2022 Fiscal Year Final Research Report
Development of an Accurate Prediction Method for Treatment Efficacy in Structural Heart Disease Using Exercise Cardiac Catheterization
Project/Area Number |
20K17139
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Research Category |
Grant-in-Aid for Early-Career Scientists
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Allocation Type | Multi-year Fund |
Review Section |
Basic Section 53020:Cardiology-related
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Research Institution | Hokkaido University |
Principal Investigator |
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Project Period (FY) |
2020-04-01 – 2023-03-31
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Keywords | 構造的心疾患 / 心不全 / 運動耐容能 / 心肺運動負荷試験 / 予後 |
Outline of Final Research Achievements |
The present study aimed to investigate the impact of mild-tricuspid regurgitation (TR) on the exercise capacity or clinical outcomes in patients with chronic heart failure (CHF). The study enrolled 511 consecutive patients with CHF who underwent cardiopulmonary exercise testing (CPET). The primary outcome was a composite of heart failure hospitalization and death. Patients with mild-TR or significant-TR displayed worse NHYA and reduced exercise capacity on CPET than those with non-TR, but these were more severely impaired in patients with significant-TR. Patients with significant-TR displayed a higher risk of events, while patients with mild-TR had a 3.0-fold higher risk of events than patients with non-TR. In conclusions, TR severity was associated with worse symptoms, reduced exercise capacity, and poor clinical outcomes. Even patients with mild-TR had worse clinical characteristics than those with non-TR.
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Free Research Field |
循環器内科学
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Academic Significance and Societal Importance of the Research Achievements |
本研究では、身体診察・問診、血液検査、心エコー図検査、肺動脈カテーテル、心肺運動負荷試験、予後調査を行い包括的に慢性心不全患者を評価した。心エコー図検査での三尖弁閉鎖不全症(TR)を定性的に3段階に評価することで、心エコー以外で評価した指標において、心不全症状、運動耐容能、予後との関係性を明らかにすることによって心エコーでのTR評価が、より詳細な心不全患者のリスク層別化に有用になることが明らかになった。本研究結果から、心不全患者の予後を改善するために、TRを標的とした治療法の有効性を示すようなさらなる研究が必要であることが示唆された。
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