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。

リケラボ 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するならリケラボ論文検索大学・研究所にある論文を検索できる

リケラボ 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するならリケラボ論文検索大学・研究所にある論文を検索できる

大学・研究所にある論文を検索できる 「Differential effects of combination therapy on the components of the risk stratification table in patients with idiopathic or heritable pulmonary arterial hypertension in a Japanese population」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。

コピーが完了しました

URLをコピーしました

論文の公開元へ論文の公開元へ
書き出し

Differential effects of combination therapy on the components of the risk stratification table in patients with idiopathic or heritable pulmonary arterial hypertension in a Japanese population

Yoshida, Masahiro Adachi, Shiro Imai, Ryo Shimokata, Shigetake Nakano, Yoshihisa Murohara, Toyoaki Kondo, Takahisa 名古屋大学

2021.05

概要

Risk stratification by ESC/ERS guideline is recommended to estimate the vital prognosis and select the treatment strategy in patients with idiopathic or heritable pulmonary arterial hypertension (IPAH/HPAH). However, we are not confident whether we can achieve low-risk status in the risk table at the follow-up shortly after combination therapy. Therefore, we aimed to verify the effects of combination therapy in IPAH/HPAH on each category of the risk table at diagnosis and at the first follow-up. We retrospectively analyzed 10 consecutive patients with IPAH/HPAH with no previous treatment history diagnosed at Nagoya University Hospital between October 2014 and January 2019. Four categories including symptoms, exercise tolerance, BNP levels and hemodynamics were validated both at baseline and at the first follow-up of right heart catheterization. Score of 1, 2 and 3 were assigned to the low risk, intermediate risk and high risk, respectively. In each category the highest score was adopted. The scores at diagnosis were compared with those at the first follow-up. The result shows that all patients were female, median age was 32 years old, and were treated with initial combination therapy. The median total risk score also was improved from 2.6 to 1.4 (p<0.01). However, the score in exercise tolerance was not improved (3 to 2.5 p=0.16). In conclusion, at the first follow up shortly after the initial combination therapy of IPAH/HPAH, the mean total risk score was significantly improved, however, even patients in the low-risk status may not achieve improvement in exercise tolerance.

参考文献

1 Galiè N, Barbera JA, Frost AE, et al. Initial Use of Ambrisentan plus Tadalafil in Pulmonary Arterial Hypertension. N Engl J Med. 2015;373(9):834–844. doi:10.1056/NEJMoa1413687.

2 Sitbon O, Jaïs X, Savale L, et al. Upfront triple combination therapy in pulmonary arterial hypertension: a pilot study. Eur Respir J. 2014;43(6):1691–1697. doi:10.1183/09031936.00116313.

3 Ogawa A, Satoh T, Tamura Y, Fukuda K, Matsubara H. Survival of Japanese Patients With Idio- pathic/Heritable Pulmonary Arterial Hypertension. Am J Cardiol. 2017;119(9):1479–1484. doi:10.1016/j. amjcard.2017.01.015.

4 Kondo T, Okumura M, Adachi S, Murohara T. Pulmonary Hypertension: Diagnosis, Management, and Treatment. Nagoya J Med Sci. 2019;81(1):19–30. doi:10.18999/nagjms.81.1.19.

5 Galiè N, Humbert M, Vachiery JL, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J. 2016;37(1):67–119. doi:10.1093/eurheartj/ehv317.

6 Galiè N, Humbert M, Vachiery JL, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Respir J. 2015;46(4):903–975. doi:10.1183/13993003.01032-2015.

7 Hoeper MM, Kramer T, Pan Z, et al. Mortality in pulmonary arterial hypertension: prediction by the 2015 European pulmonary hypertension guidelines risk stratification model. Eur Respir J. 2017;50(2): 1700740. doi:10.1183/13993003.00740-2017.

8 Boucly A, Weatherald J, Savale L, et al. Risk assessment, prognosis and guideline implementation in pulmonary arterial hypertension. Eur Respir J. 2017;50(2): 1700889. doi:10.1183/13993003.00889-2017.

9 Weatherald J, Sitbon O, Humbert M. Validation of a risk assessment instrument for pulmonary arterial hypertension. Eur Heart J. 2018;39(47):4182–4185. doi:10.1093/eurheartj/ehx301.

10 Wasserman K, Van Kessel AL, Burton GG. Interaction of physiological mechanisms during exercise. J Appl Physiol. 1967;22(1):71–85. doi:10.1152/jappl.1967.22.1.71.

11 Zafrir B. Exercise training and rehabilitation in pulmonary arterial hypertension: rationale and current data evaluation. J Cardiopulm Rehabil Prev. 2013;33(5):263–273. doi:10.1097/HCR.0b013e3182a0299a.

12 Breda AP, Pereira de Albuquerque AL, Jardim C, et al. Skeletal muscle abnormalities in pulmonary arterial hypertension. PLoS One. 2014;9(12):e114101. doi:10.1371/journal.pone.0114101.

13 Liang F, Yang S, Yao L, Belardinelli L, Shryock J. Ambrisentan and tadalafil synergistically relax endothelin-induced contraction of rat pulmonary arteries. Hypertension. 2012;59(3):705–711. doi:10.1161/ HYPERTENSIONAHA.111.182261.

14 Hirashiki A, Adachi S, Nakano Y, et al. Effects of bosentan on peripheral endothelial function in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension. Pulm Circ. 2016;6(2):168–173. doi:10.1086/685715.

15 Yamazaki M, Sato H. Human Walking With Reference to Step Length, Cadence, Speed and Energy Expenditure[in Japanese]. J Anthrop Soc. Nippon. 1990;98(4):385–401.doi:10.1537/ase1911.98.385.

16 Miyamoto S, Nagaya N, Satoh T, et al. Clinical correlates and prognostic significance of six-minute walk test in patients with primary pulmonary hypertension. Comparison with cardiopulmonary exercise testing. Am J Respir Crit Care Med. 2000;161(2 Pt 1):487–492. doi:10.1164/ajrccm.161.2.9906015.

17 de Man FS, Handoko ML, Groepenhoff H, et al. Effects of exercise training in patients with idiopathic pulmonary arterial hypertension. Eur Respir J. 2009;34(3):669–675. doi:10.1183/09031936.00027909.

18 Mereles D, Ehlken N, Kreuscher S, et al. Exercise and respiratory training improve exercise capacity and quality of life in patients with severe chronic pulmonary hypertension. Circulation. 2006;114(14):1482–1489. doi:10.1161/CIRCULATIONAHA.106.618397.

19 Fox BD, Kassirer M, Weiss I, et al. Ambulatory rehabilitation improves exercise capacity in patients with pulmonary hypertension. J Card Fail. 2011;17(3):196–200. doi:10.1016/j.cardfail.2010.10.004.

参考文献をもっと見る

全国の大学の
卒論・修論・学位論文

一発検索!

この論文の関連論文を見る