Abraham R, Riemersma R A, Wood D, Elton R, Oliver M F
Cardiovascular Research Unit, University of Edinburgh, Scotland.
Am J Cardiol. 1989 Feb 1;63(5):269-72. doi: 10.1016/0002-9149(89)90328-7.
The relation between subcutaneous adipose tissue fatty acid composition and serious ventricular arrhythmias during acute myocardial infarction was studied in 2 groups of patients. In group 1 (n = 42), studied retrospectively, patients with ventricular fibrillation or tachycardia had a higher concentration of long-chain saturated fatty acids than those without (32.5 +/- 0.8% vs 29.7 +/- 0.4% [mean +/- standard error of the mean], p less than 0.01). In a prospective study, patients with arrhythmias (n = 106) had higher levels of long-chain saturated fatty acids (32.1 +/- 0.5% vs 30.7 +/- 0.4%, p less than 0.05) and of stearic acid (4.9 +/- 0.2% vs 4.4 +/- 0.1%, p less than 0.02) and a lower concentration of palmitoleic acid (7.3 +/- 0.3% vs 8.1 +/- 0.2%, p less than 0.005). When peak plasma creatine kinase concentrations were included with the individual fatty acid levels in a multiple logistic regression, only creatine kinase correlated significantly with ventricular arrhythmias (p less than 0.01). Thus, saturated fatty acids in cardiac membranes may lead to greater vulnerability to ventricular arrhythmias, although infarct size is the only statistically significant predictor after multiple regression analysis.
在两组患者中研究了急性心肌梗死期间皮下脂肪组织脂肪酸组成与严重室性心律失常之间的关系。在回顾性研究的第1组(n = 42)中,发生心室颤动或心动过速的患者长链饱和脂肪酸浓度高于未发生者(32.5±0.8%对29.7±0.4%[平均值±平均标准误差],p<0.01)。在一项前瞻性研究中,心律失常患者(n = 106)的长链饱和脂肪酸水平(32.1±0.5%对30.7±0.4%,p<0.05)和硬脂酸水平(4.9±0.2%对4.4±0.1%,p<0.02)较高,而棕榈油酸浓度较低(7.3±0.3%对8.1±0.2%,p<0.005)。当将血浆肌酸激酶峰值浓度与个体脂肪酸水平纳入多元逻辑回归时,只有肌酸激酶与室性心律失常显著相关(p<0.01)。因此,心脏膜中的饱和脂肪酸可能导致对室性心律失常的易感性增加,尽管在多元回归分析后梗死面积是唯一具有统计学意义的预测指标。