Makharova Natalya Vladimirovna, Voevoda Michael Ivanovich, Lyutova Faina Fedorovna, Pinigina Irina Andreevna, Tarasova Vera Evstafievna
Yakutsk Scientific Center, SB RAMS, Yakutsk, Russia.
Int J Circumpolar Health. 2013 Aug 5;72. doi: 10.3402/ijch.v72i0.21219. eCollection 2013.
The aim of the study is to compare clinical, angiographic, electrocardiographic, echocardiographic data between indigenous and non-indigenous residents of Yakutia.
We performed cross-sectional analysis of the Registry of Selective Coronary Angiography (SCAG) of the Yakutsk Republican Hospital for the period from 2004 to 2007. All patients (n = 1,233) were admitted to hospital from all 35 regions of the Sakha Republic (Yakutia). Initially, 12 (1%) patients, who had abnormal coronary arteries and 259 (21%) patients with normal coronary arteries were excluded from this study. From the remaining 962 (78%) patients with detected coronary artery atherosclerosis 394 (41%) patients were excluded for having congenital heart malformations due to possible influence on the outcomes of examination for myocardial hypertrophy. Finally, only 568 patients were selected for further examinations.
We analyzed clinical data, and the findings of selective angiography, multi-detector computed tomography (CT), electrocardiography (ECG), 24-hour Holter ECG monitoring and echocardiography.
(a) In the Sakha Republic (Yakutia) single-vessel coronary disease, coronary stenosis with 50-75% and 75-90% of constriction were detected more often among indigenous males, while multiple-vessel coronary stenosis was detected more often among non-indigenous males as well as stenosis with more than 90% of constriction. Lower calcium score mean (349.1 ± 129.8 vs. 621.8 ± 115.2) was observed among indigenous patients compared to non-indigenous patients; (b) Painless myocardial infarction, painless ischaemia, arterial hypertension and atrial fibrillation were detected more often among indigenous male compared to non-indigenous participants; (c) Based on the results of ECG and echocardiographic examinations, left ventricular (LV) hypertrophy, particular eccentric type of hypertrophy, was found more commonly among indigenous than non-indigenous males; and (d) By laboratory findings, indigenous males had significantly lower triglyceride levels, while platelet counts were higher compared to non-indigenous patients. Obesity was observed less frequently among indigenous men compared to non-indigenous men.
The differences observed in this study are disputable and call for further studies. Collection of reliable data for women should be the aim of future studies.
本研究旨在比较雅库特地区原住民与非原住民居民的临床、血管造影、心电图及超声心动图数据。
我们对雅库茨克共和医院2004年至2007年期间的选择性冠状动脉造影（SCAG）登记册进行了横断面分析。所有患者（n = 1233）均来自萨哈共和国（雅库特）的35个地区。最初，12名（1%）冠状动脉异常患者和259名（21%）冠状动脉正常患者被排除在本研究之外。在其余962名（78%）检测出冠状动脉粥样硬化的患者中，394名（41%）因患有先天性心脏畸形可能影响心肌肥厚检查结果而被排除。最终，仅568名患者被选作进一步检查。
我们分析了临床数据、选择性血管造影、多排螺旋计算机断层扫描（CT）、心电图（ECG）、24小时动态心电图监测及超声心动图检查结果。
（a）在萨哈共和国（雅库特），单支冠状动脉疾病、50%-75%及75%-90%狭窄的冠状动脉狭窄在原住民男性中更为常见，而多支冠状动脉狭窄在非原住民男性中更为常见，以及狭窄超过90%的情况。与非原住民患者相比，原住民患者的平均钙评分较低（349.1±129.8对621.8±115.2）；（b）与非原住民参与者相比，无痛性心肌梗死、无痛性缺血、动脉高血压及心房颤动在原住民男性中更为常见；（c）基于心电图和超声心动图检查结果，左心室（LV）肥厚，尤其是偏心型肥厚，在原住民男性中比非原住民男性更为常见；（d）从实验室检查结果来看，原住民男性的甘油三酯水平显著较低，而血小板计数高于非原住民患者。与非原住民男性相比，原住民男性肥胖的发生率较低。
本研究中观察到的差异存在争议，需要进一步研究。收集女性的可靠数据应是未来研究的目标。
