慢性性不全性左心室機能不全の患者における運動誘発によるミトラル吐の変化の予後的重要性

Patrizio Lancellotti¹, Pierre Troisfontaines, Anne-Christine Toussaint

¹Department of Cardiology, University Hospital of Liège, B-4000 Liege, Belgium.

Circulation

|September 17, 2003

まとめ

心臓発作後の患者における運動によるミトラル吐度 (MR) 変化の評価は,重要な予後情報を提供します. 運動中に MR の有意な増加は,より密接な監視を必要とする高リスクの個人を特定します.

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
エコーカルディオグラフィーエコーカルディオグラフィー

背景:

心筋梗塞後の死亡リスクは,ミトラル吐症 (MR) の重症度と相関しています.
缺血性MRは,運動中に潜在的に評価可能なダイナミックな状態です.
運動によるMR変化の予測値は未定です.

研究の目的:

運動によるMR度の変化の定量的な評価が,不全性MRと左心室機能不全の患者に予後情報を提供するかどうかを判断する.

主な方法:

慢性性不全性左心室機能不全と少なくとも軽度のMRを有する98人の患者を対象とした前向きな研究.
静止状態および運動中のMR発吐量および有効発吐孔 (ERO) の定量測定.
19ヶ月の追跡調査で,外科患者が検閲されました.

主要な成果:

心臓発作による死亡の独立予測要因には,運動によるERO増加 (>13mm2),休息時のERO増加 (>20mm2) および短縮されたミトラス減速時間が含まれています.
運動によるMRの増加が顕著な患者は,より高い死亡率を示した.
運動中にMRが減少した患者では,心臓病による死亡は発生しなかった.

結論:

運動によるMR変化の定量的な評価は,不全性MR患者の独立した予後値を提供します.
運動によるMRの増加は,有害な結果のリスクが高い患者を特定します.

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