担当区分：筆頭著者   記述言語：英語   掲載種別：学位論文（博士）   出版者・発行元：一般社団法人 日本動脈硬化学会  

Aim: To investigate the association between a prolonged heart rate-corrected QT (QTc) interval on a 12-lead electrocardiogram and the risk of developing dementia and its subtypes using long-term prospective longitudinal data from a Japanese community. Methods: A total of 1,082 residents ≥ 60 years old without dementia were followed up for 24 years. The QT interval was corrected for the heart rate using Bazett’s equation. QTc prolongation was defined as QTc ≥ 440 ms, and participants with QTc ＜440 ms were divided into tertiles. Therefore, QTc interval levels at baseline were divided into 4 ranges: ≤ 401, 402–417, 418–439, and ≥ 440 ms. The Cox proportional hazards model was used to estimate the hazard ratios (HRs) of QTc interval levels on the risk of dementia. Results: During the follow-up period, 475 participants developed all-cause dementia, 146 had vascular dementia (VaD), and 295 had Alzheimer’s disease (AD). Compared with the lowest QTc level (≤ 401 ms), the multivariable-adjusted HRs for VaD increased significantly with longer QTc intervals (HR [95% confidence interval] 1.80 [1.05 to 3.08] for 402–417 ms, 1.93 [1.12 to 3.34] for 418–439 ms, and 2.64 [1.49 to 4.68] for ≥ 440 ms; p for trend = 0.01). No significant association was found between QTc interval and the risk of both all-cause dementia and AD. Conclusion: The present findings suggest that QTc prolongation serves as a potential indicator for identifying individuals at a high risk of developing VaD. QTc measurement may assist in the primary prevention of VaD.

DOI： 10.5551/jat.65686

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開催年月日： 2024年11月

開催地：東京  

記述言語：日本語  

記述言語：日本語   出版者・発行元：克誠堂出版(株)  

肺動脈カテーテル(pulmonary artery catheter:PAC)による肺動脈損傷を来した症例を経験した。対策として、PAC過挿入を防ぐため、経食道心エコー(transesophageal echocardiography:TEE)を用いた適正位置決定法を策定した。挿入時はTEEで観察し、PACの先端が右肺動脈に入る程度まで進めたのち、カテーテルを引いてたわみを取り、バルーンが主肺動脈にある状態を保ちながら挿入長を最短とするようにした。PACを用いた心臓手術では、留置時のみならず、術中・術後を通してPACの位置変化を注意深く観察する必要がある。(著者抄録)