Spinal kyphosis in elderly patients with aortic valve disease

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K07387
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 52010:General internal medicine-related
• Research Institution: University of Yamanashi
• Principal Investigator: Nakamura Takamitsu 山梨大学, 大学院総合研究部, 准教授 (60377512)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 大動脈弁狭窄症 / 脊椎変形 / 骨粗鬆症 / 経カテーテル的大動脈弁留置術 / 術後合併症 / BNP / ペースメーカー

Outline of Final Research Achievements

Patients with short stature were more frequently complicated by aortic meandering. Aortic tortuosity is often difficult to catheterize during procedures such as percutaneous aortic valve implantation, and accurate preoperative assessment is desirable. However, the prevalence of aortic tortuosity and its impact on clinical outcomes in AVS patients undergoing TAVR are unknown. We measured computed tomography-based aortic tortuosity index (ATI) and examined the relationship between the ATI and clinical outcomes in 120 patients with AVS undergoing TAVR. Aortic tortuosity, as measured by the ATI, is associated with increased incidence of atrioventricular block progression requiring PMI, and less of a decrease in BNP concentration in patients with AVS undergoing TAVR. Therefore, the ATI may be useful for risk stratification in patients with AVS undergoing TAVR.

Free Research Field

動脈硬化

Academic Significance and Societal Importance of the Research Achievements

骨粗鬆症や加齢を基盤とした脊椎の変形は、大動脈の蛇行形成を促進し、大動脈弁狭窄症の進行や高齢者における大動脈弁狭窄症手術後の合併症に大きな影響を与えることが明らかになった。高齢者における術後合併症を簡便に予測できる大動脈蛇行指数（ATI)は日臨床においても有用である可能性が高い。今後は、この大動脈蛇行係数を用いて、高齢者がかかえる循環器疾患全般への影響が明らかになれば本指標の開発は高齢者医療での社会的意義は高いと考えられる。