Elucidation of Mechanism of Calcified Nodule by Multifaceted Approach

2023 Fiscal Year Final Research Report

• Project/Area Number: 19K16987
• 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: Wakayama Medical University
• Principal Investigator: Terada Kosei 和歌山県立医科大学, 医学部, 学内助教 (50782835)
• Project Period (FY): 2019-04-01 – 2024-03-31
• Keywords: 石灰化結節 / 急性冠症候群 / 近赤外線スペクトロスコピー / 血管内超音波装置 / 光干渉断層法

Outline of Final Research Achievements

In cases of acute myocardial infarction, we evaluated the histomorphology of coronary culprit lesions using optical coherence tomography (OCT) and near-infrared spectroscopy (NIRS) during coronary revascularization and developed an in vivo diagnostic algorithm for calcified nodule lesions. Through this algorithm, we identified the coronary artery morphology and histological characteristics of calcified nodules. Furthermore, cardiac MRI scans demonstrated that lipid content significantly influences the occurrence of microcirculatory disturbances. We also tracked the prognosis of acute myocardial infarction cases caused by calcified nodules, finding that their prognosis was as poor as that of cases with plaque rupture. Additionally, we examined the differences in histological characteristics between calcified and non-calcified lesions in non-culprit lesions, investigating the factors influencing the development of calcified nodules.

Free Research Field

循環器疾患

Academic Significance and Societal Importance of the Research Achievements

昨今、日本人口における高齢化、慢性腎不全症例比率の増加により冠動脈疾患における石灰化病変の関与が強く取り上げられている。しかし、石灰化病変における治療は非常に複雑で、治療方針の決定、予後予測など依然不明な点が多い。そのような社会的背景の中で、今回の研究成果は今後の石灰化病変を成因とする急性心筋梗塞に対する特異的な治療方針の開発、予後予測と短期的な循環器学領域における貢献は大きい。