ハイパートロフィック閉塞性心筋症における二室ペースの効果
X Jeanrenaud1, J J Goy, L Kappenberger
1Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Lancet (London, England)
|May 30, 1992
まとめ
デュアル・チャンバー・ペースは,高縮性阻害性心筋症の非外科的な代替手段を提供します. このセラピーは,圧力グラデーションを効果的に減らし,患者の症状を改善し,長期的な利益をもたらします.
科学分野:
- 心臓病学 心臓病学
- 医療機器 医療機器について
背景:
- ハイパルトロフィック阻害性心筋病変 (HOCM) は,耐火性症例ではしばしば外科的介入を必要とします.
- デュアル・チャンバー・ペースングは,潜在的な非外科的治療の選択肢を示しています.
研究 の 目的:
- HOCMの患者における急性および長期の二重室ペースの有効性を評価する.
- 静脈内圧グラデーションと機能能力に対するペースの影響を評価する.
主な方法:
- 13人のHOCM患者で二重室ペースの急性および長期的な効果を調査した.
- 個々の患者に対して,心房静脈 (AV) の間隔を最適化 (50-90 ms).
- 62ヶ月間,圧差,心拍数,および臨床症状 (胸痛,呼吸不全) をモニタリングしました.
主要な成果:
- 急性AVシーケンシャルペースは12/13の患者でピークサブアオルティック圧力グラデーションを (82〜47mmHg,p <0.002) 大幅に低下させた.
- 長期にわたるペースは機能能力を向上させ,NYHAクラス3から1のアンギナとクラス3から2の呼吸不全を軽減しました.
- 遮断の減少への傾向が観察され,隔膜の厚さや収縮性において有意な変化はありませんでした.
結論:
- 最適化されたAV間隔で同期された双室ペースは,HOCMにおける心室内圧差を効果的に軽減します.
- この非手術療法により,機能的耐性において,有意かつ持続的な改善が得られます.
- 二重室ペースは,選択されたHOCM患者にとって手術の有効な代替手段です.
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