冠動脈疾患と冠動脈血管運動における運動訓練
S Gielen1, G Schuler, R Hambrecht
1Universität Leipzig, Herzzentrum GmbH, Klinik für Innere Medizin/Kardiologie, Leipzig, Germany.
Circulation
|January 4, 2001
まとめ
運動トレーニングは,酸化窒素の産生と微循環を強化することによって,冠動脈疾患の患者の心臓の血流を改善します. この心臓リハビリテーション戦略は,内皮機能を改善することにより,心血管のリスクを軽減します.
科学分野:
- 心臓病学 心臓病学
- 運動生理学 運動生理学
- 血管生物学 血管生物学
背景:
- 運動トレーニングは心臓リハビリテーションに不可欠であり,冠動脈疾患 (CAD) の冠動脈 perfusion を改善します.
- 動脈狭窄の回帰や改善された担保などの改善された perfusion のためのメカニズムが議論されています.
- 窒素酸化物 (NO) 生産の低下に関連した内皮機能障害は,心筋不全とパラドックスな血管収縮を引き起こす.
研究 の 目的:
- 運動訓練が冠動脈疾患の患者における心筋の perfusion を改善するメカニズムを調査する.
- 運動による冠動脈血流の改善における内皮機能と酸化窒素経路の役割を明らかにする.
主な方法:
- 人体での研究は,トレーニングがCAD患者のパラドックスな血管収縮を弱めることを確認しました.
- 研究では,トレーニング後のアセチルコリンに対する反応として冠動脈の血流が増加することを示した.
- 細胞培養および動物実験では,内皮のL-アルギニン輸送,NO合成酵素の活性,およびスーパーオキシードディスミュータゼの生成に対するシーアストレスの影響を調査した.
主要な成果:
- 運動トレーニングは,CAD患者のパラドックスの血管収縮を弱めるために確認されました.
- トレーニングは,アセチルコリンに対する冠動脈の血流反応を高めました.
- メカニズムは,アデノシンに対する微循環感受性とともに,内皮のL-アルギニン輸送,NO合成酵素活性,細胞外超酸化物ディスミュータゼの強化,および微循環感受性を含む.
結論:
- 運動トレーニングは,冠動脈の直径を変化させることでのみならず,内皮機能とNOの生物利用性を高めることによって,CADにおける筋動脈の輸血を改善します.
- 内皮機能の改善と微循環感受性は,運動によるイシュケミアの減少に寄与する.
- 内皮機能障害に対する運動の積極的な効果は,長期的な心血管疾患と死亡率を低減する役割を果たすことを示唆しています.
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