2型糖尿病与严重大动脉狭窄患者大动脉置换前后心肌结构,收缩功能,活力和血流的变化之间的关联
Nicholas Jex1,2, John P Greenwood1,2, Richard M Cubbon1,2
1University of Leeds, Multidisciplinary Cardiovascular Research Centre, and Biomedical Imaging Science Department, Leeds Institute of Cardiovascular and Metabolic Medicine, Leeds, UK (N.J., J.P.G., R.M.C., A.C., S.T., S.K., M.G., A. McGrane, A. Maccannell, M.C.-R., S.S., H.P., P.S., L.R., D.B., M.T.K., S.P., E.L.).
Circulation
|September 25, 2023
概括
2型糖尿病 (T2D) 在严重的大动脉狭窄患者中损害了心脏能量和血液流动. 在非T2D患者中,大动脉置换 (AVR) 改善了这些症状,但在T2D患者中仍存在异常.
科学领域:
- 心脏病学
- 代谢疾病
- 心脏成像
背景情况:
- 2型糖尿病 (T2D) 与严重的大动脉狭窄症 (AS) 的大动脉置换 (AVR) 后的结果有关.
- 心肌能量和血液流量受损可能解释AS型二型糖尿病患者的较差结果.
研究的目的:
- 在AVR之前和之后,与非T2DAS患者相比,测试T2D严重AS患者是否有心肌能量 (PCr/ ATP) 和血管扩张应激MBF受损.
- 确定这些异常是否在T2D患者中持续存在.
主要方法:
- 使用磁共振光谱和心血管磁共振.
- 研究了95名严重AS患者 (30名T2D患者,65名没有T2D患者) 和对照组 (健康志愿者,T2D对照组).
- 评估包括PCr/ ATP,血管扩展应力MBF,全球纵向应力,NT-proBNP和AVR前后6分钟的步行距离.
主要成果:
- 在AVR之前,AS患者的PCr/ ATP和MBF比健康志愿者低. 与非T2DAS患者和T2D对照患者相比,T2DAS患者的PCr/ ATP和MBF都较差.
- 在AVR之后,非T2DAS患者的PCr/ ATP正常化,而非T2DAS患者的PCr/ ATP正常化.
- 虽然在两组患者中MBF在AVR后得到改善,但在T2DAS患者中仍然较低. 全球纵向应变和6分钟步行距离在T2DAS患者中也没有改善.
结论:
- 在AVR后,T2D患者表现出持续的心肌能量,血流和收缩功能缺陷.
- 在没有T2D的严重AS患者中,AVR成功恢复了这些参数.
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