中心脈圧は,マーファン症候群における上昇性大動脈拡張の主要な決定因子である
G Jondeau1, P Boutouyrie, P Lacolley
1Service de Cardiologie and Consultation Marfan, Ambroise Paré, Boulogne, France.
Circulation
|May 25, 1999
まとめ
マルファン症候群 (MFS) の場合,動脈の脈圧が,動脈ではなく,大動脈の根の拡張を予測する. 動脈の硬さは主に大動脈にあるため,MFS患者の中央圧力のモニタリングの必要性を強調しています.
科学分野:
- 心血管医学 心血管医学
- 遺伝学 遺伝学とは
- 医療生理学 医療生理学
背景:
- マルファン症候群 (MFS) は,大動脈の膨張と解剖と関連しており,早死の主な原因です.
- 腕脈圧 (PP) は既知の危険因子ですが,MFSにおける大動脈の硬化と根の拡張との関係は不明です.
- 中央PPを昇動性大動脈直径の決定因子として調査することは,MFSにおけるリスク分層化にとって極めて重要です.
研究 の 目的:
- マルファン症候群 (MFS) 患者における昇動性大動脈直径の判定において,中央脈圧 (PP) と腕脈圧 (PP) を比較する.
- MFSにおける動脈の硬さとその大動脈の大きさとの相関を評価する.
- MFSにおける大動脈根の拡張を予測するための最も効果的なPP測定を特定する.
主な方法:
- 20人のMFS患者と20人の対照群を対象とした横断的,非侵襲的な研究.
- 腹部大動脈,頸動脈,股関節,放射動脈における弾性特性の測定.
- 昇動性大動脈の直径は,エコーカルディオグラフィによって評価され,PPと動脈張力度が計算された.
主要な成果:
- 昇動性大動脈直径は,MFS患者において有意に大きかった (37%増加,P<0.001).
- MFS患者の腹部大動脈では動脈張りが減少した (38%減少,P<0.01),他の動脈では減少しなかった.
- 昇動性大動脈の直径は,MFS (P<0.01) での頸動脈PPと正に相関しているが,腕動脈PPとは相関しない.
結論:
- 中枢圧力を反映した動脈脈圧は,マーファン症候群における動脈直径の上昇を決定する重要な要因である.
- 腕脈圧は,MFS患者の大動脈直径と相関していません.
- MFSにおける動脈の硬さの増加は主動脈に局限しており,ターゲットを絞った治療法を示唆しています.
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