老年人肝素,意外心力衰竭和心脏功能障碍:ARIC研究
Iman A F Aboelsaad1, Brian L Claggett1, Victoria Arthur1
1Brigham and Women's Hospital, Boston, MA.
European journal of preventive cardiology
|January 17, 2025
概括
铁代谢的标志物肝素水平较低,与老年人心力衰竭风险增加有关. 这凸显了监测铁状况的重要性,即使没有贫血,对于心血管健康.
科学领域:
- 心脏病学 心脏病学
- 铁的新陈代谢 铁的新陈代谢
- 老年病的医生 老年病的医生
背景情况:
- 肝素是铁平衡的关键调节剂.
- 铁代谢失调与各种心血管疾病有关.
- 肝素在老年人心力衰竭 (HF) 和心脏功能障碍中的作用需要进一步调查.
研究的目的:
- 调查血肝素水平与老年人发生心力衰竭 (HF) 的风险之间的关联.
- 检查肝素水平与心脏功能障碍之间的关系,包括具有保留喷射分数 (HFpEF) 的HF和具有减少喷射分数 (HFrEF) 的HF.
- 探索肝素与心脏结构和功能的回声心脏学测量之间的横截面关联.
主要方法:
- 利用社区动脉样硬化风险研究 (ARIC) 的数据,包括在访问时没有流行性贫血或HF的老年人5.
- 采用多变量Cox比例危险回归模型来评估血肝素和发生的HF之间的关联 (总体,HFpEF,HFrEF).
- 应用多变量线性回归模型来评估肝素与心声学参数的横截面关联.
主要成果:
- 较低的血肝素度与总体发生HF的风险更高 (HR每50%较低的肝素:1.15;P=0.003) 和发生HFpEF的风险更高 (HR:1.25;P=0.001) 显著相关.
- 在肝素水平和发生HFrEF的风险之间没有发现显著的关联 (HR:1.08;P=0.30).
- 较低的肝素水平与不良的心声回声学发现相关,包括更高的E波,E/e'比,左心房体积指数和肺动脉静脉压.
结论:
- 在没有贫血的社区居住的老年人中,血肝素水平降低与患心力衰竭的风险增加有关,特别是HFpEF.
- 较低的肝素水平也与透静功能障碍和心脏重塑的指标有关.
- 这些发现强调了监测老年人铁代谢失调的临床意义,以预测和潜在地预防心力衰竭.
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