Gullu Hakan, Erdogan Dogan, Tok Derya, Topcu Semra, Caliskan Mustafa, Ulus Taner, Muderrisoglu Haldun
Cardiology Department, Konya Teaching and Medical Research Center, Baskent University, Konya, Turkey.
Arterioscler Thromb Vasc Biol. 2005 Nov;25(11):2289-94. doi: 10.1161/01.ATV.0000185806.61430.7c. Epub 2005 Sep 8.
Elevated serum bilirubin concentrations protect against atherosclerotic diseases; however, it is not clear whether higher serum bilirubin concentrations in physiological ranges work in favor of the cardiovascular system in younger persons with no cardiovascular risk factors. Accordingly, we investigated the effects of high, intermediate, and low serum bilirubin concentrations on coronary flow reserve (CFR).
Fifty-two healthy subjects with hyperbilirubinemia (total bilirubin 1.43+/-0.33 mg/dL; mean age 35.9+/-7.3), 55 subjects with intermediate bilirubin level (total bilirubin: 0.69+/-0.11 mg/dL; mean age: 36.4+/-6.8), and 53 healthy subjects with hypobilirubinemia (total bilirubin 0.37+/-0.08 mg/dL; mean age, 37.6+/-6.6) were studied. Transthoracic second harmonic Doppler echocardiography examination was performed using an Acuson Sequoia C256 Echocardiography System. Coronary diastolic peak flow velocities were measured at baseline and after dipyridamole infusion (0.84 mg/kg over 6 minutes). CFR was calculated as the ratio of hyperemic to baseline diastolic peak velocities. Demographic features, coronary risk factors, echocardiographic measurements, and biochemical measurements were similar among the 3 groups, except high-sensitivity C-reactive protein (hsCRP). CFR values were significantly higher in subjects with high bilirubin concentrations than those were in the intermediate and the low bilirubin groups (3.19+/-0.73; 2.75+/-0.42; 2.56+/-0.52, respectively; P<0.0001), and hsCRP levels were significantly lower in subjects with high bilirubin concentrations than those in both intermediate and low bilirubin groups (1.4+/-1.0, 2.0+/-1.7, 3.0+/-1.9 mg/L, respectively; P<0.001). hsCRP levels correlated with total bilirubin concentration and with CFR.
Elevated serum bilirubin concentrations protect from CFR impairment, coronary microvascular dysfunction, and possibly coronary atherosclerosis.
血清胆红素浓度升高可预防动脉粥样硬化性疾病；然而，尚不清楚生理范围内较高的血清胆红素浓度是否对无心血管危险因素的年轻人的心血管系统有益。因此，我们研究了高、中、低血清胆红素浓度对冠状动脉血流储备（CFR）的影响。
研究了52名高胆红素血症健康受试者（总胆红素1.43±0.33mg/dL；平均年龄35.9±7.3岁）、55名中等胆红素水平受试者（总胆红素：0.69±0.11mg/dL；平均年龄：36.4±6.8岁）和53名低胆红素血症健康受试者（总胆红素0.37±0.08mg/dL；平均年龄37.6±6.6岁）。使用Acuson Sequoia C256超声心动图系统进行经胸二次谐波多普勒超声心动图检查。在基线和双嘧达莫输注后（6分钟内0.84mg/kg）测量冠状动脉舒张期峰值流速。CFR计算为充血期与基线舒张期峰值流速之比。除高敏C反应蛋白（hsCRP）外，三组受试者的人口统计学特征、冠状动脉危险因素、超声心动图测量和生化测量相似。高胆红素浓度受试者的CFR值显著高于中等和低胆红素组（分别为3.19±0.73；2.75±0.42；2.56±0.52；P<0.0001），高胆红素浓度受试者的hsCRP水平显著低于中等和低胆红素组（分别为1.4±1.0、2.0±1.7、3.0±1.9mg/L；P<0.001）。hsCRP水平与总胆红素浓度和CFR相关。
血清胆红素浓度升高可预防CFR受损、冠状动脉微血管功能障碍以及可能的冠状动脉粥样硬化。
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