在先天性心脏病中的血管健康:系统性审查和元分析
Juliana Lasso-Mendez1, Christopher Spence1, Lisa K Hornberger2
1Division of Cardiology, Department of Paediatrics, University of Alberta, Edmonton, Alberta, Canada.
The Canadian journal of cardiology
|November 3, 2024
概括
先天性心脏病 (CHD) 与较差的血管健康有关,包括血管扩张减少和动脉硬性增加. 这一元分析证实了各个年龄段心血管疾病患者的显著血管功能障碍.
科学领域:
- 心脏病学 心脏病学
- 血管生物学 血管生物学
- 儿童心脏病学 儿童心脏病学
背景情况:
- 先天性心脏病 (CHD) 影响1%的出生,是已知的心血管疾病风险因素.
- 以前的研究表明,心血管疾病患者的血管健康受损,但缺乏确的证据.
- 这项研究旨在确定心血管疾病和血管健康缺陷之间的联系.
研究的目的:
- 研究先天性心脏病 (CHD) 对血管功能的影响.
- 量化心脏病患者和对照人群之间的内皮依赖和独立血管扩张的差异.
- 评估心脏病患者的动脉硬度和动脉内心介质厚度.
主要方法:
- 一项对138项涉及16115名参与者的研究进行了全面的元分析.
- 搜索了8个电子数据库,截至2024年4月12日,包括除案例研究和评论外的所有研究设计.
- 分析的结果包括流量介导血管扩张,反应性高血症指数,酸甘介导扩张,动脉硬度参数,以及动脉内膜-介质厚度.
主要成果:
- 与对照人群相比,患有心血管疾病的个体表现出明显的血管功能受损.
- 关键发现包括减少流体介导血管扩张 (SMD -0.96),反应性高血压指数 (SMD -2.88),和甘介导扩张 (SMD -0.98).
- 特定的CHD亚型,如大动脉缩和法洛特四重症,显示出明显的血管功能障碍,与分流病变不同.
结论:
- 先天性心脏病绝对与广泛的血管功能障碍有关.
- 患有心血管疾病的患者表现出动脉硬度增加和心动脉内心介质厚度升高.
- 这些血管缺陷存在于患有心血管疾病的儿科和成人群体中.
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