左心室縮の重度と,縮性心筋症候群の患者における予後との関連
P M Elliott1, J R Gimeno Blanes, N G Mahon
1Department of Cardiological Sciences, St George's Hospital Medical School, London, UK. pelliott@sghms.ac.uk
Lancet (London, England)
|March 29, 2001
まとめ
ハイパートロフィック心筋症患者における重度の左心房高縮症は,突然の心臓死のみを予測するものではありません. 追加のリスク要因は,壁の厚さだけでより重要な予測要因です.
科学分野:
- 心臓病学 心臓病学
- 臨床電気生理学 臨床電気生理学
背景:
- 以前の研究では,左心室重症増幅 (LVH) と,高縮性心筋病変 (HCM) の急性心臓死 (SCD) リスクが関連していた.
- 他の臨床的リスク因子と比較して,LVHの予後値については,さらなる特徴づけが必要でした.
研究 の 目的:
- ハイパートロフィック心筋症候群の患者における左心房高縮の予後的意義を調査する.
- LVHの予測値と,突然心臓死亡の他の臨床的リスク要因を比較する.
主な方法:
- HCMの患者630人のコホートを研究した.
- 診断ツールには,エコーカルディオグラフィー,運動テスト,ホルターモニタリングが含まれていました.
- 追跡期間は平均59ヶ月でした.
主要な成果:
- 壁の厚さ (p=0.029) により,SCDまたはICDの排出リスクが増加した傾向を示した.
- 壁の厚さ≥30mmの患者は,SCDまたはICD排出の確率が高い (p=0.049) でした.
- しかし,追加の危険因子の数は,壁の厚さ (p=0.0001) よりも,SCDまたはICD放出のより強力な予測因子でした.
結論:
- 他の危険因子なしの壁の厚さ30mm以上は,積極的な予防治療を正当化するのに不十分です.
- 軽度の高縮症 (壁の厚さ<30mm) は,突然死のリスクが低いことを示さないが,ほとんどの症例がこのグループで発生した.
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