The impact of endothelial function following cardiac resynchronization therapy

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K01437
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Medical engineering assessment
• Research Institution: Oita University
• Principal Investigator: Yufu Kunio 大分大学, 医学部, 准教授 (00437930)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Keywords: 心臓再同期療法 / 血管内皮機能 / 冠微小循環

Outline of Final Research Achievements

The baseline peripheral endothelial function could predict the long-term outcome of Cardiac resynchronization therapy (CRT). The results also suggest that improvement of coronary microcirculation might be associated with the better baseline endothelial function.
The assessment of coronary flow reserve (CFR) predicts the outcome in responders to CRT. Preservation of coronary circulation flow might underlie one of the mechanisms for a better response to CRT in responders.
The factors for major adverse cerebral and cardiovascular events (MACCE) during long follow-up period were distinctively different between responders and non-responders. The patients with depressed e-GFR are suggested to have poor prognosis even if they are responder to CRT.

Free Research Field

循環器内科

Academic Significance and Societal Importance of the Research Achievements

四肢血管内皮機能・冠血流予備能が心臓再同期療法後慢性期のresponderかnon-responderかを術前予測する一助になると考えられた。四肢血管内皮機能・冠血流予備能のある程度保たれた患者を中心に同手術をおこなうことで不要な手術を減らすことになり臨床面・医療経済的に非常に有益と思われた。心臓再同期療法のresponderであってもそれは一過性のことがあり冠血流予備能の悪い患者では長期的に心不全コントロールを行うよう心がけることで心不全再入院を予知し予防することができる。また術前腎機能低下を伴うresponderでは長期的な観察を厳密に行い心・脳・血管イベントの予防に努めるべきである。