Yokoyama I, Ohtake T, Momomura S, Yonekura K, Nishikawa J, Sasaki Y, Omata M
Second Department of Internal Medicine, University of Tokyo, Japan.
J Am Coll Cardiol. 1998 Jun;31(7):1568-74. doi: 10.1016/s0735-1097(98)00166-1.
This study sought to investigate the specific role of hypertriglyceridemia in the myocardial hyperemic stress with dipyridamole/rest flow ratio (MDR).
Reduced MDR has been reported in hypercholesterolemic patients without evidence of ischemia. However, the specific role of hypertriglyceridemia in MDR has not been studied.
Fifteen nondiabetic normocholesterolemic hypertriglyceridemic patients and 13 age-matched control subjects were studied. Myocardial blood flow (MBF) during dipyridamole administration and baseline MBF in hypertriglyceridemic patients and control subjects were measured using positron emission tomography and nitrogen-13 ammonia, after which the MDR was calculated.
Baseline MBF (ml/min per 100 g heart weight) in hypertriglyceridemic patients (mean +/- SD 73.6 +/- 24.1) did not differ significantly from that in control subjects (81.6 +/- 37.2). MBF during dipyridamole loading in hypertriglyceridemic patients (198 +/- 106) was significantly reduced compared with that in control subjects (313 +/- 176, p < 0.05), as was the MDR (2.71 +/- 1.07 vs. 3.73 +/- 1.14, respectively, p < 0.05). Spearman rank-order correlation analysis showed a significant relation between plasma triglyceride concentration and MDR (r = -0.466, asymptotic SE 0.157, p = 0.0125); however, no such significant relation was seen between total plasma cholesterol concentration and MDR (r = -0.369, asymptotic SE 0.130, p = 0.059).
Impaired myocardial vasodilation was suggested in hypertriglyceridemic patients without symptoms and signs of ischemia.
本研究旨在探讨高甘油三酯血症在双嘧达莫负荷心肌充血应激与静息血流比值（MDR）中的具体作用。
已有报道称，在无缺血证据的高胆固醇血症患者中，MDR降低。然而，高甘油三酯血症在MDR中的具体作用尚未得到研究。
对15名非糖尿病、正常胆固醇水平的高甘油三酯血症患者和13名年龄匹配的对照受试者进行了研究。使用正电子发射断层扫描和氮-13氨测量双嘧达莫给药期间的心肌血流量（MBF）以及高甘油三酯血症患者和对照受试者的基础MBF，之后计算MDR。
高甘油三酯血症患者的基础MBF（每100克心脏重量每分钟毫升数）（均值±标准差73.6±24.1）与对照受试者（81.6±37.2）相比无显著差异。高甘油三酯血症患者在双嘧达莫负荷期间的MBF（198±106）与对照受试者（313±176，p<0.05）相比显著降低，MDR也降低（分别为2.71±1.07和3.73±1.14，p<0.05）。Spearman等级相关分析显示血浆甘油三酯浓度与MDR之间存在显著关系（r = -0.466，渐近标准误0.157，p = 0.0125）；然而，血浆总胆固醇浓度与MDR之间未观察到这种显著关系（r = -0.369，渐近标准误0.130，p = 0.059）。
在无症状和缺血体征的高甘油三酯血症患者中提示存在心肌血管舒张功能受损。
