Early diagnosis of pulmonary hypertension by cardiac examination using phonocardiograms and mechanocardiogram.

Research Project

Project/Area Number	18K15432
Research Category	Grant-in-Aid for Early-Career Scientists
Allocation Type	Multi-year Fund
Review Section	Basic Section 52010:General internal medicine-related
Research Institution	Kyorin University
Principal Investigator	Yamasaki Satoko 杏林大学, 医学部, 助教 (90782863)
Project Period (FY)	2018-04-01 – 2022-03-31
Project Status	Completed (Fiscal Year 2021)
Budget Amount *help	¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000) Fiscal Year 2020: ¥520,000 (Direct Cost: ¥400,000、Indirect Cost: ¥120,000) Fiscal Year 2019: ¥520,000 (Direct Cost: ¥400,000、Indirect Cost: ¥120,000) Fiscal Year 2018: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Keywords	生理検査 / 肺高血圧症 / 心音図 / 心機図 / 肺性Ⅱ音の亢進 / 心音 / 身体所見 / 心音・心機図
Outline of Final Research Achievements	We analyzed pre and post-RHC phonocardiograms of 214 patients with pulmonary hypertension who underwent RHC from 2009 to 2018, and found that both II tone wavelength ratio and amplitude ratio tended to be significantly higher in correlation with mPAP, while wavelength ratio was significantly correlated with right atrial pressure, right ventricular end-diastolic pressure, and pulmonary vascular resistance, and amplitude ratio with pulmonary vascular resistance. In a comparison of severity, both wavelength ratio and amplitude ratio showed significant differences in the borderline group - light-moderate and borderline group - severe, but not in the light-moderate and severe group. In the ROC analysis, the sensitivity and specificity were 75% and 79%, respectively, with a cutoff value of wavelength P/A ratio >=1.33, and 93% and 55%, respectively, with a cutoff value of amplitude P/A ratio >=0.70.
Academic Significance and Societal Importance of the Research Achievements	難病である肺高血圧症は従来の検査法では早期発見が難しく、症状出現から診断まで時間を要して治療介入が遅れることが多い。心音・心機図を用いて早期から現れる身体所見を非侵襲的に可視化し、診断や重症度判定、治療効果判定における有効性が証明されれば、本疾患を早期に診断するための低侵襲検査法が確立できる。