講演情報
[III-PPD3-1]小児心疾患の診断と治療における運動科学の重要性
○津田 武 (Nemours Cardiac Center, Nemours Children's Health Delaware)
キーワード：
Exercise、Stress imaging、Cardiac rehabilitation
Individual exercise capacity represents general wellness of the host as well as overall functional reserve of heart, lung, and muscle. Assessment of exercise capacity by cardiopulmonary exercise testing (CPET) provides objective measures of cardiovascular reserve of patients with and without heart disease. In addition to conventional respiratory gas analysis in CPET, stress imaging studies have emerged as new diagnostic modalities to identify subclinical myocardial pathology, including occult myocardial ischemia and/or myopathic changes with advanced technologies. On the other hand, exercise is an essential therapeutic modality to improve survival, daily functionality, and quality of life of patients with heart disease. Exercise enhances dynamic biological crosstalk among multiple organ systems, including cardiovascular system, skeletal muscle, bone, immune cells, nervous system, endocrine system, gut, and adipose tissue. These beneficial interactions exert thorough endocrine, paracrine, or autocrine pathways via cytokines called “exerkines”. This principle supports the concept of cardiac rehabilitation program for those with underlying heart disease. The molecular mechanisms of these complex interactions, however, warrant further investigations. As more and more children with heart disease, especially those with single ventricle physiology or complex congenital heart disease who underwent multiple surgical interventions, have survived into adulthood, further evolution of exercise science would open a new academic arena in pediatric cardiology.