レジストリを用いたHFpEFの運動時の血行動態に基づく個別化医療の検討

• Project/Area Number: 21K08087
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Kyorin University
• Principal Investigator: 合田 あゆみ 杏林大学, 医学部, 講師 (00625543)
• Project Period (FY): 2021-04-01 – 2026-03-31
• Project Status: Granted (Fiscal Year 2022)
• Budget Amount: ¥3,250,000 (Direct Cost: ¥2,500,000、Indirect Cost: ¥750,000); Fiscal Year 2025: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2024: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2023: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2022: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000); Fiscal Year 2021: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
• Keywords: 心不全 / 個別化医療 / データベース / ウェアラブルデバイス / 個別化治療

Outline of Research at the Start

心不全患者の多施設共同の大規模データベースを構築し、いまだ確立された治療のない”左室駆出率の保たれた心不全”の臨床像を明らかにし、①運動中の血行動態に基づくサブグループへの分類、② 患者中心アウトカムの評価、③ 生命予後/心不全再入院/患者中心アウトカムと関連する運動時指標/治療の同定を行う。最終的には、ウェアラブルデバイスを用いたリアルタイムでの身体機能計測に基づく、治療効果判定並びに生活指導による診療体制を確立する。

Outline of Annual Research Achievements

本研究では、心不全患者の多施設共同の大規模データベースを再構築し、左室収縮能の保たれた心不全(HFpEF)患者において、①運動中の血行動態に基づく比較的均一なサブグループへの分類、② 患者中心アウトカム (身体機能とQoL)の評価、③ 生命予後/心不全再入院/患者中心アウトカムと関連する運動時指標/治療の同定を行うことを目的としている。最終的には、ウェアラブルデバイスを用いたリアルタイムでの身体機能計測に基づく、治療効果判定並びに生活指導による診療体制を確立することを最終目標をしている。
当該年度において、心不全患者の多施設共同のデータベース構築を強固なものにし、症例登録を進めた。
また、多施設共同の心不全データベースを基にした論文報告や、運動負荷の指標運動負荷の指標を用いたCpC-PH検出の報告などを行った。

Current Status of Research Progress

3: Progress in research has been slightly delayed.

Reason

心不全患者の多施設共同の大規模データベースは構築され、データー入力が進んでおり、そのデータベースを基に、学会発表並びに論文報告を行えている。 しかしながら、左室収縮能の保たれた心不全(HFpEF)患者において、運動中の血行動態を評価するサブグループのエントリーには到達していない。

Strategy for Future Research Activity

引き続き大規模データベース構築をおこない、患者登録をすすめていく。 左室収縮能の保たれた心不全(HFpEF)患者において、運動負荷エコーや運動負荷右心カテーテル検査による、運動中の血行動態に基づく検討を行うため、まず、 単施設で運動中の血行動態を評価できるサブグループのエントリーを行っていくことを次の段階として検討している。単施設でサブグループのエントリーが軌道 に乗れば、心不全の登録研究に参加している多施設に協力をお願いすることを検討している。

Research Products

• [Journal Article] Low blood pressure and guideline-directed medical therapy in patients with heart failure with reduced ejection fraction (2023)
  • Author(s): Izumi Keiichi、Kohno Takashi、Goda Ayumi、Takeuchi Shinsuke、Shiraishi Yasuyuki、Saji Mike、Nagatomo Yuji、Tanaka Toshikazu D.、Takei Makoto、Nakano Shintaro、Soejima Kyoko、Kohsaka Shun、Yoshikawa Tsutomu
  • Journal Title: International Journal of Cardiology Volume: 370 Pages: 255-262
  • DOI: 10.1016/j.ijcard.2022.10.129
  • Peer Reviewed / Open Access
• [Journal Article] Geriatric Nutritional Risk Index at Hospital Admission or Discharge in Patients with Acute Decompensated Heart Failure (2023)
  • Author(s): Ono Masafumi、Mizuno Atsushi、Kohsaka Shun、Shiraishi Yasuyuki、Kohno Takashi、Nagatomo Yuji、Goda Ayumi、Nakano Shintaro、Komiyama Nobuyuki、Yoshikawa Tsutomu
  • Journal Title: Journal of Clinical Medicine Volume: 12 Issue: 5 Pages: 1891-1891
  • DOI: 10.3390/jcm12051891
  • Peer Reviewed / Open Access
• [Journal Article] Improved prediction of sudden cardiac death in patients with heart failure through digital processing of electrocardiography. (2023)
  • Author(s): Shiraishi Y, Goto S, Niimi N, Katsumata Y, Goda A, Takei M, Saji M, Sano M, Fukuda K, Kohno T, Yoshikawa T, Kohsaka S.
  • Journal Title: Europace. Volume: 25(3) Issue: 3 Pages: 922-930
  • DOI: 10.1093/europace/euac261
  • Peer Reviewed / Open Access
• [Journal Article] Impact of Left Ventricular Chamber Size on Outcome in Heart Failure with Preserved Ejection Fraction (2022)
  • Author(s): Ogawa Shou、Nagatomo Yuji、Takei Makoto、Saji Mike、Goda Ayumi、Kohno Takashi、Nakano Shintaro、Nishihata Yosuke、Ikegami Yukinori、Shoji Satoshi、Shiraishi Yasuyuki、Kohsaka Shun、Yoshikawa Tsutomu
  • Journal Title: International Heart Journal Volume: 63 Issue: 1 Pages: 62-72
  • DOI: 10.1536/ihj.21-486
  • NAID: 130008145736
  • ISSN: 1349-2365, 1349-3299
  • Year and Date: 2022-01-29
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Divergent effect of blood glucose dysregulation on long-term clinical outcome in acute decompensated heart failure: A reappraisal in contemporary practice (2022)
  • Author(s): Chishiki Toshiki、Nagatomo Yuji、Saji Mike、Takei Makoto、Goda Ayumi、Kohno Takashi、Nakano Shintaro、Nishihata Yosuke、Ikegami Yukinori、Shiraishi Yasuyuki、Kohsaka Shun、Adachi Takeshi、Yoshikawa Tsutomu
  • Journal Title: International Journal of Cardiology Volume: 365 Pages: 91-99
  • DOI: 10.1016/j.ijcard.2022.07.041
  • Peer Reviewed
• [Journal Article] Association of Potassium Level at Discharge with Long-Term Mortality in Hospitalized Patients with Heart Failure (2022)
  • Author(s): Miura Yusuke、Higuchi Satoshi、Kohno Takashi、Shiraishi Yasuyuki、Kitamura Mitsunobu、Nagatomo Yuji、Takei Makoto、Nakano Shintaro、Goda Ayumi、Soejima Kyoko、Kohsaka Shun、Yoshikawa Tsutomu
  • Journal Title: Journal of Clinical Medicine Volume: 11 Issue: 24 Pages: 7358-7358
  • DOI: 10.3390/jcm11247358
  • Peer Reviewed / Open Access
• [Journal Article] Multimorbidity, guideline‐directed medical therapies, and associated outcomes among hospitalized heart failure patients (2022)
  • Author(s): Takeuchi Shinsuke、Kohno Takashi、Goda Ayumi、Shiraishi Yasuyuki、Kawana Masataka、Saji Mike、Nagatomo Yuji、Nishihata Yosuke、Takei Makoto、Nakano Shintaro、Soejima Kyoko、Kohsaka Shun、Yoshikawa Tsutomu、West Tokyo Heart Failure Registry Investigators
  • Journal Title: ESC Heart Failure Volume: 9 Issue: 4 Pages: 2500-2510
  • DOI: 10.1002/ehf2.13954
  • Peer Reviewed / Open Access
• [Journal Article] Personalized Target Heart Rate for Patients with Heart Failure and Reduced Ejection Fraction (2022)
  • Author(s): Yumita Yusuke、Nagatomo Yuji、Takei Makoto、Saji Mike、Goda Ayumi、Kohno Takashi、Nakano Shintaro、Nishihata Yosuke、Ikegami Yukinori、Shiraishi Yasuyuki、Kohsaka Shun、Adachi Takeshi、Yoshikawa Tsutomu
  • Journal Title: Journal of Personalized Medicine Volume: 12 Issue: 1 Pages: 50-50
  • DOI: 10.3390/jpm12010050
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Use of short-acting vs. long-acting loop diuretics after heart failure hospitalization. (2022)
  • Author(s): Imaeda S, Shiraishi Y, Kohsaka S, Niimi N, Goda A, Nagatomo Y, Takei M, Saji M, Nakano S, Kohno T, Fukuda K, Yoshikawa T.
  • Journal Title: ESC Heart Fail. Volume: 9(5) Issue: 5 Pages: 2967-2977
  • DOI: 10.1002/ehf2.14030
  • Peer Reviewed / Open Access
• [Journal Article] otential association with malnutrition and allocation of combination medical therapies in hospitalized heart failure patients with reduced ejection fraction. (2022)
  • Author(s): Kawakubo Y, Shiraishi Y, Kohsaka S, Kohno T, Goda A, Nagatomo Y, Nishihata Y, Saji M, Takei M, Ikegami Y, Niimi N, Sandhu ATS, Nakano S, Yoshikawa T, Fukuda K; West Tokyo Heart Failure Registry.
  • Journal Title: Sci Rep. Volume: 12(1) Issue: 1 Pages: 8318-8318
  • DOI: 10.1038/s41598-022-12357-4
  • Peer Reviewed / Open Access
• [Journal Article] EmPHasis-10 Health-Related Quality of Life and Exercise Capacity in Chronic Thromboembolic Pulmonary Hypertension After Balloon Angioplasty. (2022)
  • Author(s): Sakamoto H, Goda A, Tobita K, Takeuchi K, Kikuchi H, Inami T, Tamura Y, Kohno T, Yamada S, Soejima K, Satoh T.
  • Journal Title: J Am Heart Assoc. Volume: 11(17) Issue: 17
  • DOI: 10.1161/jaha.122.026400
  • Peer Reviewed
• [Journal Article] Successful epoprostenol withdrawal and termination with an aid of the exercise stress test in pulmonary arterial hypertension. (2022)
  • Author(s): Takeuchi K, Goda A, Ito J, Kikuchi H, Inami T, Kohno T, Soejima K, Satoh T.
  • Journal Title: International Journal of Cardiology Volume: 346 Pages: 80-85
  • DOI: 10.1016/j.ijcard.2021.11.041
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] High prevalence of occult left ventricular diastolic dysfunction detected by exercise stress test in systemic sclerosis. (2021)
  • Author(s): Mohri T, Goda A, Takeuchi K, Kikuchi H, Inami T, Kohno T, Sakata K, Soejima K, Satoh T.
  • Journal Title: Scientific Report Volume: 2(1):2423 Issue: 1
  • DOI: 10.1038/s41598-022-06400-7
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Factors contributing to exercise capacity in chronic thromboembolic pulmonary hypertension with near-normal hemodynamics. (2021)
  • Author(s): Tobita K, Goda A, Nishida Y, Takeuchi K, Kikuchi H, Inami T, Kohno T, Yamada S, Soejima K, Satoh T.
  • Journal Title: The Journal of Heart and Lung Transplantation Volume: Jul;40(7) Issue: 7 Pages: 677-686
  • DOI: 10.1016/j.healun.2021.03.003
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Abnormal Liver Function Tests and Long-Term Outcomes in Patients Discharged after Acute Heart Failure (2021)
  • Author(s): Miyama Hiroshi、Shiraishi Yasuyuki、Kohsaka Shun、Goda Ayumi、Nishihata Yosuke、Nagatomo Yuji、Takei Makoto、Fukuda Keiichi、Kohno Takashi、Yoshikawa Tsutomu
  • Journal Title: Journal of Clinical Medicine Volume: 10 Issue: 8 Pages: 1730-1730
  • DOI: 10.3390/jcm10081730
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Phenomapping in patients experiencing worsening renal function during hospitalization for acute heart failure (2021)
  • Author(s): Yagi Ryuichiro、Takei Makoto、Kohsaka Shun、Shiraishi Yasuyuki、Ikemura Nobuhiro、Shoji Satoshi、Niimi Nozomi、Higuchi Satoshi、Goda Ayumi、Kohno Takashi、Nagatomo Yuji、Nishihata Yosuke、Sujino Yasumori、Saji Mike、Ikegami Yukinori、Nakano Shintaro、Takahashi Toshiyuki、Fukuda Keiichi、Yoshikawa Tsutomu
  • Journal Title: ESC Heart Failure Volume: 8 Issue: 6 Pages: 5192-5203
  • DOI: 10.1002/ehf2.13598
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Sudden cardiac death after acute decompensation in heart failure patients: implications of discharge haemoglobin levels (2021)
  • Author(s): Fukuoka Ryoma、Kohsaka Shun、Shiraishi Yasuyuki、Sawano Mitsuaki、Abe Takayuki、Levy Wayne C.、Nagatomo Yuji、Nishihata Yosuke、Goda Ayumi、Kohno Takashi、Kawamura Akio、Fukuda Keiichi、Yoshikawa Tsutomu
  • Journal Title: ESC Heart Failure Volume: 8 Issue: 5 Pages: 3917-3928
  • DOI: 10.1002/ehf2.13414
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Association of Non-Invasive Positive Pressure Ventilation with Short-Term Clinical Outcomes in Patients Hospitalized for Acute Decompensated Heart Failure (2021)
  • Author(s): Yukino Midori、Nagatomo Yuji、Goda Ayumi、Kohno Takashi、Takei Makoto、Nishihata Yosuke、Saji Mike、Toyosaki Yuichi、Nakano Shintaro、Ikegami Yukinori、Shiraishi Yasuyuki、Kohsaka Shun、Adachi Takeshi、Yoshikawa Tsutomu
  • Journal Title: Journal of Clinical Medicine Volume: 10 Issue: 21 Pages: 5092-5092
  • DOI: 10.3390/jcm10215092
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Different Impact of Beta-Blockers on Long-Term Mortality in Heart Failure Patients with and without Chronic Obstructive Pulmonary Disease (2021)
  • Author(s): Higuchi Satoshi、Kohno Takashi、Kohsaka Shun、Shiraishi Yasuyuki、Takei Makoto、Goda Ayumi、Shoji Satoshi、Nagatomo Yuji、Yoshikawa Tsutomu
  • Journal Title: Journal of Clinical Medicine Volume: 10 Issue: 19 Pages: 4378-4378
  • DOI: 10.3390/jcm10194378
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Assessment of Physical Activity Using Waist-Worn Accelerometers in Hospitalized Heart Failure Patients and Its Relationship with Kansas City Cardiomyopathy Questionnaire. (2021)
  • Author(s): Shiraishi Y, Niimi N, Goda A, Takei M, Kimura T, Kohno T, Kawana M, Fukuda K, Kohsaka S.
  • Journal Title: Journal of Clinical Medicine Volume: 10(18) Issue: 18 Pages: 4103-4103
  • DOI: 10.3390/jcm10184103
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Presentation] Renin-angiotensin Inhibitors for Mild-to-moderate Chronic Kidney Disease Complicated with Heart Failure with Preserved Ejection Fraction Patients (2023)
  • Author(s): 竹内 真介、河野 隆志、合田 あゆみ、白石 泰之、北村 光信、 長友 祐司、 武井 眞、 中埜 信太郎、副島 京子、香坂 俊、吉川 勉.
  • Organizer: 第87日本循環器学会学術集会
• [Presentation] Impact of Barthel Index on Home Discharge and Long-term Outcomes in Patients Hospitalized with Heart Failure (2023)
  • Author(s): Izumi K,Kohno T,Goda A, Takeuchi S,Shiraishi Y,Nagatomo Y,Kitamura M,Takei M, Sakamoto M,Mizuno A,Nakano S,Soejima K,Kohsaka S,Yoshikawa S.
  • Organizer: 第87日本循環器学会学術集会
• [Presentation] 補助人工心臓管理施設VADチームで挑むShared-Care (2022)
  • Author(s): 合田あゆみ、峯岸祥人、千木良寛子、竹内真介、飯野泰子、濱野繁、小沼健人、中村英慎、飛田和基、副島京子、河野隆志、窪田博.
  • Organizer: 第26回日本心不全学会学術集会
• [Presentation] 低血圧合併心不全における従来ガイドライン推奨薬物治療の役割 (2022)
  • Author(s): 河野隆志、香坂俊、合田あゆみ、白石泰之、泉圭一、佐地真育、長友祐司、吉川勉.
  • Organizer: 第26回日本心不全学会学術集会
• [Presentation] Evaluation of factors contributing to exercise intolerance using cardiopulmonary exercise testing with hemodynamic monitoring; Detection of occult left ventricular diastolic dysfunction. (2021)
  • Author(s): 合田あゆみ, 竹内真介, 竹内かおり, 菊池華子, 伊波巧, 河野隆志. 副島京子
  • Organizer: 第24回日本心不全学会学術集会