機能性ミトラレギュリテーションのための厳格な制限アンヌロプラスティは,機能性ミトラレギュリテーションの狭窄と肺高血圧を引き起こすのですか?
Satoshi Kainuma1, Kazuhiro Taniguchi, Takashi Daimon
1Department of Cardiovascular Surgery, Japan Labor Health and Welfare Organization Osaka Rosai Hospital, Sakai, Osaka, Japan.
Circulation
|September 14, 2011
まとめ
機能性ミトラル反吐のための制限性ミトラルアンヌロプラスティは,機能性ミトラル狭窄症を引き起こす可能性があります. しかし,手術後の残留性肺高血圧は左心房機能不全と関連しており,真髄狭窄とは関係なく,不良心疾患を予測します.
科学分野:
- 心臓病学 心臓病学
- 心臓外科手術について
- 心血管画像検査 (CVDI) について
背景:
- 機能性ミトラル反吐 (MR) のための制限性ミトラルアンヌロプラスティ (RMA) は,機能性ミトラル狭窄症 (MS) を引き起こす可能性があります.
- RMAがMSおよびその後の肺高血圧 (PH) に及ぼす影響については,依然として議論されている.
- RMA,MS,PHの関係を調査することは,患者のアウトカムにとって極めて重要です.
研究 の 目的:
- 機能性MRのRMA後の機能性MSの発生率を評価する.
- RMA後の残留性肺高血圧 (PH) の原因を特定するために.
- RMA後の不良心イベントの予測要因を特定する.
主な方法:
- LV機能不全と重度のMRを患っている108人の患者がRMAを受けた.
- ドップラーエコーカルディオグラフィーと心臓キャセテリゼーションは,ミトラル弁の機能,肺動脈の圧力,およびLVの機能を評価するために使用されました.
- 患者は,手術後のアウトカムと不良心疾患の評価のために追跡されました.
主要な成果:
- RMAは,半減期とグラデントの圧力増加によって示される機能性MSをもたらし,効果的な穴の面積を減少させた.
- 手術後の静脈性肺動脈圧 (PAP) は32±8mmHgであった.
- 残留PHは,MSではなく,LV機能不全と肺血管疾患と関連しており,不良心事象を予測した.
結論:
- 機能的なMRに対するRMAは,機能的なMSにつながる可能性があります.
- RMA後の残留PHは,主にLV機能障害と肺血管疾患によって引き起こされます.
- 機能性MSではなく,手術後のPHは,不良心疾患の主な予測因子です.
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