Duke University, Durham, NC, USA.
Am Heart J. 2010 Jun;159(6):1081-8. doi: 10.1016/j.ahj.2010.02.024.
Studies investigating the association between central aortic pressures and diastolic function have been limited.
Consecutive ambulatory patients (n = 281, mean age 49 +/- 13 years, 49% male) with normal left ventricular (LV) systolic function were included. The LV filling pressure (E/Em) was estimated by Doppler-derived ratio of mitral inflow velocity (E) to septal (Em) by tissue Doppler, LV relaxation by Em, and central aortic pressures by radial tonometry. Central aortic systolic (cSBP), diastolic (cDBP), mean (cMAP) and pulse pressure (cPP) were entered individually into stepwise linear regression models to determine their association with E/Em or Em.
In univariate analysis, cPP correlated most strongly with E/Em (Spearman's rho = 0.45, P < .001), whereas cSBP correlated most strongly with Em (Spearman's rho = -0.51, P < .001). Multivariate analysis demonstrated that the pulsatile component of afterload, cPP, contributed most to E/Em (partial r(2) = 23%); meanwhile, the nonpulsatile components (cDBP and cMAP) were significant but small contributors (partial r(2) of 6% and 5%, respectively) of LV relaxation (Em).
The nonpulsatile components of aortic afterload (cMAP and cDBP) exhibited a weak but significant association with LV relaxation, whereas the pulsatile component of afterload, cPP, exhibited strong association with LV filling pressure.
研究中心主动脉压力与舒张功能之间关系的研究有限。
连续入选 281 例静息状态下的门诊患者（平均年龄 49±13 岁，49%为男性），这些患者左心室收缩功能正常。通过多普勒测量二尖瓣血流速度（E）与间隔组织多普勒速度（Em）的比值估计左心室充盈压（E/Em），通过 Em 评估左心室舒张功能，通过桡动脉张力测量中心主动脉压力。将中心主动脉收缩压（cSBP）、舒张压（cDBP）、平均压（cMAP）和脉压（cPP）分别纳入逐步线性回归模型，以确定它们与 E/Em 或 Em 的关系。
在单变量分析中，cPP 与 E/Em 的相关性最强（Spearman 相关系数=0.45，P<0.001），而 cSBP 与 Em 的相关性最强（Spearman 相关系数=-0.51，P<0.001）。多元分析表明，后负荷的脉动成分 cPP 对 E/Em 的影响最大（部分 r²=23%）；同时，非脉动成分（cDBP 和 cMAP）也有显著但较小的影响（部分 r²分别为 6%和 5%）。
主动脉后负荷的非脉动成分（cMAP 和 cDBP）与左心室舒张功能呈弱相关，但后负荷的脉动成分 cPP 与左心室充盈压呈强相关。
