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慢性冠状动脉综合征中的尿酸:与冠状动脉疾病严重程度和左心室舒张参数的关系。

Uric acid in chronic coronary syndromes: Relationship with coronary artery disease severity and left ventricular diastolic parameter.

机构信息

Cardiology IV, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy; School of Medicine and Surgery, Milano-Bicocca University, Milan, Italy.

Cardiology I, "A.De Gasperis" Department, Ospedale Niguarda Ca' Granda, Milan, Italy.

出版信息

Nutr Metab Cardiovasc Dis. 2021 May 6;31(5):1501-1508. doi: 10.1016/j.numecd.2021.01.023. Epub 2021 Feb 6.

Abstract

BACKGROUND AND AIMS

Uric Acid (UA) has been related to the development of Cardio-Vascular (CV) events in patients affected by Chronic Coronary Syndromes (CCS). Among various hypothesis, two arise: UA may negatively act on coronary artery determining a higher degree of atherosclerotic disease, and/or on heart determining a higher prevalence of diastolic dysfunction. Both the above hypothesized effects are object of our investigation.

METHODS AND RESULTS

231 patients who were admitted to the cardiological department of the Niguarda Hospital (Milan, Italy) for CCS from January 2017 to June 2018 were enrolled. Coronary atherosclerotic burden was evaluated from coronary angiography as the number and type of involved vessels, as well as with both Gensini and Syntax scores. All subjects underwent a complete echocardiogram. At unadjusted and adjusted/multivariable analysis, UA levels were not significantly associated with variables analysed from the coronary angiography (number and type of vessels involved, neither the Gensini and Syntax scores) as well as with echocardiographic parameters regarding systolic and diastolic function.

CONCLUSIONS

In conclusion, the main finding of our work is the absence of a role for UA in determining coronary arteries disease as well as LV diastolic dysfunction in CCS subjects. Taking together the results of previous studies with ours, we hypothesize that UA could act on heart (both on coronary arteries and on LV function) in an early phase of the disease, whereas while in the advanced stages other factors (previous myocardial infarction, previous myocardial revascularization and so on) may overshadow its effects.

摘要

背景与目的

尿酸(UA)与患有慢性冠状动脉综合征(CCS)的患者心血管(CV)事件的发展有关。在各种假设中,有两个出现:UA 可能对冠状动脉产生负面影响,导致更严重的动脉粥样硬化疾病,和/或对心脏产生负面影响,导致舒张功能障碍的发生率更高。上述两个假设的影响都是我们研究的对象。

方法和结果

2017 年 1 月至 2018 年 6 月,共有 231 名患者因 CCS 入住意大利米兰 Niguarda 医院的心脏病科。通过冠状动脉造影评估冠状动脉粥样硬化负担,包括受累血管的数量和类型,以及 Gensini 和 Syntax 评分。所有患者均接受了完整的超声心动图检查。在未调整和调整/多变量分析中,UA 水平与冠状动脉造影分析的变量(受累血管的数量和类型,Gensini 和 Syntax 评分)以及收缩和舒张功能的超声心动图参数均无显著相关性。

结论

总之,我们工作的主要发现是 UA 在确定 CCS 患者的冠状动脉疾病和 LV 舒张功能障碍方面没有作用。结合我们之前的研究结果,我们假设 UA 在疾病的早期阶段可能对心脏(包括冠状动脉和 LV 功能)起作用,而在晚期阶段,其他因素(先前的心肌梗死、先前的心肌血运重建等)可能会掩盖其作用。

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