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ヒトにおける自律神経系阻害時のQT区間の調節
André Diedrich1, Jens Jordan, John R Shannon
1Autonomic Dysfunction Center, Vanderbilt University, Nashville, Tenn. 37232-2195, USA. andre.diedrich@vanderbilt.edu
Circulation
|October 23, 2002
まとめ
トリメタファンを用いた自律的封鎖は,健康な個人および自律的機能不全の患者でQT間隔を延長しました. これは,自律神経系が心臓の再極化に大きく影響していることを示唆している.
科学分野:
- 心臓病学 心臓病学
- 自律神経系の研究
- 臨床電気生理学 臨床電気生理学
背景:
- QT間隔を調節する自律神経系の役割は議論されている.
- プロプラノロールとアトロピンを併用した以前の研究では,矛盾する結果が出ました.
- ギャングリオン阻害は,QT間隔に対する自律的影響を評価するための代替方法を提供します.
研究 の 目的:
- QT インターバルに対する ギャングリオンブロックの効果を調査する.
- 正常な被験者,多発性システム縮 (MSA) 患者,純粋な自律機能不全 (PAF) 患者における自律機能とQT間隔延長を比較するために.
主な方法:
- トリメタファンの注入は,増加量 (0.5-10 mg/min IV) で,10人の正常なボランティア,9人のMSA患者,8人のPAF患者に投与された.
- 心拍数,心拍数変動 (HRV) スペクトル,QT間隔,血圧のモニタリング.
- バゼットの式 (QTc) を用いて心拍数に調整したQT間隔.
主要な成果:
- PAFの患者は, prolonged baseline QTc (465±8 ms) と非常に低いHRVを示した.
- トリメタファンは,正常な被験者のQTcを投与量に依存して延長 (469±7 msまで) し,HRVを廃止した.
- MSA患者はQTc延長 (463±7 ms) とHRVの減少を示したが,RR間隔の有意な変化はなかった.
結論:
- ギャングリオン阻害は,正常な被験者のQT間隔を,PAF患者と同様の持続時間まで延長します.
- PAF患者の残留自律的トーンをブロックすると,QT間隔の長さがさらに増加します.
- MSAの患者は,PAFの患者と比較して,ギャングリオン阻害中に残留シンパシートーンがより高く,QT間隔の延長がより顕著であることが示されています.
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