| Project/Area Number |
18K15911
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 53020:Cardiology-related
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| Research Institution | Kobe City Medical Center General Hospital(First Clinical Division, Second Clinical Division, Third |
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Principal Investigator |
KITAI TAKESHI 地方独立行政法人神戸市民病院機構神戸市立医療センター中央市民病院(第1診療部、第2診療部、第3診療部, 中央市民病院, 医長 (10470204)
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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 |
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2019: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
Fiscal Year 2018: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
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| Keywords | 心不全 / 多臓器不全 / 腸内細菌 / 心腸連関 / Heart Failure / Gut Microbiota |
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| Outline of Final Research Achievements |
There is growing literature to support the role of the gut in the pathogenesis of heart failure. Trimethylamine, which is derived from gut microbiota metabolites of specific dietary nutrients, is rapidly oxidized into TMAO by flavin monooxygenase enzymes in the liver and then released into the circulation. Circulating trimethylamine N-oxide (TMAO) levels have consistently been observed to be elevated in patients with heart failure and have been associated with the development and progression of heart failure. In this study, we examined the association of circulating levels of TMAO and clinical outcomes in 470 patients admitted with acute decompensated heart failure. Patients were divided into two groups according to the TMAO levels admission. TMAO levels were not associated with adverse clinical outcomes defined as a composite of all-cause death and readmission after discharge.
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| Academic Significance and Societal Importance of the Research Achievements |
心不全の病態整理に関する認識は、心臓ポンプ失調に伴う血行動態の悪化が主病態という概念から、他臓器・他システムに様々な影響を与える内分泌臓器としての心臓の機能異常という概念に変わってきている。心不全患者では、腸粘膜バリア機能が低下し、血液中に漏出する腸内細菌、およびその代謝産物の高値に関連することが報告されている。本研究では本邦における心不全患者でのTrimethylamine N-oxide (TMAO)値の予後予測能を調べたが、海外での報告と異なり、予後と有意な相関は見られず食事内容の違いによるものが想定された。食事内容が、腸内細菌叢及び心不全の病態に与える影響が示唆された。
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