糖尿病对重塑,微血管功能和运动能力在大动脉狭窄症中的影响
Abhishek Dattani1, Emer M Brady1, Aseel Alfuhied1
1Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK.
Open heart
|August 16, 2023
概括
患有大动脉狭窄症 (AS) 的患者的糖尿病导致运动能力降低和心肌纤维化增加,但不会显著影响心血管事件. 然而,糖尿病与更高的全因死亡风险有关.
科学领域:
- 心脏病学 心脏病学
- 糖尿病学 糖尿病学
- 医学研究 医学研究
背景情况:
- 大动脉狭窄 (AS) 是一种重要的心血管疾病.
- 糖尿病是一种常见的并发症,可以影响心血管健康.
- 了解糖尿病和AS之间的相互作用对于患者管理至关重要.
研究的目的:
- 描述AS患者的心脏重塑,运动能力和纤维炎症生物标志物,比较糖尿病患者和没有糖尿病患者.
- 评估糖尿病对中度至重度AS患者临床结果的影响.
主要方法:
- 进行了心声学,压力心血管磁共振 (CMR) 和心肺运动测试.
- 进行了血生物标志物分析.
- 生存分析包括心血管死亡率,心肌梗塞,心力衰竭住院,昏迷或心律失常作为主要终点的复合.
主要成果:
- 糖尿病组 (n=56) 与非糖尿病组 (n=198) 相比,表现出更高的细胞外体积分,更低的心肌 perfusion 储备,以及较低的峰值氧气消耗.
- 在糖尿病患者中观察到蛋白水平升高.
- 虽然糖尿病与主要的复合心血管结局无关,但它与全因死亡率 (HR 2.04) 独立相关.
结论:
- 在中度至重度AS患者中,糖尿病与运动能力受损,扩散性心肌纤维化增加和微血管功能障碍有关.
- 尽管有这些发现,但糖尿病并没有显著增加这一队列中主要心血管事件的风险.
- 糖尿病独立地预测大动脉狭窄患者的全因死亡率.
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