Study on pathophysiology and therapeutic development of HFpEF using ABPM and BIA

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K17126
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Nara Medical University
• Principal Investigator: UEDA Tomoya 奈良県立医科大学, 医学部, 助教 (80755538)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 心不全 / クリニカルシナリオ / BIA

Outline of Final Research Achievements

During the study period, hospitalization was limited due to COVID-19 infection, which also made ABPM difficult to perform. Therefore, the study focused on patients for whom Bioelectrical Impedance Analysis was available, divided by clinical scenario (CS).
The study included 90 patients, excluding CS3, who were hospitalized for acute heart failure and had a BIA measured on admission and discharge, and were divided into two groups according to systolic blood pressure on arrival at hospital: CS1 (38 patients) and CS2 (52 patients). Echocardiographic findings showed that LVEF was similar between the two groups, but LA volume was significantly higher in the CS2 group. The degree of diuretic escalation during hospitalization did not differ between the two groups. The ECW/TBW ratio at admission and discharge were not significantly different between the two groups, but the change in ETC/TBW ratio from admission to discharge was significantly lower in the CS2 group than in the CS1 group.

Free Research Field

循環器内科

Academic Significance and Societal Importance of the Research Achievements

CS2群において認められた、入院中のECW/TBWの有意な低下は、体液貯留の改善を示唆する所見と考えられた。一般的にCS1は体液のセントラルシフトが主体で体液貯留は必ずしも認められないが、CS2は全身性の体液貯留が主体であるとされており、この概念とも矛盾していない。我々の知る限り、CSの体液バランスにおける概念を定量的に示したのは今回の報告が初めてである。
本研究にて、CS1とCS2の体液貯留量のバランスに差があることが確認された。このことは心不全患者への、より的確な治療法の選択に寄与すると考えられる。今後はABPMの結果も踏まえ、心不全の各タイプにおける体液バランスについての検討も重要である。