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Detection of fibrotic remodeling of epicardial adipose tissue in patients with atrial fibrillation: Imaging approach based on histological observation

Research Project

Project/Area Number 21K12648
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 90110:Biomedical engineering-related
Research InstitutionOita University

Principal Investigator

Ishii Yumi  大分大学, 医学部, 客員研究員 (20835607)

Project Period (FY) 2021-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000)
Fiscal Year 2023: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000)
Fiscal Year 2022: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2021: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
Keywords心房細動 / 心外膜脂肪 / CT画像 / CT値 / 心房線維化
Outline of Research at the Start

心房細動は全国民の約1%が罹患する代表的な不整脈疾患である。心房細動を発見できずに脳梗塞を起こし,重度の後遺症に悩んでいる患者が多く存在する。心房細動の早期発見につながる研究をしたいと思い,心房細動患者の心筋と周囲の脂肪(心外幕脂肪)を解析し,「炎症の強い心外膜脂肪が,心筋の線維化を悪化させる」ことを発見した。これは「心外膜脂肪を見れば早期に心房細動を発見・予防できる」という画期的な成果であった。そこで,医療現場で非侵襲的に心外膜脂肪を可視化する技術を開発するためCT画像に注目した。CT画像と実際の心外膜脂肪を比較検討し「心外膜脂肪を利用した心房細動の新たな画像診断法を確立」することとした。

Outline of Final Research Achievements

It has been reported that epicardial adipose tissue (EAT) is associated with the incident of atrial fibrillation (AF). We demonstrated that EAT contained the inflammatory cytokines/chemokines richly, resulting in severely fibrosis. We named them “the fibrotic remodeling of EAT” which was the risk factor of AF. As the mechanism, we demonstrated the paracrine effect of inflammatory cytokines from adipocytes to myocardium.
As the next phase, we hypothesized that the “fibrotic remodeling of EAT” could be detected using CT images. We found that much collagen and smaller adipocytes in severe fibrosis EAT, resulting in the high density. Es-pecially, this high tissue density existed around the atrium. Assessed by CT images, %change in EAT attenuation was positively correlated with the ratio of central to marginal adipocyte diameter. It could be possible to evaluate the risk of AF using CT images in the future.

Academic Significance and Societal Importance of the Research Achievements

心房細動は脳梗塞発症の原因となる。症状なく心房細動に罹患している患者も多く存在し、脳梗塞を発症し初めて気が付くこともしばしばある。また、発作時に心電図検査を行わなければ、診断もできない。今回の私たちの研究は、心外膜脂肪をCT検査で非侵襲的に評価し、心房細動のリスクを有する患者を特定できる可能性を示した。この技術が臨床現場で応用できれば、脳梗塞発症前に心房細動患者を同定し、早期治療、脳梗塞予防に活かすことができるかもしれない。

Report

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

    (4 results)

All 2024 2022 2021

All Journal Article (2 results) (of which Peer Reviewed: 1 results,  Open Access: 1 results) Presentation (2 results)

  • [Journal Article] 心房細動患者における心外膜脂肪の線維化リモデリング:組織と画像2024

    • Author(s)
      石井 悠海
    • Journal Title

      心電図

      Volume: -

    • Related Report
      2023 Annual Research Report
  • [Journal Article] Detection of fibrotic remodeling of epicardial adipose tissue in patients with atrial fibrillation: Imaging approach based on histological observation2021

    • Author(s)
      Ishii Yumi、Abe Ichitaro、Kira Shintaro、Harada Taisuke、Takano Masayuki、Oniki Takahiro、Kondo Hidekazu、Teshima Yasushi、Yufu Kunio、Shuto Takashi、Wada Tomoyuki、Nakagawa Mikiko、Shimada Tatsuo、Asayama Yoshiki、Miyamoto Shinji、Takahashi Naohiko
    • Journal Title

      Heart Rhythm O2

      Volume: 2 Issue: 4 Pages: 311-323

    • DOI

      10.1016/j.hroo.2021.05.006

    • Related Report
      2021 Research-status Report
    • Peer Reviewed / Open Access
  • [Presentation] 心房細動患者における心外膜脂肪の線維化リモデリング:組織と画像2022

    • Author(s)
      石井悠海
    • Organizer
      第68回日本不整脈心電学会学術大会
    • Related Report
      2022 Research-status Report
  • [Presentation] 心房細動患者における心外膜脂肪の線維化リモデリング:組織と画像2021

    • Author(s)
      石井 悠海
    • Organizer
      循環器学会九州地方会
    • Related Report
      2021 Research-status Report

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Published: 2021-04-28   Modified: 2025-01-30  

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