Investigation into mechanism of reverse remodeling of children's heart

2021 Fiscal Year Final Research Report

• Project/Area Number: 17K10156
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Pediatrics
• Research Institution: Jikei University School of Medicine
• Principal Investigator: Urashima Takashi 東京慈恵会医科大学, 医学部, 准教授 (20338875)
• Co-Investigator(Kenkyū-buntansha): 角田 亘 国際医療福祉大学, 医学部, 主任教授 (00453788) ; 草刈 洋一郎 東京慈恵会医科大学, 医学部, 教授 (80338889)
• Project Period (FY): 2017-04-01 – 2022-03-31
• Keywords: 右心不全 / リバースリモデリング / ラット

Outline of Final Research Achievements

Pulmonary artery banding, which is performed as a palliative operation, presents with right ventricular hypertrophy, but there have been few studies on its reversibility before. We investigated the reverse remodeling of the right ventricular myocardium using a pulmonary artery banding model rat by a soluble band. Both right ventricular hypertrophy and right heart function were improved by releasing the strangulation. Unlike hypertrophy, fibrosis did not show improvement and was considered to be an irreversible change. There was a strong correlation between EF in the right ventricle and fibrosis, and it was considered that fibrosis had progressed significantly when the EF in the right ventricle decreased. Blood periostin has been reported to correlate with myocardial fibrosis in rats and may be useful as a biomarker for right heart function.

Free Research Field

小児科

Academic Significance and Societal Importance of the Research Achievements

長期に及ぶ心筋への圧負荷は心筋の線維化を引き起こし、不可逆的な心筋への障害の原因となる。小児先天性心疾患の外科的治療のタイミングを決めるのは困難であることが多い。体格や年齢の発達を待つことよりも心筋が不可逆的な影響を受ける前に治療を行うことが将来の心機能の維持に重要である。また心機能の維持にはミトコンドリアが重要な役割を果たしておりその機能の維持を伸ばすことの出来る治療の立案が必要である。