Hiki Masaru, Kasai Takatoshi, Sato Akihiro, Ishiwata Sayaki, Yatsu Shoichiro, Shitara Jun, Matsumoto Hiroki, Shimizu Megumi, Murata Azusa, Kato Takao, Suda Shoko, Daida Hiroyuki
Department of Cardiovascular Biology and Medicine, Juntendo University School of Medicine, 113-8421 Tokyo, Japan.
Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, 113-8421 Tokyo, Japan.
Rev Cardiovasc Med. 2025 Mar 19;26(3):28160. doi: 10.31083/RCM28160. eCollection 2025 Mar.
Interactions between the heart and other organs have been a focus in acute decompensated heart failure (ADHF). However, the association between ADHF and pancreatic exocrine insufficiency (PEI), which may lead to malnutrition, remains unclear. We investigated the relationship between exocrine pancreatic enzymes and ADHF.
We enrolled 155 and 46 patients with and without ADHF, respectively. Serum amylase and lipase levels were compared between the two groups. In the ADHF group, factors correlating with serum amylase or lipase levels were assessed using multiple regression analysis, and changes in their levels throughout the hospital course were determined.
Patients with ADHF exhibited significantly lower amylase and lipase levels. In the same group, the significant independent correlates of lower amylase levels included a lower blood urea-nitrogen level (partial correlation coefficient, 0.530; < 0.001), lower albumin level (partial correlation coefficient, 0.252; = 0.015), and higher uric acid level (partial correlation coefficient, -0.371; < 0.001). The significant independent correlates of lower lipase levels included coexisting atrial fibrillation (coefficient, 0.287; = 0.026), lower creatinine level (coefficient, 0.236; = 0.042), and higher B-type natriuretic peptide level (coefficient, -0.257; = 0.013). Both amylase and lipase levels significantly increased following the improvement in ADHF.
In patients with ADHF, decreased serum amylase and lipase levels were associated with the congestion severity, suggesting that PEI may occur in patients with ADHF, potentially due to ADHF-related congestion.
心脏与其他器官之间的相互作用一直是急性失代偿性心力衰竭（ADHF）的研究重点。然而，ADHF与可能导致营养不良的胰腺外分泌功能不全（PEI）之间的关联仍不明确。我们研究了胰腺外分泌酶与ADHF之间的关系。
我们分别纳入了155例和46例患有和未患有ADHF的患者。比较了两组患者的血清淀粉酶和脂肪酶水平。在ADHF组中，使用多元回归分析评估与血清淀粉酶或脂肪酶水平相关的因素，并确定其在整个住院过程中的水平变化。
ADHF患者的淀粉酶和脂肪酶水平显著降低。在同一组中，淀粉酶水平降低的显著独立相关因素包括较低的血尿素氮水平（偏相关系数，0.530；<0.001）、较低的白蛋白水平（偏相关系数，0.252；=0.015）和较高的尿酸水平（偏相关系数，-0.371；<0.001）。脂肪酶水平降低的显著独立相关因素包括并存心房颤动（系数，0.287；=0.026）、较低的肌酐水平（系数，0.236；=0.042）和较高的B型利钠肽水平（系数，-0.257；=0.013）。随着ADHF的改善，淀粉酶和脂肪酶水平均显著升高。
在ADHF患者中，血清淀粉酶和脂肪酶水平降低与充血严重程度相关，提示ADHF患者可能发生PEI，这可能与ADHF相关的充血有关。
