2020 Fiscal Year Final Research Report
Development of a Risk Assessment Tool for Predicting Recurrent Non-cardiac Syncope by Using Three-dimensional Echocardiography and Transcranial Doppler Ultrasonography
| Project/Area Number |
17K15904
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Multi-year Fund |
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| Research Field |
General internal medicine(including psychosomatic medicine)
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| Research Institution | Japan Organization of Occupational Health and Safety (2018-2020)
Kyorin University (2017) |
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Principal Investigator |
Uechi Takahiro 独立行政法人労働者健康安全機構横浜労災病院(臨床病態研究センター), 臨床病態研究センター, 医長 (30725487)
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| Project Period (FY) |
2017-04-01 – 2021-03-31
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| Keywords | 経頭蓋ドップラー検査 / ３次元経胸壁心エコー検査 / 非心原性失神 |
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| Outline of Final Research Achievements |
Previous studies have shown that transient loss of consciousness accounts for about 1% of cases of emergency patients, and 40% have no identified cause despite close examination. Syncope is classified into cardiogenic and non-cardiogenic. Non-cardiogenic syncope has a favorable prognosis, but its recurrence rate is as high as about 60%, and it has been suggested that it worsens the quality of life. However, the predictive factors for its recurrence are not clarified. In this study, transcranial doppler (TCD) and three-dimensional transthoracic echocardiography (3DTTE) examinations were performed on non-cardiogenic syncope patients who were referred to the emergency department of Kyorin University Hospital, and it was found that syncope was associated with recurrence in patients with high cerebral vascular resistance in the TCD test. It was also shown that the patients over 40 years of age with left ventricular dyssynchrony in the 3DTTE test were associated with more recurrent syncope.
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| Free Research Field |
非心原性失神
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| Academic Significance and Societal Importance of the Research Achievements |
本研究では、TCD検査を用いて脳血管抵抗を測定し、3DTTE検査を用いて左室内非同期を測定することで、非心原性失神の再発予測の可能性を明らかとした。両検査ともに、ベッドサイドで行われることのできる検査であり、診断に要する時間が比較的短く、非侵襲的で、患者への負担も少ない。現在、両検査ともに救急外来での普及率は高くないが、今後、普及し、解析も自動化することが予想される。多くの施設で失神再発率を予測できるようになれば、広く失神診断ツールとして利用できる可能性が高い。また、再発する失神患者の病態ごとの治療戦略をたてることができるようになるため、再発患者に対しても有益であり、その社会的意義は大きい。
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