Prognostic value of stress echocardiography in patients with paradoxical low-flow low-gradient severe aortic stenosis

• Project/Area Number: 25860627
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Cardiovascular medicine
• Research Institution: St. Marianna University School of Medicine
• Principal Investigator: IZUMO MASAKI 聖マリアンナ医科大学, 医学部, 助教 (40635372)
• Research Collaborator: TAKEUCHI MASAAKI 産業医科大学, 臨床検査・輸血部, 教授 (30236434) ; SEO YOSHIHIRO 筑波大学, 医学医療系, 准教授 (40375499)
• Project Period (FY): 2013-04-01 – 2016-03-31
• Project Status: Completed (Fiscal Year 2015)
• Budget Amount: ¥3,380,000 (Direct Cost: ¥2,600,000、Indirect Cost: ¥780,000); Fiscal Year 2015: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2014: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2013: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
• Keywords: 大動脈弁狭窄症 / 心臓超音波 / 心エコー / 負荷エコー / 多施設研究 / 負荷心エコー図

Outline of Final Research Achievements

Senile degenerative aortic stenosis (AS) is the most common form of valvular heart disease in the developed countries; its prevalence is rapidly increasing with aging. We conducted the comprehensive studies in patients with paradoxical low-flow low-gradient severe aortic stenosis (PLFLG AS) and reported that the prevalence of PLFLG AS was 10% in Japanese AS patients and the clinical outcomes of these patients were better in Japan than the western countries. In this study, we performed dobutamine stress echocardiography in patients with PLFLG AS for assessing hemodynamics and clinical outcomes. We found that the hemodynamics were varied and the half of these patients were defined as having pseudo-severe AS. This is the reason why the clinical outcomes in Japanese patients with PLFLG AS were better than those in the western countries. We presented these results in the international and Japanese conferences; the submition to an international Journal is now under consideration.

Research Products

• [Journal Article] Prognostic implications in patients with symptomatic aortic stenosis and preserved ejection fraction: Japanese multicenter aortic stenosis, retrospective (JUST-R) registry (2016)
  • Author(s): Masaki Izumo, Masaaki Takeuchi, Yoshihiro Seo, Eiji Yamashita, Kengo Suzuki, Tomoko Ishizu, Kimi Sato, Shigeru Oshima, Kazutaka Aonuma, Yutaka Otsuji, Yoshihiro J Akashi.
  • Journal Title: Journal of Cardiology Volume: in press Issue: 1 Pages: 110-118
  • DOI: 10.1016/j.jjcc.2016.01.015
  • Peer Reviewed
• [Journal Article] Prognostic value of global longitudinal strain in paradoxical low-flow, low-gradient severe aortic stenosis with preserved ejection fraction. (2014)
  • Author(s): Sato K, Seo Y, Ishizu T, Takeuchi M, Izumo M, Suzuki K, Yamashita E, Oshima S, Akashi YJ, Otsuji Y, Aonuma K.
  • Journal Title: Circulation Journal Volume: 78 Pages: 2750-9
  • NAID: 130004693850
  • Peer Reviewed
• [Presentation] Prognostic value of aortic valve area flow rate ratio in aortic stenosis with preserved ejection fraction: Japanese Multicenter Aortic Stenosis (JUST) study (2014)
  • Author(s): Masaki Izumo, Masaaki Takeuchi, Yoshihiro Seo, Eiji Yamashita, Kengo Suzuki, Tomoko Ishizu, Kimi Sato, Shigeru Oshima, Kazutaka Aonuma, Yutaka Otsuji, Yoshihiro J Akashi.
  • Organizer: ESC2014
  • Place of Presentation: Barcelona
  • Year and Date: 2014-09-01
• [Presentation] Stress Echocardiography for Assessing True Severity in Patients with Paradoxical Low-Flow Low-Gradient Severe Aortic Stenosis: Japanese Multicenter Aortic Stenosis (JUST) Study (2014)
  • Author(s): 出雲昌樹
  • Organizer: 第78回日本循環器学会学術集会
  • Place of Presentation: 東京国際フォーラム
• [Presentation] Projected aortic valve area reflects true severity in patients with paradoxical low-flow low-gradient severe aortic stenosis: A multicenter aortic stenosis assessment (MASA) study (2013)
  • Author(s): 出雲昌樹
  • Organizer: ESC congress 2013
  • Place of Presentation: Netherlands, Amsterdam