大動脈狭窄症の患者における心動力学と保存された対減少したエジェクション分数
Mark A Peterzan1, William T Clarke2, Craig A Lygate
1Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine (M.A.P., J.Y.C.L., J.J.M., J.J.R., M.J.H., S.N., O.J.R.), University of Oxford, United Kingdom.
Circulation
|May 23, 2020
まとめ
重度の大動脈狭窄症 (SevAS) は,クレアチンキナーゼ (CK) の容量と流れを低下させ,エネルギー供給に影響します. CKを標的とした治療は,AS患者におけるシストリック機能不全を予防する.
科学分野:
- 心臓病科
- 生物化学
- 医療用イメージング
背景:
- 重度の大動脈狭窄症 (SevAS) は原因不明の収縮機能障害を引き起こす可能性があります.
- この移行におけるクレアチンキナーゼ (CK) 容量およびフルースの役割が研究されています.
研究 の 目的:
- CK容量と流量低下がSevASにおけるシストリック機能不全と関連しているという仮説を検証する.
- AS患者におけるCK機能,心筋エネルギー,左心房 (LV) 機能の関係を調べる.
主な方法:
- 5つのグループで102人の参加者を募集した. 中程度のAS,エジェクション分数保存または減少のSevAS,健康なボランティア,非圧力負荷の心臓バイオプシーコントロール.
- 心臓の磁気共鳴画像と31P磁気共鳴スペクトロスコーピーを利用しました.
- CK活性,イソフォーム,シトラート合成,および全クレアチンのためのLVバイオプシを分析し,ミトコンドリア-サルコメールの拡散距離を計算した.
主要な成果:
- CK流はASで減少した (32%,P=0. 04),主にフォスフォクレアチン/ ATPの減少による.
- 総CK,シトラート合成酵素活性,CK同位体活性がASでは低かった.
- ミトコンドリア・サルコメアの拡散距離は,CK総活性と相関する (r=0. 86,P=0. 003).
結論:
- 特にシストリック不全の患者では,CKの総容量が減少しています.
- エネルギー障害は中程度のASでも存在し,シストリック機能障害の前にCK流量が減少します.
- CKの容量とフクロスをターゲットにすることは,ASにおける縮性不全の予防と治療のための潜在的な治療戦略です.
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