心肌收缩力受损对慢性冠状动脉综合征冠状动脉血流储备和炎症过程的影响

IF 0.1 Q4 MEDICINE, GENERAL & INTERNAL
V. K. Tashchuk, R. A. Bota
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引用次数: 0

摘要

目的研究慢性冠脉综合征心肌收缩力损伤与冠脉血流储备状态、全身炎症程度和内皮功能障碍之间的关系。我们对120名功能分级(FC)为II-III级的稳定型心绞痛(SAP)患者进行了研究,并将其分为两组:第一组包括65名左室射血分数(LVEF)≥55%的患者,第二组包括55名左室射血分数<55%的患者。诊断方法包括临床和仪器检查数据、血脂谱分析、炎症生物标志物、内皮功能状态、血图数据、白细胞炎症标志物和问卷调查。与第 1 组相比,第 2 组患者的左心房(p < 0.001)和右心室(p = 0.027)尺寸增大;LVEF 明显降低(50.16 ± 0.42 % vs 58.77 ± 0.41 %;p < 0.001);右心室(p = 0.003)和左心室(p = 0.027)内膜-中膜复合体增厚。003) 和左侧 (p = 0.017) 颈总动脉内膜复合体增厚;负荷阈值 (p = 0.008)、运动耐量 (p = 0.004) 和心率变异性指标 - SDNN(24 小时内正常至正常间期的标准偏差;p = 0.046)显著降低。第 2 组患者的特点是低度慢性炎症更活跃,表现为白细胞水平升高(p = 0.024)、中性粒细胞水平升高(p < 0.001)、淋巴细胞水平降低(p = 0.021);白细胞炎症标志物水平显著升高,尤其是中性粒细胞与淋巴细胞比值(p < 0.001)、血小板与淋巴细胞比值(p = 0.004)、全身免疫炎症指数(p < 0.001)、全身炎症反应指数(p < 0.001)和全身炎症综合指数(p < 0.001)。与 LVEF ≥ 55 % 的患者相比,LVEF < 55 % 的患者的纤维蛋白原(p < 0.001)、尿酸(p = 0.002)、高敏 C 反应蛋白(p = 0.007)和内皮素-1(p < 0.001)水平更高。第二组患者需要更全面的监测和更深入的治疗,以减少炎症过程。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effect of impaired myocardial contractility on coronary flow reserve and inflammatory processes in chronic coronary syndrome
Aim. To study the relationship between myocardial contractility impairment in chronic coronary syndrome and the state of coronary flow reserve, the degree of systemic inflammation and endothelial dysfunction. Materials and methods. We examined 120 patients with stable angina pectoris (SAP) of functional class (FC) II–III, who were assigned into two groups: group 1 comprised 65 patients with left ventricular ejection fraction (LVEF) ≥55 %, and group 2 was composed of 55 patients with LVEF <55 %. Diagnostic methods included clinical and instrumental examination data, analyses of lipid profile, inflammation biomarkers, endothelial functional state, hemogram data, leukocyte inflammation markers, and questionnaires. Results. Compared to group 1, group 2 patients showed an increase in the left atrium (p < 0.001) and right ventricle (p = 0.027) sizes; significantly lower LVEF (50.16 ± 0.42 % vs 58.77 ± 0.41 %; p < 0.001); thickening of the intima-media complex in the right (p = 0.003) and left (p = 0.017) common carotid arteries; significantly lower load threshold values (p = 0.008), exercise tolerance (p = 0.004) and heart rate variability indicators – SDNN (standard deviation of normal-to-normal intervals over 24 hours; p = 0.046). Group 2 patients were characterized by more active low-grade chronic inflammation, as indicated by increased levels of leukocytes (p = 0.024), neutrophils (p < 0.001), and decreased lymphocyte levels (p = 0.021); significantly higher levels of leukocyte inflammation markers, in particular, the neutrophil-to-lymphocyte ratio (p < 0.001), platelet-to-lymphocyte ratio (p = 0.004), systemic immune-inflammation index (p < 0.001), systemic inflammation response index (p < 0.001), and aggregate index of systemic inflammation (p < 0.001) as compared to group 1 individuals. Patients with LVEF <55 % had higher levels of fibrinogen (p < 0.001), uric acid (p = 0.002), high-sensitivity C-reactive protein (p = 0.007), and endothelin-1 (p < 0.001) compared to those with LVEF ≥55 %. Conclusions. Group 2 patients need a more thorough monitoring and a more intensive treatment aimed at reducing the inflammatory process.
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来源期刊
Zaporozhye Medical Journal
Zaporozhye Medical Journal MEDICINE, GENERAL & INTERNAL-
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审稿时长
8 weeks
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