Evaluating the Efficacy of Exercise Therapy in Combination with Noninvasive Positive Pressure Ventilation in Patients with Heart Failure

2023 Fiscal Year Final Research Report

• Project/Area Number: 21K16013
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Hokkaido University
• Principal Investigator: Kamiya Kiwamu 北海道大学, 大学病院, 助教 (60797108)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 心不全 / 大動脈弁狭窄症

Outline of Final Research Achievements

This study initially aimed to investigate the hemodynamics during exercise together with the impact of noninvasive positive pressure ventilation (NPPV) in patients with heart failure. However, due to the COVID-19 epidemic, this NPPV study did not progress satisfactorily. Therefore, we re-oriented our study on evaluating hemodynamics during exercise in patients with heart failure. We focused specifically on patients with aortic stenosis (AS), which is often associated with severe heart failure symptoms even with mild exertion. Passive leg raising + handgrip load was implemented in AS patients scheduled for TAVR. When comparing hemodynamics before and after TAVR, there was no significant difference at rest. However, when load was applied, significantly smaller increase in PCWP and a greater increase in RVSWI was recorded after TAVR than before. This suggests that in AS, heart failure symptoms are related to both, an increase in left heart PCWP and right heart function.

Free Research Field

心不全

Academic Significance and Societal Importance of the Research Achievements

心不全患者では、急性期から運動療法を含む心臓リハビリテーションを導入することが重要とされている。しかし、運動による症状増悪を来し心臓リハビリテーションが十分に進まない症例を経験する。特に、近年増加の一歩たどっており、軽労作で強い心不全症状を呈することが多い大動脈弁狭窄症(AS)の心不全患者に注目し研究を進めた。今回の研究により、AS患者の症状増悪に影響する病態に迫り、今後の心不全治療へ寄与することが期待される。