コミュニティにおけるシストリックおよびダイアストリック心不全

Francesca Bursi¹, Susan A Weston, Margaret M Redfield

¹Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minn 55905, USA.

JAMA

|November 9, 2006

まとめ

心不全 (HF) は多様で,コミュニティの患者の半数以上がエジェクション分数 (EF) を保存している. 保存された心不全と減少した心不全の両方が,同様の高い死亡率を示しています.

科学分野:

心臓病学心臓病学
クリニカル・メディシン臨床医学
エコーカルディオグラフィーエコーカルディオグラフィー

背景:

心不全 (HF) は異質な症候群である.
HFの特性に関するコミュニティベースのデータは限られている.
ディアストリック機能の体系的な評価は,しばしば欠けています.

研究の目的:

コミュニティに住むHF患者におけるエジェクション分数 (EF),ダイアストリック機能,および脳ナトリウレチンペプチド (BNP) レベルを将来的に評価する.
コミュニティの環境におけるHFの現象型を特徴づける.

主な方法:

オルムステッド郡の住民の発生または流行のHFを持つ将来の採用.
エコーカルディオグラフィーはEFとダイアストリック機能を評価します.
BNPレベルを測定するための血液検査.
6ヶ月の死亡率の追跡.

主要な成果:

556人の参加者がエコーカルディオグラフィーを受けた.
保存されたEF (≥50%) は55%の患者で発見され,高齢化,女性性,心筋梗塞の anamnesisなしと関連していました.
隔離された立方体機能不全 (立方体機能不全で保存されたEF) は,患者の44%に存在しました.
減少したEFとダイアストリック機能不全の両方が,より高いBNPレベルと相関しています.
6ヶ月の死亡率は,保存されたEF群と減少したEF群の両方で16%でした.

結論:

コミュニティでは,HF患者の半数以上がEFを保存しており,隔離された下痢機能不全は40%以上です.
EFと下痢機能不全は,独立してBNP濃度の上昇と関連しています.
保存されたEFを持つ心不全は,減少したEFを持つHFと同様の高い死亡リスクを持ちます.

さらに関連する動画

09:40

Induction of Right Ventricular Failure by Pulmonary Artery Constriction and Evaluation of Right Ventricular Function in Mice

Published on: May 13, 2019

04:20

Integration of Brain Tissue Saturation Monitoring in Cardiopulmonary Exercise Testing in Patients with Heart Failure

Published on: October 1, 2019

関連する概念動画

01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...

01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...

01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...

01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...

01:26

Heart Failure III: Clinical Manifestations

Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...

01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...

関連する実験動画