Assessment of Cardiomyocyte Contractility in Chronic Hemodialysis Treatment and Development of Strategies to Prevent Cardiac Arrest

2023 Fiscal Year Final Research Report

• Project/Area Number: 18K12131
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 90140:Medical technology assessment-related
• Research Institution: Kyushu University
• Principal Investigator: Hamada Hiroyuki 九州大学, 農学研究院, 助教 (80346840)
• Project Period (FY): 2018-04-01 – 2024-03-31
• Keywords: 慢性血液透析療法 / 心筋細胞拍動能 / 電気生理学 / 計算機シミュレーション / 医療技術評価 / 拍動リズム / 収縮力

Outline of Final Research Achievements

In this study, using mathematical analysis methods based on electrophysiology, we investigated the effects of decreased extracellular Ca2+ concentration during hemodialysis treatment on cardiomyocyte contractility, as well as strategies to prevent dysfunction of cardiomyocyte contraction. The beating rhythm after dialysis treatment slightly slowed compared to before treatment. On the other hand, contractile force significantly decreased after treatment compared to before. Examination of ion currents through various membrane transport mechanisms identified a notable increase in inward currents of the Na/Ca exchanger during treatment. These findings indicate that a decrease in intracellular Ca2+ concentration is one mechanism of cardiomyocyte contractile dysfunction, and that the application of Ca2+-supplementing solutions or inhibition of the Na/Ca exchanger during treatment may be useful in maintaining cardiomyocyte contractile function.

Free Research Field

医用工学　電気生理学　システム生物学　計算機科学

Academic Significance and Societal Importance of the Research Achievements

本研究では、慢性血液透析治療中の心筋細胞の負荷状況の評価と心筋細胞内Ca2+循環動態の保全方策の提案を実現する数理解析基盤を構築した。そして、透析治療中のCa2+動態の制御が心筋細胞内のCa2+循環動態の安定化に有効であることを証明した。この成果は患者の生命予後向上に大きく貢献する。本研究における「心負荷低減を目的に透析治療中の体内Ca2+動態を積極的に調節する治療戦略」は独創的研究である。また、本研究は細胞外液の時空間的電解質動態が生体機能の秩序形成に寄与することを明らかにし、細胞外液の電解質濃度の調節を通して生体機能を操作する研究分野を創造するものである。