血管炎患者の心臓病
Leonhard Binzenhöfer1, Katharina Strauß1, Linus Seifert1
1Medizinische Klinik Und Poliklinik I, Munich, Germany and DZHK (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Klinikum Der Universität München, Munich, Germany.
まとめ
血管炎の心臓合併症はまれですが,リスク因子や心臓の異常は一般的です. 血管炎の患者には,体系的なスクリーニングと多科目の治療が推奨されます.
科学分野:
- 心臓病科
- リウマトロジ
- 組織性血管炎
背景:
- 心臓の関わりは,血管炎の既知の合併症であり,しばしば患者の悪化と関連しています.
- 血管炎患者における構造性および不律性心疾患の特定の発生率に関するデータは限られている.
研究 の 目的:
- 各種の血管炎と診断された患者の構造的および不律性心疾患の発生率を調査する.
- 心血管疾患の危険因子と心臓異常を特定する.
主な方法:
- 巨大細胞動脈炎 (GCA),タカヤス動脈炎 (TAK),ポリアテリス結節炎 (PAN),ポリアテリス結節炎 (GPA),またはポリアテリス結節炎 (EGPA) の患者191人を対象とした単一センター試験.
- 心臓イメージングにはエコーカルディオグラフィー (70%) と心臓磁気共鳴 (11%) が含まれていた.
- 人口統計学的特徴,基礎疾患,治療法の分析
主要な成果:
- 重度の心臓合併症はまれでしたが,高血圧や脂質不全などの心臓血管リスク要因は,特にGCAでは一般的でした.
- 心臓の磁気共鳴検査は,それぞれ33%と40%のEGPA患者で左心室内静脈機能障害と心筋線維症を明らかにした.
- GCA患者では急性心筋梗塞が発生し,冠動脈血管検査では血管炎の種類によって介入の必要性が異なっていた.
結論:
- 血管炎患者の有意な割合は,心血管の危険因子,心臓の構造的異常,心律不整を示しています.
- 稀な重症発生にもかかわらず,循環器炎の患者にとって,体系的な心臓のスクリーニングと多学科的な管理が不可欠です.
- 心臓発作の早期発見と治療は,血管炎の治療結果を改善する可能性があります.
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