睡眠時無呼吸症候群合併及び非合併心不全患者に対する呼吸補助療法の確立

2015 Fiscal Year Annual Research Report

• Project/Area Number: 25461061
• Research Institution: Fukushima Medical University
• Principal Investigator: 義久 精臣 福島県立医科大学, 医学部, 准教授 (40448642)
• Project Period (FY): 2013-04-01 – 2016-03-31
• Keywords: 睡眠時無呼吸症候群 / 心不全

Outline of Annual Research Achievements

研究期間中に睡眠時無呼吸症候群(SAS)と心不全に関する研究を継続的に行った。
平成27年度は、下記について報告を行った。

1) 心不全患者におけるホルター心電図によるSASスクリーニングの有用性（Respir Care. 2015: 72-80）:無呼吸イベント後に生じる一過性の心拍数上昇をホルター心電図のRR時系列データトレンドから自動検出するアルゴリズムを用いることで無呼吸イベントを検出することが可能であった。周期性心拍変動(cyclic variation of heart rate (CVHR) score: total dip数/time in bed (hours) )をとらえることで心電図情報からSASスクリーニングを行うことが可能であり、SAS重症度と良好な相関を認めた。

2) 標準的な薬物療法の存在しない左室収縮の保持された心不全(HFpEF)に対する陽圧呼吸療法の効果(Clin Cardiol. 2015: 413-21)：SAS合併HFpEF患者において、Adaptive servo ventilation治療にて6か月後に左室拡張能及び血管機能の改善を認め、心臓死および心不全再入院率が低下した（5.6% vs. 38.9%, P<0.01）。またSAS合併HFpEF患者にAdaptive servo ventilationやcontinious positive airway pressureを適正に使用することで呼吸機能、運動耐容能、予後が改善した。

Research Products

• [Journal Article] Prognostic significance of periodic leg movements during sleep in heart failure patients. (2016)
  • Author(s): Yoshihisa A, Suzuki S, Kanno Y, Takiguchi M, Sato A, Miura S, Masuda A, Yokokawa T, Shimizu T, Nakamura Y, Yamauchi H, Owada T, Abe S, Sato T, Oikawa M, Saitoh S, Takeishi Y.
  • Journal Title: Int J Cardiol Volume: 212 Pages: 11-13
  • DOI: 10.1016/j.ijcard.2016.03.007.
  • Peer Reviewed
• [Journal Article] Beneficial effects of positive airway pressure therapy for sleep-disordered breathing in heart failure patients with preserved left ventricular ejection fraction (2015)
  • Author(s): Yoshihisa A, Suzuki S, Yamauchi H, Sato T, Oikawa M, Kobayashi A, Yamaki T, Sugimoto K, Kunii H, Nakazato K, Suzuki H, Saitoh S, Takeishi Y.
  • Journal Title: Clin Cardiol Volume: ３８ Pages: 413-21
  • DOI: 10.1002/clc.22412.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Cyclic variation in heart rate score by holter electrocardiogram as screening for sleep-disordered breathing in subjects with heart failure (2015)
  • Author(s): Shimizu T, Yoshihisa A, Iwaya S, Abe S, Sato T, Suzuki S, Yamaki T, Sugimoto K, Kunii H, Nakazato K, Suzuki H, Saitoh S, Takeishi Y.
  • Journal Title: Resp Care Volume: 60 Pages: 72-80
  • DOI: 10.4187/respcare.03341.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Impact of sleep-disordered breathing on myocardial damage and metabolism in patients with chronic heart failure (2015)
  • Author(s): Miyata M, Yoshihisa A, Yamauchi H, Owada T, Sato T, Suzuki S, Sugimoto K, Yamaki T, Kunii H, Nakazato K, Suzuki H, Saitoh S, Takeishi
  • Journal Title: Heart Vessels Volume: 30 Pages: 318-324
  • DOI: 10.1007/s00380-014-0479-6.
  • Peer Reviewed / Acknowledgement Compliant
• [Presentation] Impact of n-3 polyunsaturated fatty acids on mortality of patients with hospitalized heart failure patients. (2015)
  • Author(s): Watanabe S, Yoshihisa A, Kanno Y, Takiguchi M, Miura S, Sato A, Shimizu T, Nakamura Y, Yamauchi H, Owada T, Abe S, Suzuki S, Oikawa M, Sakamoto N, Yamaki T, Sugimoto K, Kunii H, Nakazato K, Suzuki H, Saitoh S, Takeishi Y:
  • Organizer: Scientific Sessions of American Heart Association 2015
  • Place of Presentation: Orland, USA
  • Year and Date: 2015-11-07 – 2015-11-11
  • Int'l Joint Research
• [Presentation] Impact of serum uric acid on mortality in heart failure with preserved ejection fraction. (2015)
  • Author(s): Shimizu T, Yoshihisa A, Takiguchi M, Miura S, Sato A, Nakamura Y, Yamauchi H, Owada T, Abe S, Suzuki S, Oikawa M, Yamaki T, Sugimoto K, Kunii H, Nakazato K, Suzuki H, Saitoh S, Takeishi Y
  • Organizer: Scientific Sessions of American Heart Association 2015
  • Place of Presentation: Orland, USA
  • Year and Date: 2015-11-07 – 2015-11-11
  • Int'l Joint Research
• [Presentation] Prognostic impact of periodic leg movements in hospitalized heart failure patients. (2015)
  • Author(s): Kanno Y, Yoshihisa A, Takiguchi M, Miura S, Sato A, Shimizu T, Nakamura Y, Yamauchi H, Owada T, Abe S, Suzuki S, Oikawa M, Sakamoto N, Yamaki T, Sugimoto K, Kunii H, Nakazato K, Suzuki H, Saitoh S, Takeishi Y
  • Organizer: Scientific Sessions of American Heart Association 2015
  • Place of Presentation: Orland, USA
  • Year and Date: 2015-11-07 – 2015-11-11
  • Int'l Joint Research
• [Presentation] The association between plasma levels of anti-angiogenic isoform of vascular endothelial growth factor and clinical profiles of peripheral artery disease. (2015)
  • Author(s): Sato A, Yoshihisa A, Kanno Y, Takiguchi M, Miura S, Shimizu T, Nakamura Y, Yamauchi H, Owada T, Abe S, Suzuki S, Oikawa M, Sakamoto N, Yamaki T, Sugimoto K, Kunii H, Nakazato K, Suzuki H, Saitoh S, Takeishi Y
  • Organizer: Scientific Sessions of American Heart Association 2015
  • Place of Presentation: Orland, USA
  • Year and Date: 2015-11-07 – 2015-11-11
  • Int'l Joint Research
• [Presentation] The CHA2DS2-VASc score predicts high mortality in hospitalized heart failure patients. (2015)
  • Author(s): Watanabe S, Yoshihisa A, Kanno Y, Takiguchi M, Miura S, Sato A, Shimizu T, Nakamura Y, Yamauchi H, Owada T, Abe S, Suzuki S, Oikawa M, Sakamoto N, Yamaki T, Sugimoto K, Kunii H, Nakazato K, Suzuki H, Saitoh S, Takeishi Y
  • Organizer: Scientific Sessions of American Heart Association 2015
  • Place of Presentation: Orland, USA
  • Year and Date: 2015-11-07 – 2015-11-11
  • Int'l Joint Research
• [Book] Heart View 診療ツールとしてのバイオマーカーを識る (2015)
  • Author(s): 鈴木 聡, 義久精臣, 竹石恭知
  • Total Pages: 44-48
  • Publisher: メジカルビュー社
• [Book] HEART nursing SASまるわかりノート (2015)
  • Author(s): 義久精臣, 鈴木 聡, 竹石恭知
  • Total Pages: 92-99
  • Publisher: メディカ出版
• [Book] 循環器内科 循環器疾患と交感神経系 睡眠呼吸障害と交感神経系. (2015)
  • Author(s): 義久精臣, 鈴木 聡, 竹石恭知
  • Total Pages: 477-484
  • Publisher: 科学評論社
• [Book] 循環器内科 循環器疾患と睡眠呼吸障害 不整脈と睡眠呼吸障害 (2015)
  • Author(s): 義久精臣, 鈴木 聡, 竹石恭知
  • Total Pages: 141-146
  • Publisher: 科学評論社
• [Book] 医学のあゆみ 睡眠呼吸障害と心不全 (2015)
  • Author(s): 義久精臣, 竹石恭知
  • Total Pages: 490-494
  • Publisher: 医歯薬出版株式会社
• [Remarks] 福島県立医科大学 研究者ホームページ
  • URL: http://www.fmu.ac.jp/kenkyu/Profiles/15/0001471/profile.html