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胰岛素抵抗与亚临床心肌功能障碍和心力衰竭中的功能能力降低与保留的喷射分数相关
Brent Gudenkauf1, Gabriel Shaya2, Monica Mukherjee2
1Osler Medical Residency, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Journal of cardiology
|June 26, 2023
概括
在心力衰竭中,胰岛素抵抗与保留喷射分数 (HFpEF) 与心肌功能恶化有关. 估计胰岛素耐药性可以指导治疗,以改善HFpEF患者的心脏健康和运动能力.
科学领域:
- 心脏病学 心脏病学
- 代谢疾病 代谢疾病
- 心血管研究研究心血管研究
背景情况:
- 肥胖和胰岛素耐药性在心力衰竭中很常见,其中保留喷射分数 (HFpEF).
- 这些情况与不良的心血管结果有关.
- 目前用于测量胰岛素耐药性的方法对于常规临床使用来说是复杂的.
研究的目的:
- 研究HFpEF患者胰岛素抵抗和心肌功能障碍之间的关联.
- 探索估计的葡萄糖排放率 (eGDR) 和心脏参数之间的相关性.
- 在HFpEF中评估胰岛素耐药性和功能能力之间的关系.
主要方法:
- 92名HFpEF患者接受了临床评估,心声回声和6分钟步行测试.
- 使用eGDR公式估计胰岛素耐药性,包括BMI,高血压和糖化血红蛋白.
- 用诸如左心室纵向应变 (LVLS) 和左心房体积等参数来评估心肌功能.
主要成果:
- 胰岛素耐药性增加,以较低的eGDR表示,显着与逐级加重LVLS相关.
- 在多变量调整后,这种关联仍然显著.
- 在胰岛素抵抗和减少6分钟的步行距离之间发现了一个单变的关联,在调整后没有持续.
结论:
- 胰岛素耐药性在HFpEF中被证明与心肌功能受损有关.
- 估计胰岛素耐药性可能为临床评估提供一种实用的方法.
- 研究结果表明,在HFpEF中,改善心脏功能和运动能力是潜在的治疗目标.
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