Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA -
Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA.
Panminerva Med. 2017 Sep;59(3):230-240. doi: 10.23736/S0031-0808.17.03331-6. Epub 2017 May 12.
Few studies have been conducted to evaluate the effect of hypophosphatemia on cardiovascular consequences. The goal of this review was to determine whether hypophosphatemia is associated with cardiovascular consequences and to increase its awareness as a new clinical entity and a reversible cause of cardiovascular consequences.
We searched MEDLINE and PubMed through September 2016 for primary studies that reported the relationship between hypophosphatemia and cardiovascular consequences including cardiomyopathy and arrhythmia.
A total of 937 articles were initially obtained. Of these articles, 921 publications were excluded according to the inclusion and exclusion criteria. Sixteen articles were included in this review. These articles included 3 prospective cohort studies, 1 retrospective cohort study, 7 case series or case reports, 2 case-control studies, 1 pre- vs. post-test in a single group, and 2 animal studies.
The mechanisms of hypophosphatemia in cardiomyopathy and arrhythmia have been reported to be a depletion of adenosine triphosphate in myocardial cells and decreased 2,3-diphosphoglycerate in erythrocytes. Left ventricular performance seems to improve when severe hypophosphatemia is corrected, 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. The association between hypophosphatemia and arrhythmia remains unclear, but anecdotal reports exist in the literature.
鲜有研究评估低磷血症对心血管后果的影响。本综述的目的在于确定低磷血症是否与心血管后果相关，并提高对其作为一种新的临床实体和心血管后果的可逆转病因的认识。
我们检索了 MEDLINE 和 PubMed，截至 2016 年 9 月，以获取报告低磷血症与包括心肌病和心律失常在内的心血管后果之间关系的原始研究。
共获得 937 篇文章。根据纳入和排除标准，其中 921 篇文章被排除。共有 16 篇文章被纳入本综述。这些文章包括 3 项前瞻性队列研究、1 项回顾性队列研究、7 项病例系列或病例报告、2 项病例对照研究、1 项单组前后对照研究和 2 项动物研究。
据报道，低磷血症导致心肌病和心律失常的机制为心肌细胞中三磷酸腺苷耗竭以及红细胞中二磷酸甘油酸减少。严重低磷血症纠正后，左心室功能似乎得到改善，但在轻至中度低磷血症患者中则不然。然而，并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。低磷血症与心律失常之间的关联仍不清楚，但文献中存在一些个案报告。
