Morphological, Hemodynamical and Molecular Biological Analysis Regarding Exercise Intolerance after Ventricular Assist Device Implantation

2023 Fiscal Year Final Research Report

• Project/Area Number: 19K17514
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Chiba University
• Principal Investigator: Iwahana Togo 千葉大学, 医学部附属病院, 助教 (00789307)
• Project Period (FY): 2019-04-01 – 2024-03-31
• Keywords: 植込型VAD / 補助人工心臓 / 重症心不全 / 左室逆リモデリング

Outline of Final Research Achievements

The aim of this study is to elucidate the cause that exercise capacity is not fully improved even after ventricular assist device (VAD) implantation, and to establish the protocol of determining the optimal setting of VAD. Invasive hemodynamic examination and cardiopulmonary exercise testing were performed concomitant with echocardiography, and examined the association each other.
We identified the three factors associated with exercise capacity; pulse pressure, right atrial pressure and aortic insufficiency. Comparison of hemodynamic and exercise parameters between several settings of VAD suggested that the exercise capacity is better with the higher settings, which is compatible with the previous reports. We continue patient inclusion to the targeted number and add detailed analysis.

Free Research Field

循環器内科学

Academic Significance and Societal Importance of the Research Achievements

重症心不全に対する植込型補助人工心臓(VAD)の適応が拡大し、今後さらに普及していくと考えられる。一方で合併症や運動耐容能が不十分であることが問題となっており、生活の質は十分とは言えない。本研究は、植込型VADの至適な設定を調整する方法を開発するために行い、良好な運動耐容能を予測する複数の因子を同定した。また、VADの回転数を上昇させることで血行動態および運動耐容能を向上させる可能性が示唆された。症例数を増やしてさらなる検討を行う余地があるが、植込型VAD装着後の運動耐容能を向上させるために有益な情報となると期待される。