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US-Japan comparative study of the sudden cardiac death of young males-pokkuri death syndrome (PDS).

美日青年男性心源性猝死的比较研究——pokkuri死亡综合征(PDS)。

基本信息

批准号：
17406023
负责人：
FUJITA Masaki q
金额：
$ 8.26万
依托单位：
Keio University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2005
资助国家：
日本
起止时间：
2005 至 2006
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-17406023/
关键词：
Pokkuri Death Syndrome (PDS)Remnant Lipoprotein Sudden Death Coronary Spasm Atherosclerosis Arrhythmia Brugada Syndrome Lipid Metabolism

项目摘要

The new concept of Pokkuri Death Syndrome (PDS) for sudden cardiac death was proposed by Takeichi and Fujita (2006), which may be caused by the strong coronary spasm associated with remnant hyperlipoproteinemia observed prevalently in 2/3 of PDS cases.The international collaboration research on the relationship between sudden cardiac death and remnant lipoproteins (RLP) were performed with the two US research institutions. One was with Dr. Virmani of CVPath (International Registry of Pathology), a forensic medicine researcher, on plasma analysis of 76 sudden cardiac death cases with severe coronary atherosclerosis. But the postmortem alteration of plasma in sudden cardiac death cases in USA was too severe to analyze lipid and lipoproteins because of the long postmortem interval at the time of autopsy in these cases for this kind of study. The other was the lipid and lipoprotein analysis in VA-HDL Intervention Trial (VA-HIT) (2531 male patients with and without gemfibrozil) with Dr. Schaefer of Tufts Univ. on the relationship to the occurrence of cardiovascular (CV) endpoints such as fatal or non-fatal MI, stroke etc. By comparing the Japanese and US casese, VA-Hit study showed that RLP-TG was a strong predictor of CV endpoints as PDS in Japan, but not apoB and LDL-C as well. As 1/3 of PDS cases were not associated with hyperlipidemia, the genetic analysis in PDS cases on SCN5A related with Brugada Syndrome was performed as the third international collaboration with Dr. Brugada at Montreal Univ., Canada. The cases with SCN5A gene mutations similar to Brugada Syndrome were found in PDS cases. Further genetic analysis is on going in these cases.

takichi和Fujita（2006）提出了心源性猝死Pokkuri Death Syndrome （PDS）的新概念，PDS可能是由2/3的PDS患者普遍存在残余高脂蛋白血症导致的强烈冠状动脉痉挛引起的。与美国两家研究机构开展心源性猝死与残余脂蛋白（RLP）关系的国际合作研究。其中一项是与CVPath （International Registry of Pathology）的法医学研究员Virmani博士一起，对76例伴有严重冠状动脉粥样硬化的心源性猝死病例进行血浆分析。但美国心脏性猝死病例的死后血浆变化太严重，无法进行脂质和脂蛋白分析，因为这些病例尸检时的死后间隔时间较长。另一项是由塔夫茨大学的Schaefer博士进行的VA-HDL干预试验（VA-HIT）（2531名服用和不服用gemfibrozil的男性患者）的脂质和脂蛋白分析，研究与心血管（CV）终点（如致死性或非致死性心肌梗死、中风等）发生的关系。通过比较日本和美国的病例，VA-Hit研究表明，RLP-TG在日本作为PDS的CV终点是一个强有力的预测因子，但apoB和LDL-C也不是。由于1/3的PDS病例与高脂血症无关，因此与加拿大蒙特利尔大学的Brugada博士进行了第三次国际合作，对PDS病例中与Brugada综合征相关的SCN5A进行了遗传分析。PDS病例中出现与Brugada综合征相似的SCN5A基因突变。目前正在对这些病例进行进一步的基因分析。