心臓の交感活動と高血圧の左心室高縮の関係
Markus P Schlaich1, David M Kaye, Elisabeth Lambert
1Human Neurotransmitter Laboratory, Baker Heart Research Institute and Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria 8008, Australia. markus.schlaich@baker.edu.au
Circulation
|July 9, 2003
まとめ
高血圧に起因する左心房高症は,心臓の交感性活動の増加と関連しています. これは,心臓におけるノレピネフリン放出量の増加が,左心室縮症の発達に寄与することを示唆しています.
科学分野:
- 心臓病学 心臓病学
- 高血圧の研究 高血圧の研究
- 自律神経系の研究 自律神経系の研究
背景:
- 左心室 (LV) ハイパルトロフィーは,高血圧患者における心血管疾患の重要な危険因子です.
- ヒトにおけるLV増殖の発達における交感性活性化の役割については,さらなる検証が必要である.
研究 の 目的:
- 左心室縮の有無と有無で高血圧患者における全身的および地域的交感性活性を調べ,比較する.
- 高血圧における交感活動と左心室質量との関係を決定する.
主な方法:
- 交感活性を評価するために,放射性トレーサーの薄解法とマイクロニューログラフィーを利用しました.
- 3つのグループを比較した. LV高圧症 (EH+),LV高圧症 (EH-) のない高圧症,およびノルモテンシブ対照群 (NT).
- 測定されたLV質量指数,全体および腎臓のノルエピネフリン溢出量,筋肉交感神経の活動,および心臓のノルエピネフリン溢出量.
主要な成果:
- 筋肉の交感神経活動と心臓のノレピネフリン溢出は,LV高圧症 (EH+) の高血圧群においてのみ有意に上昇した.
- 心臓のノルエピネフリン溢出は,すべての被験者において,LV質量指数と正の相関を示した.
- 全身および腎臓のノルエピネフリン溢出量は,高血圧の両方のグループで高かったものの,心臓特異的な活動は,EH+で独特に増加した.
結論:
- 高血圧の左心房高縮は,主に心臓に局所化された交感活動と関連しています.
- 心臓のノルエピネフリン放出量の増加は,高血圧患者における左心房縮症の発症の重要な要因であるようです.
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