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冠動脈血管内皮機能不全の予後値
Julian P J Halcox1, William H Schenke, Gloria Zalos
1Cardiology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md, USA.
Circulation
|August 7, 2002
まとめ
冠動脈内皮機能不全,特にマイクロ血管および表心臓の反応は,冠動脈疾患 (CAD) の患者および無患者の心血管疾患を予測します. この検査は,従来のリスク要因を超えて貴重な予後情報を提供します.
科学分野:
- 心臓病学 心臓病学
- 血管生物学 血管生物学
- 予防医学は,予防的な医療です.
背景:
- 多様な集団における心血管疾患のリスクを評価することは,依然として難しい課題です.
- 急性イベントに対する冠動脈血管機能検査の予測価値は完全に理解されていません.
- 冠動脈動脈硬化症 (CAD) 患者および無冠動脈動脈硬化症 (CAD) 患者における冠動脈内皮機能の調査は極めて重要です.
研究 の 目的:
- 冠動脈内皮機能検査が,急性心血管疾患のリスクの高い患者を特定できるかどうかを判断する.
- CADの患者および無患者の内皮機能と心血管のアウトカムとの関係を評価する.
- 冠動脈血管機能検査の予後値の評価をするために.
主な方法:
- 冠動脈血管抵抗 (DeltaCVR) と表心臓直径の変化は,冠動脈内アセチルコリン (ACh) を用いて,内皮に依存する機能のために測定されました.
- 内皮の独立機能は,ナトリウムニトロプロシドとアデノシンで評価されました.
- 308人の患者 (132人のCAD,176人の無) が検査を受け,平均46ヶ月間追跡調査を行いました.
主要な成果:
- エピカルディアとマイクロ血管内皮機能不全 (ACh応答によって評価) は,急性心血管疾患の独立した予測因子であった.
- 年齢,CADの存在,体量指数などの要因もイベントを予測しました.
- AChに対するよりよいマイクロ血管および上心部反応を有する患者は,CADの状態に関係なく,生存率が改善されたことを示しました.
結論:
- エピカルディアとマイクロ血管冠動脈内皮機能不全は,急性心血管疾患を独立して予測します.
- 冠動脈血管機能検査は,従来の評価を補完する予後情報を提供します.
- これらの発見は,心血管リスクの階層化における内皮機能の重要性を強調しています.
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