2023 Fiscal Year Final Research Report

Risk factors and stratification for sudden cardiac death using inflammation / metabolomics and high-resolution electrocardiograph

Research Project

PDF

Project/Area Number	20K08499
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	Tokyo Women's Medical University
Principal Investigator	Suzuki Atsushi 東京女子医科大学, 医学部, 講師 (00625626)
Co-Investigator(Kenkyū-buntansha)	志賀剛東京女子医科大学, 医学部, 客員教授 (00277211) 佐藤加代子東京女子医科大学, 医学部, 准教授 (20246482) 菊池規子東京女子医科大学, 医学部, 講師 (30747324)
Project Period (FY)	2020-04-01 – 2024-03-31
Keywords	心臓突然死 / 心不全 / メタボローム / 心電図 / 心室頻拍 / 心室細動
Outline of Final Research Achievements	Although reduced left ventricular ejection fraction (EF) is considered a major risk factor for sudden death and implantable cardioverter-defibrillators (ICDs) are effective in preventing sudden cardiac death, there are limitations in determining the indication for an ICD based on reduced EF alone. Abnormal signal-averaged electrocardiography was significantly associated with the occurrence of fatal arrhythmias in patients with nonischemic heart failure undergoing ICD implantation. Narrow QRS width was significantly associated with improved EF. Furthermore, metabolomic analysis showed that patients with ventricular arrhythmias or sudden death had reduced levels of molecules involved in energy metabolism. The results suggest that risk assessment combining electrocardiographic indices and metabolomic analysis may be useful for sudden death risk.
Free Research Field	循環器内科
Academic Significance and Societal Importance of the Research Achievements	メタボローム解析の進歩により、脂質代謝、解糖系、ミトコンドリアの代謝産物の変化が明らかになりつつある。心不全患者における炎症性サイトカインやメタボロームの解析により、心不全の代謝・炎症変化が明らかとなり、代謝・炎症リモデリングを標的とした診断・治療の開発が期待される。我々は、心不全患者の心電学的指標と代謝分子の変化を解析し、心電学的異常に結びつくマーカーを見出だした。心不全患者における非侵襲的な不整脈リスクの検出が可能になることでより早期からの適確な突然死リスク評価の確立が期待される。