Peng Tao, Hu Zhao, Wu Ling, Li Dengren, Yang Xiangdong
Department of Nephrology, Shandong University Qilu Hospital, Jinan 250012, China.
Kidney Blood Press Res. 2014;39(5):420-6. doi: 10.1159/000368455. Epub 2014 Nov 12.
BACKGROUND/AIMS: To investigate the role of endothelial dysfunction on left ventricular remodeling in patients with chronic kidney disease and to evaluate the correlation between endothelial dysfunction and left ventricular remodeling.
Seventy-three patients with chronic kidney disease as study-group and thirty healthy volunteers as control-group were enrolled in the present study. All patients in both groups had echocardiography examination. The concentration of endothelin-1, nitric oxide, and inducible nitric oxide synthase of serum of all patients and healthy volunteers was measured. The incidence of cardiac structural abnormalities in patients with chronic kidney disease, and the relationship between endothelial dysfunction and cardiac structural abnormalities were analyzed.
The incidence of left ventricular hypertrophy, left ventricular concentric remodeling, and left ventricular systolic dysfunction was 65%, 8.33%, and 16.67%, respectively. The level of endothelin-1 and nitric oxide increased in study-group, and the concentration of inducible nitric oxide synthase decreased. There was significant positively relationship between plasma endothelin-1 and left ventricular mass index, interventricular septal thickness, left ventricular diastolic diameter. There was negatively relationship between the level of serum nitric oxide and the maximum flow velocity at the mitral in left ventricular diastolic stage. There was not any correlation between inducible nitric oxide synthase with left ventricular remodeling.
The results showed that there was a higher incidence of left ventricular hypertrophy in patients with chronic kidney disease. Endothelin-1 and nitric oxide played an important role on the development of left ventricular hypertrophy.
背景/目的：探讨内皮功能障碍在慢性肾脏病患者左心室重构中的作用，并评估内皮功能障碍与左心室重构之间的相关性。
本研究纳入73例慢性肾脏病患者作为研究组，30例健康志愿者作为对照组。两组所有患者均接受超声心动图检查。检测所有患者及健康志愿者血清中内皮素-1、一氧化氮及诱导型一氧化氮合酶的浓度。分析慢性肾脏病患者心脏结构异常的发生率，以及内皮功能障碍与心脏结构异常之间的关系。
左心室肥厚、左心室向心性重构及左心室收缩功能障碍的发生率分别为65%、8.33%和16.67%。研究组内皮素-1水平及一氧化氮水平升高，诱导型一氧化氮合酶浓度降低。血浆内皮素-1与左心室质量指数、室间隔厚度、左心室舒张直径呈显著正相关。血清一氧化氮水平与左心室舒张期二尖瓣最大流速呈负相关。诱导型一氧化氮合酶与左心室重构无相关性。
结果显示慢性肾脏病患者左心室肥厚的发生率较高。内皮素-1和一氧化氮在左心室肥厚的发生发展中起重要作用。
