40歳以降の長QT症候群
Ilan Goldenberg1, Arthur J Moss, James Bradley
1Cardiology Division of the Department of Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA. Ilan.Goldenberg@heart.rochester.edu
Circulation
|April 23, 2008
まとめ
40歳以上の先天的な長QT症候群 (LQTS) の患者は,依然として重大な心疾患のリスクに直面しています. 性別,最近の昏睡,およびLQT3遺伝子型などの要因は,この高齢者集団のアウトカムに影響します.
科学分野:
- 心臓病学 心臓病学
- 遺伝学 遺伝学とは
- 内科内科は,内科の内科である.
背景:
- 生まれながらの長QT症候群 (LQTS) に関する以前の研究は,主に若い個人に焦点を当てていました.
- 高齢者集団におけるLQTSの臨床経路は,まだ十分に研究されていない.
研究 の 目的:
- 41歳から75歳までのLQTS患者における生命を脅かす心臓疾患のリスクを調査する.
- 高齢のLQTS患者の心臓発作リスクに影響を与える要因を特定する.
主な方法:
- 国際LQTSレジストリから2759人の被験者を分析し,修正されたQT間隔 (QTc) によって分類しました.
- 異なる年齢層 (41歳から60歳,61歳から75歳) で,中絶された心停止または死亡のリスクの評価.
- リスク因子として,性別の違い,臨床歴 (シンコーペ),遺伝子変異 (LQT3遺伝子型) の評価.
主要な成果:
- 41歳から60歳のLQTS患者は,影響を受けていない個人に比べて,心臓イベントのリスク (HR 2.65) が著しく高かった.
- 61歳から75歳までの年齢層ではリスクが減少した (HR 1.23),しかし依然として高かった.
- 影響を受けた女性は,境界線 (16%) と影響を受けていない (12%) 女性よりも高いイベント率 (26%) を有しており,男性の割合はグループ間で類似していました.
- 最近の (HR 9.92) とLQT3遺伝子型 (HR 4.76) は,有害事象の有意な予測者でした.
結論:
- 40歳以上の先天性QT延長症候群の患者は,生命を脅かす心臓発作のリスクが高いままです.
- 高齢者のLQTSの発現は,性別,臨床歴,特定の遺伝子変異を含む年齢に関連する要因によって形成されます.
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