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在患有催乳素瘤的男性中,胸腔积液增加是最显著的心血管血流动力学改变。

Increased Thoracic Fluid as the Most Distinctive Cardiovascular Hemodynamic Alteration in Men with Prolactinoma.

机构信息

Department of Cardiology and Internal Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland.

Department of Internal Medicine, Endocrinology and Diabetes, Medical University of Warsaw, 03-242 Warsaw, Poland.

出版信息

Nutrients. 2022 Dec 17;14(24):5369. doi: 10.3390/nu14245369.

Abstract

Hyperprolactinemia in males with prolactin-secreting adenomas, or prolactinomas, may be associated with endothelial dysfunction and co-existing cardiovascular risk factors. As a noninvasive technique of assessing cardiac function, impedance cardiography (ICG) may be useful in the early detection of hemodynamic dysfunction. The aim of the present study was to analyze and compare the hemodynamic profiles of patients with prolactinoma versus controls. A total of 20 men with prolactinoma (PR group) (mean age 43 years) and 20 men from the control group (CG) were evaluated in this prospective, observational comparative clinical study. The study subjects were propensity score-matched in terms of clinical characteristics—age, mean blood pressure [MBP], arterial hypertension [AH] rates, and body mass index [BMI]. ICG assessments of hemodynamic profiles were conducted with the use of a Niccomo™ device and included stroke volume index (SI), cardiac index (CI), systemic vascular resistance index (SVRI), velocity index (VI), acceleration index (ACI), Heather index (HI), and thoracic fluid content (TFC). AH was well-controlled in both study groups (116/76 mmHg PR vs. 119/76 mmHg CG). In comparison with CG patients, ICG revealed PR group patients to have higher rates of high thoracic fluid content (TFC) (>35 1/kOhm; p = 0.035) and lower SI values (<35 mL/m2, p = 0.072). There was a convergent tendency towards lower values of other cardiac function parameters (SI, CI, VI, ACI, and HI). Prolactinoma-associated endocrine abnormalities are related to hemodynamic profile alterations, including higher rates of increased TFC and the risk of worsened cardiac function.

摘要

男性泌乳素瘤(泌乳素腺瘤)患者的高泌乳素血症可能与血管内皮功能障碍和并存的心血管危险因素有关。作为一种评估心脏功能的非侵入性技术,阻抗心动图(ICG)可能有助于早期发现血液动力学功能障碍。本研究旨在分析和比较催乳素瘤患者与对照组的血液动力学特征。本前瞻性观察性临床研究共纳入 20 名催乳素瘤(PR 组)男性患者(平均年龄 43 岁)和 20 名对照组男性。研究对象根据临床特征(年龄、平均血压[MBP]、高血压[AH]发生率和体重指数[BMI])进行倾向评分匹配。使用 Niccomo 设备进行 ICG 评估血液动力学特征,包括每搏量指数(SI)、心输出量指数(CI)、全身血管阻力指数(SVRI)、速度指数(VI)、加速度指数(ACI)、Heather 指数(HI)和胸腔液含量(TFC)。两组患者的 AH 均得到良好控制(PR 组 116/76mmHg,CG 组 119/76mmHg)。与 CG 患者相比,ICG 显示 PR 组患者存在更高的胸腔液含量较高(TFC>35 1/kOhm;p=0.035)和较低的 SI 值(<35 mL/m2,p=0.072)。其他心脏功能参数(SI、CI、VI、ACI 和 HI)也存在低值趋势。催乳素瘤相关的内分泌异常与血液动力学特征改变有关,包括胸腔液含量较高的发生率增加和心脏功能恶化的风险增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1440/9785103/f6c03ba8cd8b/nutrients-14-05369-g001.jpg

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