著者

高沢 謙二 黒須 富士夫 斎木 徳祐 安藤 寿章 奥秋 勝彦 Ranjeet S BARAL 田中 信大 伊吹山 千晴

出版者

一般社団法人 日本動脈硬化学会

雑誌

動脈硬化 (ISSN:03862682)

巻号頁・発行日

vol.26, no.11-12, pp.313-319, 1999-10-20 (Released:2011-09-21)

参考文献数

25

被引用文献数

1 2

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Second derivative of photoplethysmogram (SDPTG) or acceleration plethysmogram (APG) is the second derivative wave of the photoplethysmogram. SDPTG has been developed to allow more accurate recognition of the inflection points on the original plethysmographic wave, ie, anacrotic or dicrotic notches. It has been recognized as the independent examination tool for vascular properties.SDPTG includes 4 systolic waves and 1 diastolic wave, namely a-wave (early systolic positive wave), b-wave (early systolic negative wave), c-wave (late systolic reincreasing wave), d-wave (late systolic redecreasing wave) and e-wave (early diastolic positive wave).The ratio of the height of the each wave to that of the a-wave (b/a, c/a, d/a and e/a) are usually used for wave analyses.We previously reported characteristic age related wave changes of SDPTG in 600 subjects (each 50 men and 50 women in each decade from the 3rd to the 8th) in our health assessment center (Hypertension, 1998; 32: 365-370.).SDPTG-AI increased with augmentation index of original photoplethysmogram which is known to increase with increasing age, and is defined as the ratio of the amplitude of the late systolic component to that of the early systolic component of the original plethysmogram.The b/a increased with age and c/a, d/a and e/a decreased with age. Thus b-c-d-e/a was taken as the aging index of SDPTG (SDPTG aging index: SDPTGAI) which increased with age. SDPTG (Y) increased with age (X) as Y=0.023X-1.515, r=0.80, p<0.001).Similar distribution of vascular ages were seen in different districts group, including women in Toba city in Mie prefecture, subjects in shinjuku in Tokyo and patients in Broussias Hospital in Paris.SDPTGAI increased with vascular stiffness represented by inceased b/a and increasing reflection wave represented by decreasing d/a. Vascular age estimated by SDPTG=43.5SDPTGAI+65.9.SDPTGAI and vascular age were significantly higher in patients with a history of hypertension, diabetes mellitus, and hyperlipidemia than in subjects without any disease (p<0.01).The possibility of arteriosclerotic disease can be considered when vascular age is higher than actual age. Though cut-off value of the difference of vascular and actual ages are under examination, the tentative cut-off value is a difference of 15-20 years, which will provide us useful information for screening of arteriosclerotic diseases.A new type of apparatus (Fukuda FCP series) provides full automated detection of each indices and prints out within 30 seconds, which will be widely used for noninvasive evaluation of arteriosclerosis through vascular age.

著者

齋藤 友紀雄 五関 善成 荒井 悌子 大滝 裕香 山下 淳 田中 宏和 石山 泰三 田中 信大 山科 章

出版者

公益財団法人 日本心臓財団

雑誌

心臓 (ISSN:05864488)

巻号頁・発行日

vol.43, no.SUPPL.2, pp.S2_87-S2_91, 2011 (Released:2012-12-05)

参考文献数

7

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症例は42歳, 男性. 自宅で夜間就寝中に突然うなり声を発した後, 意識消失したため, 妻が救急要請した. 娘が心肺蘇生術(CPR)の講習受講者であったため, 確認したところ, 心肺停止状態で消防庁司令室の指示により協力して, 11歳の息子が胸骨圧迫を開始した. 救急隊現着時, モニター上, 心静止であったため, 救急隊がCPRを引き継いだところ心室細動(VF)波形となった. DC 200J施行し, CPR継続したところ心拍再開した(心停止時間16分). 当院救急センター搬送後, 低体温療法開始し, 神経学的な後遺症は認めなかった. 冠動脈造影上有意狭窄なく, アセチルコリン負荷は陰性であった. ピルジカイニド負荷試験では右側胸部誘導にST変化を認めなかった. 心臓超音波検査では心機能良好で, 器質的心疾患を認めなかった. 重度睡眠時無呼吸症候群を認めたが, CPAP療法は希望しなかった. 特発性心室細動の診断で, 第21病日に植込み型除細動器(ICD)植え込み術を施行し, 以後経過良好にて退院した. 現在までのところ, ICD作動は認めていない.

著者

田中 信大 太田 祥一

出版者

へるす出版

雑誌

救急医学 (ISSN:03858162)

巻号頁・発行日

vol.29, no.6, pp.653-656, 2005-06

被引用文献数

1