多血管冠状动脉疾病患者左心室结构重塑类型与纤维连接蛋白缺乏的关系

Q3 Medicine
A. R. Mingalimova, N. Gumanova, N. M. Bikbova, O. N. Dzhioeva, M. S. Pokrovskaya, I. Efimova, Z. Z. Serebryanskaya, N. Bogdanova, A. I. Borisova, O. Drapkina
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引用次数: 0

摘要

研究目的评估多支血管冠状动脉疾病患者的血清纤连蛋白水平,并确定纤连蛋白水平与冠状动脉旁路移植术(CABG)后在医院出现的心房颤动(AF)以及左心室(LV)结构重塑类型之间的关系。这项前瞻性观察研究针对 2020 年 10 月至 2022 年 5 月期间在 N.V. Sklifosovsky 急诊医学研究所心脏外科№1 室接受择期 CABG 术后的 80 名患者。根据心血管外科手术后出现房颤的情况分为两组(19 名患者在心血管外科手术后(最多 10 天)在医院出现房颤,61 名患者为对照组)。所有患者都接受了一般临床检查和经胸超声心动图检查,并对左心室重塑类型进行了评估。血清纤维粘连蛋白水平通过使用纤维粘连蛋白制剂(奥地利 Technozym 公司)的酶免疫测定法进行测定。房颤组的纤维连接蛋白中位值为 110.10 [86.86; 134.00] 微克/毫升,而对比组为 120.90 [92.01; 161.50] 微克/毫升(P=0.19)。观察到的左心室形态如下:正常左心室几何形态(NLVG)--1 例患者(5.26%),同心左心室重塑(CLVR)--3 例患者(15.79%),同心左心室肥厚(CLVH)--10 例患者(52.63%),偏心左心室肥厚(ELVH)--5 例患者(26.32%)。在无房颤组中,25 名患者(40.98%)被诊断为 NLVG,26 名患者(42.62%)被诊断为 CLVR,6.56%(n=4)被诊断为 CLVR,而 6 名患者(9.84%)被诊断为 ELVH。组间几何类型差异显著(P<0,0001)。多变量分析调整了性别、年龄、心肺旁路时间后,CLVH 和 ELVH 的预测值仍为:CLVH 的几率比为 15.83(95% 置信区间为 4082-1442.00; p=0.0001),ELVH 的几率比为 5.17(95% 置信区间为 1365-19573; p=0.015)。另一项研究表明,纤连蛋白<116,496 µg/ml与CLVH(p=0,006)在两组患者中的敏感性均为78%,特异性为53%。纤维粘连蛋白<116496微克/毫升与多支冠状动脉疾病患者的CLVH相关(敏感性78%,特异性53%;P=0,006)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association of left ventricular structural remodeling types with fibronectin deficiency in patients with multivessel coronary artery disease
Aim. To evaluate the serum fibronectin level in patients with multivessel coronary artery disease, and to identify the relationship of fibronectin level with atrial fibrillation (AF) developed in the hospital after coronary artery bypass grafting (CABG) and types of left ventricular (LV) structural remodeling.Material and methods. This prospective observational study of 80 patients after elective CABG at the Cardiac Surgery Department № 1 of the N.V. Sklifosovsky Research Institute for Emergency Medicine from October 2020 to May 2022. The groups were divided depending on the development of AF after CABG surgery (19 patients with AF developed in the hospital after CABG (up to 10 days), 61 patients — control group). All patients underwent a general clinical examination and transthoracic echocardiography, with estimation of left ventricular remodeling type. Serum fibronectin level was determined by enzyme immunoassay using the Fibronectin agent (Technozym, Austria).Results. The median fibronectin values in the group with AF was 110,10 [86,86; 134,00] mcg/ml versus 120,90 [92,01; 161,50] µg/ml of the comparison group (p=0,19). The following LV patterns were observed: normal LV geometry (NLVG) — in 1 patient (5,26%), concentric LV remodeling (CLVR) — in 3 patients (15,79%), concentric LV hypertrophy (CLVH) — in 10 patients (52,63%), eccentric LV hypertrophy (ELVH) — in 5 patients (26,32%). In the group without AF, 25 patients (40,98%) were diagnosed with NLVG, 26 patients (42,62%) — CLVR, 6,56% (n=4) — CLVR, while ELVH was diagnosed in 6 patients (9,84%). Differences in geometry types between groups were significant (p<0,0001). Multivariate analysis adjusted for gender, age, cardiopulmonary bypass time, the predictive value remained for CLVH — odds ratio 15,83 (95% confidence interval, 4,082-1,442,00; p=0,0001) and ELVH — odds ratio 5,17 (95% confidence interval, 1,365-19,573; p=0,015). A further study showed that fibronectin <116,496 µg/ml with a sensitivity of 78% and specificity of 53% is associated with CLVH (p=0,006) in patients of both groups.Conclusion. Fibronectin <116,496 µg/ml is associated with CLVH in patients with multivessel coronary artery disease (sensitivity 78%, specificity 53%; p=0,006).
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来源期刊
Russian Journal of Cardiology
Russian Journal of Cardiology Medicine-Cardiology and Cardiovascular Medicine
CiteScore
2.20
自引率
0.00%
发文量
185
审稿时长
1 months
期刊介绍: Russian Journal of Cardiology has been issued since 1996. The language of this publication is Russian, with tables of contents and abstracts of all articles presented in English as well. Editor-in-Chief: Prof. Eugene V.Shlyakhto, President of the Russian Society of Cardiology. The aim of the journal is both scientific and practical, also with referring to organizing matters of the Society. The best of all cardiologic research in Russia is submitted to the Journal. Moreover, it contains useful tips and clinical examples for practicing cardiologists. Journal is peer-reviewed, with multi-stage editing. The editorial board is presented by the leading cardiologists from different cities of Russia.
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