Nasonova Research Institute of Rheumatology, Moscow, Russia.
Dokl Biochem Biophys. 2024 Aug;517(1):148-155. doi: 10.1134/S1607672924700881. Epub 2024 Jun 10.
The frequency and risk factors for the development of diastolic dysfunction (DD) in patients with CPPD and OA have not been studied. The objective of this study was to determine the frequency and identify risk factors (RF) for the development of DD of the left and right ventricles (LV and RV) in patients with calcium pyrophosphate crystal deposition disease (CPPD) and osteoarthritis (OA). The study included 26 patients with CPPD and with knee OA 18-65 years old, matched in age and gender, without cardiovascular disease (CVD), type 2 diabetes mellitus (DM2), and rheumatic diseases. Conventional risk factors (TRF) of CVD were assessed, and echocardiography was performed. The frequency of DD in patients with CPPD and OA was quite high and almost did not differ in both groups: it was detected in 19 patients, of which 11 (42%) had CPPD and 8 (31%) had OA (p = 0.39). Type 1 LV DD was detected in 10 (39%) patients with CPPD and in 8 (31%) with OA (p = 0.11); type 1RV DD was detected in 8 (31%) patients with CPPD and in 7 (27%) patients with OA (p = 0.17); and type 1 LV DD and RV DD was detected in 7 (27%) patients with both CPPD and with OA. DD types 2 and 3 were not detected in both groups. There were no differences in both groups in CV risk factors, except for the level of CRP (it was higher in CPPD) (p = 0.03). In the CPPD group, mean values of LV E/E' (p = 0.02), LVDT (p = 0.03), LVMI (p = 0.04) were significantly higher than in patients with OA. On the contrary, in patients with OA, indices EDV (p = 0.004) and TVC (p = 0.02) were higher. There were direct correlations between diastolic function indices and the following factors in CPPD: LVL, PWLV and PTH level (r = 0.7, p <0.005), LV E' and PTH level (r = 0.7, p < 0.005). Inverse correlations were found between the level of PTH and IS (r = -0.5, p < 0.005), LVMI (r = -0.5, p < 0.005), and the level of vitamin D and VDDT (r = -0.6, p < 0.005). Direct correlations in OA were found between the level of CRP and PVAdiast (r = 0.6, p < 0.005), and the level of sUA (r = 0.7, p < 0.005), and the level of vitamin D and E/E'LV (r = 0.6, p < 0.005). A high prevalence of LV and RV DD was found in patients with CPPD and OA. The presence of DD in CPPD was associated with lower vitamin D levels, and in OA with a higher level of sUA and a lower level of PTH.
CPPD 和 OA 患者舒张功能障碍（DD）的发生频率和危险因素尚未研究。本研究的目的是确定 CPPD 和骨关节炎（OA）患者左、右心室（LV 和 RV）DD 的发生频率，并确定其危险因素（RF）。研究纳入了 26 例 CPPD 合并膝 OA 的患者，年龄和性别相匹配，无心血管疾病（CVD）、2 型糖尿病（DM2）和风湿性疾病。评估了 CVD 的常规危险因素（TRF），并进行了超声心动图检查。CPPD 和 OA 患者的 DD 发生率相当高，两组之间几乎没有差异：19 例患者中检测到 DD，其中 11 例（42%）为 CPPD，8 例（31%）为 OA（p = 0.39）。CPPD 患者中有 10 例（39%）出现 1 型 LV DD，8 例（31%）出现 OA（p = 0.11）；CPPD 患者中有 8 例（31%）出现 1 型 RV DD，7 例（27%）出现 OA（p = 0.17）；7 例 CPPD 患者和 7 例 OA 患者均出现 1 型 LV DD 和 RV DD。两组均未发现 DD 类型 2 和 3。两组在 CV 危险因素方面无差异，除 CRP 水平（CPPD 较高）（p = 0.03）外。CPPD 组的 LV E/E'平均值（p = 0.02）、LVDT（p = 0.03）和 LVMI（p = 0.04）明显高于 OA 患者。相反，OA 患者的 EDV（p = 0.004）和 TVC（p = 0.02）指数较高。CPPD 患者的舒张功能指标与以下因素呈直接相关：LVL、PWLV 和 PTH 水平（r = 0.7，p <0.005）、LV E'和 PTH 水平（r = 0.7，p <0.005）。CPPD 患者中发现 PTH 水平与 IS（r = -0.5，p <0.005）、LVMI（r = -0.5，p <0.005）和维生素 D 水平与 VDDT（r = -0.6，p <0.005）呈负相关。OA 中发现 CRP 水平与 PVAdiast（r = 0.6，p <0.005）和 sUA 水平（r = 0.7，p <0.005）呈正相关，维生素 D 水平与 E/E'LV 呈正相关（r = 0.6，p <0.005）。CPPD 和 OA 患者的 LV 和 RV DD 发生率较高。CPPD 中 DD 的存在与较低的维生素 D 水平有关，而在 OA 中与较高的 sUA 水平和较低的 PTH 水平有关。
Zotero 插件