Strategy of prevention for complication predicted from lifestyle and exercise capacity assessment of patients with implantable assist device

2019 Fiscal Year Final Research Report

• Project/Area Number: 16K01470
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Rehabilitation science/Welfare engineering
• Research Institution: Tokyo Women's Medical University
• Principal Investigator: UENO ATSUKO 東京女子医科大学, 医学部, 准講師 (30277199)
• Co-Investigator(Kenkyū-buntansha): 冨澤 康子 東京女子医科大学, 医学部, 助教 (00159047) ; 上塚 芳郎 東京女子医科大学, 医学部, 特任教授 (40147418)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Keywords: 重症心不全 / 補助人工心臓 / 心臓移植 / 合併症 / 脳血管障害 / リハビリテーション

Outline of Final Research Achievements

The number of patients with end-stage heart failure who have been implanted left ventricular assist device (LVAD) is increasing, therefore the waiting period for heart transplantation is also prolonging. With prolonged waiting period for heart transplantation, complications of LVAD implantation such as cerebrovascular disease and infections have resulted in readmission, long-term hospitalization, deterioration of quality of life (QOL) and life prognosis. In our study, 17 out of 33 patients (52%) with LVAD implantation complicated from cerebrovascular disease, but it was possible to be independence of activities of daily living (ADL) with early treatment and rehabilitation. However, it was shown that patients with repeated cerebrovascular disease may have difficulty in independence of activities of daily living, and by considering higher brain dysfunctions and rehabilitation for upper limbs, it may lead to independence of activities of daily living and improvement of QOL.

Free Research Field

循環器疾患

Academic Significance and Societal Importance of the Research Achievements

心臓移植のドナーが現れるまで、補助人工心臓を植込んで待機する重症心不全患者が増えている。待機期間で合併症として多いのが感染と脳血管障害である。そのうち、脳血管障害はQOLを低下させ、入院期間を延長させる大きな要因である。我々の研究では、成人補助人工心臓植込み患者の脳血管障害との関わりを調査し、脳血管障害の発症が1回のみである場合、早期治療後リハビリテーションの介入を行い、比較的日常生活動作レベルが自立するまでに回復できることを示した。脳血管障害を合併した補助人工心臓患者でも、治療、支援によって社会復帰を円滑にできる可能性をうかがわせることに意義がある。