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福島県立医科大学学術成果リポジトリ = Fukushima Medical University Repository >
福島医学会 = The Fukushima Society of Medical Science >
福島医学雑誌 = Fukushima Medical Journal >
Vol.72 (2022) >
Vol.72 No.3 (2022) >

Please use this identifier to cite or link to this item: http://ir.fmu.ac.jp/dspace/handle/123456789/1937

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Title: 循環器領域における高齢化と先進医療 高齢者心不全の治療戦略
Other Titles: A treatment strategy of elderly patients with heart failure
Authors: 竹石, 恭知
Affiliation: 附属病院
Source title: 福島医学雑誌
Volume: 72
Issue: 3
Start page: 103
End page: 108
Issue Date: 2022
Abstract: 高齢化に伴い,心不全患者が増加している。治療の進歩にもかかわらず死亡率は高く,また医療コストは高額である。心不全の原疾患は様々であるが,高齢者に多い心臓弁膜症と心アミロイドーシスを中心に最新の治療について概説する。大動脈弁狭窄症に対して,経カテーテル的大動脈弁植え込み術(TAVI)が行われている。身体への負担が少ないため,開胸外科手術のリスクが高い症例にも治療可能で,入院期間は短く,早期に社会復帰できる。僧帽弁閉鎖不全症もカテーテルで治療できるようになった。心アミロイドーシスも高齢者に多く,極めて予後が不良な疾患である。近年,トランスサイレチン型に対する核酸医薬を含む新しい治療法が開発され,大規模臨床試験で効果が示された。難治性心疾患に対する先進医療を広く普及させ,心疾患死亡率の低下を目指したい。
The number of patients with heart failure (HF) has been rapidly increasing with aging. Despite the recent advancement in medical therapy, mortality rates of heart failure remain still high, and the hospitalization cost of HF is a significant concern worldwide. This article has focused on valvular heart diseases and cardiac amyloidosis, which are leading causes of HF in the elderly population. Several randomized trials have demonstrated that transcatheter aortic-valve implantation (TAVI) reduces mortality in high-risk patients with severe aortic stenosis. Additionally, transcatheter mitral-valve repair (TMVr) improves clinical outcomes in patients with HF who have mitral regurgitation due to left ventricular dysfunction. Transcatheter approach is much less invasive and can be performed in high-risk patients who are not candidates for surgical replacement. Furthermore, after transcatheter treatments, patients can be discharged and returned to a normal life earlier than surgical procedures. Recently, two novel therapeutic agents are available for cardiac amyloidosis. Randomized clinical trials have shown that tafamidis and patisiran reduce all-cause mortality in patients with transthyretin amyloid cardiomyopathy. With these advanced medical treatments, our goal is to reduce cardiovascular mortality in Fukushima.
Description: 特別企画 福島県近代医学教育150年顕彰記念シンポジウム総説
Publisher: 福島医学会
language: jpn
URI: http://ir.fmu.ac.jp/dspace/handle/123456789/1937
Full text URL: http://ir.fmu.ac.jp/dspace/bitstream/123456789/1937/1/FksmMedJ_72_p103.pdf
ISSN: 0016-2582
DOI: 10.5387/fmedj.72.3_103
Related Page: https://doi.org/10.5387/fmedj.72.3_103
Rights: © 2022 福島医学会
Appears in Collections:Vol.72 No.3 (2022)

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