血液透析患者左心室舒张功能障碍的决定因素

Q4 Medicine Journal of Nephropathology Pub Date : 2022-09-03 DOI:10.34172/jnp.2022.18393
D. Dragoș, D. Timofte, D. Ionescu, Andra-Elena Balcangiu-Stroescu, Maria Iuliana Ghenu, I. A. Vacaroiu, M. Manea
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摘要

引言:慢性肾脏疾病(CKD)引起心肌的变化,已知会影响发病率和死亡率,在终末期肾病患者中最为严重。目的:工作假设是,在慢性血液透析患者中,左心室舒张功能障碍的发生率与炎症、氧化、代谢、营养和动脉粥样硬化状态相关。患者和方法:对51名接受血液透析治疗的患者(年龄59.76±13.24岁)进行观察性研究。经胸心脏超声检查评估LVDD。通过心脏超声(主动脉和二尖瓣钙化)、血管超声(颈动脉和股动脉粥样硬化斑块、颈总动脉内膜-中层厚度)和腹部放射学(主动脉钙化评分)评估心脏和动脉动脉粥样硬化的负担。确定了人口统计学和人体测量参数。血液样本用于确定反映炎症、氧化和代谢/营养状况的实验室参数。结果:LVDD与血清C反应蛋白(CRP)水平(P=0.04)、血清总抗氧化能力(P=0.04,主动脉瓣环钙化(P=0.02)和二尖瓣钙化(P=0.041)。在去除主要混杂因素退行性主动脉狭窄后,只有与血清总抗氧化能力(P=0.04)和主动脉钙化评分(P=0.02)的相关性保持其统计学意义。结论:LVDD与炎症和氧化应激标志物以及主动脉钙化的严重程度呈正相关。
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Determinants of left ventricular diastolic dysfunction in hemodialysis patients
Introduction: Chronic kidney disease (CKD) induces changes in the myocardium known to influence morbidity and mortality, most severe in patients with end stage renal disease. Objectives: The working hypothesis was that in patients on chronic hemodialysis the prevalence of left ventricular diastolic dysfunction is correlated with the inflammatory, oxidative, metabolic, nutritional, and atherosclerotic status. Patients and Methods: An observational study was performed on 51 patients (age 59.76 ± 13.24 years) on hemodialysis treatment. Transthoracic cardiac ultrasound was conducted to evaluate LVDD. The burden of cardiac and arterial atherosclerosis was evaluated by cardiac ultrasound (aortic and mitral valve calcifications), vascular ultrasound (carotid and femoral atheroma plaques, common carotid intima-media thickness), and by abdominal radiography (aortic calcification score). Demographic and anthropometric parameters were determined. Blood samples were used to determine laboratory parameters reflecting the inflammatory, oxidative, and metabolic/nutrition status. Results: LVDD is positively correlated with the serum level of C-reactive protein (CRP) (P=0.04), the total antioxidant capacity of the serum (P=0.04), the presence (P=0.022) and number (P=0.04) of femoral plaques, the aortic calcification score (P=0.02), aortic valve stenosis (P=0.037), aortic annulus calcifications (P=0.02) and mitral valve calcifications (P=0.041). After the removal of the main confounder, degenerative aortic stenosis, only the associations with serum total antioxidant capacity (P=0.04) and aortic calcification score (P= 0.02) maintain their statistical significance. Conclusion: LVDD is positively correlated with inflammation and oxidative stress markers and with the severity of aortic calcification.
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来源期刊
Journal of Nephropathology
Journal of Nephropathology Medicine-Nephrology
CiteScore
1.30
自引率
0.00%
发文量
35
期刊最新文献
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