Nartowicz Sonia Alicja, Gabriel Marcin, Janus Magdalena, Cieślewicz Artur, Malesza Katarzyna, Bartczak-Rutkowska Agnieszka, Lesiak Maciej, Trojnarska Olga
1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland.
Department of General and Vascular Surgery, Poznan University of Medical Sciences, Poznań, Poland.
Front Cardiovasc Med. 2025 Apr 28;12:1531136. doi: 10.3389/fcvm.2025.1531136. eCollection 2025.
Progress in cardiology has extended the lifespan of patients with congenital heart defects (CHD). Cyanotic patients are exposed to typical diseases of adulthood, including atherosclerosis. Rheological changes typical of cyanosis affect the vascular endothelium's function and may promote atherosclerosis development. We assessed the endothelial function and its relationship to biochemical parameters, particularly sphingosine-1-phosphate, in cyanotic CHD patients.
A cross-sectional study including 36 adult CHD cyanotic patients [(12 males) (39 median, 19-73 years)] with arterial blood oxygen saturation less than 92% and 30 healthy controls [(11 males) (38.5 median, 26-59 years)] was performed. All patients underwent clinical examination, blood sampling, and ultrasonography, during which endothelial function was assessed using intima-media thickness (IMT) and flow-mediated dilatation (FMD).
We did not demonstrate any difference between CHD patients and the control group in the IMT complex and FMD. Patients with cyanosis are characterized by higher S1P serum levels ( = 0.04), lower ApoM ( = 0.04), and HDL concentrations ( = 0.02). Only FMD correlated positively with HDL cholesterol ( = 0.02) concentration. The IMT complex correlates positively only with BMI ( = 0.04). No factor was statistically significant in the multiple logistic regression model for FMD <6.5%.
The values of the analyzed biochemical and clinical factors (except for the reduced HDL fraction), the lack of inflammatory factor activity, and the increased S1P concentration indicate the dominance of antiatherosclerotic activity in this population. FMD and IMT are preserved, which suggests that the risk of early atherosclerotic changes in this group is comparable to the remaining population.
心脏病学的进展延长了先天性心脏病（CHD）患者的寿命。患有紫绀型心脏病的患者易患成年期典型疾病，包括动脉粥样硬化。紫绀典型的血液流变学变化会影响血管内皮功能，并可能促进动脉粥样硬化的发展。我们评估了紫绀型CHD患者的内皮功能及其与生化参数（尤其是1-磷酸鞘氨醇）的关系。
进行了一项横断面研究，纳入36例成年紫绀型CHD患者（12例男性，年龄中位数39岁，范围19 - 73岁），其动脉血氧饱和度低于92%，以及30例健康对照者（11例男性，年龄中位数38.5岁，范围26 - 59岁）。所有患者均接受临床检查、血液采样和超声检查，在此期间使用内膜中层厚度（IMT）和血流介导的血管舒张（FMD）评估内皮功能。
我们未发现CHD患者与对照组在IMT综合指标和FMD方面存在任何差异。紫绀患者的特征是血清S1P水平较高（P = 0.04）、载脂蛋白M较低（P = 0.04）以及高密度脂蛋白（HDL）浓度较低（P = 0.02）。仅FMD与HDL胆固醇浓度呈正相关（P = 0.02）。IMT综合指标仅与体重指数呈正相关（P = 0.04）。在FMD <6.5%的多因素逻辑回归模型中，没有因素具有统计学意义。
所分析的生化和临床因素的值（除HDL组分降低外）、炎症因子活性缺乏以及S1P浓度升高表明该人群中抗动脉粥样硬化活性占主导。FMD和IMT得以保留，这表明该组早期动脉粥样硬化改变的风险与其余人群相当。
