大動脈張張は,拡張性心筋症候群の患者における運動耐久性に独立して影響する
Stefano Bonapace1, Andrea Rossi, Mariantonietta Cicoira
1Dipartimento di Scienze Biomediche e Chirurgiche, Sezione di Cardiologia, Università degli Studi di Verona, Verona, Italy.
Circulation
|April 2, 2003
まとめ
脈波速度 (PWV) で測定される大動脈の硬さの増加は,拡張性心筋症の患者でピーク運動酸素消費量 (VO2) の減少を独立して予測し,運動不耐性を説明します.
科学分野:
- 心臓病学 心臓病学
- 心血管生理学 心血管の生理学
- バイオメディカルエンジニアリング
背景:
- ピーク運動酸素消費量 (VO2) は,心不全の予後のために不可欠です.
- 拡張性心筋病 (DCM) のVO2の血液動力学的決定因子については,さらなる解明が必要である.
- 大動脈壁の弾力性は,心臓の機能と冠動脈の血流に影響します.
研究 の 目的:
- 動脈の硬さのマーカーである大動脈脈波速度 (PWV) の増加が,DCM患者のピークVO2を予測するかどうかを調査する.
- DCMにおける大動脈の硬さと運動能力の関係を解明する.
主な方法:
- 78人のDCM患者は,大動脈PWVの測定のために,エコーカルディオグラフィとドップラー超音波検査を受けた.
- ガス交換モニタリングによる自転車運動テストにより,ピークVO2が決定されました.
- プラズマアミノ端末プロペプチドIII型プロコラーゲン (PIIINP) のレベルを分析した.
主要な成果:
- 大動脈PWV (r=-0.39) と脳卒中量 (r=0.38) はピークVO2.0と相関しています.
- PWV (P=0.04) と脳卒中量 (P=0.05) は,VO2の独立した予測因子であり,その多様性の34%を説明しました.
- PIIINPレベルは,PWVと,制限的なダイアストリック充填パターンと相関しています.
結論:
- より高いPWVによって示される大動脈の硬さの増加は,DCMにおけるピークVO2の減少の独立した予測因子です.
- 大動脈の硬さは,DCM患者の運動不耐性を部分的に説明する可能性があります.
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