慢性性不全性ミトラリゲルギテーションにおけるミトラリバルブ=心室複合体の幾何学的な歪み
Frederick A Tibayan1, Filiberto Rodriguez, Mary K Zasio
1Department of Cardiovascular and Thoracic Surgery, Stanford University School of Medicine, Stanford, CA 94305-5247, USA.
Circulation
|September 13, 2003
まとめ
慢性発血性ミトラル反発 (CIMR) は,下心筋梗塞後の心臓の特定の幾何学的な変化を伴う. これには,環状の膨張と後部 papillary 筋肉の移動が含まれ,CIMR.を理解するために不可欠です.
科学分野:
- 心血管科学の研究について
- 心臓のメカニズム 心臓のメカニズム
- 手術のアナトミーについて
背景:
- mitra valvular-ventricular complex の 3 次元の幾何学的変化を理解することは,慢性発血性 mitra regurgitation (CIMR) の外科的修復技術を改善するために重要です.
- 下心筋梗塞の後の幾何学的な変化は,CIMRを発症する心臓と発症しない心臓の間で異なることがあります.
研究 の 目的:
- 低心筋梗塞後の慢性性発血性ミトラリグルジテーション (CIMR) のミトラリバルブ-心室複合体の正確な3次元の幾何学的変化を調査する.
- CIMRを発症した動物と発症しなかった動物におけるこれらの幾何学的変化を比較する.
主な方法:
- 24頭の羊は,冠動脈スナーを設置し,ミトラアヌルス,パピラ筋,葉巻の周囲にマーカーを植え付けました.
- 下部心筋梗塞は,後部パピラリ筋に影響する,鈍い辺縁の枝を遮断することによって誘発された.
- 立体マーカーの位置は,シネフローロスコーピーを用いて追跡され,動物は7週間後にミトラル吐症の重度に基づいてグループ化されました.
主要な成果:
- CIMRを患った動物は,後部パピラ筋がミッドセプトアヌルスからより大きく移動 (P=0.02) し,より横向きに動き (P=0.01) することが示された.
- CIMR (((+)) の動物 (P=0.02) で,ミトラル環状セプトの横断直径の有意な増加が観察されました.
- また,CIMR (((+)) グループでは,後部用チラシの縁のより大きな頂上位移り (P=0.01) も認められた.
結論:
- より大きなセプト・ラテラル環状膨張,ラテラル・ポスターリア・パピラリ筋の移位,アピカル・ポスターリア・リーフレットの制限は,CIMRと関連しています.
- これらの幾何学的変異は,CIMR.の病原性において重要な役割を果たします.
- CIMRの治療戦略は,環状膨張と後部パピラ筋の移動の両方をターゲットにする必要があります.
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