A Comprehensive study on platypnea-orthodeoxia syndrome in the elderly

• Project/Area Number: 18K08107
• 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: Okayama University
• Principal Investigator: NAKAGAWA Koji 岡山大学, 大学病院, 講師 (70726132)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Project Status: Completed (Fiscal Year 2020)
• Budget Amount: ¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000); Fiscal Year 2020: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2019: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2018: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
• Keywords: Platypnea-orthodeoxia症候群 / 卵円孔開存 / 基準設定 / 態勢構築 / 実態把握 / POS / 心房中隔欠損症 / PFOカテーテル閉鎖術

Outline of Final Research Achievements

In this study, patients with suspected platypnea-orthodeoxia syndrome were detected in medical facilities and outpatient rehabilitation facilities, but the prevalence could not be evaluated due to the influence of the corona pandemic. In addition to the deviation and extension of the ascending aorta, thoracic-lumbar compression fractures were frequently observed in platypnea-orthodeoxia syndrome patients, suggesting that structural changes in the thoracic cavity cause right-left shunt via PFO. In addition, PFO closure showed a marked improvement in hypoxemia. Percutaneous PFO closure has been suggested to be a useful treatment in PFO-mediated platypnea-orthodeoxia syndrome patients.

Academic Significance and Societal Importance of the Research Achievements

Platypnea-orthodeoxia症候群は高齢者の健康寿命に大きく影響を及ぼす疾患であるが、一般的に認知度は低い。本研究により胸腰椎圧迫骨折や亀背を有する高齢者で原因不明の低酸素血症を認めた場合には本症が積極的に疑われるべきであることが示唆された。また卵円孔開存（PFO）を介したplatypnea-orthodeoxia症候群に対しては経皮的PFO閉鎖術が低酸素血症の改善に極めて有用な治療であることが示唆された。今後保険適応の取得に向けて取り組む必要が考えられる。

Research Products

• [Journal Article] New Appearance of Fragmented QRS as a Predictor of Ventricular Arrhythmic Events in Patients With Hypertrophic Cardiomyopathy (2020)
  • Author(s): Ogura S, Nakamura K, Morita H, Toh N, Nakagawa K, Yoshida M, Watanabe A, Nishii N, Miyoshi T, Ito H.
  • Journal Title: Circulation Journal Volume: 84 Issue: 3 Pages: 487-494
  • DOI: 10.1253/circj.CJ-19-0968
  • NAID: 130007801782
  • ISSN: 1346-9843, 1347-4820
  • Year and Date: 2020-02-25
  • Peer Reviewed / Open Access
• [Journal Article] Clinical Significance of Septal Malalignment for Transcatheter Closure of Atrial Septal Defect (2020)
  • Author(s): Takaya Y, Akagi T, Nakagawa K, Nakayama R, Miki T, Watanabe N, Toh N, Ito H
  • Journal Title: J Interv Cardiol Volume: 2020 Pages: 6090612-6090612
  • DOI: 10.1155/2020/6090612
  • NAID: 120006839436
  • Peer Reviewed / Open Access
• [Journal Article] Indication and prognostic significance of programmed ventricular stimulation in asymptomatic patients with Brugada syndrome (2020)
  • Author(s): Asada Saori、Morita Hiroshi、Watanabe Atsuyuki、Nakagawa Koji、Nagase Satoshi、Miyamoto Masakazu、Morimoto Yoshimasa、Kawada Satoshi、Nishii Nobuhiro、Ito Hiroshi
  • Journal Title: EP Europace Volume: - Issue: 6 Pages: 972-979
  • DOI: 10.1093/europace/euaa003
  • Peer Reviewed / Open Access
• [Journal Article] Efficacy of catheter ablation for paroxysmal atrial fibrillation in patients with atrial septal defect: a comparison with transcatheter closure alone (2019)
  • Author(s): Nakagawa K, Akagi T, Nagase S, Takaya Y, Kijima Y, Toh N, Watanabe A, Nishii N, Nakamura K, Morita H, Kusano K, Ito H
  • Journal Title: Europace Volume: 21 Issue: 11 Pages: 1663-1669
  • DOI: 10.1093/europace/euz207
  • Peer Reviewed
• [Journal Article] Impact of premature activation of the right ventricle with programmed stimulation in Brugada syndrome. (2018)
  • Author(s): Nakagawa K, Nagase S, Morita H, Wada T, Tanaka M, Murakami M, Watanabe A, Nishii N, Nakamura K, Kusano KF, Ito H, Ohe T.
  • Journal Title: J Cardiovasc Electrophysiol Volume: 29 Issue: 1 Pages: 71-78
  • DOI: 10.1111/jce.13336
  • Peer Reviewed
• [Presentation] 実際の手技を学ぶ (2020)
  • Author(s): 中川晃志
  • Organizer: 第 84 回日本循環器学会学術集会
• [Presentation] Thrombotic and Bleeding Risks in AF Patients (2020)
  • Author(s): Koji Nakagawa
  • Organizer: 第 84 回日本循環器学会学術集会
• [Presentation] Morphological Features of Patent Foramen Ovale Requiring Larger Occlusion Devices for Transcatheter Closure (2020)
  • Author(s): Takashi Miki, Teiji Akagi, Rie Nakayama, Yoichi Takaya, Koji Nakagawa, Hiroshi Ito
  • Organizer: 第 84 回日本循環器学会学術集会
• [Presentation] Catheter Ablation of Atrial Fibrillation in Patients with Both Critical Left Ventricular Dysfunction and Serious Heart Failure (2020)
  • Author(s): 水野智文, 渡辺敦之, 木村朋生, 森本芳正, 宮本真和, 中川晃志, 西井伸洋, 中村一文, 森田 宏, 伊藤 浩
  • Organizer: 第 84 回日本循環器学会学術集会
• [Presentation] Mapping of Atrial Premature Complexes Triggering Onset of Atrial Fibrillation in Patients (2019)
  • Author(s): Koji Nakagawa, Satoshi Nagase, Atsuyuki Watanabe, Saori Tsukuda, Yoshimasa Morimoto, Masakazu Miyamoto, Nobuhiro Nishii, Kazufumi Nakamura, Hiroshi Morita, Hiroshi Ito
  • Organizer: Heart Rhythm 2019
  • Int'l Joint Research
• [Presentation] Mapping of Atrial Premature Complexes Triggering Onset of Atrial Fibrillation in Patients (2018)
  • Author(s): Koji Nakagawa
  • Organizer: 第65回日本不整脈心電学会学術大会