循環器ジャーナル68巻1号

2020年01月発行

特集 U40世代が描く心不全診療の現状と未来—基礎研究を識り，臨床を素心深考する Ⅰ．心筋症

—臨床編—虚血性心筋症：急性心筋梗塞後のリモデリングの規定因子とリモデリングを抑制する方法はありますか？

著者： 藤本恒¹

所属機関： ¹淡路医療センター循環器内科

ページ範囲：P.30 - P.35

Point
・近年，心筋梗塞後の予後は目覚ましく改善しており，急性期の段階から慢性期を見据えた治療が必要である．
・心筋梗塞後急性期にリモデリングを抑えること，慢性期にリバースリモデリングを達成することは，治療目標の一つとして挙げられる．
・リモデリングを抑えるためには，急性期から慢性期にかけて一貫した，包括的治療が必要である．

参考文献

1) Masci PG, Ganama J, Francone M, et al:Relationship between location and size of myocardial infarction and their reciprocal influences on post-infarction left ventricular remodeling. Eur Heart J 32:1640-1648, 2011

2) Verma A, Meris A, Skali H, et al:Prognostic implications of left ventricular mass and geometry following myocardial infarction:the VALIANT（VALsartan In Acute myocardial iNfarcTion）Echocardiographic Study. JACC Cardiovasc Imaging 1:582-591, 2008

3) Funaro S, Torre G, Madonna M, et al:Incidence, determinants, and prognostic value of reverse left ventricular remodeling after primary percutaneous coronary intervention:results of the Acute Myocardial Infarction Contrast Imaging（AMICI）multicenter study. Eur Heart J 30:566-575, 2009

4) Jones RH, Velazquez EJ, Michler RE, et al:Coronary bypass surgery with or without surgical ventricular reconstruction. N Engl J Med 360:1705-1717, 2009

5) Schiros CG, Ahmed MI, Sanagala T, et al:Importance of three-dimensional geometric analysis in the assessment of the athlete's heart. Am J Cardiol 111:1067-1072, 2013

6) Ferrari R, et al:Effects of angiotensin-converting enzyme inhibition with perindopril on left ventricular remodeling and clinical outcome:results of the randomized Perindopril and Remodeling in Elderly with Acute Myocardial Infarction（PREAMI）Study. Arch Intern Med 166:659-666, 2006

7) Pfeffer MA, McMurray JJ, Velazquez EJ, et al:Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both. N Engl J Med 349:1893-1906, 2003

8) Møller JE, Søndergaard E, Poulsen SH, et al:Pseudonormal and restrictive filling patterns predict left ventricular dilation and cardiac death after a first myocardial infarction:a serial color M-mode Doppler echocardiographic study. J Am Coll Cardiol 36:1841-1846, 2000

9) Grigioni F, Enriquez-Sarano M, Zehr KJ, et al:Ischemic mitral regurgitation:long-term outcome and prognostic implications with quantitative Doppler assessment. Circulation 103:1759-1764, 2001

10) Park YH, Kang SJ, Song JK, et al:Prognostic value of longitudinal strain after primary reperfusion therapy in patients with anterior-wall acute myocardial infarction. J Am Soc Echocardiogr 21:262-267, 2008

11) Sakata K, Mochizuki M, Yoshida H, et al:Cardiac sympathetic dysfunction contributes to left ventricular remodeling after acute myocardial infarction. Eur J Nucl Med 27:1641-1649, 2000

12) Haykowsky M, Scott J, Esch B, et al:A meta-analysis of the effects of exercise training on left ventricular remodeling following myocardial infarction:start early and go longer for greatest exercise benefits on remodeling. Trials 12:92, 2011