区域差异和冠状动脉微血管功能障碍在心力衰竭与保存的喷射分数的心脏衰竭
Mikael Erhardsson1, Ulrika Ljung Faxén1,2, Ashwin Venkateshvaran1
1Department of Medicine, Cardiology Unit, Karolinska Institutet, Stockholm, Sweden.
ESC heart failure
|November 3, 2023
概括
在全球范围内,冠状动脉微血管功能障碍 (CMD) 在心力衰竭中常见. 区域患者差异,而不是区域本身,解释了CMD流行率的变化.
科学领域:
- 心脏病学 心脏病学
- 心脏衰竭研究研究
- 血管生物学 血管生物学
背景情况:
- 保存喷射分数 (HFpEF) 的心力衰竭表现出不同的临床表型.
- 冠状动脉微血管功能障碍 (CMD) 是HFpEF的一个潜在的统一特征.
- 了解HFpEF和CMD的区域差异对于向治疗至关重要.
研究的目的:
- 调查HFpEF患者临床特征的区域差异.
- 在HFpEF中确定CMD在不同地理区域的流行率.
- 探索区域因素是否影响CMD与临床特征之间的关联.
主要方法:
- 从多中心研究 (芬兰,新加坡,瑞典,美国) 中分析了202名稳定的HFpEF患者.
- 排除患有未重血管化的宏血管冠状动脉疾病的患者.
- 使用多普勒回声心脏成像来评估CMD,定义为冠状动脉流量储备<2.5.
主要成果:
- 患者人口统计和并发症 (例如BMI,高血压,糖尿病,心房动,CKD,吸烟) 的显著区域差异.
- 肌肉疾病的患病率在59% (美国) 到88% (芬兰) 之间,但经过对共变量进行调整后,这种差异并不显著.
- 没有观察到CMD患病率的区域和临床特征之间的显著相互作用.
结论:
- 尽管有区域性临床异质性,但全球范围内HFpEF患者中CMD的流行率很高.
- 观察到的CMD患病率的区域差异归因于患者特征的变化.
- 对于不同地区的HFpEF患者来说,CMD代表了一个潜在的共同治疗目标.
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