他汀类药物治疗可通过应变成像评估降低心肌功能。
Statin therapy decreases myocardial function as evaluated via strain imaging.
机构信息
Cardiology Division, Department of Medicine, Michigan State University, East Lansing, MI 48824, USA.
出版信息
Clin Cardiol. 2009 Dec;32(12):684-9. doi: 10.1002/clc.20644.
OBJECTIVES
The purpose of this study was to evaluate the effects of statin therapy on myocardial function as measured with echocardiography with tissue Doppler imaging (TDI) and strain imaging (SI) independent of its lipid-lowering effect.
BACKGROUND
Statin use is known to improve outcomes in the primary and secondary prevention of ischemic heart disease, but their use is also associated with myopathy, muscle weakness and in rare cases, rhabdomyolysis. We sought to evaluate whether TDI and SI is able to identify changes in myocardial function associated with statin use.
METHODS
Myocardial function was evaluated in 28 patients via echocardiography with TDI and SI. We identified 12 patients (5 females) without overt cardiovascular disease (including hypertension, smoking, and diabetes) that were on statin therapy and compared their echocardiographic findings with 16 (12 females) age, sex, and cholesterol-profile-matched controls. Tissue Doppler imaging parameters of diastolic (E(')/A(') and E/E(')) and systolic (S') function were measured. Regional systolic function was obtained by SI in 4-chamber, 2-chamber, long axis, and average global views.
RESULTS
There was no significant difference in myocardial function as measured by Doppler and minor differences as measured via TDI among the 2 groups. There was significantly better function noted with SI in the control group vs the statin group in the 4-chamber (-19.05% +/- 2.45% vs -16.47% +/- 2.37% P = 0.009), 2-chamber (-20.30% +/- 2.66% vs -17.45% +/- 4.29% P = 0.03), long axis (-17.63% +/- 3.79% vs -13.83% +/- 3.74% P = 0.01), and average global (-19.0% +/- 2.07% vs -15.91% +/- 2.81% P = 0.004) views.
CONCLUSION
Statin therapy is associated with decreased myocardial function as evaluated with SI.
目的
本研究旨在评估他汀类药物治疗对心肌功能的影响，这种影响通过超声心动图组织多普勒成像（TDI）和应变成像（SI）来测量，且不考虑其降脂作用。
背景
已知他汀类药物的使用可改善缺血性心脏病的一级和二级预防结果，但它们的使用也与肌病、肌肉无力以及极少数情况下的横纹肌溶解有关。我们试图评估 TDI 和 SI 是否能够识别与他汀类药物使用相关的心肌功能变化。
方法
通过 TDI 和 SI 对 28 例患者的心肌功能进行评估。我们确定了 12 例（5 名女性）无明显心血管疾病（包括高血压、吸烟和糖尿病）的患者正在接受他汀类药物治疗，并将他们的超声心动图检查结果与 16 例（12 名女性）年龄、性别和胆固醇谱匹配的对照组进行比较。测量舒张功能的 TDI 参数（E'/A'和 E/E'）和收缩功能的 S'。通过 SI 在 4 腔心、2 腔心、长轴和平均整体视图中获得节段性收缩功能。
结果
两组间多普勒测量的心肌功能无显著差异，TDI 测量的差异较小。与他汀组相比，对照组在 4 腔心（-19.05% +/- 2.45% vs -16.47% +/- 2.37% P = 0.009）、2 腔心（-20.30% +/- 2.66% vs -17.45% +/- 4.29% P = 0.03）、长轴（-17.63% +/- 3.79% vs -13.83% +/- 3.74% P = 0.01）和平均整体（-19.0% +/- 2.07% vs -15.91% +/- 2.81% P = 0.004）视图中具有更好的功能。
结论
他汀类药物治疗与 SI 评估的心肌功能下降有关。
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