心不全における運動誘発性肺腫
Piergiuseppe Agostoni1, Gaia Cattadori, Michele Bianchi
1Centro Cardiologico Monzino, IRCCS, Istituto di Cardiologia, Università di Milano, Via Parea 4, 20138 Milan, Italy. Piergiuseppe.agostoni@CCFM.it
Circulation
|October 29, 2003
まとめ
運動は,心不全 (HF) の患者におけるアルベオラ-毛細血管膜伝導率 (Dm) を低下させ,潜在的な肺腫を示唆する. この効果は,周期的な呼吸を持つHF患者で最も顕著です.
科学分野:
- 肺の生理学について
- 心肺動脈運動テスト
- 呼吸器系薬は呼吸器系薬として使われます.
背景:
- 心不全 (HF) の患者は,肺毛細血管の水静圧が増加したため,運動によって肺腫を発症することがあります.
- アルベオラ-毛細血管膜伝導度 (Dm) は,運動後の肺腫が発生した場合に減少すると予想されます.
研究 の 目的:
- HF患者における運動後のDmの変化を調査する.
- 運動による肺腫がDmに影響するかどうかを判断する.
主な方法:
- 測定されたDm,一酸化炭素拡散容量 (DLco),および静止状態の毛細血管血量 (Vc),運動後2分および60分.
- HF患者と対照群でRoughton-Forsterテクニックを使用した.
- 周期的な呼吸,重度のHF,中程度のHF,および健康な対照群のHF患者におけるDmの変化を比較した.
主要な成果:
- Dmは,運動後2分後にHF患者 (定期的な呼吸,重症,中等度のHF) で有意に減少したが,対照群ではそうではなかった.
- Vcはすべてのグループで運動後増加し,定期呼吸グループでのみ60分後に上昇し続けました.
- Dm/Vcは,運動後2分にHFグループで減少し,周期呼吸グループでのみ60分にDmとDm/Vcが低くなっていた.
結論:
- 運動はHF患者におけるアルベオラ-毛細血管膜伝導率の低下につながり,おそらく肺腫によるガスの交換の障害を示唆する.
- Dmの減少は,周期的な呼吸を経験したHF患者で最も顕著で,より軽度のHF患者ではより顕著ではありませんでした.
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