Comprehensive evaluation for right ventricular afterload in patients with left heart failure using echocardiography

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K20703
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 90130:Medical systems-related
• Research Institution: Hokkaido University
• Principal Investigator: Kaga Sanae 北海道大学, 保健科学研究院, 准教授 (60630978)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 左心不全 / 右室機能 / 心エコー

Outline of Final Research Achievements

Heart failure is a serious and frequent complication that contributes to the majority of deaths related to heart disease, and in our rapidly aging country, the number of heart failure patients is expected to continue to increase. It has been found that the prognosis of left heart failure patients is influenced by the right ventricular function, which is thought to be due to the afterload on the right ventricle caused by the pulmonary circulation. In this study, we investigated and demonstrated the validity of a non-invasive echocardiography method for comprehensively evaluating the afterload of the pulmonary circulation on the right ventricle in left heart failure patients, compared to invasive cardiac catheterization. Furthermore, we revealed that non-invasive pulmonary hemodynamic indices are associated with the function of the right ventricle, the progressive decline of right ventricular function over time, and the deterioration of prognosis.

Free Research Field

心エコー

Academic Significance and Societal Importance of the Research Achievements

心不全は、心疾患による死亡の大半に関わる重篤かつ頻度の高い合併症であり、今後、心不全患者が急増することが危惧されている。これに備えた心不全の予防と予後の改善が大きな課題となっている。左心不全の予後に影響を与える右室後負荷を精密に握する意義は大きいと考えられるが、従来は侵襲的な心カテーテル法を必要とした。本研究では、心エコー法を用いた右室後負荷の非侵襲的推定法を考案し、その有用性を示した。心エコー法は、重篤な症例だけでなく、高齢者や軽症例にも幅広く実施できるため、右室機能障害に至る前段階での左心不全患者のリスク評価ならびに経過観察に本研究の成果が役立つことが期待される。