2013 Fiscal Year Research-status Report
メタボリック症候群を基盤とする非虚血性慢性心不全の病態解明と疾患概念の確立
Project/Area Number |
24591055
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Research Institution | Hiroshima University |
Principal Investigator |
木原 康樹 広島大学, 医歯薬保健学研究院(医), 教授 (40214853)
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Keywords | メタボリック症候群 / 心筋障害 / 心不全 / ミトコンドリア |
Research Abstract |
メタボリック症候群(内蔵肥満)に合併したうっ血性心不全患者の入院が増加しており、65歳以下の男性では心不全入院全体の7割近くを占めている。それら患者の2/3は虚血性心不全であるが残りの1/3は非虚血性であり、後者における心筋障害の原因は不明である。本研究はメタボリック症候群に合併する非虚血性心不全の本態が、「脂質過剰に起因する心筋ミトコンドリア代謝異常である」との仮説をSPECTやMRSを用いて臨床的に検討するとともに、経カテーテル的に得た心筋生検標本における遺伝子発現と免疫組織学的検索により直接の証明を試み、新たな疾患概念として「メタボリック心筋症」を検証する。65歳以下の男性でうっ血性心不全のため初回入院した患者を対象とする。冠動脈造影検査にて冠動脈疾患が否定された者をメタボリック症候群(日本動脈硬化学会等による診断基準2005年に拠る)の有無により、メタボリック群と非メタボリック群に分類する。臨床検査として123I-MIBG心筋SPECTによる脂肪酸代謝、MR Spectroscopyによる心筋脂肪酸代謝、心臓エコー検査による左室形態の定量的評価、心臓カテーテル検査による血行動態評価と心内膜下心筋生検を施行する。次いで心筋生検標本を用いた組織学的・分子生物学的検討を行い、ミトコンドリアのマスタースイッチであるERR-α/PCG-1シグナルを受けてMitDNA転写を直接制御していることを示し、Endonucrease Gの異常活性化仮説を証明する。
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Current Status of Research Progress |
Current Status of Research Progress
2: Research has progressed on the whole more than it was originally planned.
Reason
対象患者をリクルートするため広島市内7基幹病院(広島市立安佐市民病院 土手慶五循環器内科主任部長、広島市立広島市民病院 井上一郎循環器内科主任部長、広島赤十字・原爆病院 岡田武規循環器内科部長、あかね会土谷総合病院 塩出宣雄循環器内科部長、JA広島総合病院 藤井隆循環器内科部長、県立広島病院 上田浩徳循環器内科部長、広島鉄道病院 寺川宏樹循環器内科部長)が研究協力者として参画している。研究に同意の得られた患者は広島大学病院循環器内科に転院し、インフォームドコンセントと文書による同意を確認後検討を行う。各群20名を目標としているが、現在10名のレジストレーションを終了することができた。
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Strategy for Future Research Activity |
対象症例20例の目標を達成し、その臨床評価・循環器的検索パラメターを明確にする。対象から得た心筋生検標本を用いて、免疫染色、電子顕微鏡的形態把握、PCRによる遺伝子発現状態の定量化を勧める。
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Expenditure Plans for the Next FY Research Funding |
予定した対象数に達しなかったために、それに費やす金額の執行が遅れた。 対象数を目標20例まで増加させることに集中し、予定の執行額を使用する。併せて分子生物学的評価の解析を実施する。
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Research Products
(113 results)
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[Journal Article] Rho-associated kinase activity is a predictor of cardiovascular outcomes.2014
Author(s)
Kajikawa M, Noma K, Maruhashi T, Mikami S, Iwamoto Y, Iwamoto A, Matsumoto T, Hidaka T, Kihara Y, Chayama K, Nakashima A, Goto C, Liao JK, Higashi Y.
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Journal Title
Hypertension.
Volume: 63(4)
Pages: 856-64
DOI
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[Journal Article] Clinical outcomes and causes of death in Japanese patients with long-term inferior vena cava filter implants and deep vein thrombosis.2014
Author(s)
Iwamoto Y, Okamoto M, Hashimoto M, Fukuda Y, Uchimura Y, Iwamoto A, Matsumoto T, Iwasaki T, Kinoshita H, Ueda H, Kihara Y.
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Journal Title
J Cardiol.
Volume: in press
Pages: in press
DOI
Peer Reviewed
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[Journal Article] Prognostic value of coronary artery calcium and epicardial adipose tissue assessed by non-contrast cardiac computed tomography.2014
Author(s)
Kunita E, Yamamoto H, Kitagawa T, Ohashi N, Oka T, Utsunomiya H, Urabe Y, Tsushima H, Awai K, Budoff MJ, Kihara Y.
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Journal Title
Atherosclerosis.
Volume: 233
Pages: 447-53
DOI
Peer Reviewed
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[Journal Article] Poor oral health, that is, decreased frequency of tooth brushing, is associated with endothelial dysfunction.2014
Author(s)
Kajikawa M, Nakashima A, Maruhashi T, Iwamoto Y, Iwamoto A, Matsumoto T, Hidaka T, Kihara Y, Chayama K, Goto C, Taguchi A, Noma K, Higashi Y.
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Journal Title
Circ J.
Volume: 78
Pages: 950-4
DOI
Peer Reviewed
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[Journal Article] Deterioration of the circadian variation of heart rate variability in Brugada syndrome may contribute to the pathogenesis of ventricular fibrillation.2014
Author(s)
Tokuyama T, Nakano Y, Awazu A, Uchimura-Makita Y, Fujiwra M, Watanabe Y, Sairaku A, Kajihara K, Motoda C, Oda N, Kihara Y.
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Journal Title
J Cardiol.
Volume: in press
Pages: in press
DOI
Peer Reviewed
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[Journal Article] Prediction of atrial fibrillation after off-pump coronary artery bypass grafting using preoperative total atrial conduction time determined on tissue Doppler imaging.2013
Author(s)
Fujiwara M, Nakano Y, Hidaka T, Oda N, Uchimura Y, Sairaku A, Kajihara K, Tokuyama T, Motoda C, Watanabe Y, Ikenaga H, Imai K, Sueda T, Kihara Y.
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Journal Title
Circ J.
Volume: 78
Pages: 345-52
DOI
Peer Reviewed
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[Journal Article] Hyperuricemia is independently associated with endothelial dysfunction in postmenopausal women but not in premenopausal women.2013
Author(s)
Maruhashi T, Nakashima A, Soga J, Fujimura N, Idei N, Mikami S, Iwamoto Y, Kajikawa M, Matsumoto T, Hidaka T, Kihara Y, Chayama K, Goto C, Noma K, Tomiyama H, Takase B, Yamashina A, Higashi Y.
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Journal Title
BMJ Open.
Volume: 3
Pages: 3659
DOI
Peer Reviewed
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[Journal Article] Relationship between flow-mediated vasodilation and cardiovascular risk factors in a large community-based study.2013
Author(s)
Maruhashi T, Soga J, Fujimura N, Idei N, Mikami S, Iwamoto Y, Kajikawa M, Matsumoto T, Hidaka T, Kihara Y, Chayama K, Noma K, Nakashima A, Goto C, Tomiyama H, Takase B, Yamashina A, Higashi Y.
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Journal Title
Heart.
Volume: 99
Pages: 1837-42
DOI
Peer Reviewed
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[Journal Article] Double-blind, placebo-controlled clinical trial with a rho-kinase inhibitor in pulmonary arterial hypertension.2013
Author(s)
Fukumoto Y, Yamada N, Matsubara H, Mizoguchi M, Uchino K, Yao A, Kihara Y, Kawano M, Watanabe H, Takeda Y, Adachi T, Osanai S, Tanabe N, Inoue T, Kubo A, Ota Y, Fukuda K, Nakano T, Shimokawa H.
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Journal Title
Circ J.
Volume: 77
Pages: 2619-25
DOI
Peer Reviewed
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[Journal Article] A novel noninvasive and simple method for assessment of endothelial function: enclosed zone flow-mediated vasodilation (ezFMD) using an oscillation amplitude measurement.2013
Author(s)
Idei N, Ukawa T, Kajikawa M, Iwamoto Y, Fujimura N, Maruhashi T, Mikami S, Matsumoto T, Kihara Y, Chayama K, Noma K, Nakashima A, Takayanagi T, Morimoto H, Tsuji T, Higashi Y.
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Journal Title
Atherosclerosis.
Volume: 229
Pages: 324-30
DOI
Peer Reviewed
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[Journal Article] Variable procedural strategies adapted to anatomical characteristics in catheter ablation of the cavotricuspid isthmus using a preoperative multidetector computed tomography analysis.2013
Author(s)
Kajihara K, Nakano Y, Hirai Y, Ogi H, Oda N, Suenari K, Makita Y, Sairaku A, Tokuyama T, Motoda C, Fujiwara M, Watanabe Y, Kiguchi M, Kihara Y.
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Journal Title
J Cardiovasc Electrophysiol.
Volume: 24
Pages: 1344-51
DOI
Peer Reviewed
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[Journal Article] Longitudinal extent of lipid pool assessed by optical coherence tomography predicts microvascular no-reflow after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.2013
Author(s)
Ikenaga H, Ishihara M, Inoue I, Kawagoe T, Shimatani Y, Miura F, Nakama Y, Dai K, Ohtani T, Ohi K, Miki T, Nakamura M, Kishimoto S, Sumimoto Y, Kihara Y.
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Journal Title
J Cardiol.
Volume: 62
Pages: 71-6
DOI
Peer Reviewed
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[Journal Article] Nitroglycerine-induced vasodilation for assessment of vascular function: a comparison with flow-mediated vasodilation.2013
Author(s)
Maruhashi T, Soga J, Fujimura N, Idei N, Mikami S, Iwamoto Y, Kajikawa M, Matsumoto T, Hidaka T, Kihara Y, Chayama K, Noma K, Nakashima A, Goto C, Higashi Y.
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Journal Title
Arterioscler Thromb Vasc Biol.
Volume: 33
Pages: 1401-8
DOI
Peer Reviewed
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[Journal Article] Appearance of neointima according to stent type and restenotic phase: analysis by optical coherence tomography.2013
Author(s)
Goto K, Takebayashi H, Kihara Y, Hagikura A, Fujiwara Y, Kikuta Y, Sato K, Kodama S, Taniguchi M, Hiramatsu S, Haruta S.
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Journal Title
EuroIntervention.
Volume: 9
Pages: 601-7
DOI
Peer Reviewed
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[Journal Article] Left atrial thickness under the catheter ablation lines in patients with paroxysmal atrial fibrillation: insights from 64-slice multidetector computed tomography.2013
Author(s)
Suenari K, Nakano Y, Hirai Y, Ogi H, Oda N, Makita Y, Ueda S, Kajihara K, Tokuyama T, Motoda C, Fujiwara M, Chayama K, Kihara Y.
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Journal Title
Heart Vessels.
Volume: 28
Pages: 360-8
DOI
Peer Reviewed
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[Presentation] Nonsynonymous Polymorphism in Semaphorin 3A is a New Genetic Risk Factor for Human Idiopathic Ventricular Fibrillation2014
Author(s)
Y.Nakano, M.Toshisige, H.Ochi, T.Tokuyama, A.Sairaku, N.Oda, K.Kajiahara, Y.Uchimura, M.Fujiwara, Y.Watanabe, H.Kawazoe, C.Motoda, M.Matumura, N.Oda, T.Aiba, H.Watanabe, W.Schimizu, M.Horie, N.Makita, K.Chayama, Y.Kihara
Organizer
The 78th Annual Scientific Meeting of the Japanese Circulation Society
Place of Presentation
東京
Year and Date
20140321-20140323
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[Presentation] Poor Oral Health Behavior is Associated with Endothelial Dysfunction2014
Author(s)
M.Kajikawa, Y.Higashi, A.Nakashima, Y.Iwamoto, T.Matsumoto, A.Iwamoto, T.Maruhashi, T.Hidaka, K.Noma, A.Taguchi, Y.Kihara
Organizer
The 78th Annual Scientific Meeting of the Japanese Circulation Society
Place of Presentation
東京
Year and Date
20140321-20140323
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[Presentation] Durations and Temperature Management for Comatose Survivors of Cardiac Arrest Treated with or without Percutaneous Coronary Intervention2014
Author(s)
E.Kagawa, K.Dote, M.Kato, S.Sasaki, N.Oda, Y.Nakano, Y.Sumimoto, H.Honda, Y.Takaeko, I.Inoue, T.Kawagoe, M.Ishihara, Y.Kihara
Organizer
The 78th Annual Scientific Meeting of the Japanese Circulation Society
Place of Presentation
東京
Year and Date
20140321-20140323
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[Presentation] Smoking and DNA Damage2014
Author(s)
M.Ishida, T.Ishida, Y.Kihara, M.Yoshizumi
Organizer
The 78th Annual Scientific Meeting of the Japanese Circulation Society
Place of Presentation
東京
Year and Date
20140321-20140323
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[Presentation] Differentiations of Transition of the Thoracic Impedance According to Excessive Fluid Volume of Patient with Decompensated Heart Failure2014
Author(s)
N.Oda, Y.Nakano, Y.Takaeko, H.Honda, K.Miura, A.Yamane, Y.Sumimoto, Y.Nakano, E.Kagawa, S.Sasaki, M.Kato, K.Nishioka, H.Ueda, N.Shiode, H.Teragawa, K.Dote, Y.Kihara
Organizer
The 78th Annual Scientific Meeting of the Japanese Circulation Society
Place of Presentation
東京
Year and Date
20140321-20140323
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[Presentation] Left Atrial Mechanical and Substrate Abnormality Assessed by Three-dimensional Echocardiography and Electroanatomical Mapping System in Patients with Paroxysmal Atrial Fibrillation2014
Author(s)
Y.Watanabe, Y.Nakano, N.Oda, M.Matsumura, H.Kawazoe ,M.Fujiwara, A.Motoda, T.Tokuyama, A.Sairaku, Y.Uchimura, T.Hidaka ,Y.Kihara
Organizer
The 78th Annual Scientific Meeting of the Japanese Circulation Society
Place of Presentation
東京
Year and Date
20140321-20140323
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[Presentation] Nonsynonymous Polymorphism in Semaphorin 3A as a Risk Factor for Human Unexplained Cardiac Arrest With Documented Ventricular Fibrillation2013
Author(s)
Y.Nakano,K.Chayama,H.Ochi,M.Toshishige,T.Tokuyama,N.Oda,Y.Uchimura(Makita),K.Kajihara,A.Sairaku,C.Motoda,M.Fujiwara,Y.Watanabe,H.Kawazoe,H.Ikenaga,S.Matsumoto,N.Oda,K.Suenari,Y.Yoshida,K.Ohkubo,I.Watanabe,A.Nogami,H.Watanabe,K.Hasegawa,T.Aiba,S.Ohno,W.Shimizu,M.Horie,S.Tashiro,N.Makita,Y.Kihara
Organizer
Scientific Sessions 2013 American Heart Association
Place of Presentation
Dallas, Texas,USA
Year and Date
20131116-20131120
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[Presentation] Left Atrial Mechanical and Substrate Abnormalities Assessed by Three-Dimensional Speckle-Tracking Echocardiography and Electroanatomical Mapping System in Patients With Paroxysmal Atrial Fibrillation2013
Author(s)
Y.Watanabe,Y.Nakano,M.Matsumoto,N.Oda,H.Kawazoe,M.Fujiwara,A.Motoda,T.Tokuyama,A.Sairaku,T.Hidaka,Y.Kihara
Organizer
Scientific Sessions 2013 American Heart Association
Place of Presentation
Dallas, Texas,USA
Year and Date
20131116-20131120
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[Presentation] Peripheral Augmentation Index is an Index of not Only Arterial Stiffness but Also Endothelial Function2013
Author(s)
T.Matsumoto,Y.Higashi,A.Iwamoto,M.Kajikawa,Y.Iwamoto,S.Mikami,T.Maruhashi,T.Hidaka,A.Nakashima,K.Noma,Y.Kihara
Organizer
Scientific Sessions 2013 American Heart Association
Place of Presentation
Dallas, Texas,USA
Year and Date
20131116-20131120
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[Presentation] Calcium Deposits in Heart Valves and Aortic Root, Cardiovascular Risk Factors, Subclinical Coronary Atherosclerosis, and the Risk of Future Cardiovascular Events2013
Author(s)
H.Utsunomiya,H.Yamamoto,H.Tsushima,Y.Urabe,T.Maruhashi,K.Ishibashi,N.Mitsuba,T.Kitagawa,T.Hidaka,Y.Dohi,S.Kurisu,Y.Nakano,T.Ishida,Y.Kihara
Organizer
Scientific Sessions 2013 American Heart Association
Place of Presentation
Dallas, Texas,USA
Year and Date
20131116-20131120
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[Presentation] Variable Procedural Strategies Adapted to Anatomical Characteristics in Catheter Ablation of the Cavotricuspid Isthmus Using a Preoperative Multidetector Computed Tomography Analysis2013
Author(s)
K.Kajihara,Y.Nakano,Y.Makita,A.Sairaku,T.Tokuyama,C.Motoda,M.Fujiwara,Y.Watanabe,N.Oda,Y.Kihara
Organizer
Scientific Sessions 2013 American Heart Association
Place of Presentation
Dallas, Texas,USA
Year and Date
20131116-20131120
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[Presentation] Time-Domain T-Wave Alternans in Lead V2 is Useful for Predicting Ventricular Arrhythmias in Patients With Brugada Syndrome2013
Author(s)
Y.Uchimura(Makita),Y.Nakano,A.Sairaku,T.Tokuyama,M.Fujiwara,Y.Watanabe,H.Kawazoe,M.Matsumura.N.Oda,Y.Kihara
Organizer
Scientific Sessions 2013 American Heart Association
Place of Presentation
Dallas, Texas,USA
Year and Date
20131116-20131120
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[Presentation] Prognostic Value of Coronary Artery Calcium and Epicardial Adipose Tissue Assessed by Non-contrast Computed Tomography2013
Author(s)
Yamamoto H, Kunita E, Toshiro K, Utsunomiya H, Urabe U, Tsushima H, Kihara Y, Budoff MJ
Organizer
The 8th Scientific Sessions, Society of Cardiovascular Computed Tomography
Place of Presentation
Montréal, Canada,
Year and Date
20130719-20130719
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[Presentation] Uninterrupted Anticoagulation with Warfarin or Dabigatran for Periprocedural Anticoagulation in Patients Undergoing Ablation for Atrial Fibrillation.2013
Author(s)
Y.Nakano,N.Oda,K.Kajihara,T.Tokuyama,M.Fujiwara,Y.Watanabe,H.Kawazoe,H.Ikenaga,A.Sairaku,Y.Uchimura,C.Motoda,Y.Kihara
Organizer
The 28th Annual Meeting of the Japanese Heart Rhythm Society
Place of Presentation
東京
Year and Date
20130704-20130706
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