Interventricular dyssynchrony during continuous-flow left ventricular assist device support

• Project/Area Number: 19K18201
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55030:Cardiovascular surgery-related
• Research Institution: National Cardiovascular Center Research Institute
• Principal Investigator: Shimamura Junichi 国立研究開発法人国立循環器病研究センター, 研究所, 客員研究員 (20827696)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Project Status: Completed (Fiscal Year 2021)
• Budget Amount: ¥3,380,000 (Direct Cost: ¥2,600,000、Indirect Cost: ¥780,000); Fiscal Year 2021: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2020: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2019: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
• Keywords: 左室補助人工心臓 / 重症心不全 / 同期不全 / 右心不全 / 末梢循環 / 心室間同期不全

Outline of Research at the Start

左室補助人工心臓装着中に特徴的に生じると考えられるinterventricular dyssynchronyの病態解明と、同現象が右室機能及び心室中隔運動にもたらす影響の評価を行う。さらに、自己心拍に同期したLVAD補助によりinterventricular dyssynchronyを制御することにより中隔偏位や右室機能低下を予防し得るLVAD駆動モードの開発を目指す。

Outline of Final Research Achievements

Under continuous-flow left ventricular assist device (CF-LVAD) support, the ventricular volume change and cardiac cycle between the left ventricle (LV) and right ventricle (RV) become dyssynchronous due to the shortening of the LV systole.The purpose of this study was to quantify interventricular dyssynchrony based on different CF-LVAD support conditions and assess its relationship with LV unloading. We implanted a centrifugal LVAD under general anesthesia to goats with normal hearts. We inserted the conductance catheters into LV and RV to assess the volume signal simultaneously. We defined the dyssynchronous (DYS)status as the sign of the LV volume-change opposite to that of RV volume-change. DYS was quantified and also found to be associated with the degree of LV unloading. These findings may be useful for understanding interventricular interactions and physiology during CF-LVAD support. Influences on the right ventricular function and heart failure models warrant further study.

Academic Significance and Societal Importance of the Research Achievements

本研究は左室補助人工心臓駆動時の機械的心室間同期不全の機序および心室間相互作用に及ぼす影響に関して検討したものである。左室補助人工心臓装着後の主要合併症である右心不全の詳細な機序は依然解明されていないが、本現象は重症心不全患者に合併する同期不全の増悪や、心室中隔運動への影響を介して右心機能への影響をもたらす重要な一因と考えられる。適切な左室補助人工心臓駆動により同現象を制御することは、右室機能不全改善に有用であることが示唆される。以上より、本研究で得られる知見は左室補助人工心臓駆動に伴う心室間相互作用の理解に役立ち、安全でより生理的な左室補助人工心臓駆動方法の開発に寄与するものである。

Research Products

• [Journal Article] Assessment of ocular blood flow in continuous-flow ventricular assist device by laser speckle flowgraphy (2021)
  • Author(s): Shimamura Junichi、Nishinaka Tomohiro、Mizuno Toshihide、Tsukiya Tomonori、Inatomi Ayako、Kobayashi Futoshi、Katagiri Nobumasa、Takewa Yoshiaki、Nishimura Takashi、Ono Minoru、Tatsumi Eisuke
  • Journal Title: Journal of Artificial Organs Volume: 24 Issue: 4 Pages: 419-424
  • DOI: 10.1007/s10047-021-01265-5
  • Peer Reviewed
• [Journal Article] 第58回日本人工臓器学会大会 論文賞（循環）受賞レポート Quantification of interventricular dyssynchrony during continuous-flow left ventricular assist device support (2021)
  • Author(s): 島村淳一
  • Journal Title: 人工臓器 Volume: 50 Pages: 32-33
• [Journal Article] 第58回日本人工臓器学会大会 論文賞（循環）受賞レポート Mathematical evaluation of cardiac beat synchronization control used for a rotary blood pump (2021)
  • Author(s): 小川大祐、小林信治、山﨑健二、本村禎、西村隆、島村淳一、築谷朋典、水野敏秀、武輪能明、巽英介
  • Journal Title: 人工臓器 Volume: 50 Pages: 34-36
• [Journal Article] Evaluation of cardiac beat synchronization control for a rotary blood pump on valvular regurgitation with a mathematical model. (2021)
  • Author(s): Ogawa D, Kobayashi S, Yamazaki K, Motomura T, Nishimura T, Shimamura J, Tsukiya T, Mizuno T, Takewa Y, Tatsumi E, Nishinaka T.
  • Journal Title: Artif Organs. Volume: 45 Issue: 2 Pages: 124-134
  • DOI: 10.1111/aor.13795
  • Peer Reviewed
• [Journal Article] 第58回日本人工臓器学会 論文賞（循環）受賞レポート（発表確定） (2021)
  • Author(s): 島村淳一
  • Journal Title: 人工臓器 Volume: 1 Pages: 1-1
• [Journal Article] Quantification of interventricular dyssynchrony during continuous-flow left ventricular assist device support. (2019)
  • Author(s): Shimamura J, Nishimura T, Mizuno T, Takewa Y, Tsukiya T, Inatomi A, Ando M, Umeki A, Naito N, Ono M, Tatsumi E
  • Journal Title: J Artif Organs. Volume: 22 Issue: 4 Pages: 269-275
  • DOI: 10.1007/s10047-019-01109-3
  • Peer Reviewed / Open Access
• [Journal Article] Interventricular dyssynchrony during continuous-flow left ventricular assist device support: observation using the conductance method. (2019)
  • Author(s): Shimamura J, Nishimura T, Mizuno T, Takewa Y, Tsukiya T, Inatomi A, Katagiri N, Ando M, Umeki A, Akiyama D, Arakawa M, Ono M, Tatsumi E.
  • Journal Title: J Artif Organs. Volume: 22 Issue: 4 Pages: 348-352
  • DOI: 10.1007/s10047-019-01115-5
  • Peer Reviewed / Open Access
• [Journal Article] Miniaturized centrifugal ventricular assist device for bridge to decision: preclinical chronic study in a bovine model. (2019)
  • Author(s): Shimamura J, Mizuno T, Takewa Y, Tsukiya T, Naito N, Akiyama D, Iiduka K, Katagiri N, Nishimura T, Ono M, Tatsumi E.
  • Journal Title: Artif Organs. Volume: 印刷中 Issue: 9 Pages: 821-827
  • DOI: 10.1111/aor.13459
  • Peer Reviewed / Open Access
• [Journal Article] Mathematical evaluation of cardiac beat synchronization control used for a rotary blood pump. (2019)
  • Author(s): Ogawa D, Kobayashi S, Yamazaki K, Motomura T, Nishimura T, Shimamura J, Tsukiya T, Mizuno T, Takewa Y, Tatsumi E.
  • Journal Title: J Artif Organs. Volume: 43 Issue: 4 Pages: 276-285
  • DOI: 10.1007/s10047-019-01117-3
  • Peer Reviewed
• [Presentation] JATS Research Project Award 受賞講演 (2021)
  • Author(s): 島村淳一
  • Organizer: 第74回日本胸部外科学会定期学術集会
• [Presentation] JSAO Grant技術賞論文賞講演 (2021)
  • Author(s): 島村淳一
  • Organizer: 第59回日本人工臓器学会大会
• [Presentation] 「Quantification of interventricular dyssynchrony during continuous-flow left ventricular assist device support」 〔2020年度論文賞【循環領域】〕 (2020)
  • Author(s): Shimamura J, Nishimura T, Mizuno T, Takewa Y, Tsukiya T, Inatomi A, Ando M, Umeki A, Naito N, Ono M, Tatsumi E.
  • Organizer: 第58回日本人工臓器学会大会 JSAO Grant 技術賞 論文賞 受賞者講演
  • Invited
• [Presentation] 「Mathematical evaluation of cardiac beat synchronization control used for a rotary blood pump」 〔2020年度論文賞【代謝領域】〕 (2020)
  • Author(s): Ogawa D, Kobayashi S, Yamazaki K, Motomura T, Nishimura T, Shimamura J, Tsukiya T, Mizuno T, Takewa Y, Tatsumi E, Nishinaka T.
  • Organizer: 第58回日本人工臓器学会大会 JSAO Grant 技術賞 論文賞 受賞者講演
  • Invited
• [Presentation] 定常流LVAD治療における心室間同期不全の提唱および定量化に関する検討 (2019)
  • Author(s): 島村淳一、水野敏秀、武輪能明、築谷朋典、片桐伸将、西村 隆、小野 稔、巽 英介
  • Organizer: 人工心臓と補助循環懇話会学術集会 (47)
• [Presentation] 定常流型LVAD駆動に伴う両心室容積変化に関する基礎的検討 (2019)
  • Author(s): 島村淳一、水野敏秀、武輪能明、築谷朋典、片桐伸将、西村 隆、小野 稔、巽 英介
  • Organizer: 定常流ポンプ研究会学術集会2019
• [Presentation] Interventricular dyssynchrony during continuous-flow left ventricular assist device support (2019)
  • Author(s): Shimamura J, Mizuno T, Tsukiya T, Takewa Y, Inatomi A, Nishimura T, Ono M, Tatsumi E
  • Organizer: Annual European Society for Artificial Organs Congress (46)
  • Int'l Joint Research
• [Presentation] Asynchronous ventricular volume change during coutinuous-flow left ventricularassist device support (2019)
  • Author(s): Shimamura J, Mizuno T, Tsukiya T, Takewa Y, Inatomi A, Nishimura T, Ono M, Tatsumi E
  • Organizer: Annual Meeting of the International Society for Mechanical Circulatory Support (27)
  • Int'l Joint Research