| Project/Area Number |
20K08451
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 53020:Cardiology-related
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| Research Institution | University of Miyazaki (2021-2022)
Kumamoto University (2020) |
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Principal Investigator |
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| Project Period (FY) |
2020-04-01 – 2023-03-31
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| Project Status |
Completed (Fiscal Year 2022)
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| Budget Amount *help |
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2022: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2021: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2020: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
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| Keywords | 血栓形成能 / 経カテーテル的大動脈弁留置 / T-TAS / 無症候性血栓弁 / 経カテーテル的大動脈弁留置術 |
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| Outline of Research at the Start |
経カテーテル大動脈弁留置術(TAVI)後の最適な抗血栓薬を選択するため、Total Thrombus-Formation Analysis System (T-TAS)を用いてTAVI周術期の血栓形成能を定量解析し、無症候性血栓弁の指標である造影CT上の最大低輝度大動脈弁尖肥厚、Computational fluid dynamicsによる血管壁ずり応力解析、von Willebrand 因子マルチマー解析を施行し、血栓弁の発症機序、寄与因子を解明する。本研究により、TAVI弁血栓形成に影響を及ぼす病態メカニズムが解明され、TAVI後の至適抗血栓療法の確立に寄与することが期待される。
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| Outline of Final Research Achievements |
In this study, we analyzed the relationship between the whole blood thrombogenicity using T-TAS and the subclinical leaflet thrombosis on transcatheter heart valve. Of total 36 patients, 30 treated with only antiplatelet therapy were finally analyzed. subclinical leaflet thrombosis was observed in 20% at 7 days and 21% at 3 months after TAVI, and Maximum leaflet thickness (MLT) was 1.60 mm and 1.65 mm after 7 days and 3 months, respectively. T-TAS parameter, AR10-AUC30, reached the lowest level 7 days after TAVI, and the difference in AR10-AUC30 levels between before and 2 days after TAVI (ΔAR10-AUC30) showed a significant positive correlation with MLT. Univariate linear regression analysis of contributing factors for MLT at 7 days after TAVI revealed that ΔAR10-AUC30 level was the only predictive factor associated with MLT.
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| Academic Significance and Societal Importance of the Research Achievements |
本研究は、TAVI後様々な抗血栓療法が施行されている現状を打破すべく、T-TAS、大動脈造影CT上の無症候性弁血栓およびVWFマルチマー解析等によりTAVI後の血栓形成能の評価と至適抗血栓療法を提案することを目的とした、非常に独自性が高く価値のある臨床研究である。
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