{"id":1573,"date":"2018-10-17T09:04:08","date_gmt":"2018-10-17T00:04:08","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1573"},"modified":"2018-10-17T09:04:08","modified_gmt":"2018-10-17T00:04:08","slug":"%e5%bf%83%e4%b8%8d%e5%85%a8%e6%80%a5%e6%80%a7%e5%a2%97%e6%82%aa%e3%81%ab%e3%81%8a%e3%81%91%e3%82%8b%ce%b2%e3%83%96%e3%83%ad%e3%83%83%e3%82%ab%e3%83%bc%e3%81%ae%e4%b8%ad%e6%96%ad","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1573","title":{"rendered":"\u5fc3\u4e0d\u5168\u6025\u6027\u5897\u60aa\u306b\u304a\u3051\u308b\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u306e\u4e2d\u65ad"},"content":{"rendered":"

\uff0d\u6587\u732e\u540d\uff0d
\nGuillaume Jondeau, et al. B-CONVINCED: Beta-blocker CONtinuation Vs. INterruption in patients with Congestive heart failure hospitalizED for a decompensation episode. European Heart Journal (2009) 30, 2186\u20132192<\/p>\n

\uff0d\u8981\u7d04\uff0d
\nIntroduction\uff1a
\n\uff1c\u308f\u304b\u3063\u3066\u3044\u308b\u3053\u3068\uff1e
\n\u30fb\t\u304b\u3064\u3066\u306f\u53ce\u7e2e\u671f\u5fc3\u4e0d\u5168\u81ea\u4f53\u306b\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u306e\u4f7f\u7528\u306f\u7981\u5fcc\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u305f\u3002
\n\u30fb\t\u3057\u304b\u3057\u73fe\u5728\u3067\u306f\u6162\u6027\u671f\u306e\u5fc3\u4e0d\u5168\u306e\u60a3\u8005\u306b\u304a\u3044\u3066\u306f\u3001\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u306e\u4f7f\u7528\u306f\u751f\u6d3b\u306e\u8cea\u3092\u6539\u5584\u3057\u3001\u75c5\u56e0\u30fb\u6027\u5225\u30fb\u95a2\u9023\u3059\u308b\u6cbb\u7642\u304a\u3088\u3073\u5e74\u9f62\u306b\u95a2\u308f\u3089\u305a\u5165\u9662\u7387\u3092\u4f4e\u4e0b\u3055\u305b\u308b\u3068\u4e00\u8cab\u3057\u3066\u7d50\u8ad6\u3065\u3051\u3089\u308c\u3066\u3044\u308b\u3002
\n\u30fb\t\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u306f\u5fc3\u62cd\u51fa\u91cf\u3092\u4f4e\u4e0b\u3055\u305b\u3001\u5de6\u5fc3\u5ba4\u5145\u6e80\u5727\u3092\u5897\u52a0\u3055\u305b\u308b\u4f5c\u7528\u3092\u6301\u3064\u305f\u3081\u3001\u6cbb\u7642\u304c\u5fc3\u62cd\u51fa\u91cf\u3092\u3042\u3052\u305f\u3044\u6025\u6027\u671f\u306e\u53ce\u7e2e\u5fc3\u4e0d\u5168\u306b\u65b0\u898f\u306b\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u3092\u5c0e\u5165\u3055\u305b\u308b\u3053\u3068\u306f\u7981\u5fcc\u3067\u3042\u308b\u3002
\n\uff1c\u308f\u304b\u3063\u3066\u3044\u306a\u3044\u3053\u3068\uff1e
\n\u30fb\t\u3082\u3068\u3082\u3068\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u3092\u5185\u670d\u3057\u3066\u3044\u308b\u60a3\u8005\u304c\u6025\u6027\u671f\u306e\u53ce\u7e2e\u671f\u5fc3\u4e0d\u5168\u3092\u767a\u75c7\u3057\u305f\u6642\u306b\u3001\u7d99\u7d9a\u3055\u305b\u308b\u3079\u304d\u304b\u4e2d\u6b62\u6e1b\u91cf\u3055\u305b\u308b\u3079\u304d\u304b\u4e0d\u660e\u3067\u3042\u308b\u3002
\n\u30fb\t\u904e\u53bb\u306bRCT\u3082\u306a\u304f\u3001ESC\u306e\u63a8\u5968\u3082\u4e0d\u660e\u78ba\uff1a\u6e1b\u91cf\/\u4e2d\u6b62\u3055\u305b\u308b\u3079\u304d\u304b\u3082\u3057\u308c\u306a\u3044\u304c\u3001\u53ef\u53ca\u7684\u901f\u3084\u304b\u306b\u518d\u958b\u3092\u691c\u8a0e\u3059\u308b\u3002<\/p>\n

Method\uff1a
\n\uff1c\u5bfe\u8c61\uff1e
\n\u30d5\u30e9\u30f3\u30b9\u306e36\u65bd\u8a2d\uff08cardiology center\uff09\u306b2004\u5e7410\u6708\u301c2018\u5e7410\u6708\u306b\u96c6\u3081\u3089\u308c\u305f1\u30f6\u6708\u4ee5\u4e0a\u540c\u3058\u5bb9\u91cf\u306e\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u3092\u5185\u670d\u3057\u3066\u3044\u308b18\u6b73\u4ee5\u4e0a\u306e\u6210\u4eba\u3002\u653e\u5c04\u5b66\u7684\u306a\u8a3c\u62e0\u306e\u3042\u308b\u80ba\u6c34\u816b\u3084\u6d6e\u816b\u304c\u3042\u308a\u547c\u5438\u56f0\u96e3\u3092\u4f34\u3046\u6025\u6027\u5fc3\u4e0d\u5168\u3067\u5165\u9662\u3068\u306a\u308a\u3001\u547c\u5438\u6570\uff1e24\u56de\u3067LVEF\u304c12\u30f6\u6708\u4ee5\u5185\u306b\u6e2c\u5b9a\u3055\u308c\u300140%\u672a\u6e80\u3067\u3042\u308b\u60a3\u8005\u3092\u5bfe\u8c61\u3068\u3059\u308b\u3002
\n\uff1c\u9664\u5916\u57fa\u6e96\uff1e
\nSTEMI\u3001\u30c9\u30d6\u30bf\u30df\u30f3\u304c\u5fc5\u8981\u3068\u81e8\u5e8a\u533b\u306b\u5224\u65ad\u3055\u308c\u305f\u60a3\u8005\u30012\u5ea6\u4ee5\u4e0a\u306e\u623f\u5ba4\u30d6\u30ed\u30c3\u30af\u3001\u5fc3\u62cd\u6570\u304c50bpm\u672a\u6e80\u3001\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u5897\u91cf\u4e2d\u306e\u60a3\u8005\u3001\u4ed6\u306e\u7814\u7a76\u306b\u53c2\u52a0\u3057\u3066\u3044\u308b\u60a3\u8005\u3001\u598a\u5a20\u4e2d<\/p>\n

\uff1c\u65b9\u6cd5\uff1e
\n\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u3092\u540c\u91cf\u306e\u307e\u307e\u7d99\u7d9a\u3059\u308b\u7fa4\u3068\u4e2d\u6b62\u3059\u308b\u7fa4\u306b\u7121\u4f5c\u70ba\u306b\u632f\u308a\u5206\u3051\u3001\u96a0\u853d\u5316\u3055\u308c\u305f\u3002\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u306f\u6700\u4f4e\u3067\u30823\u65e5\u9593\u306e\u7d99\u7d9a\u304c\u3055\u308c\u3066\u3044\u308b\u3002\u6700\u521d\u306e8\u65e5\u9593\u6bce\u65e5\u3001\u3082\u3057\u304f\u306f\u65e9\u671f\u306b\u9000\u9662\u3068\u306a\u3063\u305f\u30b1\u30fc\u30b9\u306f\u9000\u9662\u306b\u306a\u308b\u307e\u3067\u306e\u6bce\u65e5\u3001\u81e8\u5e8a\u30c7\u30fc\u30bf\uff08\u8108\u62cd\u3001\u8840\u5727\u3001\u547c\u5438\u6570\u3001SpO2\u3001\u80ba\u6c34\u816b\u306e\u5b58\u5728\u3001\u4e0b\u817f\u6d6e\u816b\u3001\u809d\u816b\u5927\u3001\u9838\u9759\u8108\u6012\u5f35\uff09\u3092\u96c6\u3081\u305f\u3002\u307e\u305f\u5165\u9662\u6642\u3068\u5165\u96623\u65e5\u5f8c\u306b\u8840\u6e05BNP\u5024\u3092\u6e2c\u5b9a\u3057\u3001\u5165\u96623\u65e5\u76ee\u30688\u65e5\u76ee\u306b\u76f2\u691c\u5316\u3055\u308c\u305f\u72b6\u614b\u3067\u533b\u5e2b\u306b\u3088\u308b2\u3064\u306e\u540c\u4e00\u306e\u30a2\u30f3\u30b1\u30fc\u30c8\u3067\u547c\u5438\u56f0\u96e3\u611f\u3084\u5168\u8eab\u72b6\u614b\u306e\u8a55\u4fa1\u304c\u3055\u308c\u305f\u3002\u5168\u8eab\u72b6\u614b\u306f5\u6bb5\u968e\u306b\u8a55\u4fa1\u3055\u308c\u3001\u826f\u3044\/\u82e5\u5e72\u826f\u3044\/\u5909\u308f\u308a\u306a\u3044\/\u82e5\u5e72\u60aa\u3044\/\u60aa\u3044\u3068\u5206\u3051\u3089\u308c\u305f\u3002
\n\u7814\u7a76\u306f\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u4e2d\u6b62\u7fa4\u3068\u6bd4\u8f03\u3057\u3066\u3001\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u7d99\u7d9a\u306e\u975e\u52a3\u52e2\u3092\u5b9f\u8a3c\u3059\u308b\u3053\u3068\u3092\u76ee\u7684\u306b\u3057\u3066\u3044\u308b\u30023\u65e5\u5f8c\u306e\u5168\u8eab\u72b6\u614b\u3084\u547c\u5438\u56f0\u96e3\u611f\u304c\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u7d99\u7d9a\u7fa4\u306eoutcome\u304c\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u4e2d\u6b62\u7fa4\u3068\u6bd4\u8f03\u3057\u3066\u300112.5%\u4ee5\u4e0a\u52a3\u3089\u306a\u3051\u308c\u3070\u3001\u975e\u52a3\u52e2\u3067\u3042\u308b\u3068\u5224\u65ad\u3067\u304d\u308b\u3002\u7814\u7a76\u306fPer-protocol\u3067\u8a55\u4fa1\u3092\u3055\u308c\u3066\u304a\u308a\u3001Primary outcome\u3092\u8a55\u4fa1\u3059\u308b\u305f\u3081\u306e\u75c7\u4f8b\u6570\u3092\u3042\u3089\u304b\u3058\u3081\u63a8\u5b9a\u3057\u305f\u4e0a\u3067\u7814\u7a76\u304c\u958b\u59cb\u3055\u308c\u3066\u3044\u305f\u3002<\/p>\n

\uff1cEnd point\uff1e
\n\u2022\tPrimary Outcome\uff1a\u5168\u8eab\u72b6\u614b\u30fb\u547c\u5438\u56f0\u96e3\u611f\u304c\u6539\u5584\u3057\u305f\u5272\u5408\uff08\u533b\u5e2b\u306b\u3088\u308b\u7b2c3\u75c5\u65e5\u307e\u3067\u306e\u8a55\u4fa1\uff09
\n\u2022\tSecondary Outcomes\uff1a\u5168\u8eab\u72b6\u614b\u30fb\u547c\u5438\u56f0\u96e3\u611f\u304c\u6539\u5584\u3057\u305f\u5272\u5408
\n(i) \u60a3\u8005\u306b\u3088\u308b\u7b2c3\u75c5\u65e5\u307e\u3067\u306e\u8a55\u4fa1\u3000(ii) \u533b\u5e2b\u306b\u3088\u308b\u7b2c8\u75c5\u65e5\u307e\u3067\u306e\u8a55\u4fa1\u3000(iii) \u60a3\u8005\u306b\u3088\u308b\u7b2c8\u75c5\u65e5\u307e\u3067\u306e\u8a55\u4fa1\u3001
\n\u8840\u6e05BNP\u5024(\u7b2c3\u75c5\u65e5)\u3001\u5165\u9662\u671f\u9593\u3001\u518d\u5165\u9662\u7387(3\u30f6\u6708)\u3001\u6b7b\u4ea1\u7387(3\u30f6\u6708)\u3001\u6025\u6027\u767a\u4f5c\u304b\u30893\u30f6\u6708\u5f8c\u306e\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u306e\u5185\u670d\u60a3\u8005\u6570
\nResults\uff1a
\n\u60a3\u8005\u306f\u53f3\u56f3\u306e\u3088\u3046\u306b\u632f\u308a\u5206\u3051\u3089\u308c\u3001Base line\u306f\u540c\u7b49\u3068\u5224\u65ad\u3055\u308c\u3066\u3044\u308b\uff08Table1,2\uff09\u3002\u8ffd\u8de1\u7387\u306f\u8131\u843d\u306a\u304f100%\u3067\u3042\u3063\u305f\u3002
\nPrimary outcome\uff1a\u76f2\u691c\u5316\u3055\u308c\u305f\u8a55\u4fa1\u8005\u306b\u304a\u3051\u308b3\u65e5\u76ee\u306e\u547c\u5438\u56f0\u96e3\u611f\u3068\u5168\u8eab\u72b6\u614b\u4e21\u65b9\u306e\u6539\u5584\u306f\u670d\u85ac\u4e2d\u65ad\u7fa492.3%\u306b\u6bd4\u8f03\u3057\u3066\u3001\u670d\u85ac\u7d99\u7d9a\u7fa4\u306f92.8%\u3068\u6709\u610f\u5dee\u306f\u306a\u304b\u3063\u305f\u3002
\nSecondary outcome\uff1a\u540c\u69d8\u306b\u60a3\u8005\u306b\u3088\u308b\u7b2c3\u75c5\u65e5\u3067\u306e\u8a55\u4fa1\u3067\u3082\u4e2d\u6b62\u7fa482.7%\u3001\u7d99\u7d9a\u7fa488.4%\u3068\u6539\u5584\u3092\u8a8d\u3081\u3066\u3044\u308b\u3002
\n8\u65e5\u76ee\u3067\u306e\u533b\u5e2b\u306e\u8a55\u4fa1\u306f\u4e2d\u6b62\u7fa4\uff1a\u7d99\u7d9a\u7fa4\u306795.2%\uff1a95.4%
\n8\u65e5\u76ee\u3067\u306e\u60a3\u8005\u306e\u8a55\u4fa1\u306f\u4e2d\u6b62\u7fa4\uff1a\u7d99\u7d9a\u7fa4\u306794.8%\uff1a95.2%
\n\u3044\u305a\u308c\u3082\u6709\u610f\u5dee\u306a\u3057\uff08\u4e0b\u56f3\u306eFigure 2\u53c2\u7167\uff09\u3002<\/p>\n

\"201810\u897f\u5712\"<\/a><\/p>\n

\"201810\u897f\u57122\"<\/a><\/p>\n

\u8840\u6e05BNP\u306f\u7d99\u7d9a\u7fa4\u306e\u5165\u9662\u6642\u306f1314\u00b11214pg \/ mL\u304b\u3089\u7b2c3\u75c5\u65e5\u306e882+950pg \/ mL\u306b\u6e1b\u5c11\u3002\u540c\u69d8\u306b\u4e2d\u6b62\u7fa4\u306f1387 +1124pg \/ mL\u304b\u3089876 + 1382pg \/ mL\u3078\u3068\u6709\u610f\u306b\u6e1b\u5c11\u3057\u305f\u3002\u7b2c8\u75c5\u65e5\u3082\u8840\u6e05BNP\u306f2\u3064\u306e\u7fa4\u3067\u540c\u7b49\u3067\u3042\u3063\u305f\u3002
\n\u307e\u305f\u540c\u69d8\u306b\u5165\u9662\u671f\u9593\u3001\u518d\u5165\u9662\u7387(3\u30f6\u6708)\u3001\u6b7b\u4ea1\u7387(3\u30f6\u6708)\u3082\u6709\u610f\u5dee\u306f\u306a\u304b\u3063\u305f\uff08\u4e0a\u8a18Table3\u53c2\u7167\uff09\u3002
\n\u6025\u6027\u767a\u4f5c\u304b\u30893\u30f6\u6708\u5f8c\u306e\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u306e\u5185\u670d\u60a3\u8005\u6570\u306f\u6709\u610f\u5dee\u304c\u3042\u308a\u3001\u7d99\u7d9a\u7fa4\u306e\u307b\u3046\u304c\u591a\u304f\u300119%\u304c\u6700\u5927\u6295\u4e0e\u91cf\u3092\u5185\u670d\u3057\u3066\u304a\u308a\u3001\u5c11\u306a\u304f\u3068\u308251%\u304c\u6700\u5927\u91cf\u306e\u534a\u5206\u306e\u5185\u670d\u3092\u3057\u3066\u3044\u305f\u3002<\/p>\n

\"201810\u897f\u57123\"<\/a><\/p>\n

\"201810\u897f\u57124\"<\/a><\/p>\n

Discussion\uff1a
\n\u3053\u306e\u7121\u4f5c\u70ba\u8a66\u9a13\u3067\u306f\u6162\u6027\u7684\u306b\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u3092\u5185\u670d\u3057\u3066\u3044\u308b\u60a3\u8005\u306b\u304a\u3044\u3066\u3001\u6025\u6027\u5897\u60aa\u6642\u306b\u670d\u85ac\u3092\u4e2d\u6b62\u3057\u306a\u304f\u3066\u3082\u81e8\u5e8a\u7684\u306a\u6539\u5584\u3092\u9045\u3089\u305b\u306a\u3044\u3053\u3068\u3092\u5b9f\u8a3c\u3057\u3066\u3044\u308b\uff08\u975e\u52a3\u52e2\u306e\u5b9f\u8a3c\uff09\u3002
\n\u7814\u7a76\u306e\u9650\u754c\u3068\u3057\u3066\u3001
\n\u2460\u7814\u7a76\u304cOpen\u30e9\u30d9\u30eb\u8a66\u9a13\uff08\u8a55\u4fa1\u8005\u306e\u307f\u76f2\u691c\u5316\u3055\u308c\u3066\u3044\u308b\uff09\u3067\u3042\u308a\u3001\u3088\u308a\u591a\u304f\u306e\u4eba\u6570\u304c\u5fc5\u8981\u3068\u306a\u308a\u3046\u308b3\u30f6\u6708\u306e\u6b7b\u4ea1\u3084\u5165\u9662\u306a\u3069\u306e\u53b3\u3057\u3044\u8a55\u4fa1\u9805\u76ee\u306b\u304a\u3044\u3066\u5f71\u97ff\u304c\u3042\u308b\u53ef\u80fd\u6027\u304c\u5b58\u5728\u3059\u308b\u3053\u3068\u3002
\n\u2461\u30c9\u30d6\u30bf\u30df\u30f3\u3092\u6295\u4e0e\u3059\u308b\u610f\u5fd7\u3092\u6301\u3063\u305f\u533b\u5e2b\u306e\u5bfe\u8c61\u3068\u306a\u3063\u3066\u3044\u308b\u60a3\u8005\u306f\u9664\u5916\u3057\u305f
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\uff0d\u6587\u732e\u540d\uff0d Guillaume Jondeau, et al. B-CONVINCED: Beta-blocker CONtinuation Vs. INterruption in patients with Conge … \u7d9a\u304d\u3092\u8aad\u3080 \u5fc3\u4e0d\u5168\u6025\u6027\u5897\u60aa\u306b\u304a\u3051\u308b\u03b2\u30d6\u30ed\u30c3\u30ab\u30fc\u306e\u4e2d\u65ad<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[17],"tags":[],"class_list":["post-1573","post","type-post","status-publish","format-standard","hentry","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1573","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1573"}],"version-history":[{"count":1,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1573\/revisions"}],"predecessor-version":[{"id":1578,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1573\/revisions\/1578"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1573"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1573"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1573"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}