中壁の左心室のメカニズム. 動脈高血圧における心血管リスクの独立した予測因子
G de Simone1, R B Devereux, M J Koren
1Department of Medicine, New York Hospital-Cornell Medical Center, New York 10021, USA.
Circulation
|January 15, 1996
まとめ
無症状の高血圧患者のうつ中壁の縮小は,不良心血管イベントを予測します. これと左心室上の質量を組み合わせると,リスクが著しく高まっている個人を特定できます.
科学分野:
- 心臓病学 心臓病学
- 高血圧の研究 高血圧の研究
- エコーカルディオグラフィー エコーカルディオグラフィー
背景:
- 症状のない高血圧患者の有意な数は,左心室 (LV) の性能が低下し,ミッドウォール短縮/エンドシストリックストレスの測定で検出されるが,内臓短縮の測定では検出されない.
- 高血圧におけるこの抑えた中壁心房機能の予後的意義は不明である.
研究 の 目的:
- 高血圧患者のうつ中壁の縮小が,心血管疾患の予後的な影響を及ぼすかどうかを調査する.
- 中壁の縮小が,LV質量と組み合わせて,高リスクの個人を特定できるかどうかを判断する.
主な方法:
- 294人の高血圧患者におけるエコーカルディオグラフィの内心臓および中壁のLV分数縮小/周周周末シストリックストレス関係の分析.
- 平均10年間の追跡期間における心血管疾患の評価.
- ロジスティック・サバイバル分析により,心血管疾患や心臓病による死亡の独立予測要因を特定する.
主要な成果:
- 下部中壁の縮小 (絶対的または予測される) を有する患者は,心血管疾患 (P < .004) により罹患する傾向がありました.
- 心血管疾患 (29%) と死亡 (10%) のリスクが著しく増加したのは,高 LV 質量指数と低い中壁縮小を有する患者で観察されました.
- 低中壁の縮小,高 LV 質量,年齢増加,および高収縮血圧は,独立して心血管イベントを予測しました. また,下部中壁の縮小は,特に LV 縮の患者において,心疾患による死亡を予測しました.
結論:
- 抑うつ型中壁の縮小は,動脈高血圧における有害な結果の有意な予測因子として機能する.
- 左心室の質量増加と中壁の縮小の減少の組み合わせは,高血圧の個人が心血管疾患のリスクが大幅に上昇していることを特定します.
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