{"@context":{"@vocab":"https://cir.nii.ac.jp/schema/1.0/","rdfs":"http://www.w3.org/2000/01/rdf-schema#","dc":"http://purl.org/dc/elements/1.1/","dcterms":"http://purl.org/dc/terms/","foaf":"http://xmlns.com/foaf/0.1/","prism":"http://prismstandard.org/namespaces/basic/2.0/","cinii":"http://ci.nii.ac.jp/ns/1.0/","datacite":"https://schema.datacite.org/meta/kernel-4/","ndl":"http://ndl.go.jp/dcndl/terms/","jpcoar":"https://github.com/JPCOAR/schema/blob/master/2.0/"},"@id":"https://cir.nii.ac.jp/crid/1390282679748985344.json","@type":"Article","productIdentifier":[{"identifier":{"@type":"DOI","@value":"10.5105/jse.21.436"}},{"identifier":{"@type":"NAID","@value":"10008115163"}},{"identifier":{"@type":"URI","@value":"https://search.jamas.or.jp/link/ui/2002068771"}}],"dc:title":[{"@value":"電気的交互脈，特にμＶ‐ＴＷＡについて"},{"@language":"en","@value":"<I>Clinical significance of microvolt T wave alternans (μV-TWA) </I>"}],"dc:language":"ja","description":[{"type":"abstract","notation":[{"@value":"以前から, 比較的まれではあるが心室性不整脈発生に先行してQRS波, T波などの心電図波形に1拍置きの交互変化 (alternans) がみられることが知られていた.近年, 特にT波に関してこれら体表心電図で明らかに認められる電気的交互脈のみならず, 肉眼では視認し得ないマイクロボルトレベルの極めて微細なT波高の1拍置きの交互変化 (microvolt T wave alternans: μV-TWA) を, 高速フーリエ変換法 (FFT) を用いて周波数解析することによって検出するシステムが開発され, これと心室頻拍や心室細動など重症心室性不整脈との関連性が注目されている.<BR>このμV-TWAが起こる電気生理学的機序に関しては, 心筋細胞内カルシウム動態に関連する活動電位そのものの交互変化を反映するとの説が有力であるが, 実際の臨床例ではさまざまな因子が関与し, その機序も決して単純ではないと推測される.<BR>また現在臨床で用いることの可能なμV-TWA検出システムはCH2000のみで, T波高の時系列データをFFT解析するものであるが, その解析法や評価法の詳細ならびに心拍数増加の方法, μV-TWA出現の再現性など多くの議論がなされている.<BR>臨床的には, μV-TWAと実際の心室性不整脈発生との関連性が最も重要であるが, 基礎疾患や検出法の違いにより成績が異なる.多くは80%台の比較的高いsensitivitiy, specificityが報告されているが, 心拍数をあげると疑陽性が多くなるのでその判断には注意が必要である.また長期予後との関連性では, 心拍変動, 心室遅延電位, 圧受容体反射感受性, QT dispersionなどとは独立した予後規定因子で, これらの非侵襲的検査法に匹敵するあるいはより優れた予後判定指標であることも示されている.<BR>今後, 多施設大規模前向き試験により, その臨床的有用性が客観的に証明され, μV-TWAが日常診療に広く応用される検査法として確立して行くことが期待される."}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410282679748985345","@type":"Researcher","foaf:name":[{"@language":"en","@value":"Katoh Takao"},{"@language":"ja","@value":"加藤 貴雄"}],"jpcoar:affiliationName":[{"@language":"ja","@value":"日本医科大学第一内科"}]},{"@id":"https://cir.nii.ac.jp/crid/1410001205339466377","@type":"Researcher","personIdentifier":[{"@type":"NRID","@value":"9000003870115"}],"foaf:name":[{"@language":"en","@value":"Matsumoto Shin"},{"@language":"ja","@value":"松本 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Electrocardiology"},{"@language":"en","@value":"Shindenzu"},{"@language":"ja","@value":"心電図"},{"@language":"ja","@value":"日本心電学会誌"}],"dc:publisher":[{"@language":"en","@value":"Japanese Heart Rhythm 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