Department of Cardiology, Acibadem Hospital, Kayseri, Turkey.
Clin Hemorheol Microcirc. 2010;44(4):287-96. doi: 10.3233/CH-2010-1278.
Behçet's disease (BD) is a chronic, progressive and inflammatory multisystemic disease, that significantly affects the cardiovascular system. Oxidative stress (OS) is a disturbance in oxidant/antioxidant balance in favor of oxidants. The OS that increases acutely and chronically due to the inflammatory process plays an important role in the pathogenesis of the cardiovascular system effects of the disease by causing endothelial dysfunction in vascular structures. The aim of our study was to investigate the relationship between OS and myocardial perfusion, which is based on microvascular dysfunction, in BD.
Twenty-seven patients with BD (16 M, 11 F, mean age: 38.7 +/- 9.4 years) and 22 healthy volunteers (12 M, 10 F, mean age: 35.8 +/- 6.5 years) participated in our study. Technetium-99m methoxyisobutylisonitrile single photon emission computed tomography (Tc-99m MIBI SPECT) stress-rest test was performed with two-day protocol. Myocardial perfusion scores (summed stress score, summed rest score, summed difference score, fix defect score) and perfusion defect prevalence (stress, rest, ischemic and fixed) were determined as the percentage of left ventricle. Coronary angiography was performed in patients with abnormal myocardial perfusion scintigraphy. For OS analysis, the blood samples were taken immediately before the first imaging procedure and were studied for malondialdehyde, glutathione, nitrite, nitrate, vitamin C, retinol, and carotene.
In the BD group, a total of 9 patients had abnormal findings in their stress and rest electrocardiography. Perfusion defect in myocardial perfusion scintigraphy was observed in 14 patients (51.8%). Twelve patients accepted coronary angiography, and their results were normal. In the comparison of myocardial perfusion scores, perfusion defect prevalence and OS parameters, there was a significant difference between the BD and control groups. In the BD group, no correlation was observed between myocardial perfusion scores, perfusion defect prevalence and OS parameters.
Defects in myocardial perfusion and increase in OS were observed in BD; however, there was no correlation between the two findings in the inactive period. In other words, the prevalence and intensity of myocardial perfusion defects can vary at different OS levels.
探讨 Behcet 病(BD)患者氧化应激(OS)与心肌灌注的关系,后者与血管结构内皮功能障碍有关。
27 例 BD 患者(男 16 例,女 11 例,平均年龄 38.7±9.4 岁)和 22 例健康志愿者(男 12 例,女 10 例,平均年龄 35.8±6.5 岁)参与本研究。采用锝-99m 甲氧基异丁基异腈单光子发射计算机断层扫描(Tc-99m MIBI SPECT)负荷-静息试验进行研究,方案为两天。通过左心室百分比确定心肌灌注评分(总和应激评分、总和静息评分、总和差异评分、固定缺陷评分)和灌注缺陷发生率(应激、静息、缺血和固定)。对心肌灌注闪烁显像异常的患者进行冠状动脉造影。在第一次成像前即刻采集血液样本,分析丙二醛、谷胱甘肽、亚硝酸盐、硝酸盐、维生素 C、视黄醇和胡萝卜素等 OS 参数。
BD 组中,有 9 例患者静息和(或)应激心电图异常,14 例(51.8%)患者心肌灌注闪烁显像有灌注缺陷。12 例患者接受了冠状动脉造影,结果正常。在心肌灌注评分、灌注缺陷发生率和 OS 参数的比较中,BD 组和对照组之间存在显著差异。在 BD 组中,心肌灌注评分、灌注缺陷发生率与 OS 参数之间无相关性。
BD 患者存在心肌灌注缺陷和 OS 增加,但在静止期两者之间无相关性。换句话说,心肌灌注缺陷的发生率和严重程度可能因 OS 水平的不同而有所差异。