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高 ADMA 与因急性失代偿而住院的心力衰竭患者的健康状况恶化相关。

High ADMA Is Associated with Worse Health Profile in Heart Failure Patients Hospitalized for Episodes of Acute Decompensation.

机构信息

Department of Internal Medicine, Faculty of Medicine, "Vasile Goldiș" Western University of Arad, Bulevardul Revoluției 94, 310025 Arad, Romania.

Arad County Emergency Clinical Hospital, Str. Andrényi Károly Nr. 2-4, 310037 Arad, Romania.

出版信息

Medicina (Kaunas). 2024 May 15;60(5):813. doi: 10.3390/medicina60050813.

Abstract

: episodes of acute decompensation in chronic heart failure (ADHF), a common health problem for the growing elderly population, pose a significant socio-economic burden on the public health systems. Limited knowledge is available on both the endothelial function in and the cardio-metabolic health profile of old adults hospitalized due to ADHF. This study aimed to investigate the connection between asymmetric dimethylarginine (ADMA)-a potent inhibitor of nitric oxide-and key health biomarkers in this category of high-risk patients. : this pilot study included 83 individuals with a known ADHF history who were admitted to the ICU due to acute cardiac decompensation. Selected cardiovascular, metabolic, haemogram, renal, and liver parameters were measured at admission to the ICU. Key renal function indicators (serum creatinine, sodium, and potassium) were determined again at discharge. These parameters were compared between patients stratified by median ADMA (114 ng/mL). : high ADMA patients showed a significantly higher incidence of ischemic cardiomyopathy and longer length of hospital stay compared to those with low ADMA subjects. These individuals exhibited significantly higher urea at admission and creatinine at discharge, indicating poorer renal function. Moreover, their lipid profile was less favorable, with significantly elevated levels of total cholesterol and HDL. However, no significant inter-group differences were observed for the other parameters measured. : the present findings disclose multidimensional, adverse ADMA-related changes in the health risk profile of patients with chronic heart failure hospitalized due to recurrent decompensation episodes.

摘要

慢性心力衰竭(CHF)急性失代偿(ADHF)是老年人口中日益增长的常见健康问题,给公共卫生系统带来了重大的社会经济负担。关于 ADHF 住院老年患者的内皮功能和心脏代谢健康状况,我们的了解非常有限。本研究旨在探讨 ADHF 患者中不对称二甲基精氨酸(ADMA)——一种强效一氧化氮抑制剂——与关键健康生物标志物之间的联系。这项初步研究纳入了 83 名已知 ADHF 病史的患者,这些患者因急性心功能失代偿而入住 ICU。在入住 ICU 时测量了选定的心血管、代谢、血液学、肾脏和肝脏参数。在出院时再次测定了关键肾功能指标(血清肌酐、钠和钾)。并根据 ADMA 的中位数(114ng/mL)对患者进行分层,比较这些参数。与 ADMA 水平较低的患者相比,高 ADMA 患者的缺血性心肌病发生率更高,住院时间更长。这些患者在入院时的尿素和出院时的肌酐显著升高,表明肾功能更差。此外,他们的血脂谱也不理想,总胆固醇和高密度脂蛋白水平显著升高。然而,对于其他测量的参数,未观察到组间有显著差异。本研究结果揭示了慢性心力衰竭患者因反复失代偿发作而住院时,健康风险状况中存在多维的、不利的与 ADMA 相关的变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc34/11122814/f1b16758a072/medicina-60-00813-g001.jpg

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