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原发性高血压患者的左心室舒张功能障碍与血浆不对称二甲基精氨酸浓度

Left ventricular diastolic dysfunction and plasma asymmetric dimethylarginine concentration in persons with essential hypertension.

作者信息

Poręba Rafał, Gać Paweł, Poręba Małgorzata, Derkacz Arkadiusz, Chachaj Angelika, Mazur Grzegorz, Szuba Andrzej

机构信息

Department of Internal Medicine, Occupational Diseases and Hypertension, Wroclaw Medical University, Wroclaw, Poland.

Department of Pathophysiology, Wroclaw Medical University, Wroclaw, Poland.

出版信息

Arch Med Sci. 2015 Jun 19;11(3):521-9. doi: 10.5114/aoms.2015.52354.

Abstract

INTRODUCTION

The study aimed to evaluate the relationship between plasma asymmetric dimethylarginine (ADMA) concentration and development of left ventricular diastolic dysfunction (LVDD) in patients with essential hypertension (EH). Moreover, an attempt was made to define independent risk factors of LVDD in patients with EH.

MATERIAL AND METHODS

A group of 106 individuals with EH was obtained (mean age: 47.18 ±11.76 years). Two groups of patients were distinguished: group I - individuals with EH with LVDD (n = 57); group II - persons with EH without LVDD (n = 49). Echocardiographic examination was conducted by the transthoracic technique. High-performance liquid chromatography was used to measure dimethylarginine concentrations.

RESULTS

In the group suffering from EH with LVDD, mean ADMA concentration was significantly higher and the ratio of arginine to ADMA was significantly lower than in patients with EH without LVDD. No significant differences were detected between mean concentrations of plasma symmetric dimethylarginine concentration (SDMA) and arginine or in arginine/SDMA ratios in the studied groups. Independent factors of LVDD risk in the study group included higher plasma ADMA concentration, higher serum low-density lipoprotein (LDL) concentration, higher values of body mass index (BMI), higher values of left ventricular mass index (LVMI) and higher values of mean blood pressure (mBP) (ORADMA = 1.731; ORLDL = 1.188; ORBMI = 1.056; ORLVMI = 1.062; ORmBP = 1.014; p < 0.05).

CONCLUSIONS

The results of this study showed that ADMA concentration may be of prognostic value in relation to manifestation of LVDD in patients with EH.

摘要

引言

本研究旨在评估原发性高血压(EH)患者血浆不对称二甲基精氨酸(ADMA)浓度与左心室舒张功能障碍(LVDD)发生之间的关系。此外,还试图确定EH患者LVDD的独立危险因素。

材料与方法

选取106例EH患者(平均年龄:47.18±11.76岁)。将患者分为两组:第一组为患有LVDD的EH患者(n = 57);第二组为无LVDD的EH患者(n = 49)。采用经胸技术进行超声心动图检查。使用高效液相色谱法测量二甲基精氨酸浓度。

结果

患有LVDD的EH患者组中,平均ADMA浓度显著更高,且精氨酸与ADMA的比值显著低于无LVDD的EH患者。研究组之间血浆对称二甲基精氨酸浓度(SDMA)和精氨酸的平均浓度或精氨酸/SDMA比值未检测到显著差异。研究组中LVDD风险的独立因素包括血浆ADMA浓度升高、血清低密度脂蛋白(LDL)浓度升高、体重指数(BMI)值升高、左心室质量指数(LVMI)值升高和平均血压(mBP)值升高(ORADMA = 1.731;ORLDL = 1.188;ORBMI = 1.056;ORLVMI = 1.062;ORmBP = 1.014;p < 0.05)。

结论

本研究结果表明,ADMA浓度可能对EH患者LVDD的表现具有预后价值。

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