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[社区心血管高危人群左心室扭转/解旋与舒张功能障碍的关联]

[Association between left ventricular twist/untwist and diastolic dysfunction of high cardiovascular risk population in the community].

作者信息

Wu Guo-xiang, Yang Ying, Zhang Bao-wei, Qi Li-tong, Chen Feng, Wang Shu-yu, Liu Li-sheng, Zhao Feng, Huo Yong

机构信息

Department of Cardiology, Peking University First Hospital, Beijing, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2012 Aug;40(8):667-71.

Abstract

OBJECTIVE

To assess the association between left ventricular (LV) twist and untwist with the severity of diastolic dysfunction of high cardiovascular risk population in the community.

METHODS

This cross-sectional survey was performed in high cardiovascular risk people with normal left ventricular (LV) ejection fraction in an urban community of Beijing (n = 620). Normal LV diastolic function was defined in 305 subjects, mild diastolic dysfunction in 266 subjects and moderate/severe diastolic dysfunction in 49 subjects. Peak LV twist, peak twist velocity, peak untwist velocity and untwist rate were measured in apical and basal short-axis images using speckle tracking echocardiography.

RESULTS

Peak LV twist was similar among subjects with normal diastolic function, mild diastolic dysfunction and moderate/severe diastolic dysfunction. Peak twist velocity [(129.3 ± 45.3)°/s vs. (118.0 ± 36.2)°/s] and untwist velocity [(-132.9 ± 50.4) °/s vs. (-121.2 ± 41.4)°/s] were significantly higher in mild diastolic dysfunction group than in normal diastolic function group (all P < 0.01) and similar between normal diastolic function and moderate/severe diastolic dysfunction group (P > 0.05). Untwist rate of moderate/severe diastolic dysfunction decreased significantly than that of normal diastolic function [(41.9 ± 32.9)°/s vs. (57.7 ± 36.2) °/s, P < 0.01] and mild diastolic dysfunction group [(41.9 ± 32.9)°/s vs. (60.9 ± 39.9) °/s, P < 0.01].

CONCLUSIONS

Twist and untwist parameters are increased/preserved in population with normal systolic function and mild diastolic dysfunction and "normalized" or reduced in those with advanced diastolic dysfunction. The maintaining (if not increasing) of LV twist in early diastolic dysfunction might serve as a compensatory mechanism in case of reduced myocardial relaxation in these subjects.

摘要

目的

评估社区中高心血管风险人群左心室(LV)扭转与解旋与舒张功能障碍严重程度之间的关联。

方法

本横断面研究在北京一个城市社区中对左心室(LV)射血分数正常的高心血管风险人群进行(n = 620)。305名受试者定义为左心室舒张功能正常,266名受试者为轻度舒张功能障碍,49名受试者为中度/重度舒张功能障碍。使用斑点追踪超声心动图在心底和心尖短轴图像中测量左心室峰值扭转、峰值扭转速度、峰值解旋速度和解旋率。

结果

舒张功能正常、轻度舒张功能障碍和中度/重度舒张功能障碍受试者之间的左心室峰值扭转相似。轻度舒张功能障碍组的峰值扭转速度[(129.3±45.3)°/秒对(118.0±36.2)°/秒]和解旋速度[(-132.9±50.4)°/秒对(-121.2±41.4)°/秒]显著高于舒张功能正常组(均P < 0.01),且舒张功能正常组与中度/重度舒张功能障碍组之间相似(P > 0.05)。中度/重度舒张功能障碍组的解旋率显著低于舒张功能正常组[(41.9±32.9)°/秒对(57.7±36.2)°/秒,P < 0.01]和轻度舒张功能障碍组[(41.9±32.9)°/秒对(60.9±39.9)°/秒,P < 0.01]。

结论

收缩功能正常和轻度舒张功能障碍人群的扭转和解旋参数增加/保留,而晚期舒张功能障碍人群的扭转和解旋参数“正常化”或降低。舒张功能早期障碍时左心室扭转的维持(如果不是增加的话)可能是这些受试者心肌舒张减少情况下的一种代偿机制。

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