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Potential Mechanism of Left Ventricular Spherical Remodeling: Association of Mitral Valve Complex-Myocardium Longitudinal Tissue Remodeling Mismatch

Research Project

Project/Area Number 17K09538
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field Cardiovascular medicine
Research InstitutionUniversity of Occupational and Environmental Health, Japan

Principal Investigator

Otsuji Yutaka  産業医科大学, 医学部, 教授 (30264427)

Co-Investigator(Kenkyū-buntansha) 荻ノ沢 泰司  産業医科大学, 医学部, 助教 (20596720)
竹内 正明  産業医科大学, 大学病院, 准教授 (30236434)
宮本 哲  産業医科大学, 大学病院, 准教授 (30611305)
岩瀧 麻衣  産業医科大学, 医学部, 助教 (40771308)
西村 陽介  産業医科大学, 医学部, 教授 (50301338)
尾上 武志  産業医科大学, 医学部, 非常勤医師 (50772703)
永田 泰史  産業医科大学, 医学部, 非常勤医師 (60749993)
園田 信成  産業医科大学, 医学部, 准教授 (90299610)
Project Period (FY) 2017-04-01 – 2020-03-31
Project Status Completed (Fiscal Year 2019)
Budget Amount *help
¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2019: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2018: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2017: ¥2,730,000 (Direct Cost: ¥2,100,000、Indirect Cost: ¥630,000)
Keywords心不全 / 僧帽弁 / 心エコー図 / 左室球形化
Outline of Final Research Achievements

Mitral valve complex (MVC) longitudinal tissue length (LL) less elongation vs. whole left ventricular (LV) myocardial LL elongation may limit LV-base-LL elongation, leading to LV spherical remodeling. In 30 patients with dilated cardiomyopathy (DCM), 30 with aortic regurgitation, and 30 controls, LV sphericity, LV-apex-transverse tissue length (TL) and -LL, LV-base-TL and -LL, MVC-LL and whole-LV-LL were measured by 3D echo. Ratio of each measure vs. mean normal value was obtained. LV-apex-TL, LV-apex-LL and LV-base-TL ratios were increased (p<0.01), while the LV-base-LL ratio was not increased in DCM. Whole-LV-LL ratio was increased (p<0.01), while MVC-LL ratio was not increased in DCM. Multivariable analysis revealed that LV sphericity was related to a reduced [LV-base-LL ratio/global-LV ratio] (p<0.01), which was related to a reduced [MVC-LL ratio/whole-LV-LL ratio] (p<0.01). Less MVC-LL elongation vs. whole LV myocardial tissue elongation may contribute to LV spherical remodeling.

Academic Significance and Societal Importance of the Research Achievements

心不全(心臓機能異常による息切れ等)では、なぜか楕円形の心臓筋肉が球形に近くなります。球形化は心機能を保つ上で不利とされていますが、「なぜ心臓筋肉が球形化するか?」は不明です。本研究では、「心臓の筋肉全体が伸びる(拡大)する中で心臓筋肉基部を縦につなぐ僧帽弁複合体組織があまり伸びないのでそこの心臓筋肉が縦に伸びれないために心臓全体が球形化する」という仮説を検討し、この仮説を裏付けるデータを出しました。「僧帽弁複合体組織があまり伸びない」ために「心臓筋肉が球形化する」という概念もデータも初めてです。

Report

(4 results)
  • 2019 Annual Research Report   Final Research Report ( PDF )
  • 2018 Research-status Report
  • 2017 Research-status Report
  • Research Products

    (5 results)

All 2019 2017

All Journal Article (3 results) (of which Int'l Joint Research: 3 results,  Peer Reviewed: 3 results,  Open Access: 3 results) Presentation (2 results)

  • [Journal Article] Insights into the mechanism of paradoxical low-flow, low-pressure gradient severe aortic stenosis: association with reduced O2 consumption by the whole body2019

    • Author(s)
      Onoue Takeshi、Iwataki Mai、Araki Masaru、Itoh Hideaki、Isotani Akihiro、Umeda Hiromi、Fukuda Shota、Nagata Yasufumi、Tsuda Yuki、Fujino Yoshihisa、Hanyu Michiya、Ando Kenji、Shirai Shinichi、Takeuchi Masaaki、Saeki Satoru、Levine Robert A.、Otsuji Yutaka
    • Journal Title

      American Journal of Physiology-Heart and Circulatory Physiology

      Volume: 316 Issue: 4 Pages: 840-848

    • DOI

      10.1152/ajpheart.00715.2018

    • Related Report
      2019 Annual Research Report 2018 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Possible mechanism of late systolic mitral valve prolapse: systolic superior shift of leaflets secondary to annular dilatation that causes papillary muscle traction2019

    • Author(s)
      Hei Soshi、Iwataki Mai、Jang Jeong-Yoon、Kuwaki Hiroshi、Mahara Keitaro、Fukuda Shota、Kim Yun-Jeong、Nabeshima Yosuke、Onoue Takeshi、Nagata Yasufumi、Nishino Shun、Watanabe Nozomi、Takeuchi Masaaki、Nishimura Yosuke、Song Jae-Kwan、Levine Robert A.、Otsuji Yutaka
    • Journal Title

      American Journal of Physiology-Heart and Circulatory Physiology

      Volume: 316 Issue: 3 Pages: H629-H638

    • DOI

      10.1152/ajpheart.00618.2018

    • Related Report
      2019 Annual Research Report 2018 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Normal range of myocardial layer-specific strain using two-dimensional speckle tracking echocardiography2017

    • Author(s)
      Yasufumi Nagata , Victor Chien-Chia Wu, Yutaka Otsuji, Masaaki Takeuchi
    • Journal Title

      PLoS ONE

      Volume: 12(6): e0180584. Issue: 6 Pages: e0180584-e0180584

    • DOI

      10.1371/journal.pone.0180584

    • Related Report
      2017 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Presentation] 奇異性低流量低圧較差大動脈弁狭窄症の発症機序2019

    • Author(s)
      尾上武志
    • Organizer
      日本心エコー図学会
    • Related Report
      2018 Research-status Report
  • [Presentation] 収縮後期僧帽弁逸脱に及ぼす僧帽弁形成術の効果2019

    • Author(s)
      屏 壮史
    • Organizer
      日本超音波医学会
    • Related Report
      2018 Research-status Report

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Published: 2017-04-28   Modified: 2021-02-19  

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