寒い環境での運動誘発性心筋動脈不全症. 抗血管性薬の効果について
M Juneau1, M Johnstone, E Dempsey
1Department of Medicine, Montreal Heart Institute, Quebec, Canada.
Circulation
|May 1, 1989
まとめ
寒さへの曝露は,ほとんどの安定したアンギナ患者の運動誘発性心筋動脈不全に有意な影響を及ぼさない. しかし,冷たい気温に敏感な個人は,冷たい気温で早期にイシュケミアを経験しますが,抗血管性薬は有効です.
科学分野:
- 心臓病学 心臓病学
- 環境生理学 環境生理学
背景:
- 安定したアンギナと運動による心筋動脈不全は,重大な懸念事項です.
- 寒い環境が心血管機能と缺血に与える影響は,十分に理解されていません.
研究 の 目的:
- 安定した心筋梗塞の患者において,低血症の値に対する寒さの影響を評価する.
- 寒い環境での抗性薬 (プロプラノロール,ディルティアゼム) の有効性を評価する.
主な方法:
- 安定したアンギナを患っている24人の患者は,ランダム化され, -8°Cと20°Cのトレッドミールテストをダブルブラインドで行いました.
- 薬にはプラセボ,プロプラノロール (80mg),ディルティアゼム (120mg) が含まれていた.
- 運動のエンドポイントは,ST沈下1mmまでの時間を含むが,記録された.
主要な成果:
- プラセボを受けたグループ全体で,冷たい気温と通常の気温の間のエクササイズエンドポイントの有意な差はありません.
- 寒さに敏感な患者は,20°Cと比較して -8°Cで血中不全が著しく早期に発症することを示しました.
- プロプラノロールとディルチアゼムは,両方の温度でイシュケミアまでの時間を延ばすのに同等に効果的でした.
- ディルチアゼムはプロプラノロルを含まないが,全運動期間を延長した.
結論:
- 寒さへの曝露は,安定したアンギナ患者において,通常,不血症の値を悪化させない.
- 寒さに敏感な患者のサブグループは,寒い条件下では低血栓性値を示しています.
- プロプラノロールやディルチアゼムのような抗血管性薬は,運動誘発性イシュケミアの冷たい環境での有効性を保ちます.
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