Beneficial Effects of Bioabsorbable Polymer DES on Coronary Hyperconstricting Responses

2018 Fiscal Year Annual Research Report

• Project/Area Number: 16K19384
• Research Institution: Tohoku University
• Principal Investigator: 西宮 健介 東北大学, 医学系研究科, 非常勤講師 (10734238)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 薬剤溶出性ステント / ポリマー / 冠攣縮 / 外膜 / Vasa vasorum / 光干渉 / リンパ管 / 内皮細胞

Outline of Annual Research Achievements

本研究は単施設の無作為割付化前向き比較研究として行うべく病院倫理委員会に申請を行い、2019年に入ってようやく最終的な承認を得た。2019年4月現在、患者の登録を進めている段階であり、恒久性、生体吸収性ポリマーの2種類の薬剤用溶出性ステント（DES）が冠血管機能に与える影響について具体的な前向き比較試験の結果は得られていない。この点で、当初の計画に研究は遅れていると判断される。この間、後ろ向きの検討も行った。2013年4月～2018年12月の5年8か月の間、当院でステント治療の前後で冠攣縮誘発試験とOCT画像診断を同時施行された症例のうち、恒久ポリマーDES留置例17症例と生体吸収ポリマーDES留置例16例の2群比較を行った。その結果、DES留置前後での血管反応性の変化率は2群で有意な変化は認めなかったが、生体吸収ポリマー群で低い傾向にあった。2群をまとめて検討を行うと、DES留置後に冠血管収縮反応が増悪しており、その程度はOCTで認めたVasa vasorum量と相関を示した。これらの結果は、学会、学術誌に投稿準備中である。臨床研究と並行して、DES留置後の血管炎症についてリンパ管の機能不全による炎症細胞の回収機構が破綻し冠動脈外膜面の炎症遷延に寄与しているとの結果を得、共著者としてヨーロッパ心臓病学会2018で若手研究者を受賞し、Arterioscler Thromb Vasc Biol（IF = 6.6）に論文を発表した。他に、マサチューセッツ総合病院・ハーバード大学との連携によって、超高解像度マイクロOCTを開発した。本技術が内皮細胞を鮮明に画像化できる技術であることを明らかにし、J Am Coll Cardiol　Img (IF = 10.2)へ論文を発表した。今後、DES留置後血管治癒過程の評価に役立てることが期待できる。

Research Products

• [Int'l Joint Research] Harvard Medical School/Massachusetts General Hospital(米国)
  • Country Name: U.S.A.
  • Counterpart Institution: Harvard Medical School/Massachusetts General Hospital
• [Journal Article] Micro-Optical Coherence Tomography for?Endothelial Cell Visualization in the?Coronary Arteries (2019)
  • Author(s): Nishimiya Kensuke、Yin Biwei、Piao Zhonglie、Ryu Jiheun、Osman Hany、Leung Hui Min、Sharma Gargi、Liang Chia Pin、Gardecki Joseph A.、Zheng Hui、Shimokawa Hiroaki、Tearney Guillermo J.
  • Journal Title: JACC: Cardiovascular Imaging Volume: 19 Pages: -
  • DOI: 10.1016/j.jcmg.2019.01.021
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] Treadmill exercise prevents reduction of bone mineral density after myocardial infarction in apolipoprotein E-deficient mice (2019)
  • Author(s): Kanazawa Masanori、Matsumoto Yasuharu、Takahashi Kikuyo、Suzuki Hideaki、Uzuka Hironori、Nishimiya Kensuke、Shimokawa Hiroaki
  • Journal Title: European Journal of Preventive Cardiology Volume: - Pages: -
  • DOI: 10.1177/2047487319834399
  • Peer Reviewed
• [Journal Article] Cardiac Lymphatic Dysfunction Causes Drug-Eluting Stent?Induced Coronary Hyperconstricting Responses in Pigs In Vivo (2019)
  • Author(s): Amamizu Hirokazu、Matsumoto Yasuharu、Morosawa Susumu、Ohyama Kazuma、Uzuka Hironori、Hirano Michinori、Nishimiya Kensuke、Gokon Yusuke、Watanabe-Asaka Tomomi、Hayashi Moyuru、Miyata Satoshi、Kamei Takashi、Kawai Yoshiko、Shimokawa Hiroaki
  • Journal Title: Arteriosclerosis, Thrombosis, and Vascular Biology Volume: 39 Pages: 741～753
  • DOI: 10.1161/ATVBAHA.119.312396
  • Peer Reviewed
• [Journal Article] Low-energy cardiac shockwave therapy to suppress left ventricular remodeling in patients with acute myocardial infarction (2018)
  • Author(s): Kagaya Yuta、Ito Kenta、Takahashi Jun、Matsumoto Yasuharu、Shiroto Takashi、Tsuburaya Ryuji、Kikuchi Yoku、Hao Kiyotaka、Nishimiya Kensuke、Shindo Tomohiko、Ogata Tsuyoshi、Kurosawa Ryo、Eguchi Kumiko、Monma Yuto、Ichijo Sadamitsu、Hatanaka Kazuaki、Miyata Satoshi、Shimokawa Hiroaki
  • Journal Title: Coronary Artery Disease Volume: 29 Pages: 294～300
  • DOI: 10.1097/MCA.0000000000000577
  • Peer Reviewed
• [Presentation] High-resolution micro-OCT for endothelial cell visualization in the coronary arteries (2019)
  • Author(s): Kensuke Nishimiya, Osman O. Ahsen, Biwei Yin, Zhonglie Piao, Jiheun Ryu, Hany Osman, Gargi Sharma, Hui Min Leung, Chia-Pin Liang, Joseph A. Gardecki, Guillermo J. Tearney
  • Organizer: SPIE 2018
  • Int'l Joint Research
• [Presentation] Cellular-resolution intravascular optical coherence tomography for human coronary artery imaging (2018)
  • Author(s): Biwei Yin, Kensuke Nishimiya, Zhonglie Piao, Chulho Hyun, Joseph Gardecki, Guillermo Tearney
  • Organizer: TCT 2018
  • Int'l Joint Research
• [Presentation] High-Definition Micro-Optical Coherence Tomography for Endothelial Cell Visualization in the Coronary Arteries (2018)
  • Author(s): Kensuke Nishimiya, Biwei Yin, Zhonglie Piao, Hany Osman, Jiheun Ryu, Hui Min Leung, Gargi Sharma, Joseph Gardecki, Guillermo Tearney
  • Organizer: TCT 2018
  • Int'l Joint Research
• [Presentation] High-resolution Intravascular OCT-NIRF Molecular Imaging for In Vivo Assessment of Inflammation in Atherosclerosis and Vascular Injury (2018)
  • Author(s): Zhonglie Piao, Kanwarpal Singh, Mohammed Chowdhury, Joseph Gardecki, Kensuke Nishimiya, Biwei Yin, Matthew Beatty, Ara Bablouzian, Sarah Giddings, Adam Mauskapf, Farouc Amin Jaffer, Guillermo Tearney
  • Organizer: TCT 2018
  • Int'l Joint Research
• [Presentation] Cellular-resolution, extended depth of focus optical coherence tomography catheter toward in vivo cardiovascular imaging (2018)
  • Author(s): Biwei Yin, Zhonglie Piao, Chulho Daryl Hyun, Kensuke Nishimiya, Joseph A. Gardecki, Guillermo J. Tearney
  • Organizer: SPIE 2018
  • Int'l Joint Research
• [Presentation] High-Resolution micro-OCT for Endothelial Cell Visualization in the Coronary Arteries (2018)
  • Author(s): Kensuke Nishimiya, Biwei Yin, Zhonglie Piao, Jiheun Ryu, Hany Osman, Gargi Sharma, Hui Min Leung, Chia-Pin Liang, Joseph A Gardecki, Guillermo J Tearney
  • Organizer: AHA Scientific Session 2018
  • Int'l Joint Research
• [Presentation] Assessment of Lipid Rich Plaque Containing Necrotic Core Using a Multi-Modality Near-Infrared Autofluorescence and Optical Coherence Tomography Imaging System (2018)
  • Author(s): Kohei Watanabe, Joseph A Gardecki, Kensuke Nishimiya, Zhonglie Piao, Daisuke Yamada, Guillermo J Tearney
  • Organizer: AHA Scientific Session 2018
  • Int'l Joint Research
• [Presentation] Important roles of cardiac lymphatic vessels in the regulation of coronary vasomotion after DES implantation in pigs in vivo. (2018)
  • Author(s): Hirokazu Amamizu, Yasuharu Matsumoto, Susumu Morosawa, Kazuma Ohyama, Hironori Uzuka, Michinori Hirano, Jun Sugisawa, Satoshi Tsuchiya, Kensuke Nishimiya, Moyuru Hayashi, Yoshiko Kawai, Shimokawa H.
  • Organizer: ESC 2018
  • Int'l Joint Research
• [Presentation] A novel approach for uric acid crystal detection in human coronary arteries with polarization-sensitive micro-OCT (2018)
  • Author(s): Kensuke Nishimiya, Gargi Sharma, Kanwarpal Singh, Hany Osman, Joseph A. Gardecki, Guillermo J. Tearney
  • Organizer: ESC 2018
• [Presentation] Super high-resolution micro-OCT for endothelial cell visualization in the coronary arteries (2018)
  • Author(s): Kensuke Nishimiya, Biwei Yin, Zhonglie Piao, Hany Osman, Jiheun Ryu, Hui Min Leung, Gargi Sharma, Joseph A. Gardecki, Guillermo J. Tearney
  • Organizer: ESC 2018