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心血管危险因素对与主动脉僵硬度相关的左心房和左心室功能的负面影响——二维斑点追踪超声心动图的新应用。

Negative impact of cardiovascular risk factors on left atrial and left ventricular function related to aortic stiffness--new application of 2-dimensional speckle-tracking echocardiography.

机构信息

Cardiovascular Section, Higashi Tokushima Medical Center, National Hospital Organization, Itano, Tokushima 779-0193, Japan.

出版信息

Circ J. 2013;77(6):1490-8. doi: 10.1253/circj.cj-12-1260. Epub 2013 Feb 28.

Abstract

BACKGROUND

The aim of the present study was to detect earlier the negative effect of cardiovascular risk (CVR) factors on left atrial (LA) and left ventricular (LV) function related to abdominal aortic (AAO) stiffness using 2-dimensional speckle-tracking echocardiography (2DSTE) in asymptomatic patients.

METHODS AND RESULTS

One hundred and twelve patients with CVR factors and 56 healthy individuals were studied. 2DSTE data were acquired for determination of LA and LV myocardial and AAO wall deformations. LA volume index, LV mass index, ratio of early diastolic transmitral flow to mitral annular velocity (E/e')/peak systolic LA strain (S-LAs), and AAO stiffness were greater, and peak early diastolic LV longitudinal strain rate (SR-LVe) was lower in the patient group. Among the significantly correlated variables with AAO stiffness on univariate analysis, multivariate linear regression analysis identified SR-LVe and (E/e')/S-LAs in the patient group, and only age in the healthy group, as independent predictor of AAO stiffness.

CONCLUSIONS

Structural and functional changes in the LA and LV and AAO stiffening were accelerated with CVR factors, and higher AAO stiffness was associated with deteriorated LA compliance and impaired LV relaxation in asymptomatic patients with CVR factors. 2DSTE has a potential for earlier detection of abnormal LA and LV function related to increased AAO stiffness.

摘要

背景

本研究旨在通过二维斑点追踪超声心动图(2DSTE)检测无症状患者心血管风险(CVR)因素对与腹主动脉(AAO)僵硬度相关的左心房(LA)和左心室(LV)功能的早期负面影响。

方法和结果

研究纳入 112 例 CVR 因素患者和 56 例健康个体。采集 2DSTE 数据以确定 LA 和 LV 心肌和 AAO 壁变形。患者组的 LA 容积指数、LV 质量指数、舒张早期二尖瓣血流速度与二尖瓣环速度比(E/e')/收缩期 LA 应变(S-LAs)较高,而峰值早期舒张 LV 纵向应变率(SR-LVe)较低。在单变量分析中,与 AAO 僵硬度有显著相关性的变量中,多元线性回归分析确定了患者组中的 SR-LVe 和(E/e')/S-LAs,以及健康组中的仅年龄,是 AAO 僵硬度的独立预测因子。

结论

CVR 因素可加速 LA 和 LV 的结构和功能改变以及 AAO 僵硬度的增加,并且较高的 AAO 僵硬度与 CVR 因素无症状患者 LA 顺应性降低和 LV 舒张功能受损相关。2DSTE 具有早期检测与 AAO 僵硬度增加相关的异常 LA 和 LV 功能的潜力。

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