運動による心臓トロポニンI増加と死亡率と心血管疾患
Vincent L Aengevaeren1,2, Maria T E Hopman1, Paul D Thompson3
1Departments of Physiology (V.L.A., M.T.E.H., E.A.B., D.H.J.T., T.M.H.E.), Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Circulation
|August 13, 2019
まとめ
長距離歩いた後の心臓のトロポニンI濃度の上昇は,高齢者の死亡率と心血管疾患の増加を予測します. これは運動によって引き起こされる トロポニンの増加が 単なる良性反応ではなく 将来の健康リスクを示すことを示唆しています
科学分野:
- 心臓病科
- 運動 生理学
- バイオマーカー
背景:
- 心臓のトロポニンが99パーセント以上上昇することは,急性心筋損傷と心臓発作の診断に不可欠です.
- 99パーセント以下でも トロポニンのレベルは 悪い結果を予測します
- 特に耐久運動後の運動によるトロポニンの増加の臨床的意義は不明である.
研究 の 目的:
- 運動後の心臓のトロポニンI濃度と長距離歩行者の臨床結果との関連を調査する.
- 運動によるトロポニンの上昇が心血管疾患と死亡率を予測するかどうかを判断する.
主な方法:
- 心臓のトロポニンIは30~55キロの歩行前と後に725人の参加者に測定された.
- この研究では,運動後のトロポニンIの99パーセント以上の値 (> 0. 040μg/ L) と,死亡率と主要心血管疾患の複合エンドポイントとの関連が評価されました.
- 心血管リスク因子と前病状の調整により,追跡期間は平均43ヶ月でした.
主要な成果:
- トロポニンI濃度は,歩いた後に有意に上昇した (P<. 001).
- 参加者の9% (63/ 725) が運動後のトロポニンI > 0. 040μg/ Lであった.
- 運動後のトロポニンI値が上昇した参加者は,複合エンドポイント (27%対7%,ログランクP<. 001) の発生率が著しく高く,ハザード比率は2. 48 (95%CI,1. 29~4. 78) であった.
結論:
- 運動によって引き起こされる トロポニンIの値が99パーセントを超えると 死亡率や心血管疾患の発生が 独立して予測されます
- これらの発見は,運動によって引き起こされるトロポニンの増加が良性的な生理学的反応ではないことを示唆しています.
- トロポニンの運動後の上昇は,高齢者の将来の有害な健康結果の早期マーカーとして機能する可能性があります.
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