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在冠状动脉微血管功能障碍和心力衰竭中评估动脉硬性:WISE-CVD延续研究的初步报告
P Rezaeian1, C L Shufelt2, J Wei3
1Torrance Memorial Medical Center-A Cedars-Sinai Affiliate, Torrance, CA, USA.
概括
与疑似冠状动脉微血管功能障碍 (CMD) 患者相比,心力衰竭保留射出分数 (HFpEF) 患者表现出动脉硬度增加和心脏功能降低. 这表明性可能会导致HFpEF的进展.
科学领域:
- 心脏病学 心脏病学
- 血管生物学 血管生物学
- 心脏衰竭研究研究
背景情况:
- 保存喷射分数 (HFpEF) 的心力衰竭是冠状动脉微血管功能障碍 (CMD) 的常见并发症.
- 连接CMD与HFpEF的特定途径仍然不清楚.
- 大动脉脉冲波速度 (aPWV) 测量大动脉硬度并预测心血管疾病,但其在CMD和HFpEF中的作用尚不清楚.
研究的目的:
- 为了研究动脉硬度 (aPWV) 和心脏功能之间的关系,在患有HFpEF和怀疑CMD的患者中.
- 在患有HFpEF和CMD的患者中描述aPWV.
- 探索血管硬与CMD向HFpEF进展之间的潜在联系.
主要方法:
- 评估了51名怀疑患有CMD的妇女和20名患有HFpEF的患者,所有这些都没有阻塞性冠状动脉疾病.
- 测量大动脉脉冲波速度 (aPWV),以评估动脉硬度.
- 使用心脏磁共振成像 (CMRI) 来评估左心室 (LV) 喷射分数,心肌 perfusion reserve index (MPRI) 用于CMD,以及 LV质量体积比用于重塑.
主要成果:
- 与怀疑CMD组相比,HFpEF参与者年龄较大,BMI较高,aPWV (较大的动脉硬度) 显著较高,MPRI (心肌输液减少) 较低.
- 在调整心血管风险因素后,HFpEF组表现出较低的LVEF.
- 两组之间没有观察到心室重塑的显著差异.
结论:
- 患有HFpEF的患者表现出动脉硬度增加和心肌输液受损,与怀疑患有心血管疾病的患者相比.
- 这些发现表明,动脉硬可能是从CMD发展为HFpEF的关键因素.
- 需要进一步的前性研究来证实这些观察,并阐明底层机制.
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