運動による肺動脈高血圧
James J Tolle1, Aaron B Waxman, Teresa L Van Horn
1Pulmonary and Critical Care Unit, BUL 1-148, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA. jjtolle@yahoo.com
Circulation
|November 5, 2008
まとめ
運動誘発性肺動脈高血圧 (PAH) は,PAHスペクトルの軽度で初期段階である. 侵襲的な検査は,静止状態のPAHとは異なる臨床的に重要な状態であることを確認しています.
科学分野:
- 心臓病学 心臓病学
- 肺内医学 肺内医学 肺内医学
- 運動生理学 運動生理学
背景:
- 運動誘発性肺動脈高血圧 (PAH) の臨床的意義は十分に理解されていません.
- 運動によるPAHを研究するために,直接の血液動力学的測定はめったに用いられていない.
研究 の 目的:
- 運動によるPAHの血液動力学的特性を調査する.
- 運動によって引き起こされるPAHがPAHスペクトル内の異なる生理学的段階を表しているかどうかを判断する.
主な方法:
- 侵襲的な心肺運動検査は,406人の患者に実施されました.
- 肺動脈と放射性動脈カテーテルと放射性核体心房検査を使用した.
- 運動によるPAHと静止状態のPAHと正常な対照群を比較するために,血液動力学的データを分析した.
主要な成果:
- 運動によって引き起こされたPAH (n=78) は,中間の酸素吸収と肺動脈の圧力と抵抗が正常と比較して高かった.
- 圧力-酸素吸収プロットにおける"高原"パターンは,運動能力の低下と,休息時の肺血管抵抗性の上昇と関連していた.
- この平原パターンは,休息状態のPAHにおいてより一般的であったが",離陸"パターンは,正常な状態において見られた.
結論:
- 運動によって引き起こされるPAHは,肺動脈高血圧のスペクトル内の早期,軽度の段階として識別されます.
- この状態は生理学的に独特で,臨床的に関連しています.
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