2021 Fiscal Year Final Research Report
Early detection and prevention of cancer therapeutics-related cardiac dysfunction
Project/Area Number |
19K08491
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Research Category |
Grant-in-Aid for Scientific Research (C)
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Allocation Type | Multi-year Fund |
Section | 一般 |
Review Section |
Basic Section 53020:Cardiology-related
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Research Institution | Kobe University |
Principal Investigator |
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Co-Investigator(Kenkyū-buntansha) |
杜 隆嗣 神戸大学, 医学研究科, 特命准教授 (50379418)
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Project Period (FY) |
2019-04-01 – 2022-03-31
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Keywords | 心不全 / がん治療関連心機能障害(CTRCD) / 乳がん / ドキソルビシン / 低比重リポ蛋白(HDL) / フィブロネクチン / グルタミン |
Outline of Final Research Achievements |
The sequential or concurrent use of two different types of agents such as anthracyclines and trastuzumab may increase myocardial injury and cancer therapeutics-related cardiac dysfunction (CTRCD). We studied 86 breast cancer patients with preserved LV ejection fraction (LVEF) and treated with anthracyclines, trastuzumab, or both. In accordance with the current position paper, clinical risk factors for CTRCD were defined as: cumulative dose of doxorubicin > 240 mg/m2, age > 65-year-old, body mass index > 30 kg/m2, previous radiation therapy, B-type natriuretic peptide > 100 pg/mL, previous history of cardiovascular disease, atrial fibrillation, hypertension, diabetes, and smoking. The relative decrease in LVEF after chemotherapy for patients with more than four risk factors was significantly greater than that for patients without. Our findings can thus be expected to have clinical implications for better management of patients with breast cancer referred for chemotherapy.
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Free Research Field |
循環器内科
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Academic Significance and Societal Importance of the Research Achievements |
CTRCDは予後不良の心筋症であるため、予測因子の同定はアンジオテンシン変換酵素阻害剤やアンギオテンシンII受容体遮断薬またはβ遮断薬などの確立された心臓保護薬による予防投与または早期適用を可能とする。また、担がん状態におけるHDLの役割がHDLの構成成分により異なることより、抗がん剤による心毒性のリスク層別化に役立つのみならず、生活習慣の是正を含めた新たな予防手段の開発につながる。CTRCDによる心不全の合併は予後を規定するのみならず、日常生活の質へも大きな影響を及ぼすため、本研究で得られた知見はがんサバイバーにとって福音となることが期待される。
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