Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi Mizuho-Cho Mizuho-Ku, Nagoya 467-8601, Japan.
Cardiol Res Pract. 2012;2012:243735. doi: 10.1155/2012/243735. Epub 2012 Apr 12.
We hypothesized that left ventricular (LV) diastolic dysfunction assessed by cardiac catheterization may be associated with increased risk for cardiovascular events. To test the hypothesis, we assessed diastolic function by cardiac catheterization (relaxation time constant (Tau) and end-diastolic pressure (EDP)) as well as Doppler echocardiography (early diastolic mitral annular velocity (e') and a ratio of early diastolic mitral inflow to annular velocities (E/e')) in 222 consecutive patients undergoing cardiac catheterization for coronary artery disease (CAD). During a followup of 1364 ± 628 days, 5 cardiac deaths and 20 unscheduled cardiovascular hospitalizations were observed. Among LV diastolic function indices, Tau > 48 ms and e' < 5.8 cm/s were each significantly associated with lower rate of survival free of cardiovascular hospitalization. Even after adjustment for potential confounders (traditional cardiovascular risk factors, the severity of CAD, and cardiovascular medications), the predictive value of Tau > 48 ms and e' < 5.8 cm/s remained significant. No predictive value was observed in EDP, E/e', or LV ejection fraction. In conclusion, LV diastolic dysfunction, particularly impaired LV relaxation assessed by both cardiac catheterization and Doppler echocardiography, is independently associated with increased risk for cardiac death or cardiovascular hospitalization in patients with known or suspected CAD.
我们假设通过心导管检查评估的左心室（LV）舒张功能障碍可能与心血管事件风险增加有关。为了验证这一假设，我们在 222 例因冠状动脉疾病（CAD）而行心导管检查的连续患者中通过心导管检查（弛豫时间常数（Tau）和舒张末期压力（EDP））以及多普勒超声心动图（舒张早期二尖瓣环速度（e'）和舒张早期二尖瓣流入与环速度比（E / e'））评估舒张功能。在 1364 ± 628 天的随访期间，观察到 5 例心源性死亡和 20 例计划外心血管住院。在 LV 舒张功能指标中，Tau > 48 ms 和 e' < 5.8 cm/s 均与较低的无心血管住院生存率显著相关。即使在调整了潜在混杂因素（传统心血管危险因素、CAD 的严重程度和心血管药物治疗）后，Tau > 48 ms 和 e' < 5.8 cm/s 的预测价值仍然显著。EDP、E / e'或 LV 射血分数均无预测价值。总之，LV 舒张功能障碍，特别是通过心导管检查和多普勒超声心动图评估的 LV 松弛受损，与已知或疑似 CAD 患者的心脏死亡或心血管住院风险增加独立相关。
