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Development of risk stratification strategy based on liver congestion using MR elastography in patients with heart failure

Research Project

Project/Area Number 23K07174
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 52040:Radiological sciences-related
Research InstitutionHokkaido University

Principal Investigator

永井 利幸  北海道大学, 医学研究院, 准教授 (00528218)

Co-Investigator(Kenkyū-buntansha) 常田 慧徳  北海道大学, 大学病院, 医員 (80944868)
Project Period (FY) 2023-04-01 – 2026-03-31
Project Status Granted (Fiscal Year 2023)
Budget Amount *help
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2025: ¥520,000 (Direct Cost: ¥400,000、Indirect Cost: ¥120,000)
Fiscal Year 2024: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
Fiscal Year 2023: ¥2,340,000 (Direct Cost: ¥1,800,000、Indirect Cost: ¥540,000)
Keywords核磁気共鳴肝エラストグラフィー / 心不全 / うっ血 / リスク層別
Outline of Research at the Start

心不全患者において、右心房圧は強力な予後規定因子である。我々は核磁気共鳴肝エラストグラフィー(MRE)で測定した肝硬度による非侵襲的かつ高精度な右心房圧推定法を開発した。本研究の目的は、心不全患者におけるMREで測定された肝硬度の予後的意義を解明し、肝硬度によるリスク層別法を開発することである。心不全患者300例に対してMREを施行し、肝硬度が独立して心血管イベントリスクと関連するか検討する。

Outline of Annual Research Achievements

今年度は計画通りに北海道大学病院に心不全の確定診断で入院した連続症例を前向きに登録し、年度内に250例の登録が得られ、全例に以下の検査を施行した。
肝臓MRE:3.0テスラMRI装置であるDiscovery 750W(GE Healthcare, Waukesha, WI, USA)を用いて、16および40チャネルGEMアレイコイルを使用し撮像。MRE画像は、専用のアクティブドライバー(振動源)とパッシブドライバー(振動板)を使用して患者を仰臥位として、肝臓を振動させながら撮像した。解析用の関心領域(region of interest; ROI)は、画像ビューアー(EXTREX, J-MAC System, Sapporo, Japan)を使用して描出した。原則として、ROIはモノクロ硬度画像上で、肝右葉のsegment 5(S5)領域からS8領域の間の3~4断面において波画像で平行波が伝播している領域を選択し、フリーハンドで可能な限り大きく描出した。描出したROI内の弾性率は自動計算され、計測された各断面の弾性率の平均値を、肝硬度(LS-MRE、単位: kPa)として算出した。
右心カテーテル検査:患者を仰臥位とし呼気終末で息止めを行いながら実施し、平均5心拍分の波形を取り込み、右心房圧、肺動脈楔入圧、肺動脈圧、心拍出量等を測定した。
血液検査(バイオマーカー等):肝硬度上昇の機序を血清学液に検討するため、心不全マーカー(血清トロポニン、NT-pro BNP値)、肝線維化マーカー(ヒアルロン酸、IV型コラーゲン7Sなど7項目)を測定するための血液検体を採取・保管した。

Current Status of Research Progress
Current Status of Research Progress

1: Research has progressed more than it was originally planned.

Reason

研究計画の1年目ですでに目標症例の8割の症例が登録されており、来年度に目標症例300例を対象とした解析が前倒しで解析できる目途が立った。

Strategy for Future Research Activity

可能であれば来年度早期に目標症例300例の登録を達成し、年度内に臨床転帰のデータを合わせて中間解析を開始できればと考えている。目標以上の症例登録数が得られれば、より統計学的に盤石な結果を得ることが可能となるため、可能な限り多数の症例登録を目指す。最終年度には当初予定の主解析のほか、肝硬度を鋭敏に検出する肝臓関連バイオマーカーを同定し、心不全患者のリスク層別に有用な新たなバイオマーカー戦略を開発する。

Report

(1 results)
  • 2023 Research-status Report
  • Research Products

    (31 results)

All 2024 2023

All Journal Article (11 results) (of which Peer Reviewed: 11 results,  Open Access: 6 results) Presentation (20 results) (of which Int'l Joint Research: 15 results,  Invited: 8 results)

  • [Journal Article] Prolonged delirium during hospitalization is associated with worse long-term and short-term outcomes in patients with acute heart failure2024

    • Author(s)
      Aikawa Yukio、Ogata Soshiro、Honda Satoshi、Nagai Toshiyuki、Murata Shunsuke、Morii Isao、Anzai Toshihisa、Nishimura Kunihiro、Noguchi Teruo
    • Journal Title

      International Journal of Cardiology

      Volume: 399 Pages: 131776-131776

    • DOI

      10.1016/j.ijcard.2024.131776

    • Related Report
      2023 Research-status Report
    • Peer Reviewed
  • [Journal Article] JCS 2023 Guideline on the Diagnosis and Treatment of Myocarditis2023

    • Author(s)
      Nagai Toshiyuki、Inomata Takayuki、Kohno Takashi、Sato Takuma、Tada Atsushi、Kubo Toru、Nakamura Kazufumi、Oyama-Manabe Noriko、Ikeda Yoshihiko、Fujino Takeo、Asaumi Yasuhide、Okumura Takahiro、Yano Toshiyuki、Tajiri Kazuko、Matsuura Hiroyuki、Baba Yuichi、Sunami Haruki、Tsujinaga Shingo、et al.
    • Journal Title

      Circulation Journal

      Volume: 87 Issue: 5 Pages: 674-754

    • DOI

      10.1253/circj.CJ-22-0696

    • ISSN
      1346-9843, 1347-4820
    • Year and Date
      2023-04-25
    • Related Report
      2023 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Machine learning-based gait analysis to predict clinical frailty scale in elderly patients with heart failure2023

    • Author(s)
      Mizuguchi Yoshifumi、Nakao Motoki、Nagai Toshiyuki、Takahashi Yuki、Abe Takahiro、Kakinoki Shigeo、Imagawa Shogo、Matsutani Kenichi、Saito Takahiko、Takahashi Masashige、Kato Yoshiya、Komoriyama Hirokazu、Hagiwara Hikaru、Hirata Kenji、Ogawa Takahiro、Shimizu Takuto、Otsu Manabu、Chiyo Kunihiro、Anzai Toshihisa
    • Journal Title

      European Heart Journal - Digital Health

      Volume: 5 Issue: 2 Pages: 152-162

    • DOI

      10.1093/ehjdh/ztad082

    • Related Report
      2023 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Exercise Capacity and Clinical Outcomes in Chronic Heart Failure Patients with Mild Tricuspid Regurgitation2023

    • Author(s)
      Nakamura Kosuke、Ishizaka Suguru、Omote Kazunori、Yasui Yutaro、Mizuguchi Yoshifumi、Takenaka Sakae、Shimono Yui、Motoi Ko、Aoyagi Hiroyuki、Tamaki Yoji、Kazui Sho、Takahashi Yuki、Saiin Kohei、Naito Seiichiro、Tada Atsushi、Kobayashi Yuta、Sato Takuma、Kamiya Kiwamu、Nagai Toshiyuki、Anzai Toshihisa
    • Journal Title

      Journal of Clinical Medicine

      Volume: 12 Issue: 23 Pages: 7459-7459

    • DOI

      10.3390/jcm12237459

    • Related Report
      2023 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Differences in blood flow dynamics between balloon- and self-expandable valves in patients with aortic stenosis undergoing transcatheter aortic valve replacement2023

    • Author(s)
      Takahashi Y、Kamiya K、Nagai T、Tsuneta S、Oyama-Manabe N、Hamaya T、Kazui S、Yasui Y、Saiin K、Naito S、Mizuguchi Y、Takenaka S、Tada A、Ishizaka S、Kobayashi Y、Omote K、Sato T、Shingu Y、Kudo K、Wakasa S、Anzai T
    • Journal Title

      Journal of Cardiovascular Magnetic Resonance

      Volume: 25 Issue: 1 Pages: 60-60

    • DOI

      10.1186/s12968-023-00970-9

    • Related Report
      2023 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Impact of Cardiac Power Output on Exercise Capacity and Clinical Outcome in Patients With Chronic Heart Failure2023

    • Author(s)
      Shimono Yui、Ishizaka Suguru、Omote Kazunori、Nakamura Kosuke、Yasui Yutaro、Mizuguchi Yoshifumi、Takenaka Sakae、Aoyagi Hiroyuki、Tamaki Yoji、Sato Takuma、Kamiya Kiwamu、Nagai Toshiyuki、Anzai Toshihisa
    • Journal Title

      The American Journal of Cardiology

      Volume: 206 Pages: 4-11

    • DOI

      10.1016/j.amjcard.2023.08.069

    • Related Report
      2023 Research-status Report
    • Peer Reviewed
  • [Journal Article] Prognostic Value of Liver Fibrotic Markers in Patients With Heart Failure2023

    • Author(s)
      Tada Ai、Nagai T、Kato Y、Oyama-Manabe N、Tsuneta S、Nakai M、Yasui Y、Kazui S、Takahashi Y、Saiin K、Naito S、Takenaka S、Mizuguchi Y、Kobayashi Y、Ishizaka S、Omote K、Sato T、Konishi T、Kamiya K、Kudo K、Anzai T
    • Journal Title

      The American Journal of Cardiology

      Volume: 200 Pages: 115-123

    • DOI

      10.1016/j.amjcard.2023.05.033

    • Related Report
      2023 Research-status Report
    • Peer Reviewed
  • [Journal Article] Heart failure with preserved ejection fraction phenogroup classification using machine learning2023

    • Author(s)
      Kyodo Atsushi、Kanaoka Koshiro、Keshi Ayaka、Nogi Maki、Nogi Kazutaka、Ishihara Satomi、Kamon Daisuke、Hashimoto Yukihiro、Nakada Yasuki、Ueda Tomoya、Seno Ayako、Nishida Taku、Onoue Kenji、Soeda Tsuneari、Kawakami Rika、Watanabe Makoto、Nagai Toshiyuki、Anzai Toshihisa、Saito Yoshihiko
    • Journal Title

      ESC Heart Failure

      Volume: 10 Issue: 3 Pages: 2019-2030

    • DOI

      10.1002/ehf2.14368

    • Related Report
      2023 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Trends in heart failure prevalence in Japan 2014?2019: a report from healthcare administration databases2023

    • Author(s)
      Zhang Ling、Ono Yasuhisa、Qiao Qing、Nagai Toshiyuki
    • Journal Title

      ESC Heart Failure

      Volume: 10 Issue: 3 Pages: 1996-2009

    • DOI

      10.1002/ehf2.14321

    • Related Report
      2023 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Prognostic Significance of Peak Workload-to-Weight Ratio by Cardiopulmonary Exercise Testing in Chronic Heart Failure2023

    • Author(s)
      Yasui Yutaro、Nakamura Kosuke、Omote Kazunori、Ishizaka Suguru、Takenaka Sakae、Mizuguchi Yoshifumi、Shimono Yui、Kazui Sho、Takahashi Yuki、Saiin Kohei、Naito Seiichiro、Tada Atsushi、Kobayashi Yuta、Sato Takuma、Kamiya Kiwamu、Nagai Toshiyuki、Anzai Toshihisa
    • Journal Title

      The American Journal of Cardiology

      Volume: 193 Pages: 37-43

    • DOI

      10.1016/j.amjcard.2023.01.052

    • Related Report
      2023 Research-status Report
    • Peer Reviewed
  • [Journal Article] Association of longitudinal cardiac troponin trajectory with adverse events in patients with cardiac sarcoidosis2023

    • Author(s)
      Kazui Sho、Takenaka Sakae、Nagai Toshiyuki、Kato Yoshiya、Komoriyama Hirokazu、Kobayashi Yuta、Takahashi Akinori、Kamiya Kiwamu、Sato Takuma、Tada Atsushi、Yasui Yutaro、Nakai Michikazu、Sato Takahiro、Tsujino Ichizo、Konno Satoshi、Anzai Toshihisa
    • Journal Title

      International Journal of Cardiology

      Volume: 389 Pages: 131268-131268

    • DOI

      10.1016/j.ijcard.2023.131268

    • Related Report
      2023 Research-status Report
    • Peer Reviewed
  • [Presentation] Development of an Automated Frailty Assessment Program for Elderly Patients with Heart Failure through Industry-academia-government Collaboration.2024

    • Author(s)
      Nagai T.
    • Organizer
      第88回日本循環器学会学術集会
    • Related Report
      2023 Research-status Report
    • Int'l Joint Research / Invited
  • [Presentation] 心筋炎ガイドライン改定と実臨床からみた診療の課題.2024

    • Author(s)
      永井利幸.
    • Organizer
      第43回日本画像医学会
    • Related Report
      2023 Research-status Report
    • Invited
  • [Presentation] ステロイド治療の適応と治療抵抗例に対するアプローチ.2023

    • Author(s)
      永井利幸.
    • Organizer
      第43回日本サルコイドーシス/肉芽腫性疾患学会総会
    • Related Report
      2023 Research-status Report
    • Invited
  • [Presentation] 心臓サルコイドーシスUpdate 2023.2023

    • Author(s)
      永井利幸.
    • Organizer
      第8回日本心筋症研究会
    • Related Report
      2023 Research-status Report
    • Invited
  • [Presentation] Key Points of JCS 2023 Guideline on the Diagnosis and Treatment of Myocarditis: Focus on Chronic Inflammatory Cardiomyopathy. Inflammatory cardiomyopathy, pathogenesis and treatment.2023

    • Author(s)
      Nagai T.
    • Organizer
      第87回日本循環器学会学術集会
    • Related Report
      2023 Research-status Report
    • Int'l Joint Research / Invited
  • [Presentation] Usefulness of Liver Stiffness Assessed by Magnetic Resonance Elastography in Patients with Heart Failure.2023

    • Author(s)
      Tada A, Nagai T, Kato Y, Anzai T.
    • Organizer
      第87回日本循環器学会学術集会
    • Related Report
      2023 Research-status Report
    • Int'l Joint Research
  • [Presentation] エビデンスと実臨床から心臓サルコイドーシス診療を再考する.2023

    • Author(s)
      永井利幸.
    • Organizer
      第27回日本心不全学会
    • Related Report
      2023 Research-status Report
    • Int'l Joint Research / Invited
  • [Presentation] 心不全合併心房細動に対する治療戦略Up to date.2023

    • Author(s)
      永井利幸.
    • Organizer
      第61回全国自治体病院学会
    • Related Report
      2023 Research-status Report
    • Invited
  • [Presentation] 非心臓手術周術期の心筋傷害 ~ガイドラインから対策を考える~.2023

    • Author(s)
      永井利幸.
    • Organizer
      日本麻酔科学会 第70回学術集会.
    • Related Report
      2023 Research-status Report
    • Invited
  • [Presentation] Validity and Reliability of a Palliative Care Needs Assessment Tool in Japanese Patients with Heart Failure.2023

    • Author(s)
      Tatsuta D, Nagai T, Sato T, Koya J, Nishino K, Naito S, Mizuguchi Y, Temma T, Kamiya K, Narita H, Tsuruga K, Anzai T.
    • Organizer
      American Heart Association Scientific Sessions 2023
    • Related Report
      2023 Research-status Report
    • Int'l Joint Research
  • [Presentation] Differential Impact of Self-Care Behaviour on Mortality Between Patients With Stable and Recent Worsening Chronic Heart Failure.2023

    • Author(s)
      Koya T, Nagai T, Tada A, Nakao M, Ishizaka S, Mizuguchi Y, Aoyagi H, Imagawa S, Tokuda Y, Kato Y, Takahashi M, Sakai H, Machida M, Matsutani K, Saito T, Okamoto H, Anzai T.
    • Organizer
      American Heart Association Scientific Sessions 2023
    • Related Report
      2023 Research-status Report
    • Int'l Joint Research
  • [Presentation] Machine Learning-Based Prediction of Clinical Frailty Scale Based on Gait Analysis in Elderly Patients With Heart Failure.2023

    • Author(s)
      Nakao M, Nagai T, Mizuguchi Y, Takahashi Y, Abe T, Kakinoki S, Imagawa S, Matsutani K, Saito T, Takahashi M, Hirata K, Ogawa T, Shimizu T, Otsu M, Chiyo K, Anzai T.
    • Organizer
      American Heart Association Scientific Sessions 2023
    • Related Report
      2023 Research-status Report
    • Int'l Joint Research
  • [Presentation] Prognostic Value of Combined Assessment of Cardiac Magnetic Resonance and Fluorodeoxyglucose Positron Emission Tomography in Patients with Cardiac Sarcoidosis.2023

    • Author(s)
      Kazui S, Takenaka S, Nagai T, Tsuneta S, Kato Y, Komoriyama H, Kobayashi Y, Takahashi A, Kamiya K, Tenma T, Sato T, Tada A, Yasui Y, Nakai M, Sato T, Tsujino I, Kudo K, Konno S, Anzai T.
    • Organizer
      American Heart Association Scientific Sessions 2023
    • Related Report
      2023 Research-status Report
    • Int'l Joint Research
  • [Presentation] Prognostic Value of Liver Fibrotic Markers in Patients with Heart Failure.2023

    • Author(s)
      Tada A, Nagai T, Kato Y, Yasui Y, Sho K, Yuki T, Kohei S, Naito S, Takenaka S, Mizuguchi Y, Kobayashi Y, Omote K, Sato T, Kamiya K, Anzai T.
    • Organizer
      European Society of Cardiology Congress 2023
    • Related Report
      2023 Research-status Report
    • Int'l Joint Research
  • [Presentation] Association between Aortic Valve Opening During Exercise and Right Ventricular Reserve in Patients with Left Ventricular Assist Device.2023

    • Author(s)
      Takenaka S, Sato T, Nagai T, Omote K, Kobayashi Y, Kamiya K, Konishi T, Tada A, Mizuguchi Y, Takahashi Y, Naito S, Saiin K, Ishizaka S, Wakasa S, Anzai T.
    • Organizer
      European Society of Cardiology Congress 2023
    • Related Report
      2023 Research-status Report
    • Int'l Joint Research
  • [Presentation] Machine learning-based Automatic Rating of Clinical Frailty Scale in Patients with Heart Failure: A Pilot Study.2023

    • Author(s)
      Mizuguchi Y, Nakao M, Nagai T, Takahashi Y, Abe T, Imagawa S, Matsutani K, Saito T, Hirata K, Ogawa T, Shimizu S, Otsu M, Chiyo K, Anzai T.
    • Organizer
      American College of Cardiology 2023
    • Related Report
      2023 Research-status Report
    • Int'l Joint Research
  • [Presentation] Impact of COVID-19 Pandemic on Emergency Medical System and Management Strategies in Patients with Acute Coronary Syndrome: A Report from Japanese Multicenter Registry.2023

    • Author(s)
      Takenaka S, Saiin K, Nagai T, Takahashi A, Mizuguchi Y, Konishi T, Hotta D, Kamigaki M, Yamazaki S, Fujita T, Yamashita T, Kawahatsu K, Suzuki T, Nozaki Y, Sakurada T, Anzai T, Takenaka T, Igarashi Y, Makino T.
    • Organizer
      American College of Cardiology 2023
    • Related Report
      2023 Research-status Report
    • Int'l Joint Research
  • [Presentation] Hemodynamic Exercise Responses and Quality of Life in Small Body Surface Area Patients with Left Ventricular Assist Device.2023

    • Author(s)
      Sato T, Nagai T, Takenaka S, Kazui S, Yasui Y, Saiin K, Takahashi Y, Naito S, Mizuguchi Y, Tada A, Ishizaka S, Kobayashi Y, Omote K, Kamiya K, Wakasa S, Anzai T.
    • Organizer
      American College of Cardiology 2023
    • Related Report
      2023 Research-status Report
    • Int'l Joint Research
  • [Presentation] Association of Cardiac Troponin Trajectory Following Immunosuppressive Therapy With Adverse Events in Patients With Cardiac Sarcoidosis.2023

    • Author(s)
      Kazui S, Nagai T, Takenaka S, Kato Y, Komoriyama H, Kobayashi Y, Takahashi A, Kamiya K, Sato T, Omote K, Tada A, Mizuguchi Y, Naito S, Takahashi Y, Saiin K, Yasui Y, Anzai T.
    • Organizer
      American College of Cardiology 2023
    • Related Report
      2023 Research-status Report
    • Int'l Joint Research
  • [Presentation] Differences on Periprocedural Blood Flow Dynamics between Balloon-and Self-expandable Valves in Patients with Aortic Stenosis Undergoing Transcatheter Aortic Valve Replacement.2023

    • Author(s)
      Takahashi Y, Kamiya K, Nagai T, Tsuneta S, Kazui S, Yasui Y, Saiin K, Naito S, Mizuguchi Y, Takenaka S, Tada A, Ishizaka S, Kobayashi Y, Omote K, Sato T, Shingu Y, Wakasa S, Anzai T.
    • Organizer
      American College of Cardiology 2023
    • Related Report
      2023 Research-status Report
    • Int'l Joint Research

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Published: 2023-04-13   Modified: 2024-12-25  

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