パテント・フォアメン・オヴァールと高空肺腫
Yves Allemann1, Damian Hutter, Ernst Lipp
1Department of Cardiology, Swiss Cardiovascular Center Bern, University Hospital, Inselspital, Bern, Switzerland. yves.allemann@insel.ch
JAMA
|December 28, 2006
まとめ
PFO (Patent foramen ovale) は,高地肺腫 (HAPE) に敏感な個体では4倍多く見られる. 大量のPFOは,高地でのより重度の低酸素症と関連しており,HAPEの発症に潜在的に寄与します.
科学分野:
- 心臓病学 心臓病学
- 高地医学は,高地医学である.
- 肺内医学 肺内医学 肺内医学
背景:
- 高地肺腫 (High-altitude pulmonary edema,HAPE) は,過剰な肺高血圧と低酸素症を伴うもので,そのメカニズムは不明である.
- patent foramen ovale (PFO) は,HAPEにおける低酸素血症の悪化と無作為的に関連している.
研究 の 目的:
- PFOがHAPEに敏感な個体においてより一般的であるという仮説を検証する.
- 高地でのPFOがより重度の動脈低酸素症に寄与するかどうかを判断する.
主な方法:
- 症例対照研究では,HAPEに敏感な16人の個人と,HAPEに耐性のある19人の登山者を比較した.
- トランスエゾファゲアルエコーカルディオグラフィはPFOを特定し,ドップラーエコーカルディオグラフィは肺動脈の圧力を推定し,パルス酸素測定は低高度と高高度で動脈の酸素飽和度を測定しました.
主要な成果:
- PFOは,HAPE感受性の高い個体では4倍以上の頻度で発生しました (56%対11%低高度; 69%対16%高高度).
- HAPE 感受性の高い個人は,高地での動脈酸素飽和度 (73%対83%) を著しく低下させた.
- HAPE感受性のグループでは,大きなPFOを持つ人々はより重度の低酸素症 (65%対77%) を有していました.
結論:
- Patent foramen ovaleは,HAPE.に敏感な個体において,かなり多く見られる.
- 高地での大きなPFOは,より重度の低酸素症と関連しています.
- PFOは,過度の低酸素症と高高度でのHAPE発症に寄与する要因である可能性があります.
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