ブルガダ症候群における心臓自律機能不全
Thomas Wichter1, Peter Matheja, Lars Eckardt
1Hospital of the Westfälische Wilhelms-University, Department of Cardiology and Angiology, Münster, Germany. wichtet@uni-muenster.de
Circulation
|February 13, 2002
まとめ
ブルガダ症候群の患者は,異常な心臓のノレピネフリン再吸収を示し,シナプス前交感神経機能不全を示唆しています. この発見は,ブルガダ症候群の病理生理学と心律乱症の発達に関する理解に影響を与える可能性があります.
科学分野:
- 心臓病学 心臓病学
- 自律神経系の研究
- 分子イメージングは分子イメージングです.
背景:
- ブルガダ症候群は,ECGの異常と,構造的に正常な心臓の生命を脅かす不律によって特徴付けられます.
- 自律神経系への関与は,休息時に発生する不律症と,自律的調節によるEKGの変化の兆候によって示唆されています.
研究 の 目的:
- ブルガダ症候群の患者におけるプレシナプス性心神経神経ノレピネフリン再吸収 (吸収1) を調査する.
- ブルガダ症候群の患者と健康な対照群の間のノレピネフリン再吸収を,先進的な画像技術を使用して比較するために.
主な方法:
- [123I]m-iodobenzylguanidine (123I-MIBG) を用いて,シナプス前心臓交感神経の機能を画像化しています.
- シングルフォトンエミッションCT (SPECT) と定量的な33セグメント対照分析を使用した.
- 17人のブルガダ症候群患者と10人の年齢相応の対照群を研究した.
主要な成果:
- 地域的に減少した123I-MIBG摂取は,ブルガダ症候群患者の47%で観察されましたが,コントロールのいずれもありませんでした.
- 定量分析により,ブルガダ症候群の患者の下部および隔膜の左心室壁のセグメンタル減少が示されました.
- 123I-MIBG-SPECTの発見と患者の臨床的特徴との間には相関が認められなかった.
結論:
- ブルガダ症候群で異常な123I-MIBG吸収が示され,心臓前シナプス交感機能不全を示しています.
- 発見は,ブルガダ症候群の病理生理学とリズム変異における交感性機能障害の潜在的な役割を示唆しています.
- ブルガダ症候群における交感性および寄交感性神経系のバランスを調べるためにさらなる研究が必要である.
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