冠状动脉微血管功能障碍是由原发性甲状腺功能过高引起的,在甲状腺切除术后恢复
Elena Osto1, Francesco Fallo, Maria Rosa Pelizzo
1Department of Cardiologic, Thoracic and Vascular Sciences, University of Padova, Padua, Italy.
Circulation
|July 24, 2012
概括
无症状的原发性副甲状腺炎症 (PHPT) 损害了冠状动脉微血管功能,冠状动脉流量储备 (CFR) 的减少表明了这一点. 副甲状腺切除术有效地恢复了CFR,突出了副甲状腺激素.
科学领域:
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
- 血管生物学 血管生物学
背景情况:
- 症状原发性偏甲状腺症 (PHPT) 与较高的心血管死亡率有关.
- 关于与无症状PHPT相关的心血管风险的数据有限.
- 冠状动脉流量储备 (CFR) 作为冠状动脉微血管功能的关键指标.
研究的目的:
- 在无症状PHPT患者中评估冠状动脉微血管功能.
- 评估副甲状腺激素 (PTH) 在冠状动脉微血管功能障碍中的作用.
- 在PHPT中确定副甲状腺切除术对冠状动脉微血管功能的影响.
主要方法:
- 在100名无症状PHPT患者和50名对照者中,用于测量100名无症状PHPT患者的CFR.
- 在休息状态和在腺诱导的高血压期间评估CFR.
- 进行了统计分析,包括多变量回归,以确定与CFR相关的因素.
主要成果:
- 与对照组相比,无症状的PHPT患者的CFR显著降低 (P<0.0001).
- CFR与副甲状腺激素 (PTH) 水平 (r=-0.3,P<0.004) 呈反相关性.
- 副甲状腺切除术使冠状动脉微血管功能受损 (P<0.0001) 的患者的CFR正常化 (P<0.0001).
结论:
- 无症状的PHPT与冠状动脉微血管功能障碍有关.
- PTH水平独立地与冠状动脉微血管功能障碍的严重程度相关.
- 副甲状腺切除术有效地逆转了PHPT患者的冠状动脉微血管功能障碍.
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