循環器ジャーナル71巻2号

2023年04月発行

特集 今だからこそ聞きたい心不全診療のこと。 Ⅱ．診断

心力学的視点で考える心不全における至適血圧

著者： 松下裕貴¹ 朔啓太¹

所属機関： ¹国立循環器病研究センター循環動態制御部

ページ範囲：P.220 - P.226

POINT
・心拍出量と体血管抵抗の積が血圧であり，心拍出量は，心拍数，心収縮力，心拡張能，体血管抵抗および前負荷（有効循環血液量）で決定される．
・心力学的視点から，高血圧は一回心拍出量を低下させ，心臓のエネルギー効率を悪化させる．
・心臓力学的視点，末梢灌流的視点および病態を考慮したうえで心不全の至適血圧の議論はなされるべきであり，ガイドラインに記載された目標血圧は，個別化においては課題が残されている．

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