長期にわたる右心室の体積過負荷は,心房間隔膜の欠陥を持つ患者の心筋筋のフッ素酸化グルコースの吸収を心室間隔膜に増加させます
1First Department of Internal Medicine, Tohoku University, Sendai, Japan.
Circulation
|April 12, 2000
まとめ
心房隔膜欠陥患者の長期の右心房の体積過負荷は,左心房と比較して,心筋内隔膜における心筋糖の利用量を増加させる. この研究は,慢性的なRV過負荷下の人間の心臓の代謝変化を明らかにします.
科学分野:
- 心臓病学 心臓病学
- 核医学は,核医学である.
- メタボリック研究
背景:
- 動物モデルでは,長期にわたる右心室 (RV) の過負荷が,心筋のエネルギー基板の代謝を変化させることを示しています.
- 慢性的なRVボリュームオーバーロードによる代謝変化に関するヒトのデータは限られている.
研究 の 目的:
- 長期のRV体積過負荷がヒトにおける心筋のエネルギー基板の代謝に影響するかどうかを調査する.
- 心筋のグルコース利用量,輸液量,脂肪酸摂取量を,心房隔膜障害 (ASD) の患者と健康な対照群を比較する.
主な方法:
- [(18) F]フッ素酸化グルコース (FDG) によるポジトロン放出トモグラフィ (PET) を用いて,心筋のグルコース代謝率 (MMR) を評価した.
- [201]Tl]TlCl (Tl) と[123) I]15-(p-イオドフェニル) -3-R,S-メチルペンタデカノ酸 (BMIPP) による単光子放出トモグラフィ (SPECT) によって,心筋 perfusion と脂肪酸アナログの吸収が評価されました.
- この研究では,ASD患者11人と対照患者11人を対象とした.
主要な成果:
- ASD患者では,MMRは,左心室 (LV) のフリー壁 (420+/-35 vs. 333+/-32) と比較して,心室間隔膜 (IVS) で有意に増加しました.
- コントロールのIVSとLVフリーウォールの間でMMRの有意な差は観察されなかった (347+/-27対357+/-25).
- SPECTイメージングは,IVSとLVフリー壁の間のTlまたはBMIPP吸収の有意な違いを示さなかった. IVS/LVフリーウォール比におけるMMRは,ASD患者のVR体積過負荷指数と相関する.
結論:
- ASD患者における長期にわたるRV体積過負荷は,IVSにおける心筋のグルコース利用量の増加を誘導し,LVのフリー壁に比べて増加する.
- 肌動脈の perfusion と脂肪酸アナログの吸収は,有意に変化しませんでした.
- これは,ヒトにおける慢性的なRV体積過負荷下でのグルコース利用における特定の代謝適応を示唆している.
関連する概念動画
Chambers of the Heart
The human heart is a complex organ made up of four chambers: the right and left atria and the right and left ventricles. These internal chambers are separated by partitions known as the interatrial and interventricular septa. The exterior of the heart features a groove known as the coronary sulcus that demarcates the atria from the ventricles, while the anterior and posterior interventricular sulci distinguish between the two ventricles.
Deoxygenated blood from the body is received in the right...
Deoxygenated blood from the body is received in the right...
Imbalances in Cardiac Output
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
Mitral Regurgitation I: Introduction
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
Mitral Stenosis I: Introduction
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
Heart Failure II: Pathophysiology
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...


