患有先天性心脏病的成年人内皮功能障碍:系统性审查和元分析
Amalia Baroutidou1, Theodoros Dimitroulas2, Alexandra Arvanitaki1,3,4
1First Department of Cardiology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
European journal of clinical investigation
|December 26, 2024
概括
患有先天性心脏病 (ACHD) 的成年人表现出血管功能受损和动脉硬度增加. 这可能解释了他们患心血管事件的风险更高,强调了早期检测血管损伤的必要性.
科学领域:
- 心血管医学 心血管医学
- 血管生物学 血管生物学
- 遗传性心脏病研究 遗传性心脏病研究
背景情况:
- 患有先天性心脏病 (ACHD) 的成年人面临着过早心血管事件的终身风险.
- 内皮功能障碍和动脉硬是ACHD中涉及的机制.
- 在ACHD中早期发现内皮损伤对于减轻不良事件至关重要.
研究的目的:
- 系统地审查和对患有先天性心脏病 (ACHD) 的成年人微型和宏观血管病变进行元分析.
- 与健康对照人群相比,研究ACHD患者的内皮功能和动脉硬性.
主要方法:
- 在四个主要的电子数据库 (PubMed,CENTRAL,Scopus,Web of Science),ClinicalTrials.gov和灰色文献中进行系统搜索.
- 在ACHD和对照组中,包括评估内皮功能 (流介导扩张,甘介导扩张,外围动脉度测量) 和动脉硬性 (脉冲波速度,增强指数) 的研究.
- 在研究选择和数据提取方面遵循了PRISMA指南.
主要成果:
- 包括31项研究 (1118项ACHD,794项对照).
- ACHD患者表现出减弱的手臂动脉内皮依赖和独立血管扩张 (FMD,NMD).
- 在ACHD中观察到微血管功能 (PAT) 损伤和显著更高的增强指数,而脉冲波速度没有显著差异.
结论:
- 患有先天性心脏病的成年人表现出大脑和小血管功能受损.
- 动脉硬度升高,通过更高的增强指数表明,存在于ACHD.
- 这些血管异常是导致ACHD患者心血管不良事件风险增加的潜在因素.
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