左心室機能不全,心不全,またはその両方を有する患者の心筋梗塞後の機械的不協和症
Sung-Hee Shin1, Chung-Lieh Hung, Hajime Uno
1Cardiovascular Division, Brigham and Women's Hospital, Boston, MA 02115, USA.
Circulation
|February 24, 2010
まとめ
機械的不協和は,心不全の患者でより悪い結果を予測する. この研究では,左心室不協和症は,心筋梗塞後の死亡または心不全のリスクを独立して増加させることが示されています.
科学分野:
- 心臓病学 心臓病学
- 心血管画像検査についてです.
- 心不全に関する研究
背景:
- 機械的不協和症は,心不全における有害な心血管疾患の予測因子として知られています.
- 発心筋梗塞後のメカニカル・ディシンクロニーの予後的意義については,さらなる定義が必要である.
研究 の 目的:
- 筋心臓梗塞後の患者の臨床結果に対する機械的不協和性の影響を調査する.
- 左心室不協和症が,心筋梗塞後の死亡または心不全の独立した危険因子であるかどうかを判断する.
主な方法:
- VALIANTエコーカルディオグラフィー研究から381人の患者の心室同期を評価するために,速度ベクトル画像を用いたBモードスペックルトラッキングを使用しました.
- 地域のピーク速度までの時間と,左心室の12のセグメントでストレスの速度までの時間を測定しました.
- これらの測定値の標準偏差 (SD) を非同期指数として計算した.
主要な成果:
- 多変数Coxモデルでは,ピーク速度までの時間 (HR/10 ms: 1.10) のSDと,ストレスの速度までの時間 (HR/10 ms: 1.16) のSDは,死亡または心不全の有意な独立した予測指標でした.
- これらの発見は,臨床的およびエコーカルディオグラフィの変数に調整された.
結論:
- 左心室不協和症は,心筋梗塞後の死亡率増加と心不全イベントの独立した危険因子です.
- 収縮パターンは,心筋梗塞後の期間の予後に影響を与える可能性があります.
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