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[心内膜下存活心肌比例与缺血性心脏病危险因素之间的关系]

[Relationship between the subendocardial viability ratio and risk factors for ischemic heart disease].

作者信息

Saito Masahiko, Kasuya Ayumi

机构信息

Hoshizaki Clinic of Daido Steel Co., Daido-cho, 2-30 Minami-ku, Nagoya 457-8545, Japan.

出版信息

Sangyo Eiseigaku Zasshi. 2003 May;45(3):114-9. doi: 10.1539/sangyoeisei.45.114.

DOI:10.1539/sangyoeisei.45.114
PMID:12833853
Abstract

Ischemic heart disease is one of the major causes of sudden death in Japanese workers. Hypercholesteremia, hypertension, obesity, and the smoking habit are considered to be risk factors for cardiovascular events. Generally the subendocardium is thought to be more sensitive to a shortage of blood supply than the subepicardium. Buckberg et al. have demonstrated that the ratio of the area of the diastolic phase (diastolic pressure time index: DPTI) to that of the systolic phase (time tension index: TTI) in the central aortic profile has a close correlation with the blood supply to the subendocardium. This ratio was designated as the subendocardial viability ratio: SEVR (DPTI/TTI). We examined the relationships between the SEVR, as measured by SphygmoCor (AtCor Medical Ltd.), and the data from the health examination of 178 males working for a steel company. A significantly low SEVR was observed in people with the smoking habit, a high pulse rate, obesity, abnormality of blood fat components, or hyperglycemia. Employees in the normal SEVR group (SEVR: 140% or more) n = 120 and low SEVR group (SEVR: 139% or less) n = 58 were compared. The results suggested that employees with low SEVR were older and had a higher BMI, higher pulse rate, higher total cholesterol, higher triglyceride, and higher fasting plasma glucose. They also had lower HDL-cholesterol. In the low SEVR group, the percentage of employees with hyperlipidemia or hyperglucosemia was significantly higher than that in the normal SEVR group. Results of stepwise regression analysis indicated that the pulse rate and age were significant and independent predictive factors for SEVR. These data on SEVR calculated from the wave pattern of the central artery are considered to be useful parameters for evaluating the risk of myocardial ischemia and for guiding health promotion.

摘要

缺血性心脏病是日本工人猝死的主要原因之一。高胆固醇血症、高血压、肥胖和吸烟习惯被认为是心血管事件的危险因素。一般认为心内膜下层比心外膜下层对血液供应不足更敏感。Buckberg等人已经证明,中心主动脉轮廓中舒张期面积(舒张期压力时间指数:DPTI)与收缩期面积(时间张力指数:TTI)的比值与心内膜下层的血液供应密切相关。该比值被指定为心内膜下存活比值:SEVR(DPTI/TTI)。我们研究了通过SphygmoCor(AtCor Medical Ltd.)测量的SEVR与一家钢铁公司178名男性员工的健康检查数据之间的关系。在有吸烟习惯、高脉搏率、肥胖、血脂成分异常或高血糖的人群中观察到显著较低的SEVR。比较了正常SEVR组(SEVR:140%或更高)n = 120和低SEVR组(SEVR:139%或更低)n = 58的员工。结果表明,低SEVR的员工年龄较大,BMI较高,脉搏率较高,总胆固醇较高,甘油三酯较高,空腹血糖较高。他们的高密度脂蛋白胆固醇也较低。在低SEVR组中,高脂血症或高血糖血症员工的百分比显著高于正常SEVR组。逐步回归分析结果表明,脉搏率和年龄是SEVR的显著且独立的预测因素。这些根据中心动脉波形计算出的SEVR数据被认为是评估心肌缺血风险和指导健康促进的有用参数。

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