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Mechanism of acute heart failure exacerbation by sympathetic nerve activation and its application to treatment via sympathetic nerve deactivation

Research Project

Project/Area Number 18K15851
Research Category

Grant-in-Aid for Early-Career Scientists

Allocation TypeMulti-year Fund
Review Section Basic Section 53020:Cardiology-related
Research InstitutionKyushu University

Principal Investigator

Sakamoto Takafumi  九州大学, 大学病院, 助教 (50641015)

Project Period (FY) 2018-04-01 – 2023-03-31
Project Status Completed (Fiscal Year 2022)
Budget Amount *help
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2019: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
Fiscal Year 2018: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
Keywords急性心不全 / 交感神経 / 血行動態 / 駆出率の低下した心不全 / 心不全 / 動脈圧反射 / 圧受容器反射
Outline of Final Research Achievements

Unlike normal animals, animals with heart failure and reduced ejection fraction showed significant pulmonary congestion and reduced cardiac output in a short time after sympathetic nerve activation. These results indicate that sympathetic activation directly contributes to the onset of acute heart failure. The heart failure animals not only had reduced contractility compared to normal animals, but also showed less enhancement of contractility due to sympathetic activation. Sympathetic activation similarly increased afterload in normal and heart failure animals. It is known that increased afterload in heart failure with impaired contractility contributes to congestion and lowers cardiac output, suggesting that increased afterload contributes to exacerbation of heart failure. These findings will lead to the development of novel interventions for acute heart failure.

Academic Significance and Societal Importance of the Research Achievements

駆出率の低下した慢性心不全は急性増悪を繰り返すことが特徴の一つであり、その機序の解明は長らくの課題であった。本研究により交感神経賦活化が直接的に血行動態を悪化させ、急性心不全を発症することを世界で初めて明らかにした。その機序として収縮性の増強不全や心臓エネルギー効率の悪化が関与していることも明らかにした。これらの知見は急性心不全の予防や発症後の最適な治療法の開発につながるものである。全世界で社会問題とされている心不全パンデミック時代において社会的な意義は大きいと考えられる。

Report

(6 results)
  • 2022 Annual Research Report   Final Research Report ( PDF )
  • 2021 Research-status Report
  • 2020 Research-status Report
  • 2019 Research-status Report
  • 2018 Research-status Report
  • Research Products

    (25 results)

All 2022 2021 2020 2019 2018

All Journal Article (4 results) (of which Peer Reviewed: 4 results,  Open Access: 1 results) Presentation (15 results) (of which Int'l Joint Research: 1 results,  Invited: 14 results) Book (5 results) Patent(Industrial Property Rights) (1 results) (of which Overseas: 1 results)

  • [Journal Article] Flow Pattern of Outflow Graft is Useful for Detecting Pump Thrombosis in a Patient with Left Ventricular Assist Device2019

    • Author(s)
      Sato T, Fujino T, Higo T, Ohtani K, Hiasa K, Sakamoto T, Chishaki A, Shiose A, Tsutsui H.
    • Journal Title

      International Heart Journal

      Volume: 60 Issue: 4 Pages: 994-997

    • DOI

      10.1536/ihj.18-600

    • NAID

      130007684164

    • ISSN
      1349-2365, 1349-3299
    • Year and Date
      2019-07-30
    • Related Report
      2019 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Left Ventricular Mechanical Unloading by Total Support of Impella in Myocardial Infarction Reduces Infarct Size, Preserves Left Ventricular Function, and Prevents Subsequent Heart Failure in Dogs2018

    • Author(s)
      Saku Keita、Kakino Takamori、Arimura Takahiro、Sunagawa Genya、Nishikawa Takuya、Sakamoto Takafumi、Kishi Takuya、Tsutsui Hiroyuki、Sunagawa Kenji
    • Journal Title

      Circulation: Heart Failure

      Volume: 11 Issue: 5

    • DOI

      10.1161/circheartfailure.117.004397

    • Related Report
      2018 Research-status Report
    • Peer Reviewed
  • [Journal Article] Pulmonary arterial input impedance reflects the mechanical properties of pulmonary arterial remodeling in rats with pulmonary hypertension.2018

    • Author(s)
      Nishikawa T., Saku K., Kishi T., Tohyama T., Abe K, Oga Y., Arimura T., Sakamoto T., Yoshida K., Sunagawa K., Tsutsui H.
    • Journal Title

      Life Sci.

      Volume: 21 Pages: 225-232

    • DOI

      10.1016/j.lfs.2018.10.005

    • Related Report
      2018 Research-status Report
    • Peer Reviewed
  • [Journal Article] The impact of volume loading-induced low pressure baroreflex activation on arterial baroreflex-controlled sympathetic arterial pressure regulation in normal rats2018

    • Author(s)
      Oga Yasuhiro、Saku Keita、Nishikawa Takuya、Kishi Takuya、Tobushi Tomoyuki、Hosokawa Kazuya、Tohyama Takeshi、Sakamoto Takafumi、Sunagawa Kenji、Tsutsui Hiroyuki
    • Journal Title

      Physiological Reports

      Volume: 6 Issue: 19 Pages: e13887-e13887

    • DOI

      10.14814/phy2.13887

    • Related Report
      2018 Research-status Report
    • Peer Reviewed
  • [Presentation] 麻酔に活かす血行動態と循環生理2022

    • Author(s)
      坂本隆史、筒井裕之
    • Organizer
      第69回日本麻酔科学会学術集会
    • Related Report
      2022 Annual Research Report
    • Invited
  • [Presentation] 第33回臨床モニター学会総会2022

    • Author(s)
      坂本隆史、筒井裕之
    • Organizer
      肺動脈カテーテルは循環管理に必要
    • Related Report
      2022 Annual Research Report
    • Invited
  • [Presentation] 薬物療法とCRT~双方の治療効果を最大化する治療戦略~2022

    • Author(s)
      坂本隆史
    • Organizer
      第26回日本心不全学会学術集会
    • Related Report
      2022 Annual Research Report
    • Invited
  • [Presentation] 心不全に対する交感神経ターゲットデバイス2022

    • Author(s)
      坂本隆史、筒井裕之
    • Organizer
      第87回日本循環器学会学術集会
    • Related Report
      2022 Annual Research Report
    • Invited
  • [Presentation] 心不全治療ではポンプ機能治療こそ重要 -心不全の病態生理から深読みする-2022

    • Author(s)
      坂本隆史、筒井裕之
    • Organizer
      第86回日本循環器学会学術集会
    • Related Report
      2021 Research-status Report
    • Invited
  • [Presentation] 右室機能低下を伴う心不全の 薬物療法/非薬物療法2022

    • Author(s)
      坂本隆史、筒井裕之
    • Organizer
      第23回日本成人先天性心疾患学会総会・学術集会
    • Related Report
      2021 Research-status Report
    • Invited
  • [Presentation] 心不全に対する心房間シャント作成デバイス2022

    • Author(s)
      坂本隆史、筒井裕之
    • Organizer
      第23回日本成人先天性心疾患学会総会・学術集会
    • Related Report
      2021 Research-status Report
    • Invited
  • [Presentation] 血行動態応答から考える僧帽弁閉鎖不全症に対するMitraClipの効果2021

    • Author(s)
      坂本隆史、筒井裕之
    • Organizer
      第32回日本心エコー図学会学術集会
    • Related Report
      2021 Research-status Report
    • Invited
  • [Presentation] Basic knowledge of PV loop and circulatory physiology for bedside heart failure treatment2021

    • Author(s)
      坂本隆史
    • Organizer
      第85回日本循環器学会学術集会
    • Related Report
      2020 Research-status Report
    • Invited
  • [Presentation] 心血管を操る自律神経と循環制御2021

    • Author(s)
      坂本隆史
    • Organizer
      第41回循環制御医学会総会
    • Related Report
      2020 Research-status Report
    • Invited
  • [Presentation] 血行動態から考える僧帽弁閉鎖不全症に対するMitraClipの効果2021

    • Author(s)
      坂本隆史、筒井裕之
    • Organizer
      第41回循環制御医学会総会
    • Related Report
      2020 Research-status Report
    • Invited
  • [Presentation] 生体システム応答から考える急性心不全の多臓器連関と治療対象としての可能性2020

    • Author(s)
      坂本隆史、筒井裕之
    • Organizer
      第24回日本心不全学会学術集会
    • Related Report
      2020 Research-status Report
    • Invited
  • [Presentation] 心不全に対する心房間シャントデバイスの現状と将来展望2020

    • Author(s)
      坂本隆史、筒井裕之
    • Organizer
      第24回日本心不全学会学術集会
    • Related Report
      2020 Research-status Report
    • Invited
  • [Presentation] Maladaptive hemodynamic responses to sympathetic activation play a pivotal role in the pathogenesis of acute decompensated heart failure2019

    • Author(s)
      Takafumi Sakamoto, Keita Saku, Kenji Sunagawa, Hiroyuki Tsutsui
    • Organizer
      The 92th Annual Scientific Meeting of the American Heart Association
    • Related Report
      2019 Research-status Report
    • Int'l Joint Research
  • [Presentation] Management of heart rate and rhythm in acute decompensated heart failure2019

    • Author(s)
      Takafumi Sakamoto
    • Organizer
      The 23rd Annual Scientific Meeting of the Japanese Heart Failure Society
    • Related Report
      2019 Research-status Report
    • Invited
  • [Book] 循環器ジャーナル2020

    • Author(s)
      坂本 隆史
    • Total Pages
      5
    • Publisher
      医学書院
    • Related Report
      2019 Research-status Report
  • [Book] 月刊心エコー2020

    • Author(s)
      坂本 隆史
    • Total Pages
      8
    • Publisher
      文光堂
    • Related Report
      2019 Research-status Report
  • [Book] Heart View2019

    • Author(s)
      坂本 隆史
    • Total Pages
      7
    • Publisher
      メジカルビュー社
    • Related Report
      2019 Research-status Report 2018 Research-status Report
  • [Book] 心不全治療薬の考え方、使い方2019

    • Author(s)
      坂本 隆史
    • Total Pages
      12
    • Publisher
      中外医学社
    • Related Report
      2019 Research-status Report
  • [Book] 心不全(第2版)中ー最新の基礎・臨床研究の進歩ー2019

    • Author(s)
      坂本 隆史
    • Total Pages
      7
    • Publisher
      日本臨牀社
    • Related Report
      2018 Research-status Report
  • [Patent(Industrial Property Rights)] SYSTEMS AND METHODS FOR AUTONOMIC CLOSED-LOOP NEUROMODULATION IN ACHIEVING PROGRAMMABLE CONTROL OF MEAN BLOOD PRESSURE AND BLOOD PRESSURE VARIABILITY2018

    • Inventor(s)
      朔啓太、砂川賢二、遠山岳誌、細川和也、坂本隆史
    • Industrial Property Rights Holder
      朔啓太、砂川賢二、遠山岳誌、細川和也、坂本隆史
    • Industrial Property Rights Type
      特許
    • Filing Date
      2018
    • Related Report
      2018 Research-status Report
    • Overseas

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Published: 2018-04-23   Modified: 2024-01-30  

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