運動誘発のミトラル吐が,左心室内静脈機能不全の患者における運動中風量および運動能力への貢献
Rigobert Lapu-Bula1, Annie Robert, David Van Craeynest
1Division of Cardiology, Université Catholique de Louvain, Brussels, Belgium.
Circulation
|September 11, 2002
まとめ
左心室 (LV) 機能不全の心不全患者では,運動中に機能的ミトラル吐 (MR) が悪化すると,脳卒中容量の適応が制限されます. これは,これらの個人の運動能力の低下に寄与します.
科学分野:
- 心臓病学 心臓病学
- 心不全に関する研究
- 運動生理学 運動生理学
背景:
- 機能性ミトラル反発 (MR) は,左心室 (LV) 機能不全の心不全 (HF) 患者で一般的です.
- MRの重症度は,負荷条件によって動的に変化することがあります.
研究 の 目的:
- 運動によるMR重度の変化が,運動中の脳卒中音量応答に影響するかどうかを調査する.
- LV機能不全患者の運動能力に対するMRの重度の変化の影響を決定する.
主な方法:
- 25 LV機能不全のHF患者は,さまざまな強度 (30%,60%,90%ピークVO2) の自転車運動を行った.
- 同時に測定されたものは,右心圧,心電量,VO2,MR重度 (MRジェット/左心房面積比) でした.
- MRの重度の変化と血液動力学/機能的パラメータの間の相関を分析した.
主要な成果:
- 運動中にMRIの重度が有意に増加した (15±8%から33±15%).
- ピークVO2,脳卒中量変化,毛細血管圧の変化は,MR重度の変化と相関している (r=-0.55, -0.87, 0.62;P<0.01).
- MRの重度の変化は,LV球性指数とコアプテーション距離とも相関していた.
結論:
- 運動によるMR重症度限界の増加 運動中の脳卒中容量の適応
- 運動中の機能的なMRの悪化は,LV機能不全の患者の運動不耐症に寄与する要因です.
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