運動性肺高血圧は,無症状の退行性ミトラル吐症で起こります
Julien Magne1, Patrizio Lancellotti, Luc A Piérard
1Department of Cardiology, Heart Valve Disease Clinic, University Hospital Sart Tilman, University of Liège, Belgium.
Circulation
|June 23, 2010
まとめ
運動性肺高血圧 (PHT) は,退行性ミトラル吐症の患者で一般的です. ミトラル反発の重度の増加は,運動PHTを予測し,これは症状のない生存率の減少と関連しており,症状の発症を予測します.
科学分野:
- 心臓病学 心臓病学
- エコーカルディオグラフィー エコーカルディオグラフィー
- バルブ性心疾患 バルブ性心疾患とは
背景:
- 現在のガイドラインでは,症状のない重度の変性性ミトラル吐症のミトラル手術を推奨し,LV機能が保たれ,肺高血圧 (PHT) を運動させる.
- これらの患者における運動PHTの決定因子は未評価のままである.
研究 の 目的:
- 退行性ミトラル吐症の患者における運動PHTのエコーカルディオグラフィの予測要因を特定する.
- 症状と生存に対する運動PHTの影響を評価する.
主な方法:
- 中度から重度までの退行性ミトラル反発症の78人の患者は,休息と運動のトランストロラクス回心回声検査を受けた.
- 運動性肺高血圧 (PHT) は,静脈性肺動脈圧 (SPAP) >60mmHgとして定義されました.
- 多変量分析とROC曲線を使用して予測要因を特定し,精度を評価しました.
主要な成果:
- 運動PHTは,患者の46%に存在していました.
- 運動効果のある反発性開口は,運動SPAPとPHTの独立した決定因子でした.
- 休息と運動の両方のPHTは,症状のない2年間の生存率の減少と関連していました.
- 運動PHTは症状の発生を独立して予測した (HR=3.4,P=0.002).
結論:
- 運動PHTは,無症状の退行性ミトラル吐症で頻繁に見られます.
- 運動のミトラル反発の重さは,運動SPAPとPHTを予測する.
- 運動によるPHTは,無症状生存率を著しく低下させ,症状の発症を正確に予測し,運動エコーカルディオグラフィの価値を強調する.
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