左心室の同心的改造は,全局的および地域的縮機能の低下と関連している:動脈硬化症の多民族研究
Boaz D Rosen1, Thor Edvardsen, Shenghan Lai
1Cardiology Division, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Circulation
|August 17, 2005
まとめ
集中型左心房リモデリングは,無症状の個体における地域性心筋機能の低下と関連しています. この減少は,左前面下降動脈領域で最も顕著であり,初期の心筋機能不全を示唆しています.
科学分野:
- 心臓病学 心臓病学
- 心血管画像検査についてです.
- 心筋力学 心筋力学 メカニズム
背景:
- 補償性心臓改造から心不全への進行は,ヒトでは不明である.
- 早期の心筋機能不全に影響を与える要因を調査することは極めて重要です.
研究 の 目的:
- 集中リモジリングと地域左心室 (LV) 機能の関係を調べる.
- 無症状の個体における初期発心筋機能不全の決定因子を理解する.
主な方法:
- 多民族性動脈硬化症研究 (MESA) の無症状441人の参加者において,心筋筋タグのMRIを用いた.
- ハーモニック・フェーズ (HARP) 解析によるピーク・シストリック・ミッドウォール・サーミフェンシャル・ストレンス (Ecc) を用いて,地域性心筋機能の分析.
- 左心室の質量と終末の透析体積 (M/V比) の比によって,同心的改造を評価する.
主要な成果:
- 男性のM/V比の増加とピークグローバルEcc (P<0.001) の間に有意な逆相関が観察されました.
- 女性の場合,Eccの減少は,M/V比率の最高と最低のクインチル (P=0.1) の間でのみ有意であった.
- 減少したEccとより高いM/V比の関連性は,両性 (P<0.001男性,P=0.02女性) の左前垂直冠動脈領域で顕著でした.
結論:
- 集中的な左心室リモデリングは,無症状の個体における地域性シストリック機能の低下と関連しています.
- 観察された地域機能の低下,特にLAD領域では,心筋機能不全の初期段階を示す可能性があります.
- この発見は,心臓を改造する際に画像を用いた心臓機能障害の早期発見の可能性を強調しています.
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