评估与 ST 段抬高型心肌梗死（STEMI）患者左心室射血分数（LVEF）降低相关的代谢风险标志物。

Evaluation of cardiometabolic risk markers linked to reduced left ventricular ejection fraction (LVEF) in patients with ST-elevation myocardial infarction (STEMI).

机构信息

Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Department of Clinical Nutrition, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

出版信息

BMC Cardiovasc Disord. 2022 May 14;22(1):224. doi: 10.1186/s12872-022-02660-3.

DOI:10.1186/s12872-022-02660-3

PMID:35568801

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9107768/

Abstract

BACKGROUND

It is well established that left ventricular systolic dysfunction (LVSD), as marked by reduced left ventricular ejection fraction (LVEF), notably worsens the prognosis of ST-elevation myocardial infarction (STEMI). However, the link between cardiometabolic risk markers and LVSD seems unclear. This study aimed to investigate the differences in variables affecting reduced LVEF in STEMI patients.

METHODS

In the current retrospective study, 200 consecutive STEMI patients were enrolled between April 2016 to January 2017. Analysis of serum parameters, anthropometric evaluation, and echocardiography was performed after admission. The participants were categorized according to LVEF levels as follows: group1 (normal: 50-70%, n = 35), group2 (mildly reduced: 40-49%, n = 48); group3 (moderately reduced: 30-39%, n = 94) and group4 (severely reduced: < 30%, n = 23). Between-group comparisons were made using the Kruskal-Wallis test.

RESULTS

Overall, of 200 STEMI patients with a mean age of 62 years, 27%(n = 54) were females. The median of BMI of patients in group4 (31.07 kg/m) was significantly higher than group3 (26.35 kg/m), group2 (25.91 kg/m), and group1 (24.98 kg/m; P value < 0.0001). Group4 patients showed significantly increased fasting blood sugar (FBS) than groups 1 (212.00, vs. 139.00 mg/dl; P value = 0.040). Patients in groups 1 and 2 exerted significantly elevated triglyceride levels than those in group4 (142.00, 142.50, and 95.00 mg/dl; P value = 0.001). WBC count, neutrophil%, and neutrophil to lymphocyte ratio among those in group1 (10,200/m, 70.00%, and 2.92, respectively) were significantly lower than group4 (12,900/m, 83.00%, and 5.47, respectively; P value < 0.05).

CONCLUSION

These findings highlight higher BMI, FBS, and leucocyte count linked to LVSD, probably through increasing the inflammation and reducing LVEF levels. More extensive studies are needed to clarify the clinical relevance of these results.

摘要

背景

众所周知，左心室收缩功能障碍（LVSD）表现为左心室射血分数（LVEF）降低，显著恶化 ST 段抬高型心肌梗死（STEMI）的预后。然而，心脏代谢风险标志物与 LVSD 之间的联系似乎并不清楚。本研究旨在探讨影响 STEMI 患者左心室射血分数降低的变量差异。

方法

在本回顾性研究中，纳入了 2016 年 4 月至 2017 年 1 月期间的 200 例连续 STEMI 患者。入院后进行血清参数、人体测量评估和超声心动图分析。根据 LVEF 水平将参与者分为以下几组：组 1（正常：50-70%，n=35）、组 2（轻度降低：40-49%，n=48）；组 3（中度降低：30-39%，n=94）和组 4（严重降低：<30%，n=23）。使用 Kruskal-Wallis 检验进行组间比较。

结果

总体而言，200 名 STEMI 患者的平均年龄为 62 岁，其中 27%（n=54）为女性。组 4 患者的 BMI 中位数（31.07kg/m）明显高于组 3（26.35kg/m）、组 2（25.91kg/m）和组 1（24.98kg/m；P 值<0.0001）。组 4 患者的空腹血糖（FBS）明显高于组 1（212.00 与 139.00mg/dl；P 值=0.040）。组 1 和组 2 的患者的甘油三酯水平明显高于组 4（142.00、142.50 和 95.00mg/dl；P 值=0.001）。组 1 患者的白细胞计数（10200/m）、中性粒细胞%（70.00%）和中性粒细胞与淋巴细胞比值（2.92）明显低于组 4（12900/m、83.00%和 5.47；P 值<0.05）。