Impact of Carotid Artery Revascularization on Cardiovascular Profiles in Patients with Carotid Artery Stenosis

2021 Fiscal Year Final Research Report

• Project/Area Number: 18K15878
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Akita University
• Principal Investigator: Wakana Sato 秋田大学, 医学系研究科, 助教 (50748283)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Keywords: 心臓交感神経 / 頸動脈プラーク / 心不全

Outline of Final Research Achievements

Recent studies show that prolonged carotid baroreflex activation produces sustained hypotension mediated by sympathoinhibition and subsequent inhibition of the renin-angiotensin system. An atheroma developed in the carotid sinus impairs the baroreflex sensitivity and leads to sustained excessive sympathetic nerve activation (SNA). However, the effects of carotid artery revascularization (CAR) on cardiovascular profiles have not been thoroughly examined. In this study, MIBG scintigraphy showed that the H/M ratio after CAR was significantly higher than that before CAR, suggesting the improvement of cardiac SNA. E/e’ significantly decreased after CAR. This result suggests that CAR reduced the left atrial pressure. This study showed that CAR improved the left ventricular diastolic function, which is partly mediated by modified cardiac sympathetic nerve activity.

Free Research Field

循環器内科

Academic Significance and Societal Importance of the Research Achievements

心不全の5年生存率は約50%と、未だに予後不良な病態であり、新規治療法の開発が望まれる。本研究では、頸動脈高度狭窄症例において頸動脈血行再建術を行うことによって心臓交感神経機能の改善、左房圧の低下を認めることが明らかになった。特に左室収縮能が保たれている心不全HFpPFの患者ではその恩恵を強く受ける傾向があり、今後の心不全治療の新たな選択肢となる可能性がある。