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ハイパートロフィック心筋病変における感染症性内心炎: 罹患率,発生率,および抗生物質予防のための徴候
P Spirito1, C Rapezzi, P Bellone
1Divisione di Cardiologia, Ente Ospedaliero Ospedali Galliera, Genoa, Italy. p.spirito@galliera.it
Circulation
|April 27, 1999
まとめ
ハイパートロフィック心筋病症 (HCM) の感染症性内心炎は,主に流出阻害の患者に影響します. 抗生物質の予防は,阻害性HCMの患者,特に心房拡張の患者に対してのみ推奨されます.
科学分野:
- 心臓病学 心臓病学
- 感染症 感染症は感染症です.
- 医学研究 医学研究
背景:
- ハイパートロフィック心筋病変症 (HCM) の感染症性内心炎 (IE) は十分に理解されていないが,主に症例報告から得られたデータは限られている.
- HCM患者におけるIEの正確なリスクは未定義であり,さらなる調査が必要である.
研究 の 目的:
- ハイパートロフィック心筋病変症患者のコホートにおける感染症性内心炎の発生およびリスク要因を評価する.
- 内心炎のリスクが高いHCM内の特定の患者サブグループを定義する.
主な方法:
- 1970年から1997年の間に評価された810人の心筋縮性心筋症患者の遡及的分析.
- エコカルディオグラフィーは,以前の内臓炎の特徴を特定し,左心房のサイズと出血阻害を評価するために使用されました.
- 内心炎の流行率と発生率を計算し,リスク要因を分析した.
主要な成果:
- 以前の心臓内膜炎の罹患率は,患者1000人に3.7人であった.
- 内心炎の発生率は1000人年あたり1.4であったが,出血阻害 (P=0.006) と左心房サイズ (P=0.007) と著しく関連していた.
- 閉塞と心房の膨張の両方を有する患者は,内心炎の発生率が顕著に増加しました (1000人年当たり9.2).
結論:
- HCMにおける感染症性内心炎は,出血阻害の患者で主に観察されます.
- 流出阻害と心房膨張の組み合わせは,HCM患者における心内膜炎のリスクをさらに高めます.
- 内心炎に対する抗生物質予防は,阻害性高縮性心筋症候群の患者を特に対象にすべきである.
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