在ST段升高心肌梗塞的第一个发作后,对左心室逆向重塑的血糖变异的预后重要性

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Yohei Hanajima¹, Noriaki Iwahashi², Jin Kirigaya¹

¹Division of Cardiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan.

Cardiovascular diabetology

|August 4, 2023

概括

较低的血糖变化 (GV) 与ST段升高心肌梗塞 (STEMI) 后的左心室逆向重塑 (LVRR) 有关. 这种关联表明,GV减少的患者的预后可能更好.

科学领域:

心脏病学心脏病学
内分泌学在内分泌学.
医疗成像医学成像

背景情况:

血糖变化 (GV) 越来越被认为是心血管结果的重要因素.
左心室逆转型 (LVRR) 是ST段升高心肌梗塞 (STEMI) 后恢复的关键指标.
在STEMI后的GV和LVRR之间的关系仍然是一个需要进一步调查的领域.

研究的目的:

研究血糖变异性 (GV) 对左心室逆转型 (LVRR) 对ST段升高心肌梗塞 (STEMI) 后患者的影响.
探索GV与主要心血管不良事件 (MACE) 在该患者队列中的发生率之间的关联.

主要方法:

对201名STEMI患者的队列进行了监测,这些患者在发病后12小时内接受了再注血治疗.
使用通过连续血糖监测系统 (CGMS) 通过血糖外流 (MAGE) 的平均幅度量化血糖变异性.
使用心脏磁共振成像 (CMRI) 评估左心室体积,LVRR被定义为LV末缩体积指数>10%的下降.

主要成果:

在被研究的患者中,LVRR的患病率为28%.
血糖外流 (MAGE) 的平均幅度被确定为LVRR的独立预测因子 (OR 0.98,p=0.002).
患有LVRR的患者在65个月的中位随访期间表现出明显较低的MACE发病率 (2%对13%,p=0.016).

结论:

用CGMS测量的较低的血糖变异性与STEMI后的LVRR显著相关.
潜在受到GV影响的LVRR似乎与有利的长期预后相关.
需要进一步的研究来证实GV在治疗STEMI患者和促进LVRR中的临床意义.

关键词:

剧烈的心肌梗塞急性心肌梗塞持续的葡萄糖监测系统持续的葡萄糖监测系统葡萄糖是一种葡萄糖.血糖的可变性血糖的可变性改造改造改造改造改造改造

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