Ozcan Cetin Elif Hande, Cetin Mehmet Serkan, Canpolat Ugur, Kalender Erol, Topaloglu Serkan, Aras Dursun, Aydogdu Sinan
Cardiology Clinic, Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
Med Princ Pract. 2015;24(5):444-50. doi: 10.1159/000431362. Epub 2015 Jul 4.
The aim of this research was to assess the relationship between mitral annular calcification (MAC) and whole blood viscosity (WBV).
A total of 184 patients with MAC and 133 patients without MAC were enrolled in the study. The WBV was calculated with a confirmed formulation using the hematocrit and total plasma protein at a low shear rate (LSR) and high shear rate (HSR). Early diastolic mitral annular velocity (Ea) and late diastolic mitral annular velocity (Aa) were measured using pulse Doppler tissue echocardiography. Pearson's correlation analysis was performed to assess the relationship between WBV and mitral annular motion velocities. The effects of different variables on the occurrence of MAC were assessed in univariate and multivariate logistic regression analysis.
In patients with MAC, WBV values were significantly higher at HSR (18.04 ± 0.84 vs. 17.25 ± 0.96 208 s(-1), p < 0.001) and at LSR (78.0 ± 14.2 vs. 61.9 ± 17.1 0.5 s(-1), p < 0.001). The WBV at HSR and LSR were significantly correlated with Ea (r = -0.477, p < 0.001; r = -0.385, p < 0.001, respectively) and Aa (r = -0.544, p < 0.001; r = -0.323, p < 0.001, respectively). Multivariate analysis showed that WBV of both shear rates was an independent predictor of MAC. Using the ROC curve, a cut-off value of 70.1 for WBV at LSR had a sensitivity of 83.7% and a specificity of 73.7% (AUC 0.785, p < 0.001) and a WBV cut-off value of 17.5 at HSR had a sensitivity of 79.6% and a specificity of 71.4% (AUC 0.761, p < 0.001) for the prediction of MAC.
Patients with MAC had significantly higher WBV, which independently predicted the presence of MAC. WBV had an inverse correlation with mitral annular motion velocities, indicating that a higher WBV may lead to greater limitation in annular motion and, thus, more calcification.
本研究旨在评估二尖瓣环钙化（MAC）与全血粘度（WBV）之间的关系。
本研究共纳入184例MAC患者和133例无MAC患者。采用已确认的公式，根据血细胞比容和总血浆蛋白，在低剪切率（LSR）和高剪切率（HSR）下计算WBV。使用脉冲多普勒组织超声心动图测量舒张早期二尖瓣环速度（Ea）和舒张晚期二尖瓣环速度（Aa）。采用Pearson相关分析评估WBV与二尖瓣环运动速度之间的关系。在单因素和多因素逻辑回归分析中评估不同变量对MAC发生的影响。
在MAC患者中，HSR时的WBV值显著更高（18.04±0.84对17.25±0.96 208 s(-1)，p<0.001），LSR时也显著更高（78.0±14.2对61.9±17.1 0.5 s(-1)，p<0.001）。HSR和LSR时的WBV与Ea显著相关（分别为r=-0.477，p<0.001；r=-0.385，p<0.001）和Aa（分别为r=-0.544，p<0.001；r=-0.323，p<0.001）。多因素分析表明，两种剪切率下的WBV都是MAC的独立预测因子。使用ROC曲线，LSR时WBV的截断值为70.1，预测MAC的灵敏度为83.7%，特异度为73.7%（AUC 0.785，p<0.001），HSR时WBV的截断值为17.5，预测MAC的灵敏度为79.6%，特异度为71.4%（AUC 0.761，p<0.001）。
MAC患者的WBV显著更高，其独立预测MAC的存在。WBV与二尖瓣环运动速度呈负相关，表明较高的WBV可能导致环运动的更大限制，从而导致更多钙化。
