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

—コラム—心筋症のreversibilityを病理所見から予測する

著者： 齋藤恒徳¹

所属機関： ¹

ページ範囲：P.94 - P.98

Point
・心筋症の病理学的検索法のうち，電子顕微鏡では，心筋細胞の細胞内小器官や筋原線維の超微形態変化を詳細に観察できる．
・筋原線維や核の変性は不良な予後を，オートファジー空胞の存在は良好な予後を予測させる．
・超微構造の解析が心筋症の病態解明に寄与することが期待される．

参考文献

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2) 厚生労働省：診療報酬の算定方法の制定等に伴う実施上の留意事項について　http://www.mhlw.go.jp/topics/2008/03/dl/tp0305-1d_0020.pdf

3) Saito T, Asai K, Sato S, et al:Myocardial alterations and clinical implications associated with recovery of cardiac function in dilated cardiomyopathy with obesity. Int J Cardiol 168:144-150, 2013

4) Saito T, Asai K, Sato S, et al:Ultrastructural features of cardiomyocytes in dilated cardiomyopathy with initially decompensated heart failure as a predictor of prognosis. Eur Heart J 36:724-733, 2015

5) Saito T, Asai K, Sato S, et al:Proof of myocardial autophagy by combining antigen retrieval and the avidin-biotin peroxidase complex method. Int J Cardiol 168:4843-4844, 2013

6) Nakai A, Yamaguchi O, Takeda T, et al:The role of autophagy in cardiomyocytes in the basal state and in response to hemodynamic stress. Nat Med 13:619-624, 2007

7) Kassiotis C, Ballal K, Wellnitz K, et al:Markers of autophagy are downregulated in failing human heart after mechanical unloading. Circulation 120:S191-S197, 2009

8) Saito T, Asai K, Sato S, et al:Autophagic vacuoles in cardiomyocytes of dilated cardiomyopathy with initially decompensated heart failure predict improved prognosis. Autophagy 12:579-587, 2016

9) Kanzaki M, Asano Y, Ishibashi-Ueda H, et al:A Development of Nucleic Chromatin Measurements as a New Prognostic Marker for Severe Chronic Heart Failure. PLoS One 11:e0148209, 2016