Severity index of chronic thromboembolic pulmonary hypertension

2021 Fiscal Year Final Research Report

• Project/Area Number: 20K17075
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Nagoya University
• Principal Investigator: Adachi Shiro 名古屋大学, 医学部附属病院, 病院助教 (60782430)
• Project Period (FY): 2020-04-01 – 2022-03-31
• Keywords: 肺高血圧症 / 慢性血栓塞栓性肺高血圧症 / 急性肺塞栓 / 抗凝固療法 / 肺塞栓後症候群 / 肺血管拡張薬

Outline of Final Research Achievements

The refined CT imaging method made it easier to see the thrombus in the periphery of the pulmonary artery, it was found that the residual thrombus after acute pulmonary embolism was 74%. It was found that the residual thrombus 1 month after acute pulmonary embolism is a risk factor, and it is important to follow up carefully for the group of patients with residual thrombus. The transition to chronic thromboembolic pulmonary hypertension (CTEPH) was 3.8%. Furthermore, although the amount of thrombus at the time of diagnosis of CTEPH is not related to the severity, it was found to be useful for determining the therapeutic effect of pulmonary vasodilators and catheter treatment. In addition, low thrombus volume may indicate relatively advanced pulmonary artery degeneration, suggesting that pulmonary vasodilators are more useful than catheterization in such groups.

Free Research Field

肺高血圧症

Academic Significance and Societal Importance of the Research Achievements

急性肺塞栓後、血栓残存の頻度は明確ではないが本研究により明確になった。さらに発症1か月後の血栓の残存が1年後の血栓残存のリスクであり、急性肺塞栓後の具体的なフォローアップの方法が明確になる可能性がある。また抗凝固継続の可否の重要な判断にもなりえる。また肺塞栓後症候群の最重症型であるCTEPHの治療効果判定を診断時の血栓量で予測できる可能性がある。薬剤治療とカテーテル治療の使い分けはまだ明確ではないが血栓量により血栓の問題か血管の変性の問題かを予測することでどちらの治療がより効果的かを判断できる可能性がある。これによりカテーテルと薬物治療をより明確に使い分けることできる。