Suleyman Demirel University, Faculty of Medicine, Cardiology Department, Isparta, Turkey.
Platelets. 2012;23(3):177-83. doi: 10.3109/09537104.2011.611273. Epub 2011 Sep 13.
Attenuated coronary flow reserve (CFR) has been reported in patients with idiopathic dilated cardiomyopathy (IDC). On the other hand increased platelet activity has been demonstrated in patients with congestive heart failure and left ventricular dysfunction. Accordingly, we aimed to investigate whether mean platelet volume (MPV) is increased in patients with IDC and increased MPV correlates with the degree of coronary microvascular dysfunction. MPV was measured in 37 patients with IDC. Each patient with IDC also underwent echocardiographic examination including CFR measurement. Patients with IDC were divided into two groups based on median CFR value (lower CFR group and normal CFR group). MPV was significantly higher in the lower CFR group than in the normal CFR group (9.00 ± 0.56 vs. 8.25 ± 0.76 fl; respectively, p = 0.001). CFR correlated significantly and inversely to MPV (r = -0.475, p = 0.003). Logistic regression analysis revealed that MPV level was the independent predictor of lower CFR (β = -0.750, p = 0.002). Furthermore, MPV was an accurate predictor of low CFR (p = 0.001); Area under the curve was 82% (95% CI 0.67-0.96). The best cut-off value of MPV to predict low CFR was 8.3 fl with 95% sensitivity and 69% specificity. In conclusion, the present study showed a negative correlation between MPV and CFR in patients with IDC.
在特发性扩张型心肌病（IDC）患者中已经报道了衰减的冠状动脉血流储备（CFR）。另一方面，在充血性心力衰竭和左心室功能障碍患者中已经证明了血小板活性增加。因此，我们旨在研究 IDC 患者的平均血小板体积（MPV）是否增加，以及增加的 MPV 是否与冠状动脉微血管功能障碍的程度相关。在 37 名 IDC 患者中测量了 MPV。每位 IDC 患者还接受了超声心动图检查，包括 CFR 测量。根据中位数 CFR 值（低 CFR 组和正常 CFR 组）将 IDC 患者分为两组。低 CFR 组的 MPV 明显高于正常 CFR 组（9.00±0.56 比 8.25±0.76 fl；分别为 p=0.001）。CFR 与 MPV 呈显著负相关（r=-0.475，p=0.003）。逻辑回归分析显示，MPV 水平是低 CFR 的独立预测因子（β=-0.750，p=0.002）。此外，MPV 是低 CFR 的准确预测因子（p=0.001）；曲线下面积为 82%（95%CI 0.67-0.96）。预测低 CFR 的最佳 MPV 截断值为 8.3 fl，灵敏度为 95%，特异性为 69%。总之，本研究表明 IDC 患者的 MPV 与 CFR 之间存在负相关。
