急性冠動脈症候群の患者の冠動脈動脈サンプルにおけるアンジオテンシン変換酵素活性の増加
1Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan. hoshidas@orh.go.jp
Circulation
|February 7, 2001
まとめ
血管系アンジオテンシン変換酵素 (ACE) 活性は,急性冠動脈症候群の加害者病変において上昇し,活発な冠動脈病変の発達における役割を示唆しています. これは,ACE活性が有意に増加しなかった,安定した不全性心疾患とレステノスと対照的です.
科学分野:
- 心血管医学は,心臓血管医学である.
- バイオケミストリー バイオケミストリー
- 介入性心臓病学 介入性心臓病学
背景:
- アンジオテンシン変換酵素 (ACE) 阻害剤は,心不全性疾患の二次予防に不可欠です.
- しかし,ACE阻害剤は,冠動脈手術後の回復を効果的に防ぐことはできません.
- 加害者の冠動脈損傷における血管のACE活動は,定量化されていないままである.
研究 の 目的:
- 冠動脈病変の原因となる血管のACE活性を定量化するために.
- ACE活動と急性冠状動脈症候群 (ACS) と,レステノシス付きまたはレステノシスなしの安定性発血性心疾患 (SIHD) の関係を調べる.
主な方法:
- 血管組織は,指向性冠動脈アテレクトミー (Directional Coronary Atherectomy) により得られた.
- ACS (n=17) とSIHD (n=36) の患者でACE活性が測定されました.
- SIHDの患者は,インステントおよびステントに関係のないレステノシスを含むレステノシスおよびレステノシスのないグループに分類されました.
主要な成果:
- ACE活性がACS患者の原因病変において有意に増加しました (0.87±0.12 nmol/min/mg protein; P<0.01).
- 静止病 (0.19±0.05) を有するSIHD患者と,静止病 (0.20±0.05) を有しない患者との比較では,ACE活性における有意な差異は観察されなかった.
- 血清のACE活動は,患者グループによって有意に異なるものではありませんでした.
結論:
- 強化された血管のACE活動は,急性冠動脈症候群に関連した加害者の病変に存在します.
- この発見は,増加したACE活性が,活発な冠動脈病変の病原化に寄与することを示唆しています.
- 血管のACE活動は,ACS.における新たな治療戦略の標的となる可能性があります.
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