Ariyoshi Nobuhiro, Nogi Masayuki, Ando Akika, Watanabe Hideaki, Umekawa Sari
Department of Internal Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii.
Department of Internal Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, Hawaii.
Am J Med Sci. 2016 Sep;352(3):317-23. doi: 10.1016/j.amjms.2016.04.013. Epub 2016 Apr 22.
Relatively few studies have been conducted to evaluate the effect of hypophosphatemia on cardiac function. The goal of this review was to determine whether there is an association between hypophosphatemia and cardiac function and to increase awareness of hypophosphatemia-induced cardiomyopathy as a new clinical entity and a reversible cause of heart failure. We searched MEDLINE and PubMed from 1971 until March 2015 for primary studies, which reported the relationship between hypophosphatemia and cardiac function. A total of 837 articles were initially obtained. Of these articles, 826 publications were excluded according to the inclusion and exclusion criteria. In all, 11 articles were included in this review. These articles included 7 case series or case reports, 1 case-control study, 1 pretest versus posttest in a single group and 2 animal studies. In conclusion, the mechanisms of hypophosphatemia in cardiomyopathy have been reported to be a depletion of adenosine triphosphate in myocardial cells and decreased 2,3-diphosphoglycerate in erythrocytes. After correction of hypophosphatemia, left ventricular performance seems to improve in patients with severe hypophosphatemia, but not in those with mild-to-moderate hypophosphatemia. However, analyses of the relationship between cardiac function and hypophosphatemia using clinical end points have not been conducted.
相对较少的研究致力于评估低磷血症对心脏功能的影响。本综述的目的是确定低磷血症与心脏功能之间是否存在关联，并提高对低磷血症诱发的心肌病这一新临床实体以及心力衰竭可逆病因的认识。我们检索了1971年至2015年3月期间的MEDLINE和PubMed数据库，以查找报告低磷血症与心脏功能关系的原始研究。最初共获得837篇文章。根据纳入和排除标准，排除了其中826篇出版物。本综述共纳入11篇文章。这些文章包括7个病例系列或病例报告、1项病例对照研究、1项单组前后测研究以及2项动物研究。总之，据报道，低磷血症在心肌病中的机制是心肌细胞中三磷酸腺苷耗竭以及红细胞中2,3 -二磷酸甘油酸减少。纠正低磷血症后，重度低磷血症患者的左心室功能似乎有所改善，但轻度至中度低磷血症患者则不然。然而，尚未使用临床终点对心脏功能与低磷血症之间的关系进行分析。
