閉塞性心不全における呼吸器筋肉機能障害:臨床的相関と予後的意義
F J Meyer1, M M Borst, C Zugck
1Department of Cardiology, Angiology, and Respiratory Medicine, Medical Center of the University Heidelberg, Heidelberg, Germany.
Circulation
|May 23, 2001
まとめ
最大インスピレーション圧 (Pi(max) で測定されるインスピレーション筋の強度の低下は,充血性心不全 (CHF) 患者の死亡率の有意な予測因子です. この簡単な検査は,リスク評価と心臓移植のための患者の選択を改善することができます.
科学分野:
- 心臓病学 心臓病学
- 肺病理学 肺病理学とは
- クリティカルケア・メディシン
背景:
- kongestive heart failure (CHF) での呼吸器の筋肉の強さの予後的意義は十分に確立されていません.
- 呼吸器の筋肉機能の障害は,CHFの患者でよく見られる.
研究 の 目的:
- CHFの患者における最大インスピレーション圧 (Pi(max)) の予後値を調査する.
- Pi(max) が死亡率の独立した予測因子として機能できるかどうかを判断する.
主な方法:
- 244人のCHF患者を対象とした前向きな研究.
- 最大インスピレーション圧力 (Pi ((max)) の測定.
- 単変数および多変数コックス比例リスクモデルを使用して分析された死亡率のフォローアップ.
主要な成果:
- CHFの患者は,対照群と比較して Pi (((max) が低いことを示した.
- Pi (max) の低下は,死亡率の増加と有意に関連していました.
- Pi(max) は,ピーク酸素消費量 (ピークVO(2) と比較し,LVEFと併用すると改善された,予測の独立した予測因子でした.
結論:
- インスピラトリー筋肉の強さは,心筋梗塞の患者で減少しており,予後を予測する新しい独立した予測因子です.
- Pi ((max)) 検査はシンプルで,CHF患者のリスク分層を高めることができます.
- Pi ((max)) は,心臓移植のための患者の選択に役立ちます.
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