シヌス節の交感性再神経化と心臓移植後の運動血動力学
R F Wilson1, T H Johnson, G C Haidet
1Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis 54455, USA.
Circulation
|June 14, 2000
まとめ
心臓移植を受けた患者のシヌス節の交感性リナーベーションは,運動に対する心拍の反応を部分的に回復させます. しかし,運動能力は依然として低下しており,再神経化状態とは大きく異なります.
科学分野:
- 心臓病学 心臓病学
- 移植免疫学について
- 自律神経系とは,自律神経系である.
背景:
- 心臓移植 (CT) の後の交感性心筋再内置は,ヒトでは変動する.
- この研究では,シヌス節の再内化が,運動に対する正常なクロノトロプ的反応を部分的に回復できるという仮説を調査した.
研究 の 目的:
- 心臓移植を受けた患者の運動中の心拍の応答に,交感性シヌス節の再神経化の影響を評価する.
主な方法:
- 最近のCT受容者13人,遅いCT受容者28人 (>1年),対照者20人を研究した.
- ティラミン注射後の心拍数変化による副鼻腔節の交感性再内化評価.
- トレードミルの運動中に測定された心拍数,血圧,ガス交換.
主要な成果:
- 早期のCT受容体と後期のCT受容体では,運動に対する心拍数反応が鈍化した.
- 顕著なリナーベーションを有する患者は,より正常化された心拍数応答を示し,より早くピークし,より速く低下しました.
- 運動の持続時間と最大酸素消費量は,CT患者では対照群よりも低かったが,再内蔵状態と有意な関係はなかった.
結論:
- シヌス節の交感性再内化により,移植後の運動に対する心拍の反応が部分的に回復します.
- 最大酸素消費量と運動期間は,再内膜化とは無関係に,CT患者と対照群と比較して,有意に減少しています.
- 発見は,心臓移植後の自律機能の部分的な回復と持続的な運動制限を強調しています.
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