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冠状动脉狭窄程度与心功能及运动耐力的相关性

Correlations between coronary stenosis severity and cardiac function and exercise tolerance

  • 摘要:
    目的  探讨冠状动脉狭窄程度与心功能和运动耐力的相关性。
    方法  选择2024年10月至2025年1月入住复旦大学附属中山医院心内科行冠状动脉造影的患者112例。根据造影结果计算Gensini评分,并按照评分将患者分为轻度组(<20分,n=42)、中度组(20~40分,n=43)和重度组(>40分,n=27)。比较各组左心室射血分数(left ventricular ejection fraction, LVEF)、N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide, NT-proBNP)水平及NT-proBNP异常升高比例、6 min步行距离(6-minute walk distance, 6MWD)和握力等指标。通过多元线性回归分析评估Gensini评分与各指标的相关性。通过多因素二元logistic回归分析评估重度冠脉狭窄的影响因素。
    结果  重度组的6MWD、LVEF小于轻度组和中度组(P<0.01),NT-proBNP水平及其异常升高比例大于轻度组(P<0.05)。Gensini评分与6MWD负相关(β=−0.965,P<0.01),与NT-proBNP水平及其异常升高比例正相关(β=0.015,P<0.001;β=0.003,P=0.037)。6MWD和糖尿病是重度冠脉狭窄的独立相关因素(OR=0.956, P<0.001; OR=5.701, P=0.038)。
    结论  重度冠状动脉狭窄患者的心功能和运动耐力显著下降,6MWD可用于识别重度冠状动脉狭窄人群。

     

    Abstract:
    Objective To explore the correlations of the severity degrees of coronary stenosis with cardiac function and exercise tolerance.
    Methods  A total of 112 patients who underwent coronary angiography in Cardiology Department of Zhongshan Hospital, Fudan University between October 2024 and January 2025 were enrolled. According to the imaging results, the Gensini score was calculated, and the patients were divided into three groups based on the scores: mild group (<20 points, n=42), moderate group (20-40 points, n=43), and severe group (>40 points, n=27). The left ventricular ejection fraction (LVEF), N-terminal pro-brain natriuretic peptide (NT-proBNP) level and its abnormal elevation ratio, 6-minute walk distance (6MWD), and grip strength were compared among the groups. The correlations between Gensini score and various indicators were analyzed using multivariate linear regression. And the multivariate binary logistic regression analysis was used to analyze the related factors of severe coronary stenosis.
    Results  The 6MWD and LVEF values in the severe group were lower than those in the mild and moderate groups (P<0.01), while the NT-proBNP level and its abnormal elevation ratio in the severe group were higher than those in the mild group (P<0.05). The Gensini score was negatively correlated with 6MWD (β=−0.965, P<0.01), and positively correlated with NT-proBNP level and its abnormal elevation ratio (β=0.015, P<0.001; β=0.003, P=0.037). 6MWD and diabetes were independent related factors of severe coronary stenosis (OR=0.956, P<0.001; OR=5.701, P=0.038).
    Conclusions The cardiac function and exercise tolerance in patients with severe coronary stenosis decrease, 6MWD is helpful of recognizing severe coronary stenosis population.

     

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