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Kokyu to Junkan Volume 47, Issue 8 （August 1999）

呼吸と循環 47巻8号（1999年8月発行）

Japanese English

研究

呼吸性代償開始点を用いた肥大型心筋症患者の運動耐容能の評価 Assessment of Exercise Tolerance in Hypertrophic Cardiomyopathy Using Respiratory Compensation Point 守田武志 ¹ , 平崎智士 ² , 中村隆志 ³ , 里見潤 ⁴ , 松尾あきこ ⁵ , 東秋弘 ⁵ , 杉原洋樹 ⁵ , 高松一 ⁶ , 木谷輝夫 ⁵ , 中川雅夫 ⁵ Takeshi Morita ¹ , Satoshi Hirasaki ² , Takashi Nakamura ³ , Jun Satomi ⁴ , Akiko Matsuo ⁵ , Akihiro Azuma ⁵ , Hiroki Sugihara ⁵ , Hajime Takamatsu ⁶ , Teruo Kitani ⁵ , Masao Nakagawa ⁵ ¹京都地域医療学際研究所附属病院臨床検査部 ²京都府立与謝の海病院循環器科 ³済生会滋賀県病院循環器科 ⁴立命館大学理工学部 ⁵京都府立医科大学第二内科 ⁶京都地域医療学際研究所附属病院内科 ¹Department of Clinical Laboratory, Kyoto Interdisciplinary Research Institute Hospital of Community Medicine ²Department of Cardiology, Kyoto Prefectural Yosanoumi Hospital ³Department of Cardiology, Saiseikai Shiga Hospital ⁴The Faculty of Science and Engineering, Ritsumeikan University ⁵Second Department of Medicine, Kyoto Prefectural University of Medicine ⁶Internal Medicine, Kyoto Interdisciplinary Research Institute Hospital of Community Medicine キーワード：肥大型心筋症 , 運動耐容能 , 呼吸性代償開始点 , hypertrophic cardiomyopathy , exercise tolerance , respiratory compensation point Keyword: 肥大型心筋症 , 運動耐容能 , 呼吸性代償開始点 , hypertrophic cardiomyopathy , exercise tolerance , respiratory compensation point pp.827-833

発行日 1999年8月15日 Published Date 1999/8/15

DOI https://doi.org/10.11477/mf.1404901950

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Abstract 文献概要
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　肥大型心筋症（HCM）患者では，心機能障害のため運動時に何らかの症状が生じ得る．一方，運動耐容能の客観的評価に呼気ガス分析による最高酸素摂取量（peak VO_2），嫌気性代謝閾値（AT）などが有用である．本検討では，HCM患者25例（無症候群12例，有症候群13例），健常人13例を対象にpeak VO₂，AT，さらに呼吸性代償開始点（RCP）の有用性について検討した．健常群と無症候HCM群間のpeak VO₂，AT時のVO₂（VO_2AT），RCP時のVO₂（VO_2RCP）はいずれも差がなかった．健常群と有症候HCM群間のVO_2ATは差はなかったが，peak VO₂，VO_2RCPは有症候HCM群で低下していた．peak VO₂は，VO_2ATと良好な相関を示したが，VO_2RCPとはより強い相関を示した．無症状のHCM患者の運動耐容能は比較的保たれていたが，労作時息切れなどの症状を有するHCM患者の運動耐容能は低下しており，その評価にRCPが有用であった．

　A patient with hypertrophic cardiomyopathy (HCM) can develop subjective symptoms on exercise because of cardiac dysfunction. Parameters such as peak oxygen uptake (peak VO₂) and anaerobic threshold (AT) obtained by gas exchange analysis have been useful in objectively evaluating exercise tolerance. hi this study, we evaluated the usefulness of peak VO₂, AT and a respiratory compensation point (RCP) in 25 patients with HCM (12 asymptomatic and 13 symptomatic) and 13 healthy volunteers.

　There were no differences in peak VO₂, VO₂ level at AT (VO_2AT) or VO₂ level at RCP (O_2RCP) between healthy volunteers and the patients with asymptomatic HCM. There were also no differences in VO_2AT between the healthy volunteers and the patients with symptomatic HCM, but peak VO₂ and VO_2RCP, in the symptomatic HCM group were lower than those of healthy volunteers and the patients with asymptomatic HCM. Peak VO₂, had a stronger positive correlation with VO_2RCP, than with . VO_2AT.

　Exercise tolerance was maintained relatively well in patients with asymptomatic HCM, but decreased in HCM patients showing symptoms such as shortness of breath on exertion, suggesting the usefulness of RCP in objectively evaluating exercise tolerance.