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急性ストレス誘発性 (タコツボ) 心筋病変における心筋膜および全身性炎症
Caroline Scally1, Hassan Abbas1, Trevor Ahearn1
1Aberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, UK (C.S., H.A., T.A., J.S., A.M., A.R., A.Y.-F., R.Y., C.D., P.B., H.M.W., D.K.D.).
Circulation
|December 28, 2018
まとめ
炎症はタコツボ心筋病変において重要な役割を果たし,炎症マーカーの増加とマクロファージの浸透が観察されました. これらの炎症的変化は少なくとも5ヶ月間持続し,慢性的な炎症状態を示します.
科学分野:
- 心臓病科
- 免疫学
- 医療用イメージング
背景:
- タコツーボ心筋病 ストレスによる心筋病は 心筋梗塞を模倣し 心不全を引き起こす可能性があります
- タコツボ心筋病の病理学と長期的な予後は完全に理解されていません.
- この研究は,タコツボ心筋病における炎症の役割を調査した.
研究 の 目的:
- 炎症がタコツボ心筋病変の 病理生理学の中心であるかどうかを判断する
- 肌動脈炎症と全身性炎症マーカーを評価する.
- 炎症の変化の持続性を評価する.
主な方法:
- 55人のタコツボ心筋病患者と51人の対照群を対象とした多センター前向きな研究.
- 超小型の超パラマグネット酸化鉄 (USPIO) 強化による多パラメータ心筋MRIで,心筋マクロファージを検出する.
- 血液の単細胞群と血清のサイトカインの評価
主要な成果:
- タコツーボの心筋病患者は,対照群と比較して,左心室のUSPIO増幅を示した.
- 血清のインタールイキン6とケモカインリガンド1の上昇と,変異した単細胞サブセットが,タコツボ心筋病患者で発見されました.
- 心筋USPIO増強は5ヶ月で解消したが,インタールイキン6の上昇と変異した単細胞サブセットは持続した.
結論:
- タコツボ心筋病は,心筋炎症,単細胞分布変化,全身性炎症性サイトカインの増加によって特徴付けられます.
- これらの炎症的変化は,少なくとも5ヶ月持続する低度の慢性炎症状態を示唆する.
- 炎症はタコツボ心筋病変の病理生理学と自然史の重要な要素です.
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