第17回 心臓性急死研究会 ブルガダ型心電図症例における心室細動(VF)誘発性と臨床的危険予測因子の比較検討
【目的】心室細動(VF)自然発作既往のない無症候性ブルガダ型心電図症例において,VF誘発性と他の臨床データを有症候性症例と比較し,その臨床的意義を検討した. 【方法】対象は心電図で特徴的なST上昇を認め,当科で電気生理学的検査(EPS)を施行した36症例.うち有症候例(VF自然発作群)5例,VF誘発例(VF誘発群)15例,VF非誘発例(VF非誘発群)16例. 【結果】観察期間中4例でVF出現を認めた(VF自然発作群2例,VF誘発群2例).各群の失神歴(%)はVF自然発作群:VF誘発群:VF非誘発群=100:13:25(P<0.05),突然死家族歴(%)は40:13:19(NS)であった....
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| Published in | 心臓 Vol. 37; no. Supplement3; pp. 142 - 146 |
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| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
公益財団法人 日本心臓財団
2005
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0586-4488 2186-3016 |
| DOI | 10.11281/shinzo1969.37.Supplement3_142 |
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| Abstract | 【目的】心室細動(VF)自然発作既往のない無症候性ブルガダ型心電図症例において,VF誘発性と他の臨床データを有症候性症例と比較し,その臨床的意義を検討した. 【方法】対象は心電図で特徴的なST上昇を認め,当科で電気生理学的検査(EPS)を施行した36症例.うち有症候例(VF自然発作群)5例,VF誘発例(VF誘発群)15例,VF非誘発例(VF非誘発群)16例. 【結果】観察期間中4例でVF出現を認めた(VF自然発作群2例,VF誘発群2例).各群の失神歴(%)はVF自然発作群:VF誘発群:VF非誘発群=100:13:25(P<0.05),突然死家族歴(%)は40:13:19(NS)であった.ピルジカイニド負荷時のcoved型ST上昇頻度(%)は100:93:63(NS),冠動脈攣縮陽性率(%)は50:64:25(NS),MIBG分布異常(%)は75:40:20(NS)と,VF自然発作群,VF誘発群に多い傾向のみ認めた. 【結語】無症候例の経過観察中,VF誘発群でVF自然発作を認めた.高リスク例の指標は明らかでなかったが,冠動脈攣縮誘発率やMIBG分布異常などの重要性が示唆された. |
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| AbstractList | 【目的】心室細動(VF)自然発作既往のない無症候性ブルガダ型心電図症例において,VF誘発性と他の臨床データを有症候性症例と比較し,その臨床的意義を検討した. 【方法】対象は心電図で特徴的なST上昇を認め,当科で電気生理学的検査(EPS)を施行した36症例.うち有症候例(VF自然発作群)5例,VF誘発例(VF誘発群)15例,VF非誘発例(VF非誘発群)16例. 【結果】観察期間中4例でVF出現を認めた(VF自然発作群2例,VF誘発群2例).各群の失神歴(%)はVF自然発作群:VF誘発群:VF非誘発群=100:13:25(P<0.05),突然死家族歴(%)は40:13:19(NS)であった.ピルジカイニド負荷時のcoved型ST上昇頻度(%)は100:93:63(NS),冠動脈攣縮陽性率(%)は50:64:25(NS),MIBG分布異常(%)は75:40:20(NS)と,VF自然発作群,VF誘発群に多い傾向のみ認めた. 【結語】無症候例の経過観察中,VF誘発群でVF自然発作を認めた.高リスク例の指標は明らかでなかったが,冠動脈攣縮誘発率やMIBG分布異常などの重要性が示唆された. |
| Author | 弓削, 大 平澤, 正次 森口, 昌彦 今木, 隆太 脇坂, 裕子 和泉, 徹 佐々木, 紗栄 佐藤, 大輔 佐々木, 毅 庭野, 慎一 |
| Author_xml | – sequence: 1 fullname: 平澤, 正次 organization: 北里大学医学部内科学II – sequence: 1 fullname: 森口, 昌彦 organization: 北里大学医学部内科学II – sequence: 1 fullname: 佐々木, 紗栄 organization: 北里大学医学部内科学II – sequence: 1 fullname: 弓削, 大 organization: 北里大学医学部内科学II – sequence: 1 fullname: 佐藤, 大輔 organization: 北里大学医学部内科学II – sequence: 1 fullname: 佐々木, 毅 organization: 北里大学医学部内科学II – sequence: 1 fullname: 和泉, 徹 organization: 北里大学医学部内科学II – sequence: 1 fullname: 今木, 隆太 organization: 北里大学医学部内科学II – sequence: 1 fullname: 脇坂, 裕子 organization: 北里大学医学部内科学II – sequence: 1 fullname: 庭野, 慎一 organization: 北里大学医学部内科学II |
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| References | 4) Peters RHJ, Wever EFD, Robles EO, et al: Low prevalence of coronary artery spasm in patients with normal coronary angiograms and unexplained ventricular fibrillation. Ear Heart J 1998; 19: 1070-1074 3) Wilde AA, Antzelevitch C, Borggrefe M, et al: Proposed diagnostic criteria for the Brugada syndrome: consensus report. Circulation 2002; 106: 2514-2519 6) Chlnushl M, Kuroe Y, Aizawa Y, et al Vasospastic angina accompanied by Brugadatype electrocardiographic abnormalities. J Cardiovasc Electrophysiol 2001; 12: 108-111 8) Atarashi HG, gawa S, Hayakawa H, et al Three-year follow-up of patients with riggt bundle branch block and ST segment elevation in the right precordial leads. J Am Colt 2001; 37. 1916-1920 5) 7toh E, Suzuki K, Tanabe Y: A case of vasospastic angina presenting Brugada-type EGG abnormalities. Jpn Give J 1999; 63: 493-495 7) Wichter T, Matheja P, Schafers M, et al Cardiac autonomic dysfunction in Brugada syndrome. Circulation 2002; 105: 702-706 10) Priori SG, Napolitano C, Gasparini M, et al Natural history of Brugada syndrome: Insights for risk stratification and management. Circulation 2002; 105: 1342-1347 1) Brugada P, Brugada J: Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. J Am Cole Cap cliol 1992; 20: 1391-1396 9) Brugada J, Brugada R, Brugada P: Determinants of sudden cardiac death in individuals with the electrocardiographic pattern of Brugada syndrome and no previous cardiac arrest. Circulation 2003; 108: 3092-3096 2) Priori SG, Aliot E, Zipes DP, et al: Task force on sudden cardiac death of the European Society of Cardiology. Ear Heart J 2001; 221374-1450 |
| References_xml | – reference: 4) Peters RHJ, Wever EFD, Robles EO, et al: Low prevalence of coronary artery spasm in patients with normal coronary angiograms and unexplained ventricular fibrillation. Ear Heart J 1998; 19: 1070-1074 – reference: 6) Chlnushl M, Kuroe Y, Aizawa Y, et al Vasospastic angina accompanied by Brugadatype electrocardiographic abnormalities. J Cardiovasc Electrophysiol 2001; 12: 108-111 – reference: 3) Wilde AA, Antzelevitch C, Borggrefe M, et al: Proposed diagnostic criteria for the Brugada syndrome: consensus report. Circulation 2002; 106: 2514-2519 – reference: 7) Wichter T, Matheja P, Schafers M, et al Cardiac autonomic dysfunction in Brugada syndrome. Circulation 2002; 105: 702-706 – reference: 2) Priori SG, Aliot E, Zipes DP, et al: Task force on sudden cardiac death of the European Society of Cardiology. Ear Heart J 2001; 221374-1450 – reference: 10) Priori SG, Napolitano C, Gasparini M, et al Natural history of Brugada syndrome: Insights for risk stratification and management. Circulation 2002; 105: 1342-1347 – reference: 1) Brugada P, Brugada J: Right bundle branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. J Am Cole Cap cliol 1992; 20: 1391-1396 – reference: 5) 7toh E, Suzuki K, Tanabe Y: A case of vasospastic angina presenting Brugada-type EGG abnormalities. Jpn Give J 1999; 63: 493-495 – reference: 9) Brugada J, Brugada R, Brugada P: Determinants of sudden cardiac death in individuals with the electrocardiographic pattern of Brugada syndrome and no previous cardiac arrest. Circulation 2003; 108: 3092-3096 – reference: 8) Atarashi HG, gawa S, Hayakawa H, et al Three-year follow-up of patients with riggt bundle branch block and ST segment elevation in the right precordial leads. J Am Colt 2001; 37. 1916-1920 |
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| Snippet | 【目的】心室細動(VF)自然発作既往のない無症候性ブルガダ型心電図症例において,VF誘発性と他の臨床データを有症候性症例と比較し,その臨床的意義を検討した.... |
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| SubjectTerms | ICD ブルガダ症候群 予後 心室細動 無症候牲 |
| Title | 第17回 心臓性急死研究会 ブルガダ型心電図症例における心室細動(VF)誘発性と臨床的危険予測因子の比較検討 |
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