| Project/Area Number |
16K09451
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Cardiovascular medicine
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| Research Institution | Dokkyo Medical University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
小松 孝昭 獨協医科大学, 医学部, 講師 (10597537)
田口 功 獨協医科大学, 医学部, 教授 (80316570)
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| Project Period (FY) |
2016-04-01 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000)
Fiscal Year 2018: ¥520,000 (Direct Cost: ¥400,000、Indirect Cost: ¥120,000)
Fiscal Year 2017: ¥130,000 (Direct Cost: ¥100,000、Indirect Cost: ¥30,000)
Fiscal Year 2016: ¥3,900,000 (Direct Cost: ¥3,000,000、Indirect Cost: ¥900,000)
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| Keywords | 臨床不整脈 / 心房細動 / カテーテルアブレーション / 心臓内マッピング / アブレーション治療 / 心内マッピング / .心房細動 / 臨床心臓学 |
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| Outline of Final Research Achievements |
Epicardial adipose tissue (EAT) and external anatomical structures contacting left atria (CoAs) are known as representative persistent AF (PsAF) substrates, however, the spatial and electrophysiological association between those remains unknown. In 30 PsAF patients, 3D-CT depicting EAT and CoAs, including the aorta and vertebrae was assessed. EAT was frequently observed at the roof, coronary-sinus, and anterior and posterior left atrial regions. Both the anterior and posterior EAT aspects were frequently deposited at edges of CoA regions, and that EAT had significantly lower volume, higher-dominant frequencies, and lower endocardial bipolar voltage than other EAT deposition. After re-induction of AF, catheter ablation including that of low voltage regions neighboring EAT and CoAs, terminated AF in 26% patients. Distinctive deposition patterns of EAT were confirmed at the edge of CoAs. Clustering of EAT and CoAs in specific regions was suggested to be involved with PsAF maintenance.
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| Academic Significance and Societal Importance of the Research Achievements |
心房細動（AF）は不整脈の中でもっとも頻度が高く、その患者数は2010年時点で80万人超と見積もられている。心血管疾患とくに脳卒中の主な原因であり、その有病率が増加することから、先進国における重要な臨床課題である。近年はカテーテル治療が積極的に施行され、発作性AFで70～80％の根治率が期待されるのに対し、持続性AFではわずか50～60％程度と低い。従来施行されている、肺静脈―左房接合部への焼灼による肺静脈電気的隔離術のみでは不十分であり、新しい治療法の開発が必要な状況である。本研究は大動脈等などの心臓外構造物と心臓周囲脂肪が近接する部位が新しい治療標的となりうる可能性を提唱した。
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