在糖尿病和心力衰竭患者中,隐性冠状动脉微血管功能障碍和缺血性心脏病
Noor Sharrack1, Louise A E Brown1, Jonathan Farley1
1Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
概括
患有心力衰竭 (HF) 的糖尿病患者表现出更高的无声性缺血性心脏病 (IHD) 和冠状动脉微血管功能障碍 (CMD) 的比率. 心血管磁共振 (CMR) 可以评估糖尿病HF患者的这些情况.
科学领域:
- 心脏病学 心脏病学
- 糖尿病学 糖尿病学
- 医疗成像医学成像
背景情况:
- 患有糖尿病 (DM) 和心力衰竭 (HF) 的患者与没有DM的患者相比,体验的结果较差.
- 心血管磁共振 (CMR) 是确定缺血性心脏病 (IHD) 和通过心肌 perfusion reserve (MPR) 量化冠状动脉微血管功能障碍 (CMD) 的关键成像方式.
研究的目的:
- 量化DM患者中静默性IHD和CMD的患病率,这些患者的DM呈现HF.
- 在这个患者群体中评估IHD,CMD和心血管结局之间的关联.
主要方法:
- 预期招募心力衰竭 (HF) 门诊患者进行定量 perfusion CMR,以计算心肌血流量 (MBF) 和MPR.
- 排除患有心肌痛或IHD病史的患者.
- 对主要不良心血管事件 (MACE) 的随访平均为3.0年.
主要成果:
- 分析包括343名患者:176名血糖正常,84名糖尿病前期患者,83名糖尿病前期患者.
- 默默的IHD患病率在DM中最高 (31%),其次是糖尿病前期 (20%) 和正常血糖 (17%).
- 与正常血糖患者相比,在DM和糖尿病前期组中观察到较低的压力MBF和MPR. 虽然单变量分析显示了与MACE相关的MPR和静态IHD,但在对HbA1c,年龄和LVEF进行调整后,这些关联失去意义.
结论:
- 患有HF的糖尿病患者表现出更高的沉默性IHD和CMD的证据,与更糟糕的心血管结果相关.
- 在患有高血压的糖尿病患者中,CMR对于评估沉默的IHD和CMD是有价值的,强调了血糖状况和心血管健康之间的联系.
关键词:
心血管磁共振 (CMR) 是一种心血管磁共振技术.冠状动脉微血管功能障碍 (CMD)糖尿病 (DM) 是一种糖尿病.心力衰竭 (HF) 是一种心力衰竭.心肌动脉血流 (MBF) 是指心肌动脉的血液流动.心肌输液储备 (MPR) 是指心肌输液储备.更多相关视频
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