2006 Fiscal Year Final Research Report Summary
Neurohumoral and immunological regulation on left ventricular remodeling in heart failure
| Project/Area Number |
16590677
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Circulatory organs internal medicine
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| Research Institution | Shiga University of Medical Science |
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Principal Investigator |
TSUTAMOTO Takayoshi Shiga University of Medical Science, Undergraduate School of Medicine, Assistant Professor, 医学部, 講師 (40197695)
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| Co-Investigator(Kenkyū-buntansha) |
WADA Atsuyuki Shiga University of Medical Science, Undergraduate School of Medicine, Assistant Professor(part time), 医学部, 非常勤講師 (10273400)
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| Project Period (FY) |
2004 – 2006
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| Keywords | magnetic resonance / left ventricular remodeling / brain natriuretic peptide / proteomic analysis / NT-pro BNP / adiponectin / prognosis / heart failure |
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| Research Abstract |
Previous ^<31>P magnetic resonance spectroscopy (MRS) studies demonstrated that the myocardial phosphocreatine-to-ATP ratio offered important information concerning the degree of dysfunction and prognosis in patients with cardiomyopathy. We investigated total creatine (CR) levels in 14 various diseased hearts using 1H MRS. Myocardial CR was measured using 1H MRS with point-resolved spectroscopy localization. Overall, myocardial CR levels in diseased hearts were significantly lower than those in the control group. There was a positive correlation between myocardial CR and left ventricular ejection fraction despite the different mechanisms of cardiac dysfunction (r = 0.60, p < 0.05). Myocardial CR levels in patients who were hospitalized due to heart failure within 1 year were significantly lower than those in other patients. These results suggest that noninvasive measurement of myocardial CR using 1H MRS may be valuable in the assessment of disease severity and prediction of clinical co
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urse of heart disease.
To evaluate the relation among BNP and NT-proBNP secretion, plasma levels and renal function. We measured the plasma levels of BNP and NT-proBNP in the aortic root and coronary sinus in 326 consecutive patients with chronic heart failure (CHF). Patients were divided into two groups [group I : estimated glomerular filtration rate (eGFR)≧60 mL/min and group II : eGFR< 60 mL/min]. The molar level of the transcardiac increase in NT-proBNP is lower than that of BNP. There were no differences in haemodynamics and transcardiac gradient of BNP and NT-proBNP between group I and group II. The molar ratio of the plasma NT-proBNP to BNP was significantly higher in group II than in group I. By stepwise multivariate analyses, not only the left ventricular (LV) ejection fraction and LV end-diastolic pressure, but also eGFR, LV mass index (LVMI) and haemoglobin were independent predictors of plasma NT-proBNP and BNP. These results indicate that the molar level of the transcardiac increase in NT-proBNP is lower than that of BNP, whereas the influence of renal function on plasma NT-proBNP is greater than that on BNP.
To evaluate whether plasma high-molecular weight (HMW) adiponectin provides prognostic information in addition to that obtained from clinical, haemodynamic and biochemical variables previously known to be associated with a high mortality in CHF patients. We measured the plasma levels of total and HMW adiponectin, ANP, BNP, and NT proBNP, and haemodynamic parameters in 449 consecutive CHF patients. Based on body mass index (BMI), patients were classified into 3 groups : low(<21 kg/m^2, n=133), normal (21 to 25 kg/m^2n=205), high (>25 kg/m^2n=111). After adjustment for clinical variables associated with CHF including haemodynamics, plasma total adiponectin level was an independent prognostic predictor but HMW adiponectin was not in the overall patient group. On sub-group analyses, in patients with abnormal BMI, plasma total adiponectin level was not an independent prognostic predictor, but in patients with normal BMI, plasma levels of log NT-proBNP (p=0.017) and log total adiponectin (p=0.003) were independent prognostic predictors. These findings indicate that total adiponectin is more useful for assessing mortality risk than HMW adiponectin and a high plasma total adiponectin is an independent prognostic predictor especially in CHF patients with normal BMI. Less
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Research Products
(15 results)
