JAHA:系统性右心室和心脏移植后先天性心脏病的低鼻NO

2017-12-12 xiangting MedSci原创

CHD患者低nNO的患病率高,系统性右心室和心脏移植的几率最高。

先天性心脏病(CHD)中的NO生物利用度尚没有系统进行探讨过。为了评估CHD患者的NO,考虑到血NO很难测量(半衰期<2 ms),研究人员测量了鼻腔上皮细胞产生的鼻NO(nNO)。鉴于NO在血流动力学调节中的作用以及NO生物利用度与心衰风险的相关性,研究人员假设NO水平可能随CHD生理特征的不同严重程度而不同。

共有618名受试者,483名CHD患者和135名对照。使用美国胸科学会/欧洲呼吸学会指南通过鼻孔非侵入性测量nNO。根据年龄特异性阈值将受试者二分为低nNO或正常nNO。通过不同CHD生理特征类型分析了低nNO的患病率。

CHD患者的低nNO比对照更为普遍(比值比 2.28; P = 0.001)。logistic回归模型显示单心室、系统性右心室、心室功能障碍、氧饱和度降低和内脏异位预测低nNO具有整体显著性(P=0.035),系统性右心室低nNO的几率为两倍(比值比2.04; P = 0.014)。低nNO患者发生心脏移植或死亡的风险较高(危险比为2.75; P = 0.048),心脏移植受体(n = 16)的低nNO几率为5倍(69%vs.30%,比值比,5.1; P = 0.001)。

CHD患者低nNO的患病率高,系统性右心室和心脏移植的几率最高。需要进一步的研究来探讨具有左右心室生理特征CHD患者的心衰风险,以及低nNO预测心衰风险的效用。

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    2017-12-14 zhaohui6731
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    2017-12-14 huirong
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