末梢型慢性血栓塞栓性肺高血圧症に対する新たな治療法の確立

2014 Fiscal Year Annual Research Report

• Project/Area Number: 24591032
• Research Institution: Tohoku University
• Principal Investigator: 杉村 宏一郎 東北大学, 大学病院, 助教 (60375079)
• Co-Investigator(Kenkyū-buntansha): 福本 義弘 久留米大学, 医学部, 教授 (70363372)
• Project Period (FY): 2012-04-01 – 2015-03-31
• Keywords: 経皮的肺動脈形成術 / 光干渉断層法 / 慢性血栓塞栓性肺高血圧症

Outline of Annual Research Achievements

慢性血栓塞栓性肺高血圧症（CTEPH）は、予後不良の疾患であり治療法の確立が必要とされている。われわれは、カテーテルを用いた肺動脈形成術(PTPA) による治療を確立し、その効果の機序を解明することを目標に研究に取り組んできた。ガイドワイヤー、バルーンカテーテルを使用することで行うPTPAの重大な合併症として血管損傷、再灌流障害に伴う肺水腫、喀血が問題としてあり、死亡報告もあることから克服するべき課題である。そこで、我々は、一手技を小領域にとどめ、回数を重ねて治療する方針でPTPAを行い、なおかつ、光干渉断層法（OCT）による詳細な病変の観察を行うことで合併症の克服を試みた。OCTは肺動脈での病変の観察に有用であることを報告してきた(Visualization of complete regression of pulmonary arterial remodeling on optical coherence tomography in a patient with pulmonary arterial hypertension.2014;78(11):2771)。そして、OCTを利用したPTPAの、治療効果をMRIで見た結果を2014年アメリカ心臓病学会議 (AHA 2014)2014.11.15-11.19: Chicago, USAで報告した（Percutaneous transluminal pulmonary angioplasty improves hemodynamics and right ventricular function in patients with chronic thromboembolic pulmonary hypertension -One year follow-up study.）。また、カテーテル中に採取した血液検体より、CTEPHでは血小板の活性化が診られることを英文誌に報告した（ Platelets are highly activated in patients of chronic thromboembolic pulmonary hypertension. Arterioscler Thromb Vasc Biol. 34:2486-2494,2014.）。

Research Products

• [Journal Article] Platelets are highly activated in patients of chronic thromboembolic pulmonary hypertension (2014)
  • Author(s): Yaoita N, Shirakawa R, Fukumoto Y, Sugimura K, Miyata S, Miura Y, Nochioka K, Miura M, Tatebe S, Aoki T, Yamamoto S, Satoh K, Kimura T, Shimokawa H, Horiuchi H.
  • Journal Title: Arterioscler Thromb Vasc Biol Volume: ３４ Pages: 2486-94
  • DOI: 10.1161/ATVBAHA.114.304404
  • Peer Reviewed
• [Journal Article] OCT imaging for the management of pulmonary hypertension (2014)
  • Author(s): Dai Z, Fukumoto Y, Tatebe S, Sugimura K, Miura Y, Nochioka K, Aoki T, Miyamichi-Yamamoto S, Yaoita N, Satoh K, Shimokawa H
  • Journal Title: JACC Cardiovasc Imaging Volume: ７ Pages: 843-5
  • DOI: 10.1016/j.jcmg.2014.01.020
  • Peer Reviewed
• [Journal Article] Visualization of complete regression of pulmonary arterial remodeling on optical coherence tomography in a patient with pulmonary arterial hypertension (2014)
  • Author(s): Dai Z, Sugimura K, Fukumoto Y, Tatebe S, Miura Y, Nochioka K, Aoki T, Miyamichi-Yamamoto S, Yaoita N, Satoh K, Shimokawa H.
  • Journal Title: Circ J Volume: ７８ Pages: 2771-3
  • Peer Reviewed
• [Presentation] Novel Role of Platelets in the Pathogenesis of Chronic Thromboembolic Pulmonary Hypertension (2014)
  • Author(s): Nobuhiro Yaoita, Yoshihiro Fukumoto, Shunsuke Tatebe, Saori Yamamoto, Tatsuo Aoki, Masanobu Miura, Kotaro Nochioka, Koichiro Sugimura, Kimio Satoh, Hisanori Horiuchi, Hiroaki Shimokawa
  • Organizer: American Heart Association Scientific Sessions
  • Place of Presentation: Chicago, USA
  • Year and Date: 2014-11-15 – 2014-11-19
• [Presentation] Percutaneous Transluminal Balloon Angioplasty Ameliorates Metabolic and Renal Dysfunctions Associated with Hemodynamic Improvement in Patients with Chronic Thromboembolic Pulmonary Hypertension (2014)
  • Author(s): Shunsuke Tatebe, Koichiro Sugimura, Kotaro Nochioka, Masanobu Miura, Saori Yamamoto, Nobuhiro Yaoita, Haruka Sato, Kimio Satoh, Hiroaki Shimokawa
  • Organizer: American Heart Association Scientific Sessions
  • Place of Presentation: Chicago, USA
  • Year and Date: 2014-11-15 – 2014-11-19
• [Presentation] Percutaneous Transluminal Pulmonary Angioplasty Improves Hemodynamics and Right Ventricular Function in Patients with Chronic Thromboembolic Pulmonary Hypertension One Year Follow-up Study (2014)
  • Author(s): Masanobu Miura, Koichiro Sugimura, Kotaro Nochioka, Tatsuo Aoki, Shunsuke Tatebe, Saori Yamamoto, Hironobu Yaoita, Haruka Sato, Kimio Sato, Hiroaki Shimokawa
  • Organizer: American Heart Association Scientific Sessions
  • Place of Presentation: Chicago, USA
  • Year and Date: 2014-11-15 – 2014-11-19
• [Presentation] 肺高血圧症における右不全 (2014)
  • Author(s): 杉村宏一郎
  • Organizer: 心不全学会学術集会
  • Place of Presentation: 大阪市
  • Year and Date: 2014-10-10 – 2014-10-12
  • Invited
• [Presentation] 慢性血栓塞栓性肺高血圧症に対する経皮的肺動脈形成術と右室機能に関する検討 (2014)
  • Author(s): 三浦正暢 杉村宏一郎 後岡広太郎 青木竜男
  • Organizer: 日本心臓病学会
  • Place of Presentation: 仙台市
  • Year and Date: 2014-09-26 – 2014-09-28
• [Presentation] 慢性肺血栓塞栓性肺高血圧症に対する薬物療法の効果 (2014)
  • Author(s): 青木竜男、杉村宏一郎、佐藤遥、矢尾板信裕、山本沙織、建部俊介、三浦正暢、後岡広太郎、佐藤 遥、佐藤公雄、下川宏明
  • Organizer: 日本心臓病学会
  • Place of Presentation: 仙台市
  • Year and Date: 2014-09-26 – 2014-09-28
• [Presentation] Percutaneous Transluminal Pulmonary Angioplasty Improves Right Ventricular Function in Patients with Inoperable Chronic Thromboembolic Pulmonary Hypertension (2014)
  • Author(s): Masanobu Miura, Koichiro Sugimura, Kotaro Nochioka, Syunsuke Tatebe, Saori Yamamoto,
  • Organizer: European Society of Cardiology Congress
  • Place of Presentation: Barcelona, Spain
  • Year and Date: 2014-08-30 – 2014-09-03
• [Presentation] Usefulness of Optical Coherence Tomography Imaging in Chronic Thromboembolic Pulmonary Hypertension (2014)
  • Author(s): Koichiro Sugimura, Kotaro Nochioka, Syunsuke Tatebe, Saori Yamamoto, Masanobu Miura, Takeshi Kato, Kimio Satoh, Hiroaki Shimokawa
  • Organizer: European Society of Cardiology Congress
  • Place of Presentation: Barcelona, Spain
  • Year and Date: 2014-08-30 – 2014-09-03
• [Presentation] Usefulness of Optical Coherence Tomography Imaging for Percutaneous Transluminal Pulmonary Angioplasty in Patients with Chronic Thromboembolic Pulmonary Hypertension (2014)
  • Author(s): Koichiro Sugimura, Kotaro Nochioka, Syunsuke Tatebe, Saori Yamamoto, Masanobu Miura, Takeshi Kato, Kimio Satoh, Hiroaki Shimokawa
  • Organizer: Japanese Association of Cardiovascular Intervention and Therapeutics
  • Place of Presentation: 名古屋市
  • Year and Date: 2014-07-24 – 2014-07-26
  • Invited
• [Presentation] Usefulness of Optical Coherence Tomography for Diagnosis and Treatment in Patients with Chronic Thromboembolic Pulmonary Hypertension (2014)
  • Author(s): Koichiro Sugimura, Yoshihiro Fukumoto, Yutaka Miura, Kotaro Nochioka, Tatsuo Aoki, Shunsuke Tatebe, Saori Yamamoto, Kimio Satoh, Hiroaki Shimokawa
  • Organizer: International Vascular Biology Meeting
  • Place of Presentation: 京都市
  • Year and Date: 2014-04-14 – 2014-04-17
• [Remarks] 東北大学大学院循環器内科学 東北大学病院循環器内科
  • URL: http://www.cardio.med.tohoku.ac.jp/index.html