Early diagnosis of pulmonary hypertension by cardiac examination using phonocardiograms and mechanocardiogram.

2021 Fiscal Year Final Research Report

• Project/Area Number: 18K15432
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 52010:General internal medicine-related
• Research Institution: Kyorin University
• Principal Investigator: Yamasaki Satoko 杏林大学, 医学部, 助教 (90782863)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Keywords: 生理検査 / 肺高血圧症 / 心音図 / 心機図 / 肺性Ⅱ音の亢進

Outline of Final Research Achievements

We analyzed pre and post-RHC phonocardiograms of 214 patients with pulmonary hypertension who underwent RHC from 2009 to 2018, and found that both II tone wavelength ratio and amplitude ratio tended to be significantly higher in correlation with mPAP, while wavelength ratio was significantly correlated with right atrial pressure, right ventricular end-diastolic pressure, and pulmonary vascular resistance, and amplitude ratio with pulmonary vascular resistance. In a comparison of severity, both wavelength ratio and amplitude ratio showed significant differences in the borderline group - light-moderate and borderline group - severe, but not in the light-moderate and severe group. In the ROC analysis, the sensitivity and specificity were 75% and 79%, respectively, with a cutoff value of wavelength P/A ratio >=1.33, and 93% and 55%, respectively, with a cutoff value of amplitude P/A ratio >=0.70.

Free Research Field

生理検査学

Academic Significance and Societal Importance of the Research Achievements

難病である肺高血圧症は従来の検査法では早期発見が難しく、症状出現から診断まで時間を要して治療介入が遅れることが多い。心音・心機図を用いて早期から現れる身体所見を非侵襲的に可視化し、診断や重症度判定、治療効果判定における有効性が証明されれば、本疾患を早期に診断するための低侵襲検査法が確立できる。