肺动脉高压高地人心肌损伤的临床分析

IF 1.6 4区 医学 Q4 BIOPHYSICS High altitude medicine & biology Pub Date : 2024-09-01 Epub Date: 2024-06-20 DOI:10.1089/ham.2023.0075
Maolin Zhao, Qianjin Wu, Wangsheng Duanmu, Junxian Shen, Weixin Yuan, Yingbin Sun, Xu Zhang, Jinbao Zhang, Siyi He
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引用次数: 0

摘要

背景:肺动脉高压(PH)是高海拔环境中普遍存在的不良心血管事件。长期暴露在高海拔地区可能会导致心肌损伤,而心肌损伤与不良的临床预后有关。本研究旨在探讨高海拔地区 PH 患者心肌损伤的临床特征。研究方法本回顾性研究选取了在海拔 3,650 米的一家综合性三级医院住院的连续患者。收集临床和生化数据,并根据心肌肌钙蛋白 I(cTnI)和超声心动图将患者分为心肌损伤组和非心肌损伤组。结果共纳入 231 名患者,其中 29 人(12.6%)有心肌损伤。我们发现,心肌损伤组的体重指数、左室舒张末期尺寸和血清肌酸激酶-MB(CK-MB)水平明显高于非心肌损伤组。斯皮尔曼相关性分析显示,cTnI 与 CK-MB 和乳酸脱氢酶而非天冬氨酸氨基转移酶呈显著正相关。绘制的接收器操作特征曲线显示,CK-MB 能显著预测心肌损伤的发生,曲线下面积为 0.749,3.035(灵敏度 = 59.3%,特异性 = 90.5%)是最佳的临界值。结论患有 PH 的高原人心肌损伤的发生率很高。研究发现,CK-MB 作为一种方便有效的标记物,与 cTnI 密切相关,可预测高海拔地区 PH 患者心肌损伤的发生。
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Clinical Analysis of Myocardial Injury in Highlanders with Pulmonary Hypertension.

Background: Pulmonary hypertension (PH) is a prevalent adverse cardiovascular event at high-altitude environments. Prolonged exposure to high altitudes may result in myocardial injury, which is associated with poor clinical outcomes. This study aims to investigate the clinical characteristics of myocardial injury in patients with PH at high altitude. Methods: Consecutive patients admitted to a general tertiary hospital at the altitude of 3,650 m were selected into this retrospective study. Clinical and biochemical data were collected, as well as based on cardiac troponin I (cTnI) and echocardiography, patients were divided into myocardial injury group and non-myocardial injury group. Results: A total of 231 patients were enrolled, among whom 29 (12.6%) had myocardial injury. We found that body mass index, left ventricular end-diastolic dimension, and serum level of creatine kinase-MB (CK-MB) in myocardial injury group were significantly higher than non-myocardial injury group. Spearman correlation analysis revealed that cTnI has a significant positive correlation with CK-MB and lactic dehydrogenase instead of aspartate aminotransferase. A receiver operating characteristic curve was drawn to demonstrate that CK-MB could significantly predict the occurrence of myocardial injury with an area under the curve of 0.749, and a level of 3.035 (sensitivity = 59.3%, specificity = 90.5%) was optimal cutoff value. Conclusion: The incidence of myocardial injury in highlanders with PH is significant. CK-MB, as a convenient and efficient marker, has been found to be closely associated with cTnI and plays a predictive role in the occurrence of myocardial injury with PH in individuals exposed to high altitude.

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来源期刊
High altitude medicine & biology
High altitude medicine & biology 医学-公共卫生、环境卫生与职业卫生
CiteScore
3.80
自引率
9.50%
发文量
44
审稿时长
>12 weeks
期刊介绍: High Altitude Medicine & Biology is the only peer-reviewed journal covering the medical and biological issues that impact human life at high altitudes. The Journal delivers critical findings on the impact of high altitude on lung and heart disease, appetite and weight loss, pulmonary and cerebral edema, hypertension, dehydration, infertility, and other diseases. It covers the full spectrum of high altitude life sciences from pathology to human and animal ecology.
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