糖尿病における心臓交感性神経衰弱:心臓血管リスクの増大への影響
M J Stevens1, D M Raffel, K C Allman
1Department of Internal Medicine, University of Michigan, Ann Arbor 48109-0678, USA. stevensm@umich.edu
Circulation
|September 16, 1998
まとめ
糖尿病性自律神経症は,地域的な心交感的不均衡を引き起こし,一部の領域では超内膜化,他の領域では内膜化を引き起こします. このパターンは,危険な心臓の電気的不安定性につながる可能性があります.
科学分野:
- 心臓病学 心臓病学
- 神経学 神経学とは
- 核医学は,核医学である.
背景:
- 心臓の交感性多動性は,非糖尿病性心疾患における不律症と関連しています.
- 糖尿病性自律神経症 (DAN) は死亡率の増加と関連しています.
- この研究では,糖尿病における地域性心交的変化を調査しています.
研究 の 目的:
- 糖尿病患者の地域共感性ニューロン密度とトーンを探求する.
- 糖尿病の自律神経疾患と心臓の交感性変化の関係を理解する.
主な方法:
- 11Cラベル付ヒドロキシエフェドリン ([11C]-HED) を用いたポジトロン放出トモグラフィー (PET) が使用されました.
- トレーサー保持と洗浄を測定することによって,左心室の交感性内置を評価しました.
- 健康な対照群と共に,DANとDANのない糖尿病患者を研究した.
主要な成果:
- DAN.のない糖尿病患者の40%で異常な心臓 [11C]-HED保持が見られた.
- 軽度のDANは下部壁の欠陥を示し,重度のDANは下部壁と前部壁の欠陥を示した.
- 重度のDANは,DANのない被験者と比較して,近辺トレーサー保持 (33%) が増加し,遠隔保持 (33%) が減少した.
結論:
- 糖尿病は,近接性ハイパーナーヴェーションと遠隔性デナーヴェーションによる左心房交感性ディスナーヴェーションを引き起こす可能性があります.
- この組み合わせは,生命を脅かすような心筋の電気的不安定性につながる可能性があります.
- この発見は,糖尿病患者のベータブロックからの心臓保護の強化を説明する可能性がある.
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