患有大动脉狭窄症的患者的心脏能量和保留与减少的射出分数
Mark A Peterzan1, William T Clarke2, Craig A Lygate
1Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine (M.A.P., J.Y.C.L., J.J.M., J.J.R., M.J.H., S.N., O.J.R.), University of Oxford, United Kingdom.
Circulation
|May 23, 2020
概括
严重的大动脉狭窄 (SevAS) 降低了肌酸酶 (CK) 的容量和流量,影响了能量供应. 向CK可能会预防AS患者的缩功能障碍.
科学领域:
- 心脏病学
- 生物化学
- 医学成像
背景情况:
- 严重的大动脉狭窄 (SevAS) 可能导致无法解释的缩功能障碍.
- 研究了减少肌酸酶 (CK) 容量和流量的作用.
研究的目的:
- 调查降低CK容量和流量与SevAS系统功能障碍相关的假设.
- 在AS患者中探索CK功能,心肌能量和左心室 (LV) 功能之间的关系.
主要方法:
- 在五个组中招募了102名参与者:中度AS,SevAS保留或减少喷射分数,健康志愿者和非压力负载的心脏活检对照.
- 使用心脏磁共振成像和31P磁共振光谱检测心肌能量.
- 分析了CK活性,异形,酸合成酶和总肌酸的LV活检;计算了线粒体 - 肉粒体扩散距离.
主要成果:
- 在AS中,CK流量降低 (32%,P=0.04),主要是由于脂蛋白/ ATP的降低.
- 在AS中,CK总量,酸盐合成酶活性和CK异型活性较低.
- 线粒体- 肉粒体扩散距离与CK总活性相关 (r=0.86,P=0.003).
结论:
- 在SevAS中,CK总容量降低,特别是在缩性衰竭患者中.
- 即使在中度的AS中,也存在能量损伤,在心功能障碍之前降低了CK流量.
- 向CK容量和流量是预防和治疗AS系统性衰竭的潜在治疗策略.
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