潜在性肺高血圧症の非侵襲的診断法の確立と臨床的特徴

亚临床肺动脉高压无创诊断方法的建立及临床特征

• 批准号: 23591047
• 负责人: 楠瀬 賢也
• 金额: $ 3.41万
• 依托单位: The University of Tokushima
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2011
• 资助国家: 日本
• 起止时间: 2011 至 无数据
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-23591047/
• 关键词: 肺高血圧症; 心臓超音波検査; 組織ドプラ法

目的1:運動負荷による顕在化する潜在性肺高血圧症の頻度とその臨床的特徴を明らかにすること目標症例数は3年間の研究期間で100症例であったが,研究代表者異動による研究廃止までの2011年4月-8月で62症例に対して運動負荷心エコー法を施行した.この62例中,潜在性肺高血圧症と診断されたのは15例,約25%であった.臨床的特徴として,潜在性肺高血圧症では,そうでない群と比較して年齢が高く,歩行後のSpO2の低下を認めた.その他の臨床的背景(膠原病基礎疾患,血圧,体表面積,6分間歩行距離,性別)に有意差は認められなかった.心エコー指標では左室・左房形態指標(左室容積,左房容積など)に有意差は無かったが,三尖弁逆流速度,僧房弁通過血流拡張早期波高,三尖弁輪運動速度に有意差を認めた.過去にエルゴメーター負荷により膠原病患者の潜在性PAHをみた報告では,運動負荷により平均11mmHgの肺動脈圧上昇があった.今回の我々の検討では全体で平均9mmHg程度の上昇であり,潜在性PAH症例では平均15mmHg上昇した.過去の報告と矛盾しない結果である.また2011年のD'Altoらの報告では運動負荷による肺動脈圧の上昇は早期の右室機能不全兆候である可能性も示唆されており,我々の検討の中の三尖弁輪運動速度低下がこれを反映している可能性が示唆された.日本人を対象とした運動負荷により顕在化する潜在性肺高血圧症の初の研究結果であり,臨床的意義は大きい.目的2:潜在肺高血圧症と診断された患者に対する心カテーテル検査による確定診断および治療介入上記15例のうち,5例に対して心カテーテル検査による確定診断および治療介入を行った.5例は全例,運動による有意な肺動脈圧の上昇が確認され,潜在性肺高血圧症と診断された.治療介入を3例,経過観察を2例とし,今後も治療経過をフォローアップ予定である.2011年8月末にて研究代表者は異動となりやむをえず研究実施は廃止となったが,本研究は引き続き研究分担者に引き継がれており,追加購入したインピーダンス心拍出量計によりさらなる追加知見が得られると確信している.

Objective 1: to investigate the number of target cases of latent pulmonary hypertension during the 3-year study period. Objective 1: to investigate the number of target cases of latent pulmonary hypertension during the 3-year study period. Objective 1: to investigate the number of target cases of latent pulmonary hypertension in patients with latent pulmonary hypertension during the 3-year study period. from April to August 2011, 62 cases were enrolled in the study. Of the 62 patients with latent pulmonary hypertension, 15 were diagnosed with latent pulmonary hypertension, with a rate of about 25%. The special symptoms of the bed, latent pulmonary hypertension, the number of children with pulmonary hypertension is higher than that of the elderly, and the SpO2 is lower than that of the elderly. The background of the other patient's bed (primary disease, blood disease, body surface disease, 6 minutes distance, sex) is intentional. The heart disease refers to the left ventricular atrial shape index (left atrial volume, left atrial volume). The tricuspid countercurrent velocity, the early wave height of the monk through the blood flow and the velocity of tricuspid movement are intentionally different. In the past, patients with underlying diseases were reported for latent PAH, and the average 11mmHg for lung exercise was detected. This time, the average 9mmHg level of the whole group was significantly higher than that of the latent cases of PAH. The average 15mmHg level was significantly higher than that of the control group. In the past, there were inconsistencies in reports, and the results were not satisfactory. During the 2011 D'Alto report, the possibility that the right ventricular machine could not be fully powered off in the early stage of the lung exercise was not fully indicated in the 2011 D'Alto report, and the low speed of the tricuspid motor in the vehicle reflected the possibility of vehicle failure. The results of a preliminary study on latent pulmonary hypertension in Japan show that the meaning of bed is very important. Objective: in patients with latent pulmonary hypertension, 15 patients underwent cardiac intervention and 5 patients underwent interventional therapy. In all of the 5 patients, the exercise exercise was intended to confirm the diagnosis and treatment of pulmonary hypertension and latent pulmonary hypertension. Treatment intervention was performed in 3 cases, clinical observation in 2 cases, and in the future, the decision was made after the treatment. At the end of August 2011, a clinical study was conducted by a representative of the research community. Add your information and make sure that you can make sure that you do not know.