The association between gluco-metabolic factors and parameters of left ventricular diastolic function.

2023 Fiscal Year Final Research Report

• Project/Area Number: 19K19446
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 58030:Hygiene and public health-related: excluding laboratory approach
• Research Institution: Hyogo Medical University
• Principal Investigator: Kosaka Kae 兵庫医科大学, 医学部, 非常勤講師 (90825663)
• Project Period (FY): 2019-04-01 – 2024-03-31
• Keywords: 心不全 / 左室拡張機能障害 / 自律神経機能

Outline of Final Research Achievements

I showed that presence of glucose intolerance or diabetes, or visceral adiposity was significantly associated with reduced cardiac autonomic and diastolic functions. Higher autonomic functions were significantly associated with a parameter of better cardiac diastolic function (E/A) . I also have reported that sleep problems, such as sleep apnea and poor sleep quality, were significantly associated with progression of cardiac diastolic dysfunction even in the stages without heart failure. Furthermore, it was shown that "objective" methods for assessing "sleep problems" may be more effective in assessing potential risk for progression of diastolic dysfunction than "subjective" methods, such as questionnaires. Furthermore, I showed that nocturnal hypertension was significantly associated with progressive left ventricular diastolic dysfunction in diabetic patients even in the stages without heart failure, while no such association was found in non-diabetic patients.

Free Research Field

内分泌代謝

Academic Significance and Societal Importance of the Research Achievements

本邦では心不全の罹患率は増加しており、対策を講じることは喫緊の課題である。申請者は左室収縮機能が保たれているが、左室拡張機能のみが低下した心不全に着目し、その進展リスクについて検討した。代謝異常患者については自律神経機能異常が心不全発症前から左室拡張機能に影響する可能性があることを示した。また糖尿病患者では夜間高血圧を合併することが左室拡張機能障害へ進展のリスクとなる可能性を示した。さらに睡眠時の無呼吸と睡眠の質の低下は心拡張機能障害の進行と関連することを示した。本研究にて左室拡張機能障害を来す患者背景の特徴やリスク因子について評価したことは心不全発症抑制のために非常に意義があることと考える。