Málek F, Dvorák J, Jiresová E, Spacek R
Dept. of Medicine III - Cardiology, University Hospital Vinohrady, 3rd Medical Faculty, Charles University, Prague, Czech Republic.
Cent Eur J Public Health. 2003 Dec;11(4):198-201.
Serum copper concentrations as indicators of non-specific inflammatory response are higher in patients with severe heart failure than in patients with mild to moderate cardiac insufficiency and correlate with acute phase protein concentrations. The aim of this study was to find out if baseline serum copper concentrations are higher in patients with chronic heart failure and higher one year mortality and morbidity and whether serum copper concentrations correlate with prognostic indicators.
Baseline serum copper concentrations were determined in 64 patients with chronic heart failure, functional classification NYHA II-IV (NYHA - New York Heart Association), caused by ischemic heart disease, with severe left ventricular dysfunction (ejection fraction < or = 35%). 30 patients died or were admitted to the hospital because of worsening heart failure (group A) within 12 months since their examination. 34 patients did not die and hospitalisation was not necessary within 12 months (group B). Retrospectively the presence of differences in serum copper concentrations and in prognostic indicators was assessed between both groups. Statistically significant differences between both groups were found in these parameters: baseline serum copper concentrations (p < 0.001), ejection fraction of left ventricle (p < 0.05), baseline heart rate (p < 0.01) and cardiothoracic ratio (p < 0.01). Serum copper concentrations significantly correlate with heart rate (p < 0.01), inverse correlation with left ventricular ejection fraction and positive correlation with cardiothoracic ratio are not statistically significant.
Baseline serum copper concentrations are significantly higher in patients with chronic heart failure, also correlating with higher one-year mortality and morbidity. Serum copper levels significantly correlate with baseline heart rate. Relation of serum copper concentrations with left ventricular ejection fraction and cardiothoracic ratio is not statistically significant.
作为非特异性炎症反应指标的血清铜浓度，在重度心力衰竭患者中高于轻度至中度心力衰竭患者，且与急性期蛋白浓度相关。本研究的目的是确定慢性心力衰竭患者中基线血清铜浓度是否更高，以及一年死亡率和发病率是否更高，血清铜浓度是否与预后指标相关。
对64例因缺血性心脏病导致慢性心力衰竭、纽约心脏协会（NYHA）功能分级为II-IV级（NYHA - New York Heart Association）、左心室功能严重不全（射血分数≤35%）的患者测定基线血清铜浓度。30例患者在检查后12个月内死于心力衰竭恶化或因心力衰竭恶化入院（A组）。34例患者在12个月内未死亡且无需住院（B组）。回顾性评估两组之间血清铜浓度和预后指标的差异。在这些参数中发现两组之间存在统计学显著差异：基线血清铜浓度（p < 0.001）、左心室射血分数（p < 0.05）、基线心率（p < 0.01）和心胸比率（p < 0.01）。血清铜浓度与心率显著相关（p < 0.01），与左心室射血分数呈负相关以及与心胸比率呈正相关无统计学意义。
慢性心力衰竭患者的基线血清铜浓度显著更高，也与较高的一年死亡率和发病率相关。血清铜水平与基线心率显著相关。血清铜浓度与左心室射血分数和心胸比率的关系无统计学意义。
