コミュニティにおける無症状の左心房シストリック機能不全の自然史
Thomas J Wang1, Jane C Evans, Emelia J Benjamin
1Framingham Heart Study, Framingham, MA 01702-5827, USA.
Circulation
|August 13, 2003
まとめ
症状のない左心室収縮性機能不全 (ALVD) の個人は,充血性心不全 (CHF) と死亡のリスクが著しく高くなります. このリスクは,軽度の障害でも存在し,最適な治療法に関するさらなる研究が必要であることを強調しています.
科学分野:
- 心臓病学 心臓病学
- 心血管医学は,心臓血管医学である.
- クリニック・リサーチ 臨床研究
背景:
- kongestive heart failure (CHF) の進行率と,無症状の左心室収縮機能不全 (ALVD) の個体における死亡率に関するデータは限られている.
- コミュニティに住む個人のALVDの自然経歴を特徴づけることは,疾患の進行と結果を理解するために不可欠です.
研究 の 目的:
- 無症状の左心房シストリック機能不全 (ALVD) の自然経歴を調査する.
- ALVD患者において,充血性心不全 (CHF) への進行率と死亡率を決定する.
主な方法:
- フレミングハム研究 (Framingham Study) の参加者4257人を対象とした分析.
- 症状のない左心室シストリック機能不全 (ALVD) の評価は,エジェクション分数 (EF) として定義され,CHFの anamnesis がなく ≤50%です.
- CHFと死亡率を追跡するために,最大12年間の縦断的なフォローアップ.
主要な成果:
- ALVDの罹患率は男性で6.0%,女性で0.8%でした. CHFの発生率は,ALVDの被験者では100人当たり5.8人,正常な被験者では0.7人でした.
- ALVDは,心筋梗塞のリスク4.7倍 (調整HR4.7) と死亡リスク1.6倍 (調整HR1.6) と関連していました.
- 軽度のALVD (40-50%) でさえも,心筋梗塞のリスクが3.3倍増加し,中度から重度のALVD (EF <40%) でも,リスクが7.8倍増加しました.
結論:
- 無症状の左心室収縮性機能不全 (ALVD) は,心不全 (CHF) のリスクとコミュニティにおける死亡率を著しく高めます.
- 増加したリスクは,エジェクション分数 (EF) の軽度な減少でも明らかです.
- 軽度のALVDの患者に最適な治療戦略を確立するために,さらなる研究が必要である.
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