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白藜芦醇对稳定型冠心病患者的中心血流动力学参数和心肌缺血有积极影响。

Resveratrol has a positive effect on parameters of central hemodynamics and myocardial ischemia in patients with stable coronary heart disease.

作者信息

Chekalina Nataliya I

机构信息

Department of Propaedeutics of Internal Medicine With Care for Patients, General Practice (Family Medicine), Higher State Educational Establishment Of Ukraine "Ukrainian Medical Stomatological Academy", Poltava, Ukraine.

出版信息

Wiad Lek. 2017;70(2 pt 2):286-291.

Abstract

INTRODUCTION

Cardiovascular diseases, and primarily coronary heart disease (CHD), are the leading cause of mortality in the developing countries, including Ukraine. Prognosis for patients with CHD depends mainly on progression of coronary atherosclerosis (ASVD). Molecular mechanisms of atherogenesis are studied in detail in order to find new targets of pharmacological intervention.

THE AIM

to study the effect of resveratrol on parameters of central hemodynamics and myocardial ischemia in patients with stable coronary heart disease (CHD).

MATERIAL AND METHODS

The research involved 85 patients with CHD: stable angina pectoris, FC II, and 30 healthy individuals made up the control group. Patients with CHD were randomized into the research group (30 people) and the comparison group (55 people). Patients of the comparison group were prescribed the standard therapy (Β-blockers, statins, aspirin). Resveratrol at a dose of 100 mg per os daily was added to standard treatment of the patients of the research group. The day before randomization and 2 months after the prescribing therapy to the patients, echocardiography (echo) and 24 hour Holter ECG monitoring were made.

RESULTS

Diastolic dysfunction of the left ventricle (LV) in the form of violation of relaxation (type I) had been found in 100 % of patients with CHD. The 24 hour Holter ECG monitoring revealed episodes of myocardial ischemia (σt ST depr) (11.07+2.81 episodes a day), premature atrial contractions (PACs) and premature ventricular contractions (PVCs) in patients with stable CHD. After a two-month term of therapy in all patients with CHD, left ventricular systolic function in terms of ejection fraction (EF) of LV significantly improved (by 9.7 % in the research group and by 3.2 % in the comparison group). LV diastolic function improved in both groups in terms of the ratio of the phases of the transmitral flow E/A, dominating in the research group (р=0.004). DT value dropped significantly influenced by resveratrol (by 13 %), in the comparison group it didn`t change. In both groups IVRT significance decreased (р < 0.05). According to the 24 hour Holter ECG monitoring, in patients, additionally taking resveratrol, σt ST depr decreased by 45.9 %, that prevailed the result of the comparison group by 25.2 %. Under the influence of resveratrol, unlike in the comparison group, the number of PACs and PVCs was significantly reduced.

CONCLUSIONS

The data have shown cardioprotective properties of resveratrol and its applicability in the treatment of patients with CHD.

摘要

引言

心血管疾病,主要是冠心病(CHD),是包括乌克兰在内的发展中国家的主要死因。冠心病患者的预后主要取决于冠状动脉粥样硬化(ASVD)的进展。为了寻找新的药物干预靶点,对动脉粥样硬化的分子机制进行了详细研究。

目的

研究白藜芦醇对稳定型冠心病(CHD)患者中心血流动力学参数和心肌缺血的影响。

材料与方法

该研究纳入了85例冠心病患者:稳定型心绞痛,心功能II级,以及30名健康个体组成对照组。冠心病患者被随机分为研究组(30人)和比较组(55人)。比较组患者接受标准治疗(β受体阻滞剂、他汀类药物、阿司匹林)。研究组患者在标准治疗基础上每日口服100mg白藜芦醇。在随机分组前一天以及对患者进行治疗给药2个月后,进行超声心动图(echo)和24小时动态心电图监测。

结果

100%的冠心病患者存在以舒张功能障碍(I型)形式出现的左心室舒张功能障碍。24小时动态心电图监测显示稳定型冠心病患者存在心肌缺血发作(σt ST压低)(每天11.07 + 2.81次发作)、房性早搏(PACs)和室性早搏(PVCs)。在所有冠心病患者经过两个月的治疗后,左心室射血分数(EF)方面的左心室收缩功能显著改善(研究组提高了9.7%,比较组提高了3.2%)。两组左心室舒张功能在二尖瓣血流E/A比值方面均有改善,研究组更为明显(р = 0.004)。白藜芦醇显著影响DT值下降(下降13%),比较组则无变化。两组IVRT均有显著下降(р < 0.05)。根据24小时动态心电图监测,额外服用白藜芦醇的患者中,σt ST压低下降了45.9%,比比较组的结果高出25.2%。在白藜芦醇的影响下,与比较组不同,PACs和PVCs的数量显著减少。

结论

数据表明白藜芦醇具有心脏保护特性及其在冠心病患者治疗中的适用性。

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