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		<h1 class="catchCopy">非薬物療法を有機的かつ効率的に学ぶための循環器医必携の書！</h1>
		

		<h1 class="title titleWidth">非薬物療法で心不全をコントロールして癒す（電子版のみ）<span class="version"></span></h1>
		

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				<ul class="property"><li class="disc">B5判・136頁・4色刷</li><li class="disc">ISBN&nbsp;978-4-8306-1937-3</li><li class="disc">2017年5月20日発行</li></ul>

				
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">病態の複雑さから多岐にわたる心不全の非薬物療法を有機的かつ効率的に学べるようコンパクトにまとめた．現在までにエビデンスが確立された治療法や今後発展が期待される治療法はもちろん，現在どこまで効果が確認され，どのような症例に効果が期待できるのか，そして今後解決すべき課題や発展性についてまで，すべてがわかる1冊！</section><section class="preface">序文<br><br>　心不全症例数は増加の一途をたどっており，その発症予防および予後の改善は重要な課題である．これまで薬物療法であるレニン・アンジオテンシン・アルドステロン系阻害薬やβ遮断薬については多くのエビデンスが集積されてきた．しかし，植込み型除細動器（ICD）によって致死性不整脈による突然死を回避できるように，薬物療法では解決できていない病態が多岐にわたって存在する．このため，ICDのような必須の治療法に加えて，今後に発展が期待される再生医療を含め多様な非薬物療法が開発され，その発展は日進月歩である．そこで，現在注目されている非薬物療法について有機的かつ効率的に学ぶ機会を提供するため本書を企画するに至った．<br>　不整脈では致死性不整脈による突然死の回避とともに，高率に合併する心房細動も重要な課題である．デバイス治療法同様に近年大きく発展したカテーテル治療法が注目される．革新的なデバイス治療法である心臓再同期療法（CRT）は既にエビデンスのある治療法であるものの，ノンレスポンダーなどの課題が残っており，それらを解決する術が模索され続けている．CRTの効果では心臓容量が減少するリバースリモデリングが知られているが，不全心におけるリモデリングの抑制はいまだに大きな課題であり，その治療法はチャレンジングである．虚血性心疾患では残存虚血や心筋バイアビリティを多角的に評価しリモデリングの抑制を目指している．しかし，血行再建の適応を含めて議論があるところである．また，リモデリングによって生じる虚血性僧帽弁閉鎖不全への介入も重要な課題であり，その克服に向けた病態把握とさまざまな治療法の開発が行われている．<br>　一方，心不全では自律神経機能不全も重要な治療ターゲットである．臨床で使用されている陽圧換気療法や低温サウナを使用した和温療法は自律神経改善を介して効果を発揮するところが大きい．また，迷走神経刺激や高血圧治療法で注目される腎交換神経アブレーションは直接自律神経系に介入する治療法である．神経体液性因子活性化の抑制は心不全薬物療法の礎となる病態であるが，交感神経活動の活性化や副交感神経機能異常を薬物によって十分コントロールすることは困難である．ゆえに，自律神経系のコントロールを介した心不全非薬物治療についてさらに注目すべきである．最後に期待を込めて再生医療，特にiPS細胞を取り上げた．iPS細胞は眼疾患で臨床応用が試みられているように，循環器分野での臨床応用も意外に近い将来訪れるかもしれない．その日に備え，臨床医もこの分野の知識を蓄えていく必要があると思う．<br>　本書により非薬物療法の現状，課題および展望を知り，治療法相互の有機的な理解が深まれば幸いである．<br><br>2017年5月<br>　瀬尾由広</section><section class="indexes">I　総　論－非薬物療法－<br>II　心臓を再同期させる<br>　1　心不全における心臓非再同期を識り，評価する<br>　2　心臓再同期療法を期待できる病態とは？<br>　3　心臓再同期療法に残された課題と展望<br>III　不整脈をコントロールする<br>　1　心不全における心房細動とその治療法<br>　2　心不全における心室不整脈治療<br>　3　心不全における突然死と植込み型除細動器デバイスの効果と課題<br>IV　心室リモデリングへの対応<br>　1　心不全における虚血性心疾患と血行再建の適応<br>　2　機能性（虚血性）僧帽弁逆流の病態と評価方法<br>　3　僧帽弁形成術ならびに左室形成術について<br>　4　MitraClipの現状<br>V　自律神経をコントロールする<br>　1　心不全に対する陽圧換気療法の適応と効果<br>　2　和温療法<br>　3　迷走神経刺激<br>　4　腎交感神経デナベーション<br>VI　再生医療に期待する<br>　1　iPS細胞を用いた再生心筋細胞移植<br>　2　重症心不全に対する細胞シート移植の現状と展望<br>索　引</section></article>
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