慢性的な右心房伸縮が,心房隔膜欠陥の患者における心房電気再構築に与える影響
Joseph B Morton1, Prashanthan Sanders, Jitendra K Vohra
1Department of Cardiology, The Royal Melbourne Hospital, Grattan Street, Parkville, Melbourne, Australia.
Circulation
|April 1, 2003
まとめ
心房隔膜欠陥 (ASD) は,慢性的なストレッチによる右心房 (RA) の電気的改造を引き起こします. 導電の遅延を含むこの改造は,ASDの閉塞後に持続し,潜在的に心房不律につながる可能性があります.
科学分野:
- 心臓病学 心臓病学
- 電気生理学 電気生理学
- 心臓外科手術について
背景:
- 心房隔膜障害 (ASD) の成人は,後年において心房不律を発症することが多い.
- 慢性的な右心房 (RA) 伸縮は,この電気的改造の疑わしい原因である.
研究 の 目的:
- ASDの成人の慢性RAの伸びによって引き起こされる心房電気再構築のパターンと持続性を特徴づける.
主な方法:
- 電気生理学的研究は,13人のASD患者と17人の対照群で,心房効果的耐火期 (AERP),伝導時間,および副鼻節機能を測定するために実施されました.
- 測定には,AERP分散,crista terminalis伝導遅延,P波の持続時間などが含まれていました.
- 追跡調査は,ASDが閉鎖された後に行われました.
主要な成果:
- ASDの患者は,対照群と比較して,著しく長い下側AERP,P波の持続時間,およびより大きなcrista terminalis伝導遅延を示しました.
- ASDの閉塞の後,RAの体積は増加し続け,crista terminalisの伝導の遅延が続いた.
- フォローアップでは,変更されたAERPへの傾向が観察されました.
結論:
- ASDにおける慢性RAのストレッチは,RAERPの増加,シヌスノード機能不全,クリストターミナリス伝導遅延を含む電気的リモデリングにつながります.
- ASDの閉塞後のcrista terminalisの持続的な伝導遅延は,長期的な心房不律の基板に寄与する可能性があります.
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