心不全や中枢睡眠時無呼吸症候群における交感性神経活動の上昇は,心不全の重度によるものです
Darren Mansfield1, David M Kaye, Hanspeter Brunner La Rocca
1Department of Respiratory Medicine and Monash University, Alfred Hospital, Melbourne, Victoria, Australia.
Circulation
|March 19, 2003
まとめ
中枢睡眠時無呼吸症候群の閉塞性心不全患者は,交感神経の活動と肺動脈の圧力が高くなります. これらの上昇は,睡眠時無呼吸症候群の重症度そのものではなく,心不全の重症度に関連しています.
科学分野:
- 心臓病学 心臓病学
- スリープ・メディシン (睡眠医学)
- 生理学 生理学とは
背景:
- 中枢睡眠時無呼吸症候群 (CHF-CSA) による閉塞性心不全は,ノルエピネフリン (NE) と肺動脈圧 (PAP) の上昇と関連しています.
- CSA,交感神経の活動,およびCHFの重症度との関係は不明である.
研究 の 目的:
- 中枢睡眠時無呼吸症候群 (CHF-CSA),阻害性睡眠時無呼吸症候群 (CHF-OSA),および正常呼吸 (CHF-N) を有するCHF患者における交感性神経活動の調査.
- NEの転移と心臓の血液動力学と,CHF患者における呼吸不全の重度との相関を図る.
主な方法:
- 55人のCHF患者で,放射性同位素の希釈を用いて計測された全体および心臓のノレピネフリン (NE) の溢出量.
- ポリソムノグラフィに基づいたCHF-N (19),CHF-OSA (15),CHF-CSA (21) グループに分類された患者.
- 肺動脈の平均圧 (PAP) を含む,心臓の血液動力学を評価し,右心臓のキャセテリゼーションを介して.
主要な成果:
- CHF-CSAの患者は,CHF-NおよびCHF-OSAのグループと比較して,全身および心筋NEの転移が著しく高かった.
- CHF-CSA患者も,PAPの平均値が著しく高かった.
- CHFの重症度をコントロールした後,グループ間でNE運動において有意な差異は認められなかった.
- 平均PAPは,全体と心臓のNE溢出と独立して相関していました.
結論:
- CHF-CSAにおける交感性神経活動の上昇は,アプネアの重度ではなく,心不全の重度に関連しています.
- 肺動脈の平均血圧は,CHF患者における交感性活性化の重要な決定因子である.
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