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高血圧持続の動脈硬化性心疾患の発生時期, 進行及び降圧による心形態変化

伴有持续性高血压的动脉硬化性心脏病的发病和进展时间，以及低血压引起的心脏形态变化

基本信息

批准号：
61480239
负责人：
白石友邦
金额：
$ 3.2万
依托单位：
Kansai Medical University
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (B)
财政年份：
1986
资助国家：
日本
起止时间：
1986 至 1987
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-61480239/
关键词：
本態性高血圧心筋肥大動脈硬化症本能性高血圧

项目摘要

本研究は, 急激な血圧上昇, 及び数年にわたる高血圧状態が心大血管形態に及ぼす影響について, 本態性高血圧症例を用いて検討した, 急性高血圧状態については, 自転車エルゴメータ負荷直前後の胸部単純X線像による心形態変化を, 心電図, 心筋シンチ像を参考に計測した, こに結果, 負荷により, 中等症高血圧例までは, 全心容積が縮小を, 重症例又は虚血性心疾患合併例では拡大傾向を示した. 次に, 市民健診13,000例中, 2年間以上経過を観察できた本態性高血圧症106例の胸部単純X線像, 心電図, 理学所見の経年変化について検討した. 本症を3年の経過で全心容積増大, 不変, 縮小の3群に別けると, 各群の心大血管形態, 心電図, 血圧変化の差を生じた. 即ち, 全心容積は, 正常値と比較して, 増大群では, 初年度平均50%増大が, 3年目80%増大となり, 逆に, 縮小群では, 80%増大から50%増大へと, 心拡大が改善した. 血圧値は全群で上昇したが, 縮小群で上昇率が低かった. 大動脈径は増大群で増加, 縮小群で減少傾向を示した. 縮小群の心電図変化は, 肥大所見からほぼ正常所見への移行例も見られた.このように, 長期の圧負荷により, 一部症例で虚血性心疾患を含む高血圧性心疾患の非代償期への進行が予想され, その心形態上の境界は, 全心容積80%拡大時点であった. それ以上の心拡大は, 肥大心筋の伸展不良により収縮力が低下し, 非代償性心拡張即ち高血圧性心不全に進行する. このような症例では, 一過性の急激な血圧上昇でも心拡大を生じ, 長期予後を負荷試験で再現可能であった. 一方, 大動脈拡張は, 血圧とほぼ平行状態にあり, 降圧により, 縮小することが判明した. 心電図も心筋肥大, 虚血所見をほぼ忠実に表現した. 以上, 代償期にある本態性高血圧症例の心形態, 検査所見の変化を検討して, 本症の長期予後の予測を可能にした.

This study investigated the effects of acute hypertension on cardiovascular morphology and changes in cardiac morphology in patients with idiopathic hypertension and in patients with acute hypertension over several years. Moderate cases of high blood pressure, decreased heart volume, severe cases of heart disease combined with cases of deficiency, increased tendency. In addition, among the 13,000 cases examined by the general public, 106 cases of idiopathic hypertension were examined by chest X-ray, ECG and physical examination during more than 2 years. The heart volume increases, decreases and decreases in 3 groups after 3 years of the disease, and the changes in cardiovascular morphology, ECG and blood pressure in each group occur. That is to say, the total heart capacity is opposite, the normal value is compared, the increase group is opposite, the average of the first year is increased by 50%, the increase of the third year is increased by 80%, the reverse group is opposite, the increase of the third year is increased by 50%, and the heart rate is improved greatly. The blood pressure value is increased in the whole group, and the increase rate is decreased in the reduced group. Arterial diameter increases in large groups and decreases in small groups. Narrowing group ECG changes, hypertrophy changes, normal changes, transition changes. In this regard, long-term pressure load, one case of hypoglycemic heart disease, including hyperbaric heart disease, the non-compensatory phase of the disease is expected to progress, and the cardiac morphology of the state, from 80% to 80% of the total heart capacity. The above cardiac hypertrophy, hypertrophic cardiac muscle malextension, contractile force reduction, non-compensatory cardiac tension, i.e. hyperbaric cardiac insufficiency. The symptoms are transient, rapid blood pressure increases, heart rate increases, and long-term load increases may occur. On one side, the artery is open, the blood pressure is parallel, the pressure is reduced, and the judgment is made. The heart muscle hypertrophy of the heart muscle, the deficiency of blood seen by the loyal performance. In the above, cardiac morphology of patients with intrinsic hypertension during compensatory phase was investigated, and the long-term prediction of the disease was possible.