Abassade P, Baudouy P Y, Gobet L, Lhosmot J P
Service de cardiologie, hôpital Saint-Michel, 33, rue O-de-Serres, 75015 Paris.
Arch Mal Coeur Vaiss. 2001 Aug;94(8):767-70.
Arterial distensibility is one of the components of afterload. Arterial distensibility, left ventricular (LV) mass and LV function are closely linked. The aim of this study is to describe the relations between LV mass LV function and arterial distensibility evaluated by echography Doppler (échography Doppler) and ambulatory monitoring pressure. Sixty-two patients with or without cardiac disease were prospectively enrolled excepted those with atrial fibrillation, left bundle branch block pace maker, or valvulopathy. Echography Doppler study collected stroke volume, LV diameters and wall thickness, ejection time (ET) and preejection time (PET); were calculated ejection fraction (EF), systolic pressure/systolic diameter ratio, LV mass index (LVMI), relative wall thickness ratio (e/r). AMP collected usual pressure datas and QKd, time interval between QECG and diastolic Korotkoff sound, instantaneous, over 24 h (i, 24 h), and for a pressure of 100 mm Hg and a heart rate of 60 bpm (QKd 100-60).
QKd 24 h was correlated with LVMI (r = 0.40, p = 0.006) and e/r (r = 0.32, p = 0.028). QKdi was correlated with EF (p < 0.001, r = 0.65), with systolic pressure/systolic diameter ratio (p < 0.001, r = 0.75), and with ET/PET (r = 0.56, p < 0.001). When PET was withdrawn from QKd, no correlation exist between QKd-PET and LV function index, excepted QKd-PET versus systolic pressure/systolic diameter (r = 0.46, p = 0.005).
QKd is not only an arterial distensibility index but also a LV function index, because PET is included in it. Echography Doppler and AMP are available and common tools to study the aorta/LV relationship.
动脉可扩张性是后负荷的组成部分之一。动脉可扩张性、左心室(LV)质量和LV功能密切相关。本研究的目的是描述通过超声多普勒(echography Doppler)和动态血压监测评估的LV质量、LV功能与动脉可扩张性之间的关系。除患有心房颤动、左束支传导阻滞起搏器或瓣膜病的患者外,前瞻性纳入了62例有或无心脏病的患者。超声多普勒研究收集了每搏输出量、LV直径和壁厚、射血时间(ET)和射血前期时间(PET);计算了射血分数(EF)、收缩压/收缩直径比、LV质量指数(LVMI)、相对壁厚比(e/r)。动态血压监测收集了常规血压数据以及QKd,即心电图Q波与舒张压科罗特科夫音之间的时间间隔,在24小时内的瞬时值(i,24 h),以及对于100 mmHg的压力和60次/分钟的心率(QKd 100 - 60)。
24小时QKd与LVMI相关(r = 0.40,p = 0.006)和e/r相关(r = 0.32,p = 0.028)。瞬时QKd与EF相关(p < 0.001,r = 0.65),与收缩压/收缩直径比相关(p < 0.001,r = 0.75),以及与ET/PET相关(r = 0.56,p < 0.001)。当从QKd中去除PET时,QKd - PET与LV功能指标之间不存在相关性,除了QKd - PET与收缩压/收缩直径之间(r = 0.46,p = 0.005)。
QKd不仅是动脉可扩张性指标,也是LV功能指标,因为其中包含PET。超声多普勒和动态血压监测是研究主动脉/LV关系的可用且常用工具。