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暫定的な動脈前腕閉塞に対する周周回フロー応答は,心筋 perfusion reserve を反映していない
M Bøttcher1, M M Madsen, J Refsgaard
1Department of Cardiology B, Aarhus University Hospital, University of Aarhus, Aarhus, Denmark. mboe@dadlnet.dk
Circulation
|February 27, 2001
まとめ
周辺微小血管機能は,心筋 perfusion を予測しない. この研究では,前腕の血流反応と心筋 perfusion の間に相関関係がないことが判明し,異なる規制メカニズムを示唆しました.
科学分野:
- 心血管生理学 心血管の生理学
- マイクロ血管機能
- 心筋パルフュージョン評価
背景:
- 超音波を用いた全身動脈機能評価は一般的です.
- 冠動脈と腕動脈の内皮機能は,文書化された相関を示しています.
- システミック・マイクロ循環と心筋 perfusion の関係については不明である.
研究 の 目的:
- 外周微循環評価が心筋 perfusion の代理マーカーとして機能するかどうかを調査する.
- 周辺の微循環床と心筋の間の相関を決定する.
主な方法:
- 23人の冠動脈疾患 (CAD),16人のX症候群 (SX),45人の健康な対照群 (C) を研究した.
- 静止状態のポジトロン放出トモグラフィー (PET) を使用して測定された心筋膜 perfusion と dipyridamole の注入後.
- 腕動脈の血流は,ドップラー超音波で休息状態と反応性高血症 (過渡的な前腕不全症) の後に評価された.
主要な成果:
- 心筋 perfusion (ディピリダモール後) と外側前腕流 (イシュケミア後) の両方がすべてのグループで有意に増加しました.
- 周辺および心筋の微循環床の間には有意な相関は観察されなかった.
- この相関の欠如は,静止流量,高血圧流量,および流量リザーブ (r(2) <0.1,P:=NS) に対して真実であった.
結論:
- 反応性高血症に対する周辺 perfusion 応答は,ディピリダモール誘発の心筋高血症と相関していません.
- これは,異なる血管床におけるマイクロ血管の活性化と調節を制御する明確なメカニズムを示唆しています.
- 発見は,外周および心筋の微循環評価の間の推計が科学的に適切でないことを示しています.
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