Servicio de Cardiología, Complejo Hospitalario Universitario Insular Materno Infantil, Avd. Marítima del Sur s/n, 35016, Las Palmas de Gran Canaria, Spain.
Medical and Surgical Sciences Department, Facultad de Ciencias de la Salud, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain.
World J Urol. 2023 Oct;41(10):2839-2845. doi: 10.1007/s00345-023-04557-y. Epub 2023 Aug 8.
Crystalluria is a frequent finding in normal individuals and in patients suffering from urolithiasis. As nephrolithiasis has been associated with cardiovascular risk factors and most congenital heart disease (CHD) patients reach adulthood, the objective of this study is to determine the presence of crystalluria and if it influences their cardiovascular outcome.
Case-control and observational prospective study design of patients with CHD older than 14 years with a stable CHD verified with imaging tests and a control population.
214 patients with CHD [median age 21 (17-35) years and 41 (19%) males] and 345 controls were studied and followed up. None of them had symptoms of renal calculi. Nine (4%) patients with CHD and 24 (7%) patients in the control group showed crystalluria (p = 0.180), all of them composed of calcium oxalate. No significant differences were seen in age, sex, body mass index, CHD complexity, cardiovascular risk factors, NYHA functional class, cyanosis, and medical treatment between CHD patients with and without crystalluria. In relation to survival, 18 patients with CHD had a major acute cardiovascular event (MACE) (3 strokes, 2 myocardial infarction, 9 cardiovascular death and 4 non cardiovascular mortality) during the follow up time [7.3 (4.4-8.5) years] without significant differences in the Kaplan-Meier analysis (p = 0.358) between patients with and without crystalluria.
No significant differences were found between CHD and control patients in relation to crystalluria and it had no impact on the occurrence of cardiovascular events in the medium term follow up of patients with CHD.
结晶尿在正常个体和尿路结石患者中很常见。由于肾结石与心血管危险因素有关，且大多数先天性心脏病 (CHD) 患者都已成年，因此本研究的目的是确定结晶尿的存在情况，以及其是否会影响心血管结局。
采用病例对照和观察性前瞻性研究设计，纳入年龄大于 14 岁、经影像学检查证实存在稳定 CHD 的 CHD 患者和对照组人群。
共纳入 214 例 CHD 患者[中位数年龄 21（17-35）岁，41 例男性（19%）]和 345 例对照组，两组均无肾石病症状。9 例 CHD 患者（4%）和 24 例对照组患者（7%）出现结晶尿（p=0.180），均由草酸钙组成。两组间在年龄、性别、体重指数、CHD 严重程度、心血管危险因素、NYHA 心功能分级、发绀和药物治疗方面无显著差异。在生存方面，18 例 CHD 患者在随访期间发生重大急性心血管事件（MACE）（3 例脑卒中、2 例心肌梗死、9 例心血管死亡和 4 例非心血管死亡）[7.3（4.4-8.5）年]，Kaplan-Meier 分析未发现结晶尿患者与无结晶尿患者间存在差异（p=0.358）。
CHD 患者与对照组患者在结晶尿方面无显著差异，且在 CHD 患者的中期随访中，结晶尿对心血管事件的发生无影响。
