Longitudinal study on cardiac response during exercise in connective tissue disease

2020 Fiscal Year Final Research Report

• Project/Area Number: 17K01450
• 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: Kanazawa University
• Principal Investigator: Someya Fujiko 金沢大学, 保健学系, 教授 (60187903)
• Project Period (FY): 2017-04-01 – 2021-03-31
• Keywords: 膠原病 / 肺機能 / 心機能 / 運動 / 体力 / 生活の質

Outline of Final Research Achievements

In previous cross-sectional studies, impaired stroke volume in patients with systemic sclerosis was reported, however no cardiac parameter using echocardiography was detected as the relating factor for the stroke volume reduction. In this study, the patients were re-evaluated, and correlations between the change of stroke volume for interval periods and cardiac parameters were analyzed.
As the results, individual changes for the interval in stroke volume were found, which was not related to cardiac parameters, but was significantly related to the diffusion capacity of the lung for carbon monoxide. Significant relation was also found between the distance walked and the stroke volume. Thus, a limited lung diffusion capacity may affect stroke volume due to the exercise intolerance in systemic sclerosis without pathological heart involvement.

Free Research Field

リハビリテーション医学

Academic Significance and Societal Importance of the Research Achievements

膠原病患者の１回拍出量が低下する原因が、心エコーなどの心機能評価で得られていた左室収縮能、拡張能障害と予想していたが、本研究ではそれが証明されず、むしろ肺機能障害の２次的影響が大きいことが示された。また、この結果は四肢機能障害の少ない全身性強皮症で明確となったが、皮膚筋炎・多発性筋炎では、筋炎による筋力低下の少ない症例の一部で、体力低下がそれぞれ１回拍出量と肺機能と関連していた。そこで、今後の膠原病患者の運動療法を考えるにあたり、心臓リハビリテーションではなく呼吸リハビリテーションを基にしたプログラムを行うことが合理的であると示唆された。