBN: 9784524248940