使用动态 CZT-SPECT 检测血清白蛋白与冠状动脉微血管功能障碍严重程度的关系

IF 1.9 4区医学 Q3 HEMATOLOGY

Microcirculation Pub Date : 2024-05-01 DOI:10.1111/micc.12853

Shih-Chieh Chien, Shan-Ying Wang, Cheng-Ting Tsai, Yu-Chien Shiau, Yen-Wen Wu

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引用次数: 0

摘要

目的低血清白蛋白（SA）浓度和冠状动脉微血管功能障碍（CMD）都是心力衰竭（HF）发病的危险因素。我们假设 SA 浓度与心肌血流储备（MFR）相关，并与 HF 的病理生理机制有关。方法我们回顾性研究了 2018 年 4 月至 2020 年 2 月期间接受动态心脏镉锌碲心肌灌注成像的 454 例患者。根据SA水平（g/dL）将人群分为三组：第一组：>4，第二组：3.5-4，第三组：<3.5。比较了心肌血流（MBF）和心肌血流储备（MFR，定义为应激/静息 MBF 比值）。结果整个组群的平均年龄为 66.2 岁，65.2% 为男性。随着 SA 的降低，应激 MBF（mL min-1 g-1）和 MFR 也随之降低（第 1 组 MBF：3.29 ± 1.03，MFR：3.46 ± 1.33；第 2 组 MBF：2.95 ± 1.13，MFR：2.51 ± 0.93；第 3 组 MBF：2.64 ± 1.16，第 3 组 MFR：1.90 ± 0.50），而静息 MBF（毫升 min-1 g-1）增加（第 1 组 MBF：1.05 ± 0.42，第 2 组 1.27 ± 0.56，第 3 组 1.41 ± 0.61）。调整协变量后，与第 1 组相比，第 2 组 MFR 受损（定义为 MFR < 2.5）的几率比为 3.57（95% CI：2.32-5.48），第 3 组为 34.9（95% CI：13.23-92.14）。使用 SA 预测 CMD 的风险是可以接受的，其 AUC 为 0.76。

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Significant Association of Serum Albumin With the Severity of Coronary Microvascular Dysfunction Using Dynamic CZT-SPECT

Objective

Both low serum albumin (SA) concentration and coronary microvascular dysfunction (CMD) are risk factors for the development of heart failure (HF). We hypothesized that SA concentration is associated with myocardial flow reserve (MFR) and implicated in pathophysiological mechanism of HF.

Methods

We retrospectively studied 454 patients undergoing dynamic cardiac cadmium-zinc-telluride myocardial perfusion imaging from April 2018 to February 2020. The population was categorized into three groups according to SA level (g/dL): Group 1: >4, Group 2: 3.5–4, and Group 3: <3.5. Myocardial blood flow (MBF) and myocardial flow reserve (MFR, defined as stress/rest MBF ratio) were compared.

Results

The mean age of the whole cohort was 66.2 years, and 65.2% were men. As SA decreased, stress MBF (mL min⁻¹ g⁻¹) and MFR decreased (MBF: 3.29 ± 1.03, MFR: 3.46 ± 1.33 in Group 1, MBF: 2.95 ± 1.13, MFR: 2.51 ± 0.93 in Group 2, and MBF: 2.64 ± 1.16, MFR: 1.90 ± 0.50 in Group 3), whereas rest MBF (mL min⁻¹ g⁻¹) increased (MBF: 1.05 ± 0.42 in Group 1, 1.27 ± 0.56 in Group 2, and 1.41 ± 0.61 in Group 3). After adjusting for covariates, compared with Group 1, the odds ratios for impaired MFR (defined as MFR < 2.5) were 3.57 (95% CI: 2.32–5.48) for Group 2 and 34.9 (95% CI: 13.23–92.14) for Group 3. The results would be similar if only regional MFR were assessed. The risk prediction for CMD using SA was acceptable, with an AUC of 0.76.

Conclusion

Low SA concentration was associated with the severity of CMD in both global and regional MFR as well as MBF.

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来源期刊

Microcirculation 医学-外周血管病

CiteScore

5.00

自引率

4.20%

发文量

审稿时长

6-12 weeks

期刊介绍： The journal features original contributions that are the result of investigations contributing significant new information relating to the vascular and lymphatic microcirculation addressed at the intact animal, organ, cellular, or molecular level. Papers describe applications of the methods of physiology, biophysics, bioengineering, genetics, cell biology, biochemistry, and molecular biology to problems in microcirculation. Microcirculation also publishes state-of-the-art reviews that address frontier areas or new advances in technology in the fields of microcirculatory disease and function. Specific areas of interest include: Angiogenesis, growth and remodeling; Transport and exchange of gasses and solutes; Rheology and biorheology; Endothelial cell biology and metabolism; Interactions between endothelium, smooth muscle, parenchymal cells, leukocytes and platelets; Regulation of vasomotor tone; and Microvascular structures, imaging and morphometry. Papers also describe innovations in experimental techniques and instrumentation for studying all aspects of microcirculatory structure and function.