Morris Daniel A, Otani Kyoko, Bekfani Tarek, Takigiku Kiyohiro, Izumi Chisato, Yuda Satoshi, Sakata Konomi, Ohte Nobuyuki, Tanabe Kazuaki, Friedrich Katharina, Kühnle York, Nakatani Satoshi, Otsuji Yutaka, Haverkamp Wilhelm, Boldt Leif-Hendrik, Takeuchi Masaaki
Charité University Hospital, Berlin, Germany.
University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
J Am Soc Echocardiogr. 2014 May;27(5):493-500. doi: 10.1016/j.echo.2014.01.017. Epub 2014 Feb 26.
The aim of this multicenter study was to determine the normal ranges and the clinical relevance of multidirectional systolic parameters to evaluate global left ventricular (LV) systolic function.
Three hundred twenty-three healthy adult subjects prospectively included at 10 centers and a cohort of 310 patients with hypertension were analyzed. Multidirectional global LV systolic function was analyzed using two-dimensional speckle-tracking echocardiography by means of two indices: longitudinal-circumferential systolic index (the average of longitudinal and circumferential global systolic strain) and global systolic index (the average of longitudinal, circumferential, and radial global systolic strain).
The ranges of values of the multidirectional systolic parameters in healthy subjects were -21.22 ± 2.22% for longitudinal-circumferential systolic index and 29.71 ± 5.28% for global systolic index. In addition, the lowest expected values of these multidirectional indices were determined in this population (calculated as -1.96 SDs from the mean): -16.86% for longitudinal-circumferential systolic index and 19.36% for global systolic index. Concerning the clinical relevance of these measurements, these indices indicated the presence of subtle LV global systolic dysfunction in patients with hypertension, even though LV global longitudinal systolic strain and LV ejection fraction were normal. Moreover, in these patients, functional class (dyspnea [New York Heart Association classification]) was inversely related to both the longitudinal-circumferential index and the global systolic index.
In the present multicenter study analyzing a large cohort of healthy subjects and patients with hypertension, the normal range and the clinical relevance of multidirectional systolic parameters to evaluate global LV systolic function have been determined.
这项多中心研究的目的是确定多方向收缩期参数的正常范围及其在评估左心室（LV）整体收缩功能方面的临床相关性。
对前瞻性纳入10个中心的323名健康成年受试者以及310名高血压患者队列进行了分析。使用二维斑点追踪超声心动图通过两个指标分析左心室整体多方向收缩功能：纵向 - 圆周收缩期指数（纵向和圆周整体收缩期应变的平均值）和整体收缩期指数（纵向、圆周和径向整体收缩期应变的平均值）。
健康受试者中多方向收缩期参数的值范围为纵向 - 圆周收缩期指数为 -21.22 ± 2.22%，整体收缩期指数为29.71 ± 5.28%。此外，在该人群中确定了这些多方向指标的最低预期值（计算为均值减去1.96个标准差）：纵向 - 圆周收缩期指数为 -16.86%，整体收缩期指数为19.36%。关于这些测量的临床相关性，这些指标表明高血压患者存在轻微的左心室整体收缩功能障碍，即使左心室整体纵向收缩期应变和左心室射血分数正常。此外，在这些患者中，功能分级（呼吸困难[纽约心脏协会分级]）与纵向 - 圆周指数和整体收缩期指数均呈负相关。
在本项分析大量健康受试者和高血压患者队列的多中心研究中，已确定了评估左心室整体收缩功能的多方向收缩期参数的正常范围及其临床相关性。
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