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原发性痛风患者家族史与左心室舒张功能的关联:一项横断面研究。

Association Between Family History in Patients with Primary Gout and Left Ventricular Diastolic Function: A Cross-Sectional Study.

作者信息

Wen Wen, Lei Ping, Dang Wantai, Ma Liwen, Hu Jing, Liu Jian

机构信息

Department of Ultrasound, First Affiliated Hospital, Clinical Medical College of Chengdu Medical College, Chengdu, People's Republic of China.

Department of Rheumatology, First Affiliated Hospital, Clinical Medical College of Chengdu Medical College, Chengdu, People's Republic of China.

出版信息

Int J Gen Med. 2024 Apr 3;17:1311-1322. doi: 10.2147/IJGM.S450951. eCollection 2024.

Abstract

OBJECTIVE

This study aimed to employ echocardiography for measuring the markers of left ventricular (LV) diastolic function to investigate the effects of family history of gout on the LV diastolic function in patients with primary gout.

METHODS

Two hundred and eighty-four patients with primary gout who visited the Department of Rheumatology and Immunology of the First Affiliated Hospital of Chengdu Medical College from September 2020 to July 2022 were selected and their family history of gout, general information, and laboratory markers were recorded. Parameters of LV diastolic function were measured via echocardiography. The correlation between family history and LV diastolic function markers was analyzed using univariate and multivariate regression and the receiver operating characteristic (ROC) curve analyses.

RESULTS

LV diastolic function parameters, peak early mitral diastolic velocity (E)/peak late mitral diastolic velocity (A), and early septal mitral annulus diastolic motion velocity (Sepe'), early lateral mitral annulus diastolic motion velocity (Late') and their mean (e'), were significantly lower in patients with familial primary gout, while left atrial volume index (LAVI) and E/e' were markedly elevated in patients with sporadic primary gout. In patients with family history, the proportion of grade ≥2 LV diastolic insufficiency was distinctly higher than that in patients without family history (41.6% vs 12.3%). Even after adjusting for confounding variables, LAVI, E/A, Sepe', Late', e', E/e' were obviously associated with family history of gout. The area under ROC of family history combined with SUA level for identifying grade ≥2 LV diastolic insufficiency in patients with primary gout was 0.872 (<0.05).

CONCLUSION

Family history of gout was closely related to echocardiographic LV diastolic function parameters in patients with gout, what is more, family history of gout combined with SUA level was found to be a valuable indicator for discriminating grade ≥2 LV diastolic insufficiency in patients with primary gout.

摘要

目的

本研究旨在采用超声心动图测量左心室(LV)舒张功能指标,以探讨痛风家族史对原发性痛风患者左心室舒张功能的影响。

方法

选取2020年9月至2022年7月在成都医学院第一附属医院风湿免疫科就诊的284例原发性痛风患者,记录其痛风家族史、一般资料及实验室指标。通过超声心动图测量左心室舒张功能参数。采用单因素和多因素回归分析以及受试者工作特征(ROC)曲线分析痛风家族史与左心室舒张功能指标之间的相关性。

结果

家族性原发性痛风患者的左心室舒张功能参数,即二尖瓣舒张早期峰值速度(E)/二尖瓣舒张晚期峰值速度(A)、二尖瓣环间隔侧舒张早期运动速度(Sepe')、二尖瓣环外侧舒张早期运动速度(Late')及其平均值(e')显著降低,而散发性原发性痛风患者的左心房容积指数(LAVI)和E/e'明显升高。有家族史的患者中,左心室舒张功能不全≥2级的比例明显高于无家族史的患者(41.6%对12.3%)。即使在调整混杂变量后,LAVI、E/A、Sepe'、Late'、e'、E/e'仍与痛风家族史明显相关。痛风家族史联合血清尿酸水平用于识别原发性痛风患者左心室舒张功能不全≥2级的ROC曲线下面积为0.872(<0.05)。

结论

痛风家族史与痛风患者超声心动图左心室舒张功能参数密切相关,此外,痛风家族史联合血清尿酸水平是鉴别原发性痛风患者左心室舒张功能不全≥2级的有价值指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7865/10999183/8a64035356ea/IJGM-17-1311-g0001.jpg

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