Garcia Maristela Magnavita Oliveira, Rodrigues Marília Galeffi, Reis Neto Joaquim Antônio Dos, Correia Luis Claudio
Escola Bahiana de Medicina e Saúde Pública, Fundação de Desenvolvimento de Pesquisas da Bahia. marisma@@cardiol.br
Arq Bras Cardiol. 2010 Oct;95(4):473-8. doi: 10.1590/s0066-782x2010005000114. Epub 2010 Aug 27.
it is plausible that subclinical atherosclerosis alters coronary reserve and impairs diastolic function of the left ventricle. However, the relationship between subclinical stages of atherosclerosis and diastolic function has not been established in subjects free of cardiovascular disease.
to test the hypothesis that subclinical atherosclerosis has a negative association with diastolic function.
individuals > 35 years old, free of cardiovascular disease, with normal blood pressure and negative treadmill stress test, were selected to have common carotid intima-media thickness (IMT) assessed by ultrasound and parameters of diastolic function by echocardiography, primarily tissue Doppler E'/A' ratio.
forty-eight subjects were studied, aged 56 ± 10 years, 67% females. Composite common carotid IMT had a significant negative correlation with tissue Doppler E'/A' ratio (r = - 0.437, p = 0.002). Individuals in the fourth quartile of IMT had a significant lower tissue Doppler E'/A' ratio (0.76 ± 0.25), as compared with the first (1.2 ± 0.29), second (1.2 ± 0.36) and third quartiles (1.1 ± 0.25) - p = 0.002. Composite common carotid IMT in the fourth quartile (> 0.8 mm) independently predicted E'/A' ratio (p = 0.02), after adjustment for potentially confounding variables, such as age, female gender, waist circumference, diastolic blood pressure, HDL-cholesterol and Framingham Risk.
early stage of subclinical atherosclerotic disease is negatively associated with diastolic function parameters in healthy individuals, regardless of age and clinical characteristics.
亚临床动脉粥样硬化可能会改变冠状动脉储备并损害左心室舒张功能。然而，在无心血管疾病的受试者中，动脉粥样硬化亚临床阶段与舒张功能之间的关系尚未确立。
检验亚临床动脉粥样硬化与舒张功能呈负相关这一假设。
选取年龄大于35岁、无心血管疾病、血压正常且平板运动试验阴性的个体，通过超声评估其颈总动脉内膜中层厚度（IMT），并通过超声心动图评估舒张功能参数，主要是组织多普勒E'/A'比值。
共研究了48名受试者，年龄为56±10岁，女性占67%。颈总动脉综合IMT与组织多普勒E'/A'比值呈显著负相关（r = - 0.437，p = 0.002）。与第一（1.2±0.29）、第二（1.2±0.36）和第三四分位数（1.1±0.25）相比，IMT处于第四四分位数的个体其组织多普勒E'/A'比值显著更低（0.76±0.25）——p = 0.002。在调整了年龄、女性性别、腰围、舒张压、高密度脂蛋白胆固醇和弗雷明汉风险等潜在混杂变量后，第四四分位数（> 0.8 mm）的颈总动脉综合IMT独立预测E'/A'比值（p = 0.02）。
在健康个体中，亚临床动脉粥样硬化疾病的早期阶段与舒张功能参数呈负相关，与年龄和临床特征无关。
