β-地中海贫血轻度患者的冠状动脉微血管功能、外周血管内皮功能和颈动脉 IMT

Coronary Microvascular function, Peripheral Endothelial Function and Carotid IMT in beta-thalassemia minor.

机构信息

Baskent University, Teaching and Medical Research Centers, Cardiology Department, Adana and Konya, Turkey.

出版信息

Thromb Res. 2013 Jun;131(6):e247-52. doi: 10.1016/j.thromres.2013.03.013. Epub 2013 May 15.

DOI:10.1016/j.thromres.2013.03.013

PMID:23683324

Abstract

UNLABELLED

Higher prevalence of cardiovascular disease in Thalassemia patients have been known. Potential mechanisms are enhanced platelet activation, LDL oxidation, macrophage activation, and increased nitric oxide destruction. We have investigated coronary flow reserve (CFR), brachial artery flow mediated dilation (FMD) and Carotid intima-media thickness (IMT) in patients with Beta thalessemia minor (BTM).

METHODS

Forty patients with BTM and 35 healthy control subjects were included. In all subjects CFR, brachial artery FMD, carotid artery IMT were measured.

RESULTS

CFR measurements: Coronary baseline diastolic peak flow velocity (DPFV) of left anterior descending coronary artery (LAD) was significantly higher in the BTM group (23.8 ± 3.9 vs. 22.1 ± 3.0, P = 0.04). However, hyperemic DPFV was significantly lower (61.1 ± 13.0 vs. 68.2 ± 14.2, P = 0.02), and CFR was significantly lower (2.57 ± 0.46 vs. 3.07 ± 0.48, P < 0.0001) in the BTM group than that in the control group. Brachial artery FMD and carotid IMT measurements: Percent FMD measurements were significantly lower in the BTM group than that in the controls (6.22 ± 4.29 vs. 8.10 ± 4.00, P = 0.01). Carotid IMT measurements were significantly but slightly higher in the BTM group than that in the controls (0.57 ± 0.07 vs. 0.54 ± 0.04, P = 0.04).

CONCLUSION

CFR reflecting coronary microvascular function and brachial artery FMD are decreased, and carotid IMT is increased in patients with BTM.

摘要

目的

已知地中海贫血患者心血管疾病的患病率较高。潜在机制包括血小板活化增强、LDL 氧化、巨噬细胞活化和一氧化氮破坏增加。我们研究了β地中海贫血（BTM）患者的冠状动脉血流储备（CFR）、肱动脉血流介导的扩张（FMD）和颈动脉内膜中层厚度（IMT）。

方法

纳入 40 例 BTM 患者和 35 名健康对照者。所有受试者均测量 CFR、肱动脉 FMD、颈动脉 IMT。

结果

CFR 测量：左前降支冠状动脉（LAD）的冠状动脉基础舒张期峰值流速（DPFV）在 BTM 组明显较高（23.8 ± 3.9 比 22.1 ± 3.0，P = 0.04）。然而，充血性 DPFV 明显较低（61.1 ± 13.0 比 68.2 ± 14.2，P = 0.02），CFR 明显较低（2.57 ± 0.46 比 3.07 ± 0.48，P < 0.0001）。肱动脉 FMD 和颈动脉 IMT 测量：BTM 组的 FMD 百分比明显低于对照组（6.22 ± 4.29 比 8.10 ± 4.00，P = 0.01）。BTM 组的颈动脉 IMT 测量值略高于对照组（0.57 ± 0.07 比 0.54 ± 0.04，P = 0.04）。