The efficacy and optimization of exercise training for physical and neurocognitive frailty in elderly heart failure patients

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K19318
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: General internal medicine(including psychosomatic medicine)
• Research Institution: Jichi Medical University
• Principal Investigator: Komori Takahiro 自治医科大学, 医学部, 講師 (80406107)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 認知機能 / 心不全 / 深部白質病変 / 血圧日内変動

Outline of Final Research Achievements

The purpose of this study is the evaluation of physical and neurocognitive frailty in elderly heart failure patients in terms of skeletal muscle, brain, neurohumoral factor, and hemodynamics, and the significance of exercise training will be established by those examination. We enrolled 73 of hospitalized heart failure patients, and 28 patients who underwent ambulatory blood pressure monitoring, brain MRI, and examination of cognitive function completely were analyzed in this study. The patients with non-dipper BP pattern, of which nocturnal BP decline is abnormal, shows significantly higher volume of deep white matter lesion than the patients with dipper BP pattern, of which nocturnal BP decline is normal (1.31±1.28 ml vs 0.55±0.58 ml, p=0.04). The exercise intervention could not perform because most patients hard to attend hospital for exercise training.

Free Research Field

医学

Academic Significance and Societal Importance of the Research Achievements

本研究からは、心不全患者の深部白質病変と血圧日内変動の関係が示唆された。高血圧患者においては、大脳の深部白質病変は認知機能低下との関係が報告されており、また、血圧日内変動異常との関係も報告されているが、心不全患者においては明らかでなかった。心不全患者の多くに認知機能低下および血圧日内変動異常を呈することが知られており、その機序に深部白質病変の増加が関係している可能性が本研究から示唆された。