Bière Loïc, Donal Erwan, Terrien Gwenola, Furber Alain, Martin Ludovic, Prunier Fabrice
L'UNAM Université, Angers, France; Université Angers, Laboratoire Cardioprotection, Remodelage et Thrombose, CHU Angers, Service de Cardiologie, Angers, France.
Service de Cardiologie et CIC-IT 804, CHU de Rennes & Laboratoire Traitement du Signal et de l'Image, INSERM U1099, Rennes, France.
PLoS One. 2014 Mar 20;9(3):e90364. doi: 10.1371/journal.pone.0090364. eCollection 2014.
Pseudoxanthoma elasticum (PXE) is a rare autosomal recessive disorder characterized by the mineralization and fragmentation of elastic fibers in the skin, retina, and vascular walls. While there is no doubt that peripheral arterial disease is associated with PXE, several other cardiac complications have been linked with PXE, mainly based on case reports. It remains unclear, whether cardiac systolic or diastolic function impairment is a common complication of PXE.
This study conducted systematic assessment of left ventricular systolic and diastolic function via standard echocardiography and two-dimensional strain imaging, in a large cohort of asymptomatic PXE patients (n = 75) and matched healthy controls (n = 30).
PXE and controls did not differ in terms of any of the diastolic parameters tested: E-wave (82 ± 17 cm/s vs. 82 ± 13 cm/s, p = 0.890), E deceleration time (191.7 ± 55.6 ms vs. 190.0 ± 35.9 ms, p = 0.879), and E/Em ratio (7.1 ± 2.3 vs. 7.0 ± 1.8, p = 0.829). In addition, no significant differences were observed between PXE and control in terms of left ventricular volumes and ejection fraction, as well as global, basal, mid, and apex longitudinal strains.
These findings revealed that preclinical cardiac dysfunction is uncommon in a large population of asymptomatic PXE patients.
弹性假黄瘤(PXE)是一种罕见的常染色体隐性疾病,其特征为皮肤、视网膜和血管壁中的弹性纤维矿化和断裂。虽然外周动脉疾病与PXE相关这一点毋庸置疑,但其他几种心脏并发症也与PXE有关,主要基于病例报告。目前尚不清楚心脏收缩或舒张功能损害是否为PXE的常见并发症。
本研究通过标准超声心动图和二维应变成像,对一大群无症状PXE患者(n = 75)和匹配的健康对照者(n = 30)进行了左心室收缩和舒张功能的系统评估。
PXE组和对照组在任何一项测试的舒张参数方面均无差异:E波(82±17 cm/s对82±13 cm/s,p = 0.890)、E减速时间(191.7±55.6 ms对190.0±35.9 ms,p = 0.879)以及E/Em比值(7.1±2.3对7.0±1.8,p = 0.829)。此外,PXE组和对照组在左心室容积、射血分数以及整体、基底、中间和心尖纵向应变方面均未观察到显著差异。
这些发现表明,在一大群无症状PXE患者中,临床前心脏功能障碍并不常见。