ストレス誘発性 (タコツボ) 心筋病変による長期にわたる構造的,機能的,代謝的変化
Caroline Scally1, Amelia Rudd2, Alice Mezincescu2
1Aberdeen Cardiovascular and Diabetes Research Centre, University of Aberdeen, United Kingdom (C.S., A.R., A.M., H.W., J.S., P.B., D.K.D.). carolinescally@abdn.ac.uk.
Circulation
|November 13, 2017
まとめ
タコツーボ心筋病は,しばしばストレスに関連しており,初期回復後でも,長期的な心不全の症状と心機能障害を引き起こす可能性があります. この研究は,最初のイベントの長い後に患者で持続的な機能障害を明らかにします.
科学分野:
- 心臓病科
- 心血管医学
- 心不全 の 研究
背景:
- 急性心不全症候群であるタコツボ心筋病 (TTC) は 感情的ストレスによって引き起こされます
- 左心室噴出分子の初期回復は一般的ですが,長期的な影響は不明です.
研究 の 目的:
- タコツボ心筋病の長期的臨床的および機能的結果を調査する.
- 前回のTTC患者における持続的な心機能障害と心不全のフェノタイプを評価する.
主な方法:
- 37人のTTC患者 (> 12ヵ月後) と37人の対照群を対象とした観察症例対照試験.
- 試験用アンケート (ミネソタ州 心不全患者),心肺運動検査,心声検査, 31Pスペクトロスコーピによる心筋MRIを用いた.
主要な成果:
- TTC患者の88%は,持続的な心不全症状と運動制限を報告した.
- 心臓の変形障害 (ストレスの減少),T1マッピングの上昇,心臓のエネルギー値の低下 (フォスフォクレアチン/ ATP比) がTTC患者で観察されました.
- 正常なエジェクション分数とバイオマーカーにもかかわらず,有意な亜臨床心機能不全が明らかでした.
結論:
- タコツーボの心筋病は,以前から考えられていたこととは違って,長期的な臨床的影響をもたらします.
- 患者は,サブクリニック性心機能障害による持続的な症状および機能障害を発症します.
- 長期にわたる心不全のフェノタイプは,タコツボ心筋症の後で確立されます.
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