Davidsen Einar Skulstad, Omvik Per, Hervig Tor, Gerdts Eva
Department of Heart Disease, Haukeland University Hospital, Norway.
Scand Cardiovasc J. 2009 Feb;43(1):32-8. doi: 10.1080/14017430802203811.
We recently demonstrated reduced exercise capacity in phlebotomy treated genetic haemochromatosis in spite of normal systolic function. The present objective was to investigate diastolic function at rest.
Diastolic function was echocardiographically assessed in 132 phlebotomy treated genetic haemochromatosis patients and 50 controls.
Patients had higher body mass index and heart rate, higher transmitral early (E) (11.2+/-2.6 versus 10.4+/-2.2 cm) and atrial (A) (5.7+/-1.6 versus 5.0+/-1.6) velocity time integrals, pulmonary venous systolic peak velocity (0.58+/-0.12 versus 0.54+/-0.13 m/s) and ratio of E to spectral tissue Doppler E' velocity (6.3+/-1.6 versus 5.6+/-1.4, all p <0.05). Independently of age, heart rate, systolic blood pressure and body weight, having haemochromatosis remained statistically significantly associated with higher E (beta=0.27) and A (beta =0.18) velocity time integrals, pulmonary venous systolic peak velocity (beta =0.21), and E/E'-ratio (beta=0.25) in separate multivariate analyses (all p <0.05). In the youngest age tertile, patients had longer isovolumic relaxation time and lower E' than controls.
Our findings are compatible with mildly impaired diastolic function in treated haemochromatosis, with delayed relaxation in the younger tertile, and an elevated filling pressure and pseudonormalisation with increasing age.
我们最近证明，尽管收缩功能正常，但放血治疗的遗传性血色素沉着症患者的运动能力有所下降。目前的目的是研究静息时的舒张功能。
对132例接受放血治疗的遗传性血色素沉着症患者和50例对照者进行超声心动图舒张功能评估。
患者的体重指数和心率较高，二尖瓣早期（E）（11.2±2.6对10.4±2.2 cm）和心房（A）（5.7±1.6对5.0±1.6）速度时间积分、肺静脉收缩期峰值速度（0.58±0.12对0.54±0.13 m/s）以及E与频谱组织多普勒E'速度之比（6.3±1.6对5.6±1.4，均p<0.05）更高。在多因素分析中，独立于年龄、心率、收缩压和体重，血色素沉着症仍与较高的E（β=0.27）和A（β =0.18）速度时间积分、肺静脉收缩期峰值速度（β =0.21）以及E/E'比值（β=0.25）在统计学上显著相关（均p<0.05）。在最年轻的年龄三分位数中，患者的等容舒张时间更长，E'低于对照组。
我们的研究结果与治疗后的血色素沉着症舒张功能轻度受损相符，在较年轻的三分位数中舒张延迟，随着年龄增长充盈压升高和假性正常化。
