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1型糖尿病における冠動脈微血管機能障害と心臓のエネルギー障害の関係
G Nallur Shivu1, T T Phan, K Abozguia
1Department of Cardiovascular Medicine, University of Birmingham, Edgbaston, Birmingham, UK. drgani23@gmail.com
Circulation
|March 3, 2010
まとめ
1型糖尿病は,疾患の持続時間に関係なく,若い成人の心臓のエネルギーに悪影響を及ぼします. この心臓機能障害はマイクロ血管の問題と関連していないので,代謝問題が主な原因であることを示唆しています.
科学分野:
- 心臓病学 心臓病学
- 糖尿病学 糖尿病学
- メタボリック研究
背景:
- 糖尿病の無症状の個人は,しばしば心不全の潜在的前駆体である心臓のエネルギー機能の低下を示します.
- 1型糖尿病 (T1DM) は,症状がない場合でも,心臓のエネルギー代謝に大きな影響を与える可能性があります.
研究 の 目的:
- T1DMの被験者における心臓エネルギー障害の発達におけるマイクロ血管機能障害の役割を調査する.
- T1DMの無症状の個体における心臓のエネルギーとマイクロ血管機能を評価する.
主な方法:
- 25人の無症状T1DM被験者 (新たに診断され,長期間) と26人の健康な対照群を募集しました.
- エコーカルディオグラフィー,エクササイズEKG,磁気共鳴スペクトロスコピー,およびストレスの磁気共鳴画像を用いた.
- 評価されたフォスフォクレアチン/ガンマ-ATP比と心筋 perfusion reserve index. 評価されたフォスフォクレアチン/ガンマ-ATP比と心筋 perfusion reserve index. 評価された心筋 perfusion reserve index. そして心筋 perfusion reserve index.
主要な成果:
- T1DMの被験者は,新たに診断された者,またはより長い期間,コントロールと比較して,フォスフォクレアチン/ガンマ-ATP比が著しく低下したことを示しました.
- 新たに診断されたグループと,より長く続いたT1DMグループでは,フォスフォクレアチン/ガンマ-ATP比の有意な違いは観察されなかった.
- 長期T1DM患者では,心筋 perfusion reserve indexが低かったが,フォスフォクレアチン/ガンマ-ATP比との相関は認められなかった.
結論:
- 合併症のないT1DMの若い個人は,糖尿病の期間に関係なく,心筋動脈のエネルギーが低下しています.
- T1DMにおける心臓エネルギー障害は,冠動脈微血管機能不全と関連していません.
- 微血管障害ではなく代謝機能不全がT1DMにおける心臓のエネルギー障害の主な要因であると仮定されています.
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