閉塞性心不全の有無で左心室機能不全の患者における神経内分泌活性化の比較. 左心室機能障害の研究 (SOLVD) のサブ研究
G S Francis1, C Benedict, D E Johnstone
1Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892.
Circulation
|November 1, 1990
まとめ
神経内分泌の活性化は,明らかな心不全症状が現れる前に,左心室機能不全の初期段階でも起こります. この活性化は,心不全の悪化と利尿剤の使用とともに増大する.
科学分野:
- 心臓病学 心臓病学
- エンドクリノロジー エンドクリノロジー
- 内科内科は,内科の内科である.
背景:
- 心不全では神経内分泌の活性化が観察される.
- 心不全の症状に相対する神経内分泌活性化のタイミングは不明である.
研究 の 目的:
- 左心室機能不全 (LVD) と異なる程度の心不全の患者における神経内分泌活性化を調査する.
- 明らかに心不全の症状の前に神経内分泌の活性化があるかどうかを判断する.
主な方法:
- 左心室機能不全の研究 (SOLVD) は,射出分数 ≤35%の患者を対象とした.
- ノルエピネフリン,レニン活性,心房ナトリウレティック因子,アルギニンバソプレシンのベースライン血レベルを測定した.
- 比較された神経内分泌マーカーは,対照群,LVD患者 (明らかな心不全なし),および心不全の患者で比較された.
主要な成果:
- プラズマノレピネフリン,心房ナトリウレティック因子,アルギニンバソプレシン,およびレニン活性が大幅に上昇したものは,対照群と比較して,LVD患者で発見されました.
- 神経内分泌の活性化は,心不全の患者で最も顕著でした.
- 血レニンの活性度は,利尿薬を使用していない心不全のLVD患者では正常でしたが,利尿薬を使用している患者では有意に増加しました.
結論:
- 明らかに心不全のない左心室機能不全の患者でも神経内分泌の活性化がある.
- 明らかに心不全が発症するにつれて,神経内分泌の活性化が強まります.
- 利尿薬療法は,LVD患者における血レニン活性に影響を与える可能性があります.
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