左心室射血分数对冠心病患者内皮功能的影响。
Impact of left ventricular ejection fraction on endothelial function in patients with coronary artery disease.
作者信息
Bae Jang-Ho, Bassenge Eberhard, Kim Moo-Hyun, Park Ki-Rack, Kim Ki-Young, Synn Yi-Chul, Schwemmer Michael
机构信息
Division of Cardiology, College of Medicine, Konyang University Hospital, Daejeon, South Korea.
出版信息
Clin Cardiol. 2004 Jun;27(6):333-7. doi: 10.1002/clc.4960270606.
BACKGROUND
Endothelial dysfunction is present in patients with coronary artery disease (CAD) or with congestive heart failure.
HYPOTHESIS
This study was performed to evaluate the impact of systolic heart function on endothelial function in patients with CAD.
METHODS
The study population consisted of 283 consecutive patients (mean age 59 years, 176 men) undergoing coronary angiography. Endothelial function was assessed by measuring flow-mediated vasodilation (FMD) of the brachial artery.
RESULTS
Patients (n = 236) with an ejection fraction (EF) > or = 55% on routine echocardiogram were younger (mean age 58 vs. 62 years), showed a lower prevalence of diabetes (15 vs. 38%) and myocardial infarction (13 vs. 66%), and showed a higher FMD (4.8 +/- 2.4 vs. 4.0 +/- 2.0%, p < 0.05) than patients (n = 47) with an EF < 55%. The correlation coefficient between FMD/endothelial function and EF/systolic heart function was 0.149 (p < 0.02) in the overall study population. Multivariate analysis showed that of age, gender, frequency of diabetes mellitus, myocardial infarction, and CAD extent, EF was the only significant independent parameter correlating with FMD in patients with CAD.
CONCLUSIONS
Compared with the other tested risk factors, EF surprisingly was the only significant independent parameter correlating with endothelial function in patients with CAD. Our results support the view that endothelial function is an independent prognostic factor in patients with CAD.
背景
冠状动脉疾病（CAD）或充血性心力衰竭患者存在内皮功能障碍。
假设
本研究旨在评估收缩期心脏功能对CAD患者内皮功能的影响。
方法
研究人群包括283例连续接受冠状动脉造影的患者（平均年龄59岁，男性176例）。通过测量肱动脉的血流介导的血管舒张（FMD）来评估内皮功能。
结果
常规超声心动图显示射血分数（EF）≥55%的患者（n = 236）更年轻（平均年龄58岁对62岁），糖尿病（15%对38%）和心肌梗死（13%对66%）的患病率更低，且FMD更高（4.8±2.4%对4.0±2.0%，p < 0.05），高于EF < 55%的患者（n = 47）。在整个研究人群中，FMD/内皮功能与EF/收缩期心脏功能之间的相关系数为0.149（p < 0.02）。多变量分析显示，在年龄、性别、糖尿病频率、心肌梗死和CAD程度中，EF是CAD患者中与FMD相关的唯一显著独立参数。
结论
与其他测试的危险因素相比，EF出人意料地是CAD患者中与内皮功能相关的唯一显著独立参数。我们的结果支持内皮功能是CAD患者独立预后因素的观点。
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