ハイパートロフィック心筋症候群における心筋原の周回量
Raffaella Lombardi1, Sandro Betocchi, Maria Angela Losi
1Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Federico II University School of Medicine, Naples, Italy.
Circulation
|September 4, 2003
まとめ
コラーゲンの周回量は,高縮性心筋病 (HCM) で増加します. 強化されたコラーゲンI合成と抑制されたマトリックス金属タンパク質酵素 (MMPs) は,HCM患者における静脈機能不全に寄与する.
科学分野:
- 心血管科学の研究について
- 細胞外マトリックスの生化学
- 心臓病理生理学 心臓病理生理学
背景:
- 筋のインタースティシャル線維症は,高縮性心筋病変 (HCM) の特徴です.
- コラーゲンの改造を理解することは,HCMの進行を理解するために重要です.
研究 の 目的:
- ハイパートロフィック心筋病 (HCM) 患者におけるコラーゲン周回率マーカーの調査.
- HCMにおけるコラーゲン周回と左心室 (LV) のダイアストリック機能の関係を評価する.
主な方法:
- 放射性免疫測定法とELISAは,コラーゲン合成 (PIIINP,PICP,PINP),分解 (ICTP),マトリックス金属タンパク質酶 (MMP:MMP-1,MMP-2,MMP-9) および金属タンパク質酶-1の組織阻害剤 (TIMP-1) を測定するために使用されました.
- エコーカルディオグラフィーは,左心室 (LV) のダイアストリック機能を評価し,トランスミトラル (A) と肺静脈 (AR) の波長 (A-Ar) を用いて被動的ダイアストリック機能を推定しました.
- 制限的または擬似正常なLV充填パターンを有する患者は,被動的立方体機能不全を患っていると特定されました.
主要な成果:
- HCMの患者は,対照群と比較して,PIIINP,ICTP,MMP-2,MMP-9,およびTIMP-1の総値が著しく高かった.
- PIIINPのレベルは,LVの終端ダイアストリック直径と逆に相関していた.
- パッシブ・ダイアストリック機能 (A-Ar) は,コラーゲンI蓄積マーカー (PICP,PINP,ICTP) と逆関係があり,MMP-1およびMMP-2レベルと直接関係していました.
結論:
- コラーゲンの周回量は,高縮性心筋病 (HCM) の患者で著しく上昇しています.
- MMP-1とMMP-2の阻害は,デグラデーションに対するコラーゲンI合成の普及と併せて,HCMにおける被動性ダイアストリック機能不全につながる.
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