循環器ジャーナル72巻2号

2024年04月発行

特集 心エコー　何をどこまで評価できるか？ Ⅰ. 心機能を心エコーで評価する

肺循環と右心不全　心エコー評価のポイントは？

著者： 唐澤由香¹ 村田光繁²

所属機関： ¹東海大学医学部付属八王子病院循環器内科 ²東海大学医学部付属八王子病院臨床検査科

ページ範囲：P.196 - P.203

POINT
・左心疾患による肺高血圧症は，従来は左房圧の上昇の受動的な伝播によるものと考えられていたが，その状態が続くと受動的な圧の伝播のみならず肺血管のリモデリングが起こりpre-capillary PHへと進行し，最終的に右心機能障害まで至ることが明らかになってきた．
・右心不全の存在は，左心機能とは独立した患者の予後因子であり，心不全の際は肺高血圧症，右心機能の評価も行う必要がある．
・右室の評価の際は，右室は左室とは異なる特性をもち，形態も複雑であるため，複数のエコー指標を組み合わせた評価が必要である．

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