症状のない冠動脈疾患の患者における全身双心房機能不全は,心筋炎によって引き起こされる可能性があります
A Frustaci1, C Chimenti, A Maseri
1Cardiology Institute, Catholic University, Rome, Italy.
Circulation
|March 17, 1999
まとめ
筋炎は,無症状の冠動脈疾患の患者で重度の二気管機能不全を引き起こす可能性があります. 免疫抑制治療は心臓機能を改善し,炎症がこれらの心不全症例の重要な要因であることを示唆しています.
科学分野:
- 心臓病学 心臓病学
- 免疫学 免疫学とは
- 病理学 パトロジー
背景:
- 心筋梗塞なしの重度のグローバル二心房機能不全における無症状の重篤な冠動脈阻害の役割は不明である.
- 発血不全以外の潜在的な原因を調査することは,心不全の管理に極めて重要です.
研究 の 目的:
- 症状のない重度の冠動脈疾患が,全身双心房機能不全を引き起こす可能性があるかどうかを判断する.
- このような症例における心筋梗塞の潜在的な役割を調査し,治療結果を評価する.
主な方法:
- エコーカルディオグラフィー,心臓カテーテリゼーション,冠動脈血管グラフィー,エンドミオカルディアル生検を用いて,重度のグローバルバイブントリキュラー機能障害を有する291人の患者を研究した.
- 炎症 (心筋炎) のための生検サンプルを分析し,心臓の自己抗体を評価しました.
- 免疫抑制療法 (プレドニゾンとアザチオプリン) を用いて,活発な心筋炎患者のサブセットを治療した.
主要な成果:
- 7人の患者 (2.4%) は重度の冠動脈疾患と全身二心房機能不全を示し,生検により全部の心筋炎が確認されました.
- 免疫抑制療法を受けた患者は,8ヶ月間にわたって心臓の体積と機能の有意な改善を示しました.
- 従来の治療法で治療された患者は改善は見られず,死亡率は1人でした.
結論:
- 心筋炎は,重度の無症状冠動脈疾患と前発性心筋梗塞のない患者の全身二心房機能不全の潜在的な原因です.
- 心筋炎の組織学的発見は,免疫抑制が有望な結果を示し,治療決定を導くことができます.
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