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Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

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Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
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Gastroesophageal Reflux Disease I: Meaning and Pathophysiology01:29

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Gastroesophageal Reflux Disease (GERD) involves the recurrent backflow of the stomach or duodenal contents into the esophagus, leading to troublesome symptoms and potential esophageal mucosal damage. Although GERD is often referred to as a disease, it is more accurately described as a syndrome, as it encompasses a range of symptoms and complications rather than a singular pathological entity, impacting a large number of individuals as the most prevalent upper gastrointestinal problem. Roughly...
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Heart Failure I: Introduction01:27

Heart Failure I: Introduction

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Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
657
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

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The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
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Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

663
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Barrett Esophagus-I: Introduction01:21

Barrett Esophagus-I: Introduction

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Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
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胃癌進行に伴う心不全リスクの増加：全国人口ベースのコホート研究

Seunghan Lee1, Mi Jin Oh1, Bokyung Kim1

  • 1Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.

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まとめ

胃癌の病期が進むにつれて心不全のリスクが高まります。遠隔期の胃癌患者は、局所期の患者と比較して、入院を必要とする心不全のリスクが3倍近く高くなります。

キーワード:
疫学胃癌心不全リスク因子SEERプログラム

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科学分野:

  • 腫瘍学
  • 心臓病学
  • 公衆衛生

背景:

  • 治療の進歩により、胃癌の生存率は向上しています。
  • 胃癌生存者、特に心血管疾患のような非癌性疾患への関心が高まっています。
  • 胃癌の病期と心不全リスクの関係については、さらなる調査が必要です。

研究 の 目的:

  • 胃癌患者における心不全のリスクを調査すること。
  • 胃癌の初期病期に基づいた心不全リスクを分析すること。

主な方法:

  • 全国規模の人口ベースの後ろ向きコホート研究を、韓国癌公開図書館データベースを使用して実施しました。
  • 2012年から2019年の間に胃癌と診断された患者を2020年まで追跡しました。
  • 胃癌の病期分類（局所期、区域期、遠隔期）は、Surveillance, Epidemiology, and End Results Programの基準に基づきました。

主要な成果:

  • 対象となった胃癌患者は合計202,347人で、そのうち7.9%が心不全を発症しました。
  • 心不全の発生率は、胃癌の進行段階とともに有意に増加しました（p<0.001）。
  • 局所期と比較した場合、心不全の調整ハザード比は、区域期で1.52、遠隔期で2.87でした。

結論:

  • 入院を必要とする心不全のリスクは、胃癌の病期が悪化するにつれて増加します。
  • 若年者や代謝リスク因子を持たない患者を含む、すべての胃癌患者に対して、厳密な心不全モニタリングが不可欠です。
  • これらの発見は、胃癌患者の腫瘍学的および心血管系の健康の両方に対応する統合ケアの重要性を強調しています。