Impact of Culprit Plaque Tissue and Microvascular Embolization on Reperfusion Injury and Development of Optimal Interventional Procedures

2016 Fiscal Year Annual Research Report

• Project/Area Number: 26461075
• Research Institution: Kumamoto University
• Principal Investigator: 辻田 賢一 熊本大学, 大学院生命科学研究部(医), 教授 (60571263)
• Project Period (FY): 2014-04-01 – 2017-03-31
• Keywords: 再灌流障害 / 微小循環障害 / 冠動脈プラーク

Outline of Annual Research Achievements

本研究を通して、まず、冠微小血管抵抗：hMRが、冠微小循環障害の評価に耐えうるかの検証研究を行った。結果、hMRが、従来指標の冠血流予備能：CFRや冠血流予備量比：FFRに比し、より鋭敏に冠微小循環障害を評価しうる事、また、プラーク不安定性が増した場合にhMRの上昇を来しやすい事が明らかになった。さらに、左室肥大の程度に相関してhMRの増加がみられること、また全身性の内皮機能障害および微小循環障害指標と考えられる推定糸球体濾過量と有意に負の相関を認めることが明らかになった。
また治療介入としては、不安定プラークが検出された際、フィルトラップなどのデバイスを事前使用することで、この再灌流障害に伴うno reflow/slow flowを低減させうることも明らかになった。冠動脈インターベンションの前治療として、当科が有効性をすでに発表しているニコランジルやプラークの安定化を促進させる脂質低下療法を先行させることで、これらの再灌流障害を低減させるメカニズムは、やはり責任病変プラークの安定化が主要な要因であることが推察された。またこの研究の過程で、左室肥大を呈する心筋症においても、この冠微小循環障害が存在し、心機能低下の要因となり得る事も判明し、心不全パンデミックが喫緊の課題であるが、心不全対策の切り札として、今後の研究課題が浮かび上がってきた。本研究データをもとに、今後更なる冠微小循環研究の発展が大きく期待される。

Research Products

• [Journal Article] Lenvatinib, an oral multi-kinases inhibitor, -associated hypertension: Potential role of vascular endothelial dysfunction (2017)
  • Author(s): Sueta D, Suyama K, Sueta A, Tabata N, Yamashita T, Tomiguchi M, Takeshita T, Yamamoto-Ibusuki M, Yamamoto E, Izumiya Y, Kaikita K, Yamamoto Y, Hokimoto S*, Iwase H and Tsujita K
  • Journal Title: Atherosclerosis Volume: in press Pages: in press
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Identification and Assessment of Cardiac Amyloidosis by Myocardial Strain Analysis of Cardiac Magnetic Resonance Imaging (2017)
  • Author(s): Oda S*, Utsunomiya D, Nakaura T, Yuki H, Kidoh M, Morita K, Takashio S, Yamamuro M, Izumiya Y, Hirakawa K, Ishida T, Tsujita K, Ueda M, Yamashita T, Ando Y, Hata H, Yamashita Y
  • Journal Title: Circ J Volume: in press Pages: in press
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Identification and assessment of cardiac amyloidosis by myocardial strain analysis of cardiac magnetic resonance imaging (2017)
  • Author(s): Oda S, Utsunomiya D, Nakaura T, Yuki H, Kidoh M, Morita K, Tkashio S, Yamamuro M, Izumiya Y, Hirakawa K, Ishida T, Tsujita K, Ueda M, Yamashita T, Ando Y, Hata H, Yamashita Y
  • Journal Title: Circ J Volume: in press Pages: in press
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Correlation between microvascular dysfunction and B-type natriuretic peptide levels in non-ischemic heart failure patients with cardiac fibrosis (2017)
  • Author(s): Hirakawa K, Yamamuro M*, Uemura T, Takashio S, Kaikita K, Utsunomiya D, Nakayama M, Yamamoto E, Yamashita Y, Hokimoto S, Tsujita K
  • Journal Title: Int J Cardiol Volume: in press Pages: in press
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Reduced trans-mitral A-wave velocity predicts the presence of wild-type transthyretin amyloidosis in elderly patients with left ventricular hypertrophy (2016)
  • Author(s): Yamamura S, Izumiya Y*, Ishida T, Onoue Y, Kimura Y, Hanatani S, Araki S, Fujisue K, Sueta D, Kanazawa H, Takashio S, Usuku H, Sugamura K, Sakamoto K, Yamamoto E, Yamamuro M, Yasuda H, Kojima S, Kaikita K, Hokimoto S, Ogawa H, Tsujita K
  • Journal Title: Heart Vessels Volume: 23 Pages: 1-6
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Helicobacter pylori Seropositivity in Patients with Interleukin-1 Polymorphisms Is Significantly Associated with ST-Segment Elevation Myocardial Infarction (2016)
  • Author(s): Tabata N, Sueta D, Akasaka T, Arima Y, Sakamoto K, Yamamoto E, Izumiya Y, Yamamuro M, Tsujita K, Kojima S, Kaikita K, Morita K, Oniki K, Saruwatari J, Nakagawa K, Hokimoto S.*
  • Journal Title: PLoS ONE Volume: 11 Pages: e0166240
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Association of CYP2C19 variants and epoxyeicosatrienoic acids on patients with microvascular angina (2016)
  • Author(s): Akasaka T, Sueta D, Arima Y, Tabata N, Takashio S, Izumiya Y, Yamamoto E, Yamamuro M, Tsujita K, Kojima S, Kaikita K, Kajiwara A, Morita K, Oniki K, Saruwatari J, Nakagawa K, Ogata Y, Matsui K, Hokimoto S
  • Journal Title: Am J Physiol Heart Circ Physiol Volume: 311 Pages: H1409-H1415
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Prognostic significance of circulating leukocyte subtype counts in patients with coronary artery disease (2016)
  • Author(s): Yamamoto E, Sugiyama S, Hirata Y, Tokitsu T, Tabata N, Fujisue K, Sugamura K, Sakamoto K, Tsujita K, Matsumura T, Kaikita K, Hokimoto S
  • Journal Title: Atherosclerosis Volume: 255 Pages: 210-216
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Changes in the risk factors for coronary spasm (2016)
  • Author(s): Ishii M, Kaikita K*, Sato K, Yamanaga K, Miyazaki T, Akasaka T, Tabata N, Arima Y, Sueta D, Sakamoto K, Yamamoto E, Tsujita K, Yamamuro M, Kojima S, Soejima H, Hokimoto S, Matsui K, Ogawa H
  • Journal Title: IJC Heart and Vasculature Volume: 12 Pages: 85-87
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Prevalence of coronary macro- and micro-vascular dysfunctions after drug-eluting stent implantation without in-stent restenosis (2016)
  • Author(s): Hokimoto S*, Tabata N, Yamanaga K, Sueta D, Akasaka T, Tsujita K, Sakamoto K, Yamamoto E, Yamamuro M, Izumiya Y, Kaikita K, Kojima S, Matsui K, Ogawa H
  • Journal Title: Int J Cardiol Volume: 222 Pages: 185-194
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Impact of aspirin on the prognosis in patients with coronary spasm without significant atherosclerotic stenosis (2016)
  • Author(s): Ishii M, Kaikita K*, Sato K, Yamanaga K, Miyazaki T, Akasaka T, Tabata N, Arima Y, Sueta D, Sakamoto K, Yamamoto E, Tsujita K, Yamamuro M, Kojima S, Soejima H, Hokimoto S, Matsui K, Ogawa H
  • Journal Title: Int J Cardiol Volume: 220 Pages: 328-332
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Clinical and morphological presentations of acute coronary syndrome without coronary plaque rupture - An intravascular ultrasound study (2016)
  • Author(s): Tsujita K*, Yamanaga K, Komura N, Sakamoto K, Miyazaki T, Oimatsu Y, Ishii M, Tabata N, Akasaka T, Sueta D, Yamamoto E, Yamamuro M, Izumiya Y, Kojima S, Nakamura S, Kaikita K, Hokimoto S, Ogawa H
  • Journal Title: Int J Cardiol Volume: 220 Pages: 112-115
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Synergistic effect of ezetimibe addition on coronary atheroma regression in patients with prior statin therapy: subanalysis of PRECISE-IVUS trial (2016)
  • Author(s): Tsujita K*, Yamanaga K, Komura N, Sakamoto K, Sugiyama S, Sumida H, Shimomura H, Yamashita T, Oka H, Nakao K, Nakamura S, Ishihara M, Matsui K, Sakaino N, Nakamura N, Yamamoto N, Koide S, Matsumura T, Fujimoto K, Tsunoda R, Morikami Y, Matsuyama K, Oshima S, Kaikita K, Hokimoto S, Ogawa H
  • Journal Title: Eur J Prev Cardiol Volume: 23 Pages: 1524-1528
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Lipid profile associated with coronary plaque regression in patients with acute coronary syndrome: subanalysis of PRECISE-IVUS trial (2016)
  • Author(s): Tsujita K*, Yamanaga K, Komura N, Sakamoto K, Sugiyama S, Sumida H, Shimomura H, Yamashita T, Oka H, Nakao K, Nakamura S, Ishihara M, Matsui K, Sakaino N, Nakamura N, Yamamoto N, Koide S, Matsumura T, Fujimoto K, Tsunoda R, Morikami Y, Matsuyama K, Oshima S, Kaikita K, Hokimoto S, Ogawa H
  • Journal Title: Atherosclerosis Volume: 251 Pages: 367-372
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Presentation] 冠動脈プラーク退縮におけるエゼチミブ追加治療への期待～PRECISE-IVUSトライアルからの知見～ (2017)
  • Author(s): 辻田賢一
  • Organizer: 第81回日本循環器学会総会・学術集会・Fireside Seminar1
  • Place of Presentation: 石川県立音楽堂ほか（石川県金沢市）
  • Year and Date: 2017-03-17 – 2017-03-19
• [Presentation] アセチルコリン誘発冠攣縮におけるコンボワイヤーを用いた血行動態評価 (2016)
  • Author(s): 辻田賢一
  • Organizer: 第64回日本心臓病学会学術集会・ファイアーサイドシンポジウム
  • Place of Presentation: 東京国際フォーラム（東京都千代田区）
  • Year and Date: 2016-09-23 – 2016-09-25
• [Book] 冠動脈疾患の検査・診断 血管内超音波(IVUS),光干渉断層法(OCT) (2016)
  • Author(s): 辻田賢一*、小川久雄
  • Total Pages: 253-259
  • Publisher: 日本臨牀社