Pecková M, Charvat J, Schuck O, Hill M, Svab P, Horackova M
Department of Medicine, University Hospital Motol, Second Medical School, Charles University, V Úvalu 84, 150 06 Prague 5, Czech Republic.
J Int Med Res. 2011;39(6):2178-86. doi: 10.1177/147323001103900614.
This prospective study evaluated the relationship between echocardiography parameters of left ventricular (LV) diastolic function and mild-to-moderate renal function impairment in 82 patients with type 2 diabetes mellitus. The mean age of the patients was 61.1 years. A significant correlation was found between estimated glomerular filtration rate (eGFR) and the ratio of peak velocity of early transmitral flow (E) to peak velocity of early diastolic mitral annular motion (E'). Cluster analysis revealed two subgroups of patients with different E' values but comparable eGFRs. The correlation between eGFR and E/E' was significant in 38 patients with E' ≤ 7.1 cm/s, but not significant in 44 patients with E' > 7.1 cm/s. The results suggest that the deterioration of LV relaxation (E') represents the underlying condition for the association between mild-to-moderate renal function impairment and the non-invasive parameter of LV end-diastolic pressure (E/E'), in patients with type 2 diabetes without any previous cardiovascular event and with well-controlled blood pressure.
这项前瞻性研究评估了82例2型糖尿病患者左心室(LV)舒张功能的超声心动图参数与轻度至中度肾功能损害之间的关系。患者的平均年龄为61.1岁。研究发现,估算肾小球滤过率(eGFR)与二尖瓣早期血流峰值速度(E)与二尖瓣环早期舒张运动峰值速度(E')之比之间存在显著相关性。聚类分析显示,患者分为两个亚组,其E'值不同,但eGFR相当。在E'≤7.1 cm/s的38例患者中,eGFR与E/E'之间的相关性显著,而在E'>7.1 cm/s的44例患者中则不显著。结果表明,在既往无任何心血管事件且血压控制良好的2型糖尿病患者中,左心室舒张功能减退(E')是轻度至中度肾功能损害与左心室舒张末期压力无创参数(E/E')之间关联的潜在条件。