Clinical evaluation of blood coagulation based on dielectric permittivity measurement: a study in cardiac surgery.

• Project/Area Number: 17K11073
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Anesthesiology
• Research Institution: Tokyo Medical and Dental University
• Principal Investigator: Yamamoto Yudai 東京医科歯科大学, 東京医科歯科大学病院, 助教 (50710026)
• Co-Investigator(Kenkyū-buntansha): 内田 篤治郎 東京医科歯科大学, 大学院医歯学総合研究科, 教授 (40262183)
• Project Period (FY): 2017-04-01 – 2022-03-31
• Project Status: Completed (Fiscal Year 2021)
• Budget Amount: ¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000); Fiscal Year 2019: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000); Fiscal Year 2018: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000); Fiscal Year 2017: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
• Keywords: 血液凝固 / 誘電率 / トロンビン / フィブリノーゲン / 連銭形成 / 心臓血管外科手術 / 凝固検査 / トロンビン生成 / フィブリノゲン

Outline of Final Research Achievements

The dielectric coagulometer is a blood coagulation assay device that measures changes in dielectric permittivity. In this study of cardiovascular surgery, it was shown that erythrocyte rouleau formation measured by dielectric coagulometry predict plasma fibrinogen concentration as well as rotational thromboelastometry.　Dielectric coagulometry with tissue factor stimulating reagents has the potential to measure thrombin generation. In addition, the relationship between tissue factor pathway inhibitor and decreased thrombin generation was demonstrated. Plasminogen activator inhibitor-1 after cardiopulmonary bypass tended to be associated with duration of cardiopulmonary bypass time.

Academic Significance and Societal Importance of the Research Achievements

本研究により、心臓血管外科手術において誘電コアグロメーターはフィブリノーゲン濃度の予測やトロンビン生成能の変化の測定が可能であることが示唆され、血液凝固障害の診断への臨床応用が期待される。また、血液の組織因子への反応性が組織因子経路インヒビター(tissue factor pathway inhibitor: TFPI) により抑制されているような状態が考えられ、TFPIの中和など、新たな治療的な介入の提案につなげていくことができると考えられる。また、直接経口抗凝固薬の薬効作用など、トロンビン生成能に影響を与える薬剤の薬効評価への応用などが期待される。

Research Products

• [Journal Article] Dielectric blood coagulometry as a means of evaluating the change in thrombin generation induced by direct oral anticoagulants (2020)
  • Author(s): Yudai Yamamoto, Tokujiro Uchida
  • Journal Title: Thrombosis Research Volume: 197 Pages: 141-143
  • DOI: 10.1016/j.thromres.2020.11.007
  • Peer Reviewed
• [Presentation] Estimation of plasma fibrinogen level and platelet count using dielectric blood coagulometer in patients undergoing cardiovascular surgery: single center prospective observational study (2020)
  • Author(s): Tokujiro Uchida, Yudai Yamamoto
  • Organizer: EUROANAESTHESIA (The European Anaesthesiology Congress)
  • Int'l Joint Research
• [Presentation] Evaluation of dielectric blood coagulometer as a point of care test for measurement of anticoagulation potential caused by direct oral anticoagulants (2020)
  • Author(s): Tokujiro Uchida, Yudai Yamamoto
  • Organizer: EUROANAESTHESIA (The European Anaesthesiology Congress)
  • Int'l Joint Research
• [Presentation] Elevation in the level of plasminogen activator inhibitor-1 in the post cardiopulmonary bypass period in cardiovascular surgery (2019)
  • Author(s): Yudai Yamamoto, , Aya Takemoto, Tokujiro Uchida
  • Organizer: Anesthesiology 2019
  • Int'l Joint Research
• [Presentation] Reduction in Thrombin Generation by Tissue Factor Pathway Inhibitor After Cardiopulmonary Bypass (2018)
  • Author(s): Yudai Yamamoto, Tokujiro Uchida
  • Organizer: ANESTHESIOLOGY 2018
  • Int'l Joint Research
• [Presentation] Dielectric Coagulametry: A New Method to Estimate Thrombin Generation in Cardiac Surgery (2018)
  • Author(s): Yudai Yamamoto, Tokujiro Uchida
  • Organizer: ANESTHESIOLOGY 2018
  • Int'l Joint Research
• [Presentation] 心臓血管外科手術におけるThrombelastograghy (TEG6s), Rotational thromboelastometry (ROTEM), 血液凝固検査の比較:前向き観察研究 (2017)
  • Author(s): 山本雄大, 内田篤治郎, 木戸浩司, 槇田浩史
  • Organizer: 日本麻酔科学会 第64回学術集会