Cardiac Ultrasound Laboratory and Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USA.
Eur Heart J Cardiovasc Imaging. 2013 Nov;14(11):1092-8. doi: 10.1093/ehjci/jet036. Epub 2013 Mar 20.
Chronic excess salt intake may have blood pressure-independent adverse effects on the heart such as myocardial hypertrophy and fibrosis. Effects of subacute sodium loading with excess dietary salt on diastolic function in normotensive individuals have been conflicting and the mechanisms are poorly understood.
Thirteen healthy normotensive subjects (age 24 ± 4 years) entered a 2-week crossover study with 1 week of a low-salt diet <10 mEq/day and 1 week of a high-salt diet >200 mEq/day. At the end of each study week, left ventricular dimensions, systolic, and diastolic function were assessed with echocardiography before and after 2 L of normal saline infusion. One week of high-salt and low-salt diets did not lead to differences in echocardiographic parameters of systolic or diastolic function, even after rapid volume expansion with saline infusion. The peak early diastolic strain rate (SR) increased after volume loading both after completion of low-salt (1.62 ± 0.23/s vs. 1.82 ± 0.14/s, P < 0.05) and high-salt diets (1.67 ± 0.16/s vs. 1.86 ± 0.22/s, P < 0.05). There was a positive correlation between the peak early diastolic SR and the cardiac index (r = 0.52, P = 0.017).
In healthy normotensive individuals, subacute excess dietary sodium intake does not affect diastolic function. The peak early diastolic SR, similar to other mitral Doppler and tissue Doppler parameters of diastolic function, appears to be strongly dependent on pre-load.
慢性过量盐摄入可能对心脏产生血压-independent 的不良影响,如心肌肥大和纤维化。亚急性钠负荷对正常血压个体舒张功能的影响存在争议,其机制尚不清楚。
13 名健康的正常血压受试者(年龄 24 ± 4 岁)参加了一项为期 2 周的交叉研究,其中 1 周低盐饮食<10mEq/天,1 周高盐饮食>200mEq/天。在每一周的研究结束时,在超声心动图检查前和生理盐水输注后 2 L 后评估左心室尺寸、收缩和舒张功能。1 周的高盐和低盐饮食并没有导致收缩或舒张功能的超声心动图参数差异,即使在盐水输注快速容量扩张后也是如此。容量负荷后,早期舒张峰值应变率(SR)均增加,低盐(1.62 ± 0.23/s 比 1.82 ± 0.14/s,P < 0.05)和高盐(1.67 ± 0.16/s 比 1.86 ± 0.22/s,P < 0.05)饮食结束后。早期舒张峰值 SR 与心指数呈正相关(r = 0.52,P = 0.017)。
在健康的正常血压个体中,亚急性过量膳食钠摄入不会影响舒张功能。早期舒张峰值 SR,与其他二尖瓣多普勒和组织多普勒舒张功能参数相似,似乎强烈依赖于前负荷。