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Determinants of the severity of ischemic heart disease with the burden of multiple risk factors.

缺血性心脏病严重程度的决定因素与多种危险因素的负担。

基本信息

批准号：
10307016
负责人：
TOMOIKE Hitonobu
金额：
$ 6.91万
依托单位：
First Department of Internal Medicine, Yamagata University School of Medicine
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (A).
财政年份：
1998
资助国家：
日本
起止时间：
1998 至 2000
项目状态：
已结题

项目摘要

In industrial countries, the concept of multiple risk factors has favored cardiologists and epidemiologists for treating and/or preventing the ischemic heart disease. Recent advances of motorization and increases of intaking a high caloric food containing animal fat and rich in carbohydrates have gotten worse in the severity of ischemic heart disease. However, the mechanisms not only in evolution and progression of atherosclerosis but also in ensuing ischemic heart disease have not been settled. The goals of this project were 1) epichemiological survey of occurrence and prognosis of acute myocardial infarction in Yamagata and to elucidate risk factors and their clinical significance, 2) development of genetic animal models with multiple risk factors, especially related to hyperlipidemia and 3) to elucidate pathophysiological significance of hypertriglyceridemia in atherogenosis and myocardial ischemia. Regional epidemiological studies of acute myoardial infarction in Yamagata showed that (1) early reperfusion reduced acute mortality from 18 % to about 5 % and (2) diurnal peaks of the onset of acute myocardial infarction were prodominantly seen in aged but not younger patients. Rabbit studies have succeeded in segregating heritable models of hypertriglyceridemia and post prandial hypertriglyceridemia. The latter model is now applying patients in domestic and in the U.S.A.

在工业化国家，多种危险因素的概念有利于心脏病学家和流行病学家治疗和/或预防缺血性心脏病。运动化的最新进展和含有动物脂肪和富含碳水化合物的高热量食物摄入量的增加使缺血性心脏病的严重程度变得更糟。然而，无论是动脉粥样硬化的发生、发展，还是缺血性心脏病的发病机制，至今尚未完全阐明。本研究的目的是：1）对Yamagata地区急性心肌梗死的发生和预后进行流行病学调查，并阐明其危险因素及其临床意义; 2）建立具有多种危险因素的遗传动物模型，特别是与高脂血症相关的模型; 3）阐明高脂血症在动脉粥样硬化和心肌缺血中的病理生理学意义。对山形县急性心肌梗死的区域流行病学研究表明：（1）早期再灌注可将急性死亡率从18%降至约5%;（2）急性心肌梗死发病的昼夜高峰主要见于老年患者，而非年轻患者。兔子研究成功地分离了高胆固醇血症和餐后高胆固醇血症的遗传模型。后一种模式目前正在国内和美国的患者中应用。