The role of plasma aminothiols in the prediction of coronary microvascular dysfunction and plaque vulnerability
The role of plasma aminothiols in the prediction of coronary microvascular dysfunction and plaque vulnerability
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DOI：
10.1016/j.atherosclerosis.2011.05.020
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发表时间：
2011-11-01
期刊：
影响因子：
5.3
通讯作者：
Samady, Habib
中科院分区：
文献类型：
--
作者：
Dhawan, Saurabh S.;Eshtehardi, Parham;Samady, Habib
背景：虽然氧化应激被认为是介导血管功能障碍和动脉粥样硬化发展的关键致病步骤，但它们之间的关联尚未在体内人体冠状动脉循环中得到评估。因此，我们假设较高的氧化应激与冠状动脉心外膜结构和微血管功能异常有关。方法：应用血管内超声（IVUS）测量47例心导管置入术患者的冠状动脉血流速度储备（CFVR）和充血微血管阻力（HMR）作为微血管功能指标，以及心外膜斑块体积和坏死核心。血浆谷胱甘肽、胱氨酸及其比值作为氧化应激的测量指标，而高敏c反应蛋白（hs-CRP）作为炎症的测量指标。结果：低谷胱甘肽，氧化应激增加的指标与微血管功能受损[CFVR （r = 0.39, p = 0.01）和HMR (r = -0.43, p = 0.004)]、斑块负担加重（r = -0.32, p = 0.03）和核心坏死（r = -0.39, p = 0.008）相关。同样，较高的胱氨酸/谷胱甘肽比值与微血管功能受损[CFVR (r = -0.29, p = 0.04)]和较大的坏死核心相关（r = 0.37, p = 0.01）。相比之下，较高的hs-CRP仅与较大的坏死核心相关（r = 0.45, p = 0.003）。在对年龄、性别、高血压、糖尿病、急性冠状动脉综合征表现、体重指数、吸烟、他汀类药物使用和hs-CRP进行多因素调整后，谷胱甘肽仍然是CFVR、HMR和核心坏死的独立预测因子（p < 0.05）。结论：较低的血浆谷胱甘肽水平是氧化应激增加的一个指标，是冠状动脉微血管功能受损和斑块核心坏死的独立预测因子。2011爱思唯尔爱尔兰有限公司版权所有。
Background: Although oxidative stress is considered a key pathogenic step in mediating vascular dysfunction and atherosclerosis development, their association has not been evaluated in human coronary circulation in vivo. Accordingly, we hypothesized that higher oxidative stress would be associated with abnormal coronary epicardial structure and microvascular function.Methods: We measured coronary flow velocity reserve (CFVR) and hyperemic microvascular resistance (HMR) as indices of microvascular function, and epicardial plaque volume and necrotic core using intravascular ultrasound (IVUS) in 47 patients undergoing cardiac catheterization. Plasma glutathione, cystine and their ratio served as measures of oxidative stress while high-sensitivity C-reactive protein (hs-CRP) served as a measure of inflammation.Results: Lower glutathione, a measure of increased oxidative stress was associated with impaired microvascular function [CFVR (r = 0.39, p = 0.01) and HMR (r = -0.43, p = 0.004)], greater plaque burden (r = -0.32, p = 0.03) and necrotic core (r = -0.39, p = 0.008). Similarly, higher cystine/glutathione ratio was associated with impaired microvascular function [CFVR (r = -0.29, p = 0.04)] and greater necrotic core (r = 0.37, p = 0.01). In comparison, higher hs-CRP was associated only with greater necrotic core (r = 0.45, p = 0.003). After multivariate adjustment for age, gender, hypertension, diabetes, acute coronary syndrome presentation, body mass index, tobacco abuse, statin use and hs-CRP, glutathione remained an independent predictor of CFVR, HMR and necrotic core (p < 0.05).Conclusions: Lower plasma glutathione level a measure of increased oxidative stress, was an independent predictor of impaired coronary microvascular function and plaque necrotic core. (C) 2011 Elsevier Ireland Ltd. All rights reserved.