ヒストロジカルに正常な心帯の厚さを有する26人の患者における狭窄性心帯炎
Deepak R Talreja1, William D Edwards, Gordon K Danielson
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
Circulation
|October 1, 2003
まとめ
狭窄性 perikarditisは,正常な perikardial 厚さで,異常な顕微鏡の発見でも発生することができます. 循環器内皮切除は,循環器の厚さに関係なく,症状の緩和に有効です.
科学分野:
- 心臓病学 心臓病学
- 病理学 パトロジー
- 胸部外科手術について
背景:
- 狭窄性心膜炎の診断は,伝統的に心膜の厚さの増加に依存しています.
- 収縮性 perikarditis の正常な perikardial 厚さは,非侵襲的に観察されていますが,臨床病理学的詳細は欠けていました.
研究 の 目的:
- 正常な心臓の厚さを持つ患者における収縮性心周炎の臨床病理学的相関性を調査する.
主な方法:
- 収縮性 perikarditisのためにpericardiectomyを受けた143人の患者の遡及的レビュー (1993-1999).
- ベースラインの特徴,手術データ,およびヒストパト学的標本の分析.
- 正常 (<または=2mm) と厚くなった (>2mm) の循環器群に分類する.
主要な成果:
- 患者の18% (26/143) が正常な心周の厚さを持っていた.
- 通常の原因は,通常の厚さのグループには,以前の手術,放射線,心臓発作,およびイディオパシー疾患が含まれています.
- 組織病理学では,すべての正常厚さの症例で軽度の焦点異常が明らかになった; 循環器切除の結果は,グループ間で類似していた.
結論:
- 凝縮性 perikarditisでは,焦点ヒストパト学的異常にもかかわらず,心周の厚さが常に増加することはありません.
- 収縮の疑いのある心不全患者の場合,正常な心周厚さを示す非侵襲的イメージングに関係なく,心周切除術を考慮する必要があります.
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