The development of neuro-mechanical unloading therapy for myocardial infarction

2020 Fiscal Year Final Research Report

• Project/Area Number: 18K15893
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: National Cardiovascular Center Research Institute (2019-2020); Kyushu University (2018)
• Principal Investigator: Saku Keita 国立研究開発法人国立循環器病研究センター, 研究所, 室長 (40567385)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Keywords: 循環器内科 / 血行動態 / 心筋梗塞 / 心力学 / 左室補助装置 / 自律神経 / 神経刺激

Outline of Final Research Achievements

In the development of neuro-mechanical unloading therapy, we established a control algorithm to regulate both the percutaneous left ventricular assist device and the neurostimulator, after the individual verification in animal experiments. We proved that the addition of bradycardic agent to the percutaneous left ventricular assist device resulted in significant suppression of myocardial oxygen consumption, while improving hemodynamics. We also confirmed that the use of the control algorithm during the acute phase of myocardial infarction enabled stable and marked left ventricular unloading. Finally, we examined the impact of developed system in a canine model of ischemia-reperfusion, and found that the system significantly limited infarct size and worsening of heart failure.

Free Research Field

医学

Academic Significance and Societal Importance of the Research Achievements

心筋梗塞治療において、再還流による酸素供給再開に加えて、酸素需要を下げることは梗塞サイズが縮小するが、血行動態を保ちながら心筋酸素消費を抑制する治療法は存在しない。心筋梗塞急性期における左室補助装置と迷走神経刺激を併用した機械-神経最適減負荷アルゴリズムを構築することは、両者の機能、効果を補完することで、血行動態を悪化させることなく、著明な酸素消費低減や心筋保護効果を誘導し、最終的に梗塞サイズの極小化と遠隔期心不全の劇的な予防をもたらす可能性がある。