生まれながらの心疾患の若い患者における心房動の負担
Zacharias Mandalenakis1, Annika Rosengren2, Georg Lappas2
1Institute of Medicine, Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, University of Gothenburg, Sweden. zacharias.mandalenakis@gu.se.
Circulation
|November 3, 2017
まとめ
先天性心疾患 (CHD) の患者は,心房細動 (AF) の発生リスクが著しく高い. この増加したリスクは,特に複雑な欠陥の場合,心筋梗塞および心不全などの合併症に対する標的型モニタリングを必要とします.
科学分野:
- 心臓病科
- 小児心臓科
- 電気生理学
背景:
- 生まれながらの心疾患 (CHD) の患者は,解剖学的および外科的要因により,心房細動 (AF) のリスクが高いと推定されています.
- 過去の研究では,小児および若年成人における心臓発作の発生と合併症を対照群と比較して適切に比較できませんでした.
研究 の 目的:
- 生まれながらの心疾患 (CHD) を有する子供および若年成人における心房細動 (AF) の発生率を調査し,対照群と比較する.
- CHDの患者におけるAFに関連した合併症を特定する.
主な方法:
- 1970年から1993年に生まれたスウェーデンの患者と死因の登録を活用した.
- 生年,性別,郡によって 10人の対照群と一致した.
- 2011年までデータ収集を追跡した.
主要な成果:
- CHDの患者は,対照群と比較して,AFを発症するリスクが22倍 (21. 99倍) 高い.
- 冠状動脈の欠陥は最大AFリスク (HR 84.27) であった.
- 42歳までには,心筋梗塞患者の8. 3%が心筋梗塞を発症し,心筋梗塞の主要な合併症は心筋梗塞の10. 7%であった.
結論:
- CHDの子供と若者は,かなりAFの危険性が高くなります.
- 複合性先天性心疾患は最大AFリスクと関連しており,標的型モニタリングが必要である.
- 心不全は,心不全を発症した患者にとって重大な合併症です.
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