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2008, Número 2

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Arch Cardiol Mex 2008; 78 (2)


Estudio de la función endotelial mediante tomografía por emisión de positrones en pacientes con hipercolesterolemia

Alexánderson RE, Meave GA, García-Rojas CL, Rodríguez VM, Lamothe MPA, Talayero PJA, Sierra FC, García-Villa PC, Rodríguez ZHG, Barrera PM, Carrera CRE, Calleja TR, Martínez GA, Ricalde AA, Romero IJL, Alexánderson RG

Idioma: Español
Referencias bibliográficas: 60
Paginas: 139-147
Archivo PDF: 148.12 Kb.


RESUMEN

La hipercolesterolemia predispone al desarrollo de disfunción endotelial (DE) y la DE precipita la aterogénesis. La DE ocurre temprano en el curso de la aterogénesis y es considerada un marcador pronóstico para el desarrollo de cardiopatía isquémica. Objetivo: Evaluar la función endotelial (FE) mediante tomografía por emisión de positrones (PET) de pacientes asintomáticos con dislipidemia sin antecedente de cardiopatía isquémica ni tratamiento hipolipemiante previo. Material y métodos: Se estudiaron catorce pacientes asintomáticos con diagnóstico reciente (‹ 6 meses) de dislipidemia mediante un perfil lipídico, glucosa en sangre y un estudio de 13N-amonio PET en tres fases: reposo, prueba presora con frío (CPT) y estrés farmacológico con adenosina. Se evaluó su FE mediante el cálculo de la reserva de flujo coronario (RFC), índice de vasodilatación endotelio-dependiente (IVED) y porcentaje del incremento del flujo coronario en CPT (% Δ FC). Resultados: El 79% de los pacientes tuvieron disfunción endotelial (DE), y todos los valores de los pacientes con dislipidemia fueron menores a los parámetros normales previamente publicados: flujo coronario (FC) en reposo (FCR)0.44 ± 0.12 vs 0.57 ± 0.147 (p = 0.002), FC en CPT 0.57 ± 0.17 vs 0.88 ± 0.26 (p = 0.001), FC en estrés (FCE) 1.24 ± 0.05 vs 1.81 ± 0.35 (p = 0.005), IVED 1.28 ± 0.25 vs 1.53 ± 0.24 (p 0.017), RFC 2.79 ± 0.94 vs 3.15 ± 0.48 (p 0.198) y % Δ FC 29.08 ± 24.62% vs 53 ± 24.60% (p 0.022).Conclusiones: Los pacientes asintomáticos en etapas tempranas de dislipidemia tienen mayor prevalencia de DE que puede ser identificada mediante 13N-amonio PET.


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