Department of Nephrology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China.
Department of Cardiology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China.
BMC Cardiovasc Disord. 2020 Jan 30;20(1):40. doi: 10.1186/s12872-020-01326-2.
Endothelial dysfunction may play a key role in non-obstructive coronary artery atherosclerosis. Our study aimed to evaluate the vascular endothelial function and its influencing factors in patients with non-obstructive coronary artery atherosclerosis.
A total of 131 consecutive patients with non-obstructive coronary artery atherosclerosis were enrolled. Flow-mediated dilatation (FMD) was measured at baseline and 1-year follow-up. Endothelial progenitor cells (EPCs) were counted by staining the fasting venous blood with antibodies against CD34 and vascular endothelial growth factor receptor 2.
Systolic blood pressure, pulse pressure and the levels of HbA1c in participants with baseline FMD < 6% (n = 65) were significantly higher than those with baseline FMD ≥ 6% (n = 66). Baseline FMD was negatively associated with EPC counts (r = - 0.199, P < 0.05) and systolic blood pressure (r = - 0.315, P < 0.01). The 1-year FMD was significantly increased compared to the baseline FMD [(9.31 ± 5.62) % vs (7.31 ± 5.26) %, P < 0.001]. Independent predictors of FMD improvement included elevated EPC counts (OR = 1.104, 95% CI: 1.047-1.165, P < 0.001) and decreased levels of serum creatinine (OR = 0.915, 95% CI: 0.843-0.993, P = 0.034).
Family history of premature cardiovascular diseases, hypertension, elevated systolic pressure, and HbA1c > 6.5% are independent risk factors for endothelial dysfunction in non-obstructive atherosclerotic patients. Elevated peripheral blood EPC counts and decreased levels of serum creatinine are independent predictors of endothelial function improvement.
内皮功能障碍可能在非阻塞性冠状动脉粥样硬化中起关键作用。我们的研究旨在评估非阻塞性冠状动脉粥样硬化患者的血管内皮功能及其影响因素。
共纳入 131 例连续的非阻塞性冠状动脉粥样硬化患者。在基线和 1 年随访时测量血流介导的扩张（FMD）。通过用针对 CD34 和血管内皮生长因子受体 2 的抗体对空腹静脉血进行染色来计数内皮祖细胞（EPC）。
在基线 FMD<6%（n=65）的患者中，收缩压、脉压和 HbA1c 水平明显高于基线 FMD≥6%（n=66）的患者。基线 FMD 与 EPC 计数呈负相关（r=-0.199，P<0.05），与收缩压呈负相关（r=-0.315，P<0.01）。与基线 FMD 相比，1 年 FMD 显著增加[（9.31±5.62）%比（7.31±5.26）%，P<0.001]。FMD 改善的独立预测因素包括 EPC 计数升高（OR=1.104，95%CI：1.047-1.165，P<0.001）和血清肌酐水平降低（OR=0.915，95%CI：0.843-0.993，P=0.034）。
早发心血管疾病家族史、高血压、收缩压升高和 HbA1c>6.5%是非阻塞性动脉粥样硬化患者内皮功能障碍的独立危险因素。外周血 EPC 计数升高和血清肌酐水平降低是内皮功能改善的独立预测因素。
