Establishment of diagnostic and therapeutic methods for cardiogenic cerebral infarction by multiple approaches

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K17566
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Yamaguchi University
• Principal Investigator: Omuro Takuya 山口大学, 大学院医学系研究科, 助教 (00760787)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 心房細動 / 血栓 / 血流解析 / 左房心内膜障害 / 左房壁ずり応力

Outline of Final Research Achievements

We investigated the relationship between left atrial blood flow and left atrial wall shear stress (WSS) in atrial fibrillation and left atrial endocardial injury. The left atrial blood flow vector in patients with a history of AF was observed to be smaller than that in non-AF patients, and left atrial circulation measured by 4D-flow MRI showed a significant positive correlation with the CHA2DS2-VASc score. Left atrial WSS was significantly lower in the paroxysmal AF group than in the non-paroxysmal AF group.
Left atrial low-voltage areas (LVAs), which electrophysiologically represent left atrial endocardial injury, were determinants of thrombosis risk (spontaneous echocardiographic contrast and decreased left atrial appendage flow velocity) on transesophageal echocardiography. Furthermore, left atrial WSS tended to decrease as LVAs became widespread.

Free Research Field

心房細動

Academic Significance and Societal Importance of the Research Achievements

心房細動における左房内血栓形成と左房内血流および左房心内膜障害の直接的な関連性は不明である。本研究では、心房細動既往の有無により洞調律下においても左房内血流が変化し、左房内渦流や左房壁ずり応力の低下を認め、左房心内膜障害の程度も左房内血栓形成リスクおよび左房壁ずり応力と関連していた。今後、さらに研究を要するが、左房内血栓形成リスク診断には、CHA2DS2-Vasc Scoreのような臨床的背景に加え、左房心内膜障害や左房内血流の流体力学的評価を加えることで、より個別的な予防および治療が行える可能性がある。そして心原生脳塞栓症予防に寄与できれば健康維持および医療費削減にも期待できる。