手術による再血管化の後の麻痺状態と冬眠状態のセグメントの機能回復の時間経過
J J Bax1, F C Visser, D Poldermans
1Department of Cardiology, Leiden University Medical Center, Leiden. jbax@knoware.nl
Circulation
|September 25, 2001
まとめ
麻痺した心筋は,再血管化後の早期に機能を回復するが,冬眠状態の心筋は機能改善が遅れている. この研究では,血栓性心筋疾患の患者における両疾患の回復期間を比較した.
科学分野:
- 心臓病学 心臓病学
- 核医学は,核医学である.
- 心臓外科手術について
背景:
- 発血性心筋症は,心筋麻痺や冬眠により,左心室機能不全を引き起こす可能性があります.
- 麻痺した心筋と冬眠状態の心筋に,再循環化後の心機能の回復は可能である.
- 冬眠状態の心筋は,麻痺状態の心筋と比較して,より長い回復期間を必要とすることがあります.
研究 の 目的:
- 冬眠状態での機能回復の時間経過を,手術による再血管化後の麻痺した心筋と比較する.
- リヴァスキュラライゼーション後の異なる心筋動脈状態における長期的な機能的アウトカムを評価する.
主な方法:
- 手術による再血管化を施した,不全性心筋症の26人の患者を研究した.
- (201) Tl SPECTを用いた地域性輸血, (18) F-2-デオキシグルコース SPECTを用いたグルコース利用,および2Dエコーカーディオグラフィーによる収縮機能の評価.
- 麻痺した心筋は,正常な perfusion/グルコース利用の機能不全部分として,冬眠状態の心筋は,減少した perfusion/保存されたグルコース利用の機能不全部分として定義される.
主要な成果:
- 266の機能不全のセグメントのうち,22%が麻痺状態,23%が冬眠状態,そして55%が痕組織であった.
- 麻痺した心筋は3ヶ月で重要な機能的改善を示した (61%改善),14ヶ月でさらなる変化はなかった.
- 冬眠状態の心筋は漸進的な機能回復を示し,3ヶ月で31%が改善し,61%が14ヶ月でさらなる改善を示しました.
結論:
- 麻痺した心筋は,通常,リバスカライゼーション後の早期の機能回復を示します.
- 冬眠状態の心筋は,再血管化後の完全な機能回復を達成するために,より長い期間を必要とします.
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