ディゴキシンが,心房細動による急性心房屈折性の変化に及ぼす影響
C Sticherling1, H Oral, J Horrocks
1Division of Cardiology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor, MI 48109-0022, USA.
Circulation
|November 15, 2000
まとめ
ディゴキシンは,心房動 (AF) のエピソード後に心房の屈折性を悪化させ,再発したAFのリスクを高めます. この効果はおそらくディゴキシンのせいである.
科学分野:
- 心血管電気生理学 心血管電気生理学
- 心律不整症とは,心律不整症のこと.
- 薬理学 薬理学とは
背景:
- 心房細動 (AF) は心房の有効耐火期 (ERP) を短縮し,さらなるAFエピソードへの感受性を高めます.
- 心房不屈性における急性変化は,心拍動脈によって引き起こされる細胞内カルシウム過負荷に起因する可能性があります.
研究 の 目的:
- 細胞内カルシウムを増加させる薬であるディゴキシンが,ヒトにおける心房不屈性に対するAFの急性効果を強化するかどうかを調査する.
主な方法:
- 自律性阻害後の38人の健康な成人の心房ERPの測定,19人がディゴキシン治療を受けた.
- 短時間のAFエピソード前後に350および500msの基本ドライブサイクルの長さ (BDCLs) で評価された心房ERP.
- ディゴキシンと対照群の間のAF後のERP変化と二次AFエピソードの発生率の比較.
主要な成果:
- AF後の心房ERPは,AF前の値と比較して,両方のグループで著しく短かった.
- 心房ERPの減少は,ディゴキシン群では,両方のBDCLにおける対照群よりも有意に大きかった.
- 二次性AFエピソードは,対照群 (16%),ディゴキシン群 (32%) でより頻繁に発生しました.
結論:
- ディゴキシンは,AFエピソード後の心房屈折性の急性縮小を増加させます.
- このディゴキシンによる増強は,ヴァゴトニック効果とは独立して,AF再誘導に患者を誘導します.
- この発見は,細胞内カルシウムに対するディゴキシンの影響が,AFにおけるその前動脈不良の可能性に貢献することを示唆しています.
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