Impact of ventricular interdependence on cardiac resynchronization therapy

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K17513
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: University of Tsukuba
• Principal Investigator: Sato Kimi 筑波大学, 医学医療系, 助教 (30823679)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: 心不全 / 心エコー / Multimodality imaging / 心臓再同期療法

Outline of Final Research Achievements

Cardiac resynchronization therapy is a treatment option for symptomatic patients with heart failure despite guideline-directed medical therapy to improve cardiac function, symptoms, and prognosis by adjusting left ventricular dyssynchrony. Although, around 30% of candidates ultimately do not benefit from the therapy, indicating the importance of incorporating ventricular interdependence and right ventricular function as well as left side of the heart. In this study, we showed that synchronized left ventricular pacing showed greater improvement in right ventricular function and response to the treatment. This results indicated that physiologic pacing had an advantage in right ventricular mechanics, which may lead to a favorable outcome.

Free Research Field

循環器内科

Academic Significance and Societal Importance of the Research Achievements

心臓再同期療法は薬物治療が有効でない心不全症例に対する治療法として現在広く行われているが、右心機能が低下した症例では治療効果が乏しい事や、治療反応性が悪い症例が一定数認められることが問題となっている。この研究により、右心機能の悪い症例であっても、特定のペーシングアルゴリズムを選択することで治療反応性が期待できる可能性が示され、心臓再同期療法の治療効果を高めるためには左心室だけでなく、右心室との関連も含めた総合的評価が重要であることが示唆された。