与右心室功能和补偿相关的心脏代谢风险因素在被转诊进行心声图的患者中得到补偿
Amanda M Morrison1, Shi Huang1, Jeffrey S Annis1
1Vanderbilt University Medical Center Nashville TN.
Journal of the American Heart Association
|June 10, 2023
概括
代谢综合征标志物与较差的右心室 (RV) 功能和较高的肺压力有关. 这些发现突显了心脏代谢健康状况.
科学领域:
- 心脏病学 心脏病学
- 代谢综合征是代谢综合征的一种.
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 肺高血压和右心室 (RV) 功能障碍是对不良健康结果的重要贡献者.
- 对VR功能障碍的可修改风险因素尚不清楚,需要对相关的临床标志物进行进一步调查.
- 代谢综合征的组成部分代表了改善RV功能干预的潜在目标.
研究的目的:
- 调查代谢综合征的临床标志物与RV功能的心声测量之间的关联.
- 为了在大量患者队列中分析这些关联,参考了心声回声学.
- 确定影响RV压力和功能的潜在可修改的风险因素.
主要方法:
- 追溯性队列研究,使用来自18岁以上患者的电子健康记录数据.
- 纳入标准:2010年至2020年期间转诊于胸前回声心脏成像的患者,记录了RV静心压 (RVSP) 或三环状平面静心外流 (TAPSE).
- 肺高血压定义为RVSP>33 mmHg;RV功能障碍定义为TAPSE ≤1.8厘米. 统计分析探讨了关联和非线性关系.
主要成果:
- 这项研究包括37,203名患者,其中40%的RVSP升高,32%的RV功能障碍.
- 增加的RVSP与较低的LDL,HDL和较高的血红蛋白A1c和BMI相关.
- 降低TAPSE与较高的甘油三:HDL比率,较高的血红蛋白A1c以及较低的BMI,LDL,HDL和静脉血压相关. 关联在很大程度上是非线性的.
结论:
- 心脏代谢健康的临床测量与RV功能和肺压力的回声心脏学指标有显著的关联.
- 代谢综合征标志物显示出与肺压升高和RV功能受损的强烈联系.
- 这些发现强调了管理心脏代谢风险因素的重要性,以潜在地改善右心室健康.
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