2023 Fiscal Year Final Research Report

Quantification of right ventricular fibrosis with cardiac magnetic resonance imaging and dual-energy computed tomography

Research Project

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Project/Area Number	20K08449
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 53020:Cardiology-related
Research Institution	Kyushu University
Principal Investigator	Kenichiro Yamamura 九州大学, 大学病院, 特任講師 (30532858)
Co-Investigator(Kenkyū-buntansha)	坂本一郎九州大学, 大学病院, 助教 (90616616) 山崎誘三九州大学, 大学病院, 助教 (00643347) 孝橋賢一九州大学, 医学研究院, 准教授 (10529879) 帯刀英樹九州大学, 医学研究院, 共同研究員 (40343321) 塩瀬明九州大学, 医学研究院, 教授 (30363336)
Project Period (FY)	2020-04-01 – 2024-03-31
Keywords	ファロー四徴症 / 右室心筋線維化 / 画像診断
Outline of Final Research Achievements	Pulmonary valve replacement surgery after Tetralogy of Fallot repair is the most common reoperation in adult congenital heart disease patients, but its criteria are not well established. The current standards based on right ventricular (RV) volume do not necessarily improve long-term outcomes, and the severity of RV myocardial fibrosis is also considered important. However, myocardial biopsy is invasive, so we aimed to establish a non-invasive evaluation method. Traditional MRI T1 mapping, performed during end-diastole, had limitations in evaluating the thin RV myocardium. By imaging during systole and using compressed sensing technology to enhance spatial resolution, accurate and reproducible assessment of the RV myocardium, similar to that of the left ventricle, became possible. In the future, we plan to collect pre- and postoperative data to further investigate the usefulness of this non-invasive evaluation method in predicting long-term cardiac function changes and outcomes.
Free Research Field	小児循環器　成人先天性心疾患
Academic Significance and Societal Importance of the Research Achievements	本研究では、MRI高分解能T1 mappingにより非侵襲的に右室心筋線維化を評価する新しい手法を確立し、精度と再現性の向上を得ることができた。将来的には術前と術後遠隔期のデータを収集することで、心機能の経時的変化や予後予測における有用性を高めることを目指す。近年わが国でも経皮的肺動脈弁置換術が導入された事情もあり、Fallot四徴症患者の治療方針決定において、本研究で向上した画像診断の情報は重要な意義を持つだろう。さらには、肺高血圧症など右室心筋線維化をきたす他の多くの心疾患の評価においても、本研究の成果は非侵襲的に重要な情報を提供し、患者の方針決定・予後改善に広く寄与することが期待される。