膠原病患者における運動誘発性肺高血圧症の予測因子の検討

• Material Type: 博士論文
• Title: 膠原病患者における運動誘発性肺高血圧症の予測因子の検討
• Author/Editor: 宮永, 直
• Author Heading: 宮永, 直 ミヤナガ, スナオ
• Publication, Distribution, etc.: Springer
• Publication Date: 2019
• Publication Date (W3CDTF): 2019
• Alternative Title: Predictors of Exercise-lnduced Pulmonary Hypertension in Patients with Connective Tissue Disease
• Periodical title: Heart and Vessels
• No. or year of volume/issue: 34
• Volume: 34
• Pages: 1509-1518
• Degree grantor/type: 鹿児島大学
• Date Granted: 2019-07-16
• Dissertation Number: 甲総研第514号
• Degree Type: 博士(医学); Doctor of Philosophy in Medical Science
• Text Language Code: eng
• Subject Heading: Exercise-induced pulmonary hypertension; Connective tissue disease; Echocardiography; Right ventricular Tei index
• Target Audience: 一般
• Note (General): 博士論文全文, 博士論文要旨, 最終試験結果の要旨, 論文審査の要旨; Screening and early detection of pulmonary arterial hypertension (PAH) in connective tissue disease (CTD) is currently recommended for early treatment. Exercise induced pulmonary hypertension (EIPH) is thought to be a potential risk of developing resting pulmonary hypertension. However, accurately diagnosis of EIPH is needed hemodynamics by right heart catheterization during exercise. Therefore, we compared various parameters of EIPH group with non-EIPH group in patients with CTD. This study aimed to investigate non-invasive predictors of EIPH. A total of 162 consecutive patients with CTD who received screening of PAH was studied. Thirty-four patients with suspected PAH received right heart catheterization (RHC) at rest. Twenty-four patients without PAH underwent RHC during exercise, and they were divided into the EIPH group (n = 7) and the non-EIPH group (n = 17). Exercise tolerance such as 6-minute walk distance and peak VO2/kg in the EIPH group was lower than that in the non-EIPH group. For Hemodynamics, pulmonary artery pressure, right atrial pressure, and vascular resistance in the EIPH group were significantly higher than those in the non-EIPH group. In echocardiography, RV Tei index in the EIPH group was significantly higher than that in the non-EIPH group (EIPH vs non-EIPH = 0.42 [0.41, 0.47] vs 0.25 [0.20, 0.32], P=0.007). The receiver operating characteristics curve showed a cut-off value of RV Tei index (0.41) with a sensitivity of 0.857 and specificity of 0.882. In conclusion, RV Tei index might be a feasible predictor of EIPH in patients with CTD. Sunao Miyanaga, Kayoko Kubota, Noriko Iwatani, Kenjuro Higo, Masaaki Miyata, Yoshihisa Horizoe, Satoko Ojima, Shin Kawasoe, Takuro Kubozono & Mitsuru Ohishi Predictors of exercise-induced pulmonary hypertension in patients with connective tissue disease Heart and Vessels, 34, 1509–1518, (2019) This is a post-peer-review, pre-copyedit version of an article published in Heart and Vessels. The final authenticated version is available online at: https://doi.org/10.1007/s00380-019-01373-6
• Format (IMT): application/pdf
• Source: Diss_宮永_直_ISK514_2019 （fulltext）; https://ir.kagoshima-u.ac.jp/record/14852/files/Diss_%E5%AE%AE%E6%B0%B8_%E7%9B%B4_ISK514_2019.pdf
• Access Restrictions: インターネット公開
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 鹿児島大学 : 鹿児島大学リポジトリ