Exploratory research on a new histological diagnostic marker of end-stage hypertrophic cardiomyopathy

2020 Fiscal Year Final Research Report

• Project/Area Number: 19K17562
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Osaka University
• Principal Investigator: MIYAWAKI HIROSHI 大阪大学, 医学部附属病院, 医員 (00838956)
• Project Period (FY): 2019-04-01 – 2021-03-31
• Keywords: 拡張相肥大型心筋症 / 拡張型心筋症 / 重症心不全 / 冠微小血管障害

Outline of Final Research Achievements

Differentiating end-stage hypertrophic cardiomyopathy (ES-HCM) from dilated cardiomyopathy (DCM) is often difficult in clinical settings, in spite of its importance. We analyzed left ventricle specimens in ES-HCM and DCM patients who implanted a left ventricular assist device, making a quantitative assessment of coronary microvascular density. We found the difference of coronary microvascular rarefaction between ES-HCM and DCM, indicating the clinical utility as a possible clue in the differential diagnosis. Coronary microvascular rarefaction was also associated with serum levels of troponin T. These results will contribute to the next researches for the pathophysiology of ES-HCM.

Free Research Field

循環器

Academic Significance and Societal Importance of the Research Achievements

拡張相肥大型心筋症は、診断後の予後が悪く、心臓移植治療を必要とする重症心不全の原因疾患の一つであるため早期に移植治療を見据えた治療方針をたてることが重要となるが、臨床現場では拡張型心筋症との鑑別が困難な場合も多い。今回、心筋病理を用いた新たな評価項目が鑑別診断につながる可能性が示されたことで、予後改善につながる適切な治療選択に寄与する可能性と、病理学的知見に基づく新たな病態解明につながることが期待される。