| Project/Area Number |
18K12098
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 90130:Medical systems-related
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| Research Institution | The University of Tokyo |
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Principal Investigator |
Daimon Masao 東京大学, 医学部附属病院, 講師 (80343094)
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| Co-Investigator(Kenkyū-buntansha) |
中尾 倫子 東京大学, 医学部附属病院, 助教 (30597216)
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| Project Period (FY) |
2018-04-01 – 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: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2019: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2018: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
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| Keywords | 画像診断 / 心不全 / 心エコー / 心機能 / 右心室 / 心エコー図 / 病理 |
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| Outline of Final Research Achievements |
We evaluated the prognostic values of the right ventricular (RV) function parameters using echocardiography in patients with dilated cardiomyopathy (DCM) and compared them with digitally processed pathological findings. In a study of 109 patients with DCM, cardiac events were observed in 41 cases within one year, and the combination of right ventricular longitudinal strain (RVSL) and fractional area change (FAC) was most useful for predicting the cardiac events (hazard ratio 11.3). However, echocardiographic parameters considering the RV-PA coupling did not improve the prognostic values. In 31 patients who underwent myocardial biopsy, RV myocardial fibrosis was quantified using a digital process and compared with the echocardiographic parameters. However, the RV myocardial fibrosis rate did not correlate with RV systolic parameters such as RVLS, FAC, and TAPSE.
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| Academic Significance and Societal Importance of the Research Achievements |
心エコーによる右心機能指標はDCMの予後予測に有用であるが、単一の指標でなくRVSLとFACの組み合わせることで、より的確な予後予測を行うことが可能となることが明らかとなった。少なくともDCM症例では、RV-PA coupling指標は予後予測能を改善しない。一方で、右心機能指標は、単に心筋線維化だけでなく圧や容量などの血行動態や液性因子など他の因子に影響を受けている可能性がある。今後右心機能改善の治療法を開発する上で、これらの病態を解明する研究の進展が望まれる。
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