Underlying mechanisms of reverse cardiac remodeling after renal transplantation

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K09415
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular medicine
• Research Institution: Akita University
• Principal Investigator: watanabe hiroyuki 秋田大学, 医学系研究科, 教授 (80323145)
• Co-Investigator(Kenkyū-buntansha): 伊藤 宏 秋田大学, その他部局等, 特任教授 (10232464) ; 飯野 健二 秋田大学, 医学部附属病院, 講師 (30400485) ; 飯野 貴子 秋田大学, 医学部附属病院, 助教 (70620871)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 心血管機能 / 末期腎不全 / 心筋リモデリング

Outline of Final Research Achievements

Renal transplantation (RT) causes LV reverse remodeling. We aimed to identify the contributor associated with LV reverse remodeling after RT. Methods: Sixty-two end-stage renal disease patients with LVH who underwent RT were enrolled. Echocardiographic data were obtained before RT, at 1-, 6-, and 12-month after RT. Results: Forty-six patients (74%) were classified into responders characterized by a decrease in LVMI. LV ejection fraction (EF) time-dependently increased from 59±11% to 69±3% in responders, but not obvious in non-responders. Of note, RT had strong negative correlation with basal EF value. Although most non-responders received RT after the dialysis therapy, 61% of responders have not received dialysis therapy. Responders had a good control of the home BP after RT. Conclusion: RT cardiac responders are characterized by low EF, low prevalence rate of maintenance dialysis at baseline and maintained good home BP control after RT.

Free Research Field

循環器内科

Academic Significance and Societal Importance of the Research Achievements

本研究では腎移植後心リバースリモデリング群に術前の心筋重量係数が高値、EFの低値、血液透析導入率の低値、短期透析期間、術後の家庭血圧管理率良好という特性が示された。この結果は末期腎不全患者の心筋症に可逆性のステージがあることを証明し、今後これら腎移植後心機能回復の影響因子に着目することで、腎移植の早期対象化、究極的に慢性腎不全患者の生命予後改善につながるものと考えられる。さらにuremic cardiomyopathyの新規治療法開発・発展にも寄与する可能性がある。