シャドーイング練習: Hypertrophic Cardiomyopathy Made Easy | (Includes Hypertrophic Obstructive Cardiomyopathy & SAM) - 動画で英語スピーキングを学ぶ
練習モードを選ぶ
各モードは全画面の練習ルームで開きます。
76 文
文が短すぎたり長すぎる場合は、Editをタップして調整してください。
1
Hypertrophic cardiomyopathy is a genetic disorder of the cardiac muscle tissue,
2
characterised by abnormal thickening of the cardiac muscle without any clear cause.
3
It is the second most common cardiomyopathy with a prevalence of around 1 in 500,
4
and it is the most frequent cause of sudden cardiac death in young patients.
5
Overall, males and females are equally affected.
6
However, females are more likely to present at an older age with more significant heart failure.
7
All ethnicities can be affected.
8
However, a form of hypertrophic cardiomyopathy affecting the apex is significantly more prevalent in Asian people.
9
It is inherited in an autosomal dominant fashion and the genetic abnormalities occur primarily in genes that code for sarcomere proteins.
10
40 % are in the gene coding for beta myosin heavy chains on chromosome 14
11
and 40 % in the cardiac myosin binding protein C gene.
12
In total over 150 mutations have been identified to be involved with this condition.
13
These mutations lead to altered translation efficiency,
14
followed by changes in the signaling pathways and ultimately leading to changes in the histology,
15
including myocyte hypertrophy and fibrosis.
16
This leads to parts of the heart becoming thicker than usual.
17
The most commonly affected areas are the interventricular septum and the left ventricle, although any part can be affected.
18
The left ventricular outflow tract is particularly susceptible to encroachment from the thickening of the septum,
19
leading to obstruction of the left ventricular outflow tract.
20
This is known as hypertrophic obstructive cardiomyopathy and is seen in around 25 % of those with hypertrophic cardiomyopathy.
21
A unique feature of this obstruction is that it is dynamic, meaning it is not fixed.
22
The left ventricular outflow tract is encroached in these patients due to the increased size of the interventricular septum,
23
particularly evident during systole.
24
Another feature that contributes to the obstruction is systolic anterior motion,
25
or SAM, which is the anterior movement of the mitral valve during systole leading to worsening of the outflow tract obstruction.
26
This is best seen on a parasternal view on echocardiography.
27
Although it is not specific for hypertrophic cardiomyopathy it is more commonly seen.
28
Several other factors can also contribute to the dynamic nature of the obstruction such as contractility for example during exercise
29
which causes a more forceful contraction and a greater degree of obstruction.
30
A reduction in preload can also worsen the left ventricular outflow tract obstruction,
31
where preload is the volume in the ventricle at the end of diastole.
32
Examples that reduce preload include hypovolemia, vasodilation, such as after administration of nitrates,
33
and tachycardia that reduces preload due to shorter diastolic filling time.
34
The smaller left ventricular volume facilitates the systolic anterior motion of the mitral valve.
35
Over time, as the fibrosis increases, the ventricle becomes stiffer and less compliant, leading to diastolic heart failure,
36
also known as heart failure with a preserved ejection fraction.
37
A marker of this is increased pressure in the left atrium, which increases the risk of arrhythmias like atrial fibrillation.
38
In long -standing cases, the interstitial fibrosis and the left ventricular outflow tract obstruction lead to thinning of the left ventricle,
39
eventually producing a systolic failure.
40
Often, patients are asymptomatic.
41
When symptoms are present, they are usually the result of four main mechanisms.
42
First is diastolic dysfunction, leading to increased left atrial pressure and pulmonary vein pressure.
43
This is exacerbated in exertion, giving exertional dyspnea.
44
It can also manifest as orthopnea, which is breathlessness when lying flat,
45
and paroxysmal nocturnal dyspnea, which is sudden onset shorness of breath during sleeping.
46
Peripheral edema is another possible or finding.
47
Secondly, we have obstruction of the left ventricular outflow tract which can also cause dyspnea but can cause syncope,
48
especially during exercise.
49
Next we have arrhythmias which can include atrial fibrillation which is seen in around 25 % of patients,
50
ventricular tachycardia and ventricular fibrillation.
51
These can lead to palpitations, lightheadedness or syncope, shortness of breath and chest pain.
52
We also mentioned earlier
53
that hypertrophic cardiomyopathy is the most common cause of sudden cardiac death in young patients and this is largely due to arrhythmias.
54
This brings us to the fourth mechanism, an imbalance between the myocardial oxygen supply and the demand.
55
Oxygen supply is reduced because the flow of blood through the hypertrophy tissue is lower,
56
while there is an increase in the demand due to the thicker myocardial tissue.
57
This can cause chest pain that may have typical features of angina.
58
For the diagnosis, a physical exam will often reveal a mid -systolic murmur best heard at the left sternal border.
59
An ECG may show left ventricular hypertrophy voltages shown by large amplitude QRS complexes
60
and possibly Q waves that are distinguished from previous infarctions by having a width of less than 40 milliseconds.
61
The diagnosis of hypertrophic cardiomyopathy is based on abnormal thickening.
62
This is defined as a thickness of the interventricular septum of 15 millimeters or greater,
63
or 13 millimeters with a family history or genetic background.
64
It can be difficult to distinguish between hypertrophic cardiomyopathy and physiological hypertrophy seen in athletes.
65
A possible distinguishing feature is that the volume of the cavity in physiological hypertrophy is not reduced,
66
whereas the volume is reduced in hypertrophic cardiomyopathy.
67
An asymmetrical distribution of the hypertrophy also favours hypertrophic cardiomyopathy.
68
The primary therapy is the use of beta blockers as they serve to reduce contractility and to increase diastolic filling time.
69
Calcium channel blockers are options in patients not responsive to beta blockers or in patients in whom beta blockers are contraindicated.
70
In patients who have developed heart failure, diuretics may be useful, however, must be used with care in order to avoid hypovolemia,
71
which as we said, can precipitate the left ventricular outflow tract obstruction.
72
Higher risk patients, such as athletes, patients with previous ventricular fibrillation or tachycardia,
73
symptomatic patients, patients with significant thickening of the septum or ventricular wall, typically defined above 30 mm,
74
or a family history of sudden cardiac death should be considered for an implantable cardioverter defibrillator, known as an ICD.
75
Septal myomectomy or ablation can be considered in patients with severe obstruction that despite pharmacotherapy are still symptomatic.
76
Thank you.
アプリをダウンロード
流暢に話すために必要なすべて
AI発音採点文ごとに採点
IPA練習すべての音をマスター
単語学習自分の単語帳を作る
単語ゲーム遊びながら覚える
同じチャンネル
FOR YOU
おすすめ動画
C16
83 文
Hypertrophic Cardiomyopathy - Patient’s Guide for Better Understanding
Daily ConversationUniversity Students
C12
39 文
Immunology of the rheumatoid joint
Daily ConversationUniversity Students
C11
164 文
Genetics of Hypertrophic Cardiomyopathy
Daily ConversationUniversity Students
C11
182 文
Thyroid Gland | Anatomy and Embryology | Lobes and Blood supply | Development of the Thyroid Gland
Daily ConversationUniversity Students
C11
124 文
Ischemic Stroke - causes, symptoms, diagnosis, treatment, pathology
Daily ConversationUniversity Students
C11
8 文
Clinical Cuts - Chronic obstructive pulmonary disease (COPD)
Daily ConversationUniversity Students
C1192 文
Other Corneal Disorders - CRASH! Medical Review Series
Daily ConversationUniversity Students
C11
27 文
What is AL amyloidosis?
Daily ConversationUniversity Students
C13
14 文
Huntington's Disease Overview with Francisco Cardoso
Daily ConversationUniversity Students
C11
230 文
Left Sided Heart Failure
Daily ConversationUniversity Students
C1310
17 文
How exercise benefits your body
Daily ConversationUniversity StudentsWorking Adults
このレッスンの語彙とスピーキングのポイント
このスピーキングレッスンは、動画「Hypertrophic Cardiomyopathy Made Easy」を教材にしています。 繰り返し出てくる語は次のとおりです：ventricular, patients, cardiomyopathy, obstruction, hypertrophic。 この動画には、シャドーイング用の文が76文、単語が1004語あります。 音声の長さは8:40です。 話す速さは1分あたり約116語で安定しており、シャドーイングしやすいペースです。 英語の頻出3,000語に含まれる単語は67%だけなので、語彙は難しめです。
この動画の重要語彙
動画に出てくる覚えておきたい単語15語を、発音と意味つきで紹介します。
| 単語 | 発音 | 意味 |
|---|---|---|
| sudden 形容詞 | /ˈsʌd.ən/ | 突然の |
| beta 名詞 | /ˈbeɪtə/ | ベータ |
| gene 名詞 | /d͡ʒiːn/ | 遺伝子 |
| genetic 形容詞 | /d͡ʒəˈnɛt.ɪk/ | 遺伝的 |
| tissue 名詞 | /ˈtɪʃ.(j)u/ | 織物 |
| distinguish 動詞 | /dɪˈstɪŋ.ɡwɪʃ/ | 区別する |
| thick 形容詞 | /θɪk/ | 太い, 厚い |
| muscle 名詞 | /ˈmʌs.əl/ | 筋肉, 筋 |
| contribute 動詞 | /kənˈtɹɪb.jut/ | 貢献する |
| dynamic 形容詞 | /daɪˈnæm.ɪk/ | 動的 |
| mechanism 名詞 | /ˈmɛk.ə.nɪ.zəm/ | 仕組み, 機構 |
| oxygen 名詞 | /ˈɑksɪd͡ʒən/ | 酸素 |
| diagnosis 名詞 | /daɪəɡˈnəʊsɪs/ | 診断 |
| valve 名詞 | /ˈvælv/ | バルブ |
| athlete 名詞 | /ˈæθ.liːt/ | 陸上競技の選手, 陸上選手 |
この動画の文法
話し手がよく使っている文型を、動画の実際の表現とともに紹介します。
| 文型 | 動画での表現 |
|---|---|
| 受動態 be + 過去分詞 — 誰がするかより、何が起きるかに焦点を当てる | are equally affected · can be affected · is inherited |
| 関係詞節 who / which + 節 — 人や物について情報を加える | SAM, which is · orthopnea, which is · dyspnea, which is |
| 現在完了形 have/has + 過去分詞 — 過去の出来事が今も関係している | have been identified · have developed |
注意したい発音
- 「th」の音: thick /θɪk/, athlete /ˈæθ.liːt/, thin /ˈθɪn/, width /ˈwɪtθ/, pathway /ˈpæθˌweɪ/
- 「sh」と「zh」の音: obstruction /əbˈstɹʌk.ʃən/, tissue /ˈtɪʃ.(j)u/, distinguish /dɪˈstɪŋ.ɡwɪʃ/, mutation /mjuˈteɪʃən/, reduction /ɹɪˈdʌk.ʃən/
- 長い単語（アクセントの位置に注意）: anterior /ænˈtɪɹ.i.ɚ/, mechanism /ˈmɛk.ə.nɪ.zəm/, physiological /ˌfɪz.i.əˈlɑ.d͡ʒɪ.kəl/, primarily /ˈpɹaɪ.mə.ɹə.li/, efficiency /ɪˈfɪʃ.ən.si/
日本語話者が苦手な音：
- /r/ と /l/ の区別 — /l/ は舌先を歯茎につけ、/r/ はどこにもつけない: abnormal /ˌæbˈnɔɹ.ml̩/, primarily /ˈpɹaɪ.mə.ɹə.li/, reveal /ɹɪˈviːl/, translation /tɹænzˈleɪʃən/, alter /ˈɔl.təɹ/
- /v/ — /b/ にならないように、上の歯を下唇に当てる: valve /ˈvælv/, reveal /ɹɪˈviːl/, preserve /pɹəˈzɝv/, voltage /ˈvəʊltɪd͡ʒ/, evident /ˈɛv.ə.dənt/
- /f/ — 「フ」ではなく、上の歯と下唇で出す: define /dɪˈfaɪn/, physiological /ˌfɪz.i.əˈlɑ.d͡ʒɪ.kəl/, efficiency /ɪˈfɪʃ.ən.si/, frequent /ˈfɹiː.kwənt/, facilitate /fəˈsɪlɪteɪt/
この動画での練習方法
- まず声を出さずに動画を最後まで聞き、知らない単語をメモします。
- 通常の速度で一文ずつシャドーイングし、話し手のリズムに合うまで繰り返します。
- 自分の声を録音して元の音声と比べます。sudden, beta, geneなどの単語に特に注意しましょう。
シャドーイングとは？英語上達に効果的な理由
シャドーイング（Shadowing）は、もともとプロの通訳者養成プログラムで開発された言語学習法で、多言語習得者として知られるDr. Alexander Arguelles によって広く普及されました。方法はシンプルですが非常に効果的：ネイティブスピーカーの英語を聞きながら、1〜2秒の遅延で声に出してすぐに繰り返す——まるで「影（shadow）」のように話者を追いかけます。文法ドリルや受動的なリスニングと異なり、シャドーイングは脳と口の筋肉が同時にリアルタイムで英語を処理・再現することを強制します。研究により、発音精度、抑揚、リズム、連音、リスニング力、そして会話の流暢さが大幅に向上することが確認されています。IELTSスピーキング対策や自然な英語コミュニケーションを目指す方に特におすすめです。