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左心室最大纵向松弛速度:其临床价值及与心力衰竭患者血浆NT-proBNP水平的关系

Maximum longitudinal relaxation velocity of the left ventricle: its clinical value and relationship with NT-proBNP plasma levels in heart failure.

作者信息

Taléns-Visconti Raquel, Rivera Miguel, Climent Vicente, Valero Ricardo, Martínez-Dolz Luis, Sancho-Tello Ma José, Cortés Raquel, Miro Vicente, Sevilla Begoña, Perez-Bosca Jose Leandro, Bertomeu Vicente, Salvador Antonio, Jordan Alejandro, Marin Francisco, Sogorb Francisco

机构信息

Research Center La Fe Hospital, Valencia, Spain.

出版信息

Echocardiography. 2006 Apr;23(4):295-302. doi: 10.1111/j.1540-8175.2006.00205.x.

Abstract

BACKGROUND

M-mode recordings of the mitral annulus to measure the maximum ascending velocity during early diastole as an expression of maximum longitudinal relaxation velocity of the left ventricle (RVm) can be used as an index of left ventricular (LV) diastolic function. The purpose of this study was to determine the relationship of RVm with LV functional parameters in patients with heart failure, with N-terminal pro-brain natriuretic peptide (NT-proBNP) plasma levels, and with their functional classification.

METHODS AND RESULTS

RVm was recorded in 97 patients by M-mode echocardiography. Patients were classified according to the New York Heart Association (NYHA) and the concentration of NT-proBNP was determined. Patients with ejection fraction (EF)>40 showed a significant correlation between RVm and mitral annulus motion (MAM), mitral flow propagation velocity, E/A, age, deceleration time (DT), and NT-proBNP. In patients with EF<or=40, RVm correlated significantly with MAM, EF, and NT-proBNP. RVm values were higher in NYHA class I compared to II and III, P<0.0001.

CONCLUSIONS

RVm correlates better with functional parameters in patients with EF>40, though its relationship with NT-proBNP both in patients with EF>or<or=40 is to be highlighted. Correlation between RVm and NT-proBNP is influenced by age, EF, and E/A, whereas in patients with EF>40 it is influenced only by age. RVm values showed a significant decrease in NYHA class II and III.

摘要

背景

通过M型记录二尖瓣环以测量舒张早期最大上升速度,作为左心室最大纵向松弛速度(RVm)的一种表现,可用于作为左心室(LV)舒张功能的指标。本研究的目的是确定心力衰竭患者中RVm与左心室功能参数、N末端脑钠肽前体(NT-proBNP)血浆水平及其功能分级之间的关系。

方法与结果

通过M型超声心动图记录了97例患者的RVm。根据纽约心脏协会(NYHA)对患者进行分类,并测定NT-proBNP的浓度。射血分数(EF)>40%的患者中,RVm与二尖瓣环运动(MAM)、二尖瓣血流传播速度、E/A、年龄、减速时间(DT)和NT-proBNP之间存在显著相关性。在EF≤40%的患者中,RVm与MAM、EF和NT-proBNP显著相关。NYHA I级患者的RVm值高于II级和III级,P<0.0001。

结论

在EF>40%的患者中,RVm与功能参数的相关性更好,尽管其在EF>或≤40%的患者中与NT-proBNP的关系都值得关注。RVm与NT-proBNP之间的相关性受年龄、EF和E/A的影响,而在EF>40%的患者中仅受年龄影响。NYHA II级和III级患者的RVm值显著降低。

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