拡張性心筋疾患における制限性ミトラアヌロプラスティック手術後の左心房と心室の逆改造を評価するためのMRI
Jos J M Westenberg1, Rob J van der Geest, Hildo J Lamb
1Division of Image Processing, Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. j.j.m.westenberg@lumc.nl
Circulation
|September 15, 2005
まとめ
制限性アンヌロプラスティは,拡張性心筋症患者の左心房と心室の容量を効果的に減少させました. この心臓外科手術は,MRIによって確認されたように,1年以上にわたり,重要な逆転リモデリングと改善された心臓機能を示しました.
科学分野:
- 心臓病学 心臓病学
- 心臓外科手術について
- メディカルイマージング (医学イメージング)
背景:
- 左心房 (LA) と左心室 (LV) の逆転リモデリングに関するデータは限られている.
- エコーカルディオグラフィは典型的なフォローアップ方法ですが,改造を評価する際の限界は認識されています.
研究 の 目的:
- 連続MRIを用いたDCM患者におけるLAとLVの逆転リフォームに対する制限性アンヌロプラスティの影響を評価する.
- この患者集団における制限性アンヌロプラスティーの臨床結果と安全性を評価する.
主な方法:
- 重度のミトラルリグルジテーションのDCM患者20人は,限定的なミトラルアンヌロプラスティを施しました.
- 連続した心筋MRIスキャンは,手術前,手術後2ヶ月,そして手術後1年で行われました.
- LAとLVの主要な体積および機能的パラメータを分析した.
主要な成果:
- LAのエンドシストリックおよびエンドダイアストリック容量の有意な減少が1年以上にわたって観察されました (P <0.01).
- LVの終末ダイアストリック量は著しく減少 (P <0.01),LVのエジェクション分数は著しく増加 (P <0.01).
- LV質量も有意な減少を示した (P = 0.02),逆改造を示す.
結論:
- DCM患者の制限性アンヌロプラスティは,LAとLVの重要な逆改造につながります.
- この処置は,MRIで可視化されるように,優れた臨床結果と,長期的な心臓構造の変化に有利な結果と関連しています.
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