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Quantification of right ventricular fibrosis with cardiac magnetic resonance imaging and dual-energy computed tomography

Research Project

Project/Area Number 20K08449
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 53020:Cardiology-related
Research InstitutionKyushu University

Principal Investigator

Kenichiro Yamamura  九州大学, 大学病院, 特任講師 (30532858)

Co-Investigator(Kenkyū-buntansha) 坂本 一郎  九州大学, 大学病院, 助教 (90616616)
山崎 誘三  九州大学, 大学病院, 助教 (00643347)
孝橋 賢一  九州大学, 医学研究院, 准教授 (10529879)
帯刀 英樹  九州大学, 医学研究院, 共同研究員 (40343321)
塩瀬 明  九州大学, 医学研究院, 教授 (30363336)
Project Period (FY) 2020-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2022: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2021: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2020: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Keywordsファロー四徴症 / 右室心筋線維化 / 画像診断 / 心筋線維化 / 病理 / CT / MRI
Outline of Research at the Start

Fallot四徴症は心内修復術後も肺動脈弁閉鎖不全/狭窄により慢性的な右室負荷が残存し、成人期に右室機能不全、致死性不整脈を生じうる。これに対する肺動脈弁置換術の手術適応は世界的に見ても未だに定まっていない。本研究では、肺動脈弁置換術中の右室心筋生検組織と、MRI高分解能T1 mappingやDual-energy CTといった最新の画像診断技術を用いて、右室心筋線維化の重症度を非侵襲的、定量的に正確に評価する手法を確立する。Fallot四徴症の再手術適応判断はもちろん、肺高血圧症の治療効果判定などにも新たに安全かつ有用な指標を提供し、ガイドライン改訂/患者予後改善に寄与することを目指す。

Outline of Final Research Achievements

Pulmonary valve replacement surgery after Tetralogy of Fallot repair is the most common reoperation in adult congenital heart disease patients, but its criteria are not well established. The current standards based on right ventricular (RV) volume do not necessarily improve long-term outcomes, and the severity of RV myocardial fibrosis is also considered important. However, myocardial biopsy is invasive, so we aimed to establish a non-invasive evaluation method. Traditional MRI T1 mapping, performed during end-diastole, had limitations in evaluating the thin RV myocardium. By imaging during systole and using compressed sensing technology to enhance spatial resolution, accurate and reproducible assessment of the RV myocardium, similar to that of the left ventricle, became possible. In the future, we plan to collect pre- and postoperative data to further investigate the usefulness of this non-invasive evaluation method in predicting long-term cardiac function changes and outcomes.

Academic Significance and Societal Importance of the Research Achievements

本研究では、MRI高分解能T1 mappingにより非侵襲的に右室心筋線維化を評価する新しい手法を確立し、精度と再現性の向上を得ることができた。将来的には術前と術後遠隔期のデータを収集することで、心機能の経時的変化や予後予測における有用性を高めることを目指す。近年わが国でも経皮的肺動脈弁置換術が導入された事情もあり、Fallot四徴症患者の治療方針決定において、本研究で向上した画像診断の情報は重要な意義を持つだろう。さらには、肺高血圧症など右室心筋線維化をきたす他の多くの心疾患の評価においても、本研究の成果は非侵襲的に重要な情報を提供し、患者の方針決定・予後改善に広く寄与することが期待される。

Report

(5 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • 2020 Research-status Report
  • Research Products

    (7 results)

All 2024 2023 2021

All Journal Article (6 results) (of which Peer Reviewed: 6 results,  Open Access: 4 results) Presentation (1 results)

  • [Journal Article] Adherence to clinical practice guidelines for pulmonary valve intervention after tetralogy of Fallot repair: A nationwide cohort study2024

    • Author(s)
      Massarella Danielle、McCrindle Brian W.、Runeckles Kyle、Yamamura Kenichiro、Farkouh Michael、Wald Rachel M. et.al.
    • Journal Title

      JTCVS Open

      Volume: 17 Pages: 215-228

    • DOI

      10.1016/j.xjon.2023.11.013

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Visibility of Pulmonary Valve and Pulmonary Regurgitation on Intracardiac Echocardiography in Adult Patients with Tetralogy of Fallot2023

    • Author(s)
      Sakamoto I, Yamamura K, Ishikita A, Ohtani K, Umemoto S, Kaku H, Yamasaki Y, Abe K, Ide T, Tsutsui H.
    • Journal Title

      J Cardiovasc Dev Dis

      Volume: 10 (1) Issue: 1 Pages: 24-24

    • DOI

      10.3390/jcdd10010024

    • Related Report
      2023 Annual Research Report 2022 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Paradoxical spells during ACTH treatment in an infant with Tetralogy of Fallot.2023

    • Author(s)
      Kikuno R, Yamamura K, Nagatomo Y, Nagata H, Ichimiya Y, Sakai Y, Ohga S.
    • Journal Title

      Pediatrics International

      Volume: 65(1) Issue: 1

    • DOI

      10.1111/ped.15503

    • Related Report
      2023 Annual Research Report 2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Patient-Reported Outcomes After Tetralogy of Fallot Repair2023

    • Author(s)
      Kovacs Adrienne H.、Lebovic Gerald、Raptis Stavroula、Yamamura Kenichiro、Farkouh Michael E.、Wald Rachel M. et.al.
    • Journal Title

      Journal of the American College of Cardiology

      Volume: 81 Issue: 19 Pages: 1937-1950

    • DOI

      10.1016/j.jacc.2023.03.385

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Unchanged right ventricular strain in repaired tetralogy of Fallot after pulmonary valve replacement with radial long-axis cine magnetic resonance images2021

    • Author(s)
      Masateru Kawakubo, Yuzo Yamasaki, Daisuke Toyomura, Kenichiro Yamamura, Ichiro Sakamoto, Tetsuhiro Moriyama, Hidetake Yabuuchi, Kousei Ishigami
    • Journal Title

      Sci Rep

      Volume: 11(1) Issue: 1 Pages: 18879-18879

    • DOI

      10.1038/s41598-021-98464-0

    • NAID

      120007170359

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] The impact of pulmonary valve replacement on pregnancy outcomes in women with tetralogy of Fallot2021

    • Author(s)
      Kenichiro Yamamura, Valeria Duarte , Gauri Rani Karur, Julia Graf, Kate Hanneman, Tal Geva, Anne Marie Valente, Rachel M Wald
    • Journal Title

      Int J Cardiol

      Volume: 330 Pages: 43-49

    • DOI

      10.1016/j.ijcard.2021.02.006

    • Related Report
      2020 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] マルチモダリティを用いた右室機能評価Update2023

    • Author(s)
      河窪 正照, 山崎 誘三, 長尾 充展, 阿部 弘太郎, 細川 和也, 永田 弾, 山村 健一郎, ほか
    • Organizer
      第87回日本循環器学会学術集会
    • Related Report
      2023 Annual Research Report

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Published: 2020-04-28   Modified: 2025-01-30  

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