重度の圧力過負荷性多動症の患者におけるLVダイアストリック機能に対するNOドナーの影響
C M Matter1, L Mandinov, P A Kaufmann
1Division of Cardiology, University Hospitals Zurich and Bern, Switzerland.
Circulation
|May 11, 1999
まとめ
窒素酸化物 (NO) ドナーは,末端の気圧を低下させることで,重度の圧力過負荷高縮症の患者で,気圧関節機能を著しく改善します. この研究は,高縮した心臓を強調しています.
科学分野:
- 心臓病学 心臓病学
- 薬理学 薬理学とは
- 生理学 生理学とは
背景:
- 酸化窒素 (NO) は心機能を調節し,シストリック収縮とダイアストリックリラックスの両方に影響を与えることが知られています.
- NOドナーに対する重度の圧力過負荷高縮症および透析機能不全の患者の特定の反応は,特徴づけられていないままです.
研究 の 目的:
- 冠内窒素酸化物 (NO) ドナーの心臓機能に対する影響を,重度の圧力過負荷高縮症および透析機能不全の患者で調査する.
主な方法:
- 重度の大動脈狭窄を患った17人の患者は,冠内NOドナー (ニトログリセリンまたはナトリウムニトロプロシド) を受けました.
- 左心室 (LV) 血圧と血管図は,ベースラインおよび最大NOドナー用量後に測定されました.
- NOドナーに対して,用量反応曲線が確立されました.
主要な成果:
- 冠内NOドナーにより,LVの終末ダイアストリック圧が著しく低下した (23 mmHgから14 mmHg,-39%).
- LVピークシストリック圧はわずかな低下 (206 mmHgから196 mmHg,-4%) しか示されなかった.
- 末端ダイアストリックと末端シストリック室の硬さが著しく低下し,心拍数,射出分数,充填率は変わらなかった.
結論:
- 冠内NOドナーは,重度の圧力過負荷高縮症の患者で,LVの終末ダイアストリック圧力を有意に低下させます.
- NOドナーは,この患者グループでは,LVシストリックポンプ機能を損なわない.
- ハイパルトロフィ化した心筋はNOドナーに対して特に感受性が高く,ダイアストリック機能の改善につながります.
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