Brugada症候群と早期再分極症候群（J波症候群）の薬物療法
Brugada症候群と早期再分極症候群は，心室細動（VF）を発症し突然死を起こす可能性がある．両症候群は，心電図でST上昇（J波）を認める．その主な機序として，一過性外向き電流（Ito）の増加が考えられている．キニジンに代表されるItoを抑制する薬剤はVFの発生を抑制するとの報告があり，同時にJ波を消失させることも明らかにされている．このような薬剤は，Brugada症候群と早期再分極症候群において植込み型除細動器施行後のVFに対する補助的治療として使用される．本論文では，Brugada症候群と早期再分極症候群に対して有効な薬剤の作用機序を解説し，薬物療法の既報についてまとめる．...
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| Published in | 心電図 Vol. 35; no. 2; pp. 95 - 103 |
|---|---|
| Main Authors | , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本不整脈心電学会
2015
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0285-1660 1884-2437 |
| DOI | 10.5105/jse.35.95 |
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| Abstract | Brugada症候群と早期再分極症候群は，心室細動（VF）を発症し突然死を起こす可能性がある．両症候群は，心電図でST上昇（J波）を認める．その主な機序として，一過性外向き電流（Ito）の増加が考えられている．キニジンに代表されるItoを抑制する薬剤はVFの発生を抑制するとの報告があり，同時にJ波を消失させることも明らかにされている．このような薬剤は，Brugada症候群と早期再分極症候群において植込み型除細動器施行後のVFに対する補助的治療として使用される．本論文では，Brugada症候群と早期再分極症候群に対して有効な薬剤の作用機序を解説し，薬物療法の既報についてまとめる． |
|---|---|
| AbstractList | Brugada症候群と早期再分極症候群は，心室細動（VF）を発症し突然死を起こす可能性がある．両症候群は，心電図でST上昇（J波）を認める．その主な機序として，一過性外向き電流（Ito）の増加が考えられている．キニジンに代表されるItoを抑制する薬剤はVFの発生を抑制するとの報告があり，同時にJ波を消失させることも明らかにされている．このような薬剤は，Brugada症候群と早期再分極症候群において植込み型除細動器施行後のVFに対する補助的治療として使用される．本論文では，Brugada症候群と早期再分極症候群に対して有効な薬剤の作用機序を解説し，薬物療法の既報についてまとめる． |
| Author | 林, 秀樹 堀江, 稔 |
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| References | 8) Aizawa Y, Yamakawa H, Takatsuki S, Katsumata Y, Nishiyama T, Kimura T, Nishiyama N, Fukumoto K, Tanimoto Y, Tanimoto K, Mitamura H, Ogawa S, Fukuda K : Efficacy and safety of bepridil for prevention of ICD shocks in patients with Brugada syndrome and idiopathic ventricular fibrillation. Int J Cardiol, 2013 ; 168 : 5083-5085 11) Szél T, Koncz I, Antzelevitch C : Cellular mechanisms underlying the effects of milrinone and cilostazol to suppress arrhythmogenesis associated with Brugada syndrome. Heart Rhythm, 2013 ; 10 : 1720-1727 13) Haïssaguerre M, Sacher F, Nogami A, Komiya N, Bernard A, Probst V, Yli-Mayry S, Defaye P, Aizawa Y, Frank R, Mantovan R, Cappato R, Wolpert C, Leenhardt A, de Roy L, Heidbuchel H, Deisenhofer I, Arentz T, Pasquié JL, Weerasooriya R, Hocini M, Jais P, Derval N, Bordachar P, Clémenty J : Characteristics of recurrent ventricular fibrillation associated with inferolateral early repolarization role of drug therapy. J Am Coll Cardiol, 2009 ; 53 : 612-619 2) Minoura Y, Panama BK, Nesterenko VV, Betzenhauser M, Barajas-Martínez H, Hu D, Di Diego JM, Antzelevitch C : Effect of Wenxin Keli and quinidine to suppress arrhythmogenesis in an experimental model of Brugada syndrome. Heart Rhythm, 2013 ; 10 : 1054-1062 3) Belhassen B, Glick A, Viskin S : Efficacy of quinidine in high-risk patients with Brugada syndrome. Circulation, 2004 ; 110 : 1731-1737 7) Hasegawa K, Ashihara T, Kimura H, Jo H, Itoh H, Yamamoto T, Aizawa Y, Horie M : Long-term pharmacological therapy of Brugada syndrome: is J-wave attenuation a marker of drug efficacy? Intern Med, 2014 ; 53 (14) : 1523-1526 9) Watanabe A, Fukushima Kusano K, Morita H, Miura D, Sumida W, Hiramatsu S, Banba K, Nishii N, Nagase S, Nakamura K, Sakuragi S, Ohe T : Low-dose isoproterenol for repetitive ventricular arrhythmia in patients with Brugada syndrome. Eur Heart J, 2006 ; 27 : 1579-1583 5) Mizusawa Y, Sakurada H, Nishizaki M, Hiraoka M : Effects of low-dose quinidine on ventricular tachyarrhythmias in patients with Brugada syndrome : low-dose quinidine therapy as an adjunctive treatment. J Cardiovasc Pharmacol, 2006 ; 47 (3) : 359-364 6) Ashino S, Watanabe I, Kofune M, Nagashima K, Ohkubo K, Okumura Y, Mano H, Nakai T, Kunimoto S, Kasamaki Y, Hirayama A : Effects of quinidine on the action potential duration restitution property in the right ventricular outflow tract in patients with Brugada syndrome. Circ J, 2011 ; 75 : 2080-2086 10) Tsuchiya T, Ashikaga K, Honda T, Arita M : Prevention of ventricular fibrillation by cilostazol, an oral phosphodiesterase inhibitor, in a patient with Brugada syndrome. J Cardiovasc Electrophysiol, 2002 ; 13 : 698-701 15) Shinohara T, Ebata Y, Ayabe R, Fukui A, Okada N, Yufu K, Nakagawa M, Takahashi N : Combination therapy of cilostazol and bepridil suppresses recurrent ventricular fibrillation related to J-wave syndromes. Heart Rhythm, 2014 ; 11 : 1441-1445 14) Iguchi K, Noda T, Kamakura S, Shimizu W : Beneficial effects of cilostazol in a patient with recurrent ventricular fibrillation associated with early repolarization syndrome. Heart Rhythm, 2013 ; 10 : 604-606 4) Márquez MF, Bonny A, Hernández-Castillo E, De Sisti A, Gómez-Flores J, Nava S, Hidden-Lucet F, Iturralde P, Cárdenas M, Tonet J : Long-term efficacy of low doses of quinidine on malignant arrhythmias in Brugada syndrome with an implantable cardioverter-defibrillator : a case series and literature review. Heart Rhythm, 2012 ; 9 : 1995-2000 1) Sosunov EA, Anyukhovsky EP, Rosen MR : Effects of quinidine on repolarization in canine epicardium, midmyocardium, and endocardium : I. In vitro study. Circulation, 1997 ; 96 : 4011-4018 12) Haïssaguerre M, Derval N, Sacher F, Jesel L, Deisenhofer I, de Roy L, Pasquié JL, Nogami A, Babuty D, Yli-Mayry S, De Chillou C, Scanu P, Mabo P, Matsuo S, Probst V, Le Scouarnec S, Defaye P, Schlaepfer J, Rostock T, Lacroix D, Lamaison D, Lavergne T, Aizawa Y, Englund A, Anselme F, O'Neill M, Hocini M, Lim KT, Knecht S, Veenhuyzen GD, Bordachar P, Chauvin M, Jais P, Coureau G, Chene G, Klein GJ, Clémenty J : Sudden cardiac arrest associated with early repolarization. N Engl J Med, 2008 ; 358 : 2016-2023 |
| References_xml | – reference: 10) Tsuchiya T, Ashikaga K, Honda T, Arita M : Prevention of ventricular fibrillation by cilostazol, an oral phosphodiesterase inhibitor, in a patient with Brugada syndrome. J Cardiovasc Electrophysiol, 2002 ; 13 : 698-701 – reference: 9) Watanabe A, Fukushima Kusano K, Morita H, Miura D, Sumida W, Hiramatsu S, Banba K, Nishii N, Nagase S, Nakamura K, Sakuragi S, Ohe T : Low-dose isoproterenol for repetitive ventricular arrhythmia in patients with Brugada syndrome. Eur Heart J, 2006 ; 27 : 1579-1583 – reference: 6) Ashino S, Watanabe I, Kofune M, Nagashima K, Ohkubo K, Okumura Y, Mano H, Nakai T, Kunimoto S, Kasamaki Y, Hirayama A : Effects of quinidine on the action potential duration restitution property in the right ventricular outflow tract in patients with Brugada syndrome. Circ J, 2011 ; 75 : 2080-2086 – reference: 1) Sosunov EA, Anyukhovsky EP, Rosen MR : Effects of quinidine on repolarization in canine epicardium, midmyocardium, and endocardium : I. In vitro study. Circulation, 1997 ; 96 : 4011-4018 – reference: 3) Belhassen B, Glick A, Viskin S : Efficacy of quinidine in high-risk patients with Brugada syndrome. Circulation, 2004 ; 110 : 1731-1737 – reference: 15) Shinohara T, Ebata Y, Ayabe R, Fukui A, Okada N, Yufu K, Nakagawa M, Takahashi N : Combination therapy of cilostazol and bepridil suppresses recurrent ventricular fibrillation related to J-wave syndromes. Heart Rhythm, 2014 ; 11 : 1441-1445 – reference: 4) Márquez MF, Bonny A, Hernández-Castillo E, De Sisti A, Gómez-Flores J, Nava S, Hidden-Lucet F, Iturralde P, Cárdenas M, Tonet J : Long-term efficacy of low doses of quinidine on malignant arrhythmias in Brugada syndrome with an implantable cardioverter-defibrillator : a case series and literature review. Heart Rhythm, 2012 ; 9 : 1995-2000 – reference: 8) Aizawa Y, Yamakawa H, Takatsuki S, Katsumata Y, Nishiyama T, Kimura T, Nishiyama N, Fukumoto K, Tanimoto Y, Tanimoto K, Mitamura H, Ogawa S, Fukuda K : Efficacy and safety of bepridil for prevention of ICD shocks in patients with Brugada syndrome and idiopathic ventricular fibrillation. Int J Cardiol, 2013 ; 168 : 5083-5085 – reference: 7) Hasegawa K, Ashihara T, Kimura H, Jo H, Itoh H, Yamamoto T, Aizawa Y, Horie M : Long-term pharmacological therapy of Brugada syndrome: is J-wave attenuation a marker of drug efficacy? Intern Med, 2014 ; 53 (14) : 1523-1526 – reference: 14) Iguchi K, Noda T, Kamakura S, Shimizu W : Beneficial effects of cilostazol in a patient with recurrent ventricular fibrillation associated with early repolarization syndrome. Heart Rhythm, 2013 ; 10 : 604-606 – reference: 5) Mizusawa Y, Sakurada H, Nishizaki M, Hiraoka M : Effects of low-dose quinidine on ventricular tachyarrhythmias in patients with Brugada syndrome : low-dose quinidine therapy as an adjunctive treatment. J Cardiovasc Pharmacol, 2006 ; 47 (3) : 359-364 – reference: 2) Minoura Y, Panama BK, Nesterenko VV, Betzenhauser M, Barajas-Martínez H, Hu D, Di Diego JM, Antzelevitch C : Effect of Wenxin Keli and quinidine to suppress arrhythmogenesis in an experimental model of Brugada syndrome. Heart Rhythm, 2013 ; 10 : 1054-1062 – reference: 13) Haïssaguerre M, Sacher F, Nogami A, Komiya N, Bernard A, Probst V, Yli-Mayry S, Defaye P, Aizawa Y, Frank R, Mantovan R, Cappato R, Wolpert C, Leenhardt A, de Roy L, Heidbuchel H, Deisenhofer I, Arentz T, Pasquié JL, Weerasooriya R, Hocini M, Jais P, Derval N, Bordachar P, Clémenty J : Characteristics of recurrent ventricular fibrillation associated with inferolateral early repolarization role of drug therapy. J Am Coll Cardiol, 2009 ; 53 : 612-619 – reference: 12) Haïssaguerre M, Derval N, Sacher F, Jesel L, Deisenhofer I, de Roy L, Pasquié JL, Nogami A, Babuty D, Yli-Mayry S, De Chillou C, Scanu P, Mabo P, Matsuo S, Probst V, Le Scouarnec S, Defaye P, Schlaepfer J, Rostock T, Lacroix D, Lamaison D, Lavergne T, Aizawa Y, Englund A, Anselme F, O'Neill M, Hocini M, Lim KT, Knecht S, Veenhuyzen GD, Bordachar P, Chauvin M, Jais P, Coureau G, Chene G, Klein GJ, Clémenty J : Sudden cardiac arrest associated with early repolarization. N Engl J Med, 2008 ; 358 : 2016-2023 – reference: 11) Szél T, Koncz I, Antzelevitch C : Cellular mechanisms underlying the effects of milrinone and cilostazol to suppress arrhythmogenesis associated with Brugada syndrome. Heart Rhythm, 2013 ; 10 : 1720-1727 |
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| Snippet | Brugada症候群と早期再分極症候群は，心室細動（VF）を発症し突然死を起こす可能性がある．両症候群は，心電図でST上昇（J波）を認める．その主な機序として，一過性外... |
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| SubjectTerms | Brugada症候群 早期再分極症候群 薬物療法 |
| Title | Brugada症候群と早期再分極症候群（J波症候群）の薬物療法 |
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