美国人口中的叶酸及其与充血性心力衰竭的关联
Longbo Wang1, Fangcong Yu1, Jiaran Shi1
1Department of Cardiology, The First Affiliated Hospital of Zhejiang University School of Medicine, 310003 Hangzhou, Zhejiang, China.
Reviews in cardiovascular medicine
|July 30, 2024
概括
红细胞 (RBC) 叶酸水平高,就像叶酸缺乏一样,可能会增加充血性心力衰竭 (CHF) 的风险. 需要进一步的研究来证实这种联系,并确定最佳的叶酸水平.
科学领域:
- 心脏病学 心脏病学
- 营养科学 营养科学
- 公共卫生 公共卫生
背景情况:
- 充血性心力衰竭 (CHF) 是一个重要的公共卫生问题.
- 红细胞 (RBC) 叶酸水平在心血管疾病风险中的作用尚未完全理解.
- 研究像叶酸这样的营养因素对于理解和管理心血管健康至关重要.
研究的目的:
- 为了检查红细胞 (RBC) 叶酸度和充血性心力衰竭 (CHF) 的患病率之间的联系.
- 为了确定与增加CHF风险相关的红细胞叶酸的潜在值.
- 探索红细胞叶酸和CHF之间的非线性关系.
主要方法:
- 分析了来自全国健康和营养检查调查 (NHANES) 的12820名个人数据.
- 利用加权的单变量和多变量逻辑回归模型.
- 使用限制性立方线 (RCS) 模型来评估剂量反应关系.
主要成果:
- 红细胞叶酸的最高三位数与CHF显著更高的风险相关 (OR=3.09).
- 多变量分析证实了这一关联 (OR=1.98).
- RCS模型表明,超过预测的红血细胞叶酸水平为2757nmol/L (p=0.001) 的CHF风险增加.
结论:
- 红血细胞叶酸度高 (超过2637nmol/L) 和叶酸缺乏可能与心血管疾病风险增加有关.
- 红细胞叶酸和CHF之间的关系似乎很复杂,可能是U形.
- 进一步进行大规模的临床研究是有必要的,以确定因果关系和心血管健康的最佳RBC叶酸水平.
相关概念视频
01:17Pathophysiology of Heart Failure
1.5K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.5K
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
69
Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
69
01:26Imbalances in Cardiac Output
1.4K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K
01:22Heart Failure Drugs: β-Blockers
332
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
332
01:26Heart Failure Drugs: Inotropic Agents
555
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
555
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
413
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
413