疑似微血管性心绞痛患者肱动脉血流介导的血管舒张功能及高敏C反应蛋白水平与杜克运动平板评分的相关性

The association of brachial flow-mediated dilation and high-sensitivity C-reactive protein levels with Duke treadmill score in patients with suspected microvascular angina.

作者信息

Luo Chufan, Li Yi, Liu Donghong, Hu Chengheng, Du Zhimin

机构信息

Division of Cardiology, Sun Yat-sen University, Guangzhou, China;

出版信息

Exp Clin Cardiol. 2012 Winter;17(4):197-201.

PMID:23592935

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3627274/

Abstract

BACKGROUND

Although earlier studies demonstrated endothelial dysfunction and systemic inflammation in patients with microvascular angina (MVA), the correlations between flow-mediated dilation (FMD), high-sensitivity C-reactive protein (hsCRP) levels and Duke treadmill score (DTS), a comprehensive index representing the severity of ischemia, have not been elucidated in this setting.

OBJECTIVE

To explore the possible relationships among brachial FMD, serum hsCRP levels and DTS in MVA patients.

METHODS AND RESULTS

A total of 89 subjects with chest pain and a normal coronary angiogram were studied. The exercise treadmill test (ETT) was performed using the Bruce protocol for calculating the DTS. Brachial FMD and serum hsCRP levels were measured. The mean (± SD) brachial FMD was 5.45±2.24% in the group with positive ETT and 8.19±2.78% in the group with a negative ETT (P<0.001). Mean serum hsCRP levels were significantly higher in the group with positive ETT than in the group with negative ETT (4.93±1.63 mg/L versus 3.41±1.65 mg/L; P<0.001). Brachial FMD and serum hsCRP levels showed significant differences among the three groups according to DTS risk stratification. The DTS was positively correlated with FMD (r=0.532; P<0.001) and negatively correlated with hsCRP level (r= 0.461; P<0.001).

CONCLUSIONS

Brachial FMD and serum hsCRP levels may be associated with DTS in patients with MVA.

摘要

背景

尽管早期研究表明微血管性心绞痛（MVA）患者存在内皮功能障碍和全身炎症，但在此情况下，血流介导的血管舒张（FMD）、高敏C反应蛋白（hsCRP）水平与杜克运动平板评分（DTS，一种代表缺血严重程度的综合指标）之间的相关性尚未阐明。

目的

探讨MVA患者肱动脉FMD、血清hsCRP水平与DTS之间的可能关系。

方法与结果

共研究了89例胸痛且冠状动脉造影正常的受试者。采用布鲁斯方案进行运动平板试验（ETT）以计算DTS。测量肱动脉FMD和血清hsCRP水平。ETT阳性组的平均（±标准差）肱动脉FMD为5.45±2.24%，ETT阴性组为8.19±2.78%（P<0.001）。ETT阳性组的平均血清hsCRP水平显著高于ETT阴性组（4.93±1.63 mg/L对3.41±1.65 mg/L；P<0.001）。根据DTS风险分层，三组之间肱动脉FMD和血清hsCRP水平存在显著差异。DTS与FMD呈正相关（r=0.532；P<0.001），与hsCRP水平呈负相关（r=0.461；P<0.001）。