イディオパシー・オーソスタティック不耐症の患者における異常なバロレフレクスの反応
W B Farquhar1, J A Taylor, S E Darling
1Center for Autonomic and Peripheral Nerve Disorders, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Circulation
|January 11, 2000
まとめ
イディオパシー・オーソスタティック不耐症の患者は,心臓の静脈静脈反射の感度が低下し,血液量が低下し,直立時に心拍数が過剰に増加します. これは,彼らの衰弱させる症状に寄与する.
科学分野:
- 心臓病学 心臓病学
- 自律神経系の生理学 自律神経系の生理学
背景:
- Idiopathic orthostatic intolerance (IOI) は,立ち上がった時に頭がぼんやり,疲労,吐き気がする.
- 症状は,血圧の有意な低下なしに発生し,しばしば心拍数上昇 (心拍不動症) を伴います.
研究 の 目的:
- IOI患者のバロレフレクスの機能,血液量,静脈適合性を調査する.
- IOIにおける過度な姿勢性短心症の生理学的根拠を理解する.
主な方法:
- 修正されたオックスフォードテクニックを用いて,心臓のヴァガルバロレフレクスの感受性を評価した.
- 下部体負圧 (LBNP) を使用して,低血圧をシミュレートし,統合バロレフレクスの応答をテストしました.
- 測定された血液量と静脈適合.
主要な成果:
- IOIの患者は,対照群と比較して,心筋動脈バロレフレクスの感度が著しく低下した.
- LBNPの間,患者は安定した血圧にもかかわらず,より速い心拍数応答と症状の増加を示しました.
- 患者グループでは,血量低下の傾向が観察されました.
結論:
- 心臓の気管のバロレフレクスの感度低下とわずかに血量低下がIOIの特徴です.
- これらの要因は,罹患した個人の過剰な心拍数応答と症状に寄与する可能性があります.
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