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大学・研究所にある論文を検索できる 「Relationship between Mitral Leaflet Size and Coaptation-zone area and their Associated Factors in Patients with Normal Left Ventricular Size and Systolic Function: Real-time 3D Echocardiographic Analysis」の論文概要。リケラボ論文検索は、全国の大学リポジトリにある学位論文・教授論文を一括検索できる論文検索サービスです。

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Relationship between Mitral Leaflet Size and Coaptation-zone area and their Associated Factors in Patients with Normal Left Ventricular Size and Systolic Function: Real-time 3D Echocardiographic Analysis

徐, 博卿 東京大学 DOI:10.15083/0002007011

2023.03.24

概要

[課程-2]
審査の結果の要旨
氏名徐

博卿

本研究は機能性僧帽弁逆流の病理因子と予防因子を明らかにするため、僧帽弁の弁葉面積
と接合面積に影響する臨床因子の係にて、リアルタイム 3 次元心エコー図による解析を試
みたものであり、下記の結果を得ている。
1. 2015 年 10 月から 2017 年 12 月まで東京大学医学部附属病院を受け当院で来院した
175 名を対象とした。対象患者に正常な左心室収縮機能と大きさの患者でリアルタイム
3 次元心エコー図による僧帽弁の弁葉面積と閉鎖部面積を測定し、臨床因子と分析をし
た。僧帽弁の弁葉面積は僧帽弁の閉鎖機能に有意な影響がある(r=0.481, p<0.001)。僧
帽弁の弁葉面積は、年齢や LV サイズよりも体サイズによって本質的に決定される可能
性があるが、僧帽弁の弁葉面積/ 体表面積は比較的一定である(r=0.907, p<0.001)。心
臓の左室拡張末期体積は、僧帽弁の弁葉面積の縮小に関連している可能性がある

(p<0.001)。 左心室拡張機能は、僧帽弁の閉鎖部面積の決定要因である(p=0.001)。冠
状動脈疾患は、僧帽弁の閉鎖部面積を縮小させる可能性がある(p=0.034)。
2. 2015 年 10 月から 2017 年 12 月まで東京大学医学部附属病院を受け当院で来院した 66
名を対象とした。対象患者に正常な左心室収縮機能と大きさの患者でリアルタイム 3 次
元心エコー図による僧帽弁の弁葉面積と接合面積を測定し、 CAVI(cardio-ankle

vascular index)と分析をした。アテローム性動脈硬化症の進行中に、僧帽弁の弁葉面
積(r =-0.440, p=0.015)と閉鎖部面積(r =-0.611, p<0.001)が縮小する可能性がある。
以上、本論文は僧帽弁の弁葉面積と接合面積に影響する臨床因子において、リアルタイ
ム 3 次元心エコー図による解析から、機能性僧帽弁逆流に新しい病理因子と予防因子を明
らかにした。本研究はこれまで未知に等しかった、機能性僧帽弁逆流の解明に重要な貢献
をなすと考えられる。
よって本論文は博士( 医学 )の学位請求論文として合格と認められる。

この論文で使われている画像

参考文献

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