慢性恰加斯病性心肌病患者的左心房功能
Left Atrial Function in Patients with Chronic Chagasic Cardiomyopathy.
作者信息
Fragata Claudia da Silva, Matsumoto Afonso Y, Ramires Felix J A, Fernandes Fabio, Buck Paula de Cássia, Salemi Vera Maria C, Nastari Luciano, Mady Charles, Ianni Barbara Maria
机构信息
Seção Médica de Eletrofisiologia, Instituto Dante Pazzanese de Cardiologia, São Paulo, BR.
Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BR.
出版信息
Arq Bras Cardiol. 2015 Jul;105(1):28-36. doi: 10.5935/abc.20150045. Epub 2015 May 8.
BACKGROUND
Chagas disease is a cause of dilated cardiomyopathy, and information about left atrial (LA) function in this disease still lacks.
OBJECTIVE
To assess the different LA functions (reservoir, conduit and pump functions) and their correlation with the echocardiographic parameters of left ventricular (LV) systolic and diastolic functions.
METHODS
10 control subjects (CG), and patients with Chagas disease as follows: 26 with the indeterminate form (GI); 30 with ECG alterations (GII); and 19 with LV dysfunction (GIII). All patients underwent M-mode and two-dimensional echocardiography, pulsed-wave Doppler and tissue Doppler imaging.
RESULTS
Reservoir function (Total Emptying Fraction: TEF): (p <0.0001), lower in GIII as compared to CG (p = 0.003), GI (p <0.001) and GII (p <0.001). Conduit function (Passive Emptying Fraction: PEF): (p = 0.004), lower in GIII (GIII and CG, p = 0.06; GI and GII, p = 0.06; and GII and GIII, p = 0.07). Pump function (Active Emptying Fraction: AEF): (p = 0.0001), lower in GIII as compared to CG (p = 0.05), GI (p<0.0001) and GII (p = 0.002). There was a negative correlation of E/e' (average) with the reservoir and pump functions (TEF and AEF), and a positive correlation of e' (average) with s' wave (both septal and lateral walls) and the reservoir, conduit and pump LA functions.
CONCLUSION
An impairment of LA functions in Chagas cardiomyopathy was observed.
背景
恰加斯病是扩张型心肌病的一个病因，关于该病左心房（LA）功能的信息仍然匮乏。
目的
评估不同的左心房功能（储存、管道和泵功能）及其与左心室（LV）收缩和舒张功能的超声心动图参数的相关性。
方法
10名对照受试者（CG），以及患有恰加斯病的患者，如下：26名处于不确定形式（GI）；30名有心电图改变（GII）；19名有左心室功能障碍（GIII）。所有患者均接受了M型和二维超声心动图、脉冲波多普勒和组织多普勒成像检查。
结果
储存功能（总排空分数：TEF）：（p<0.0001），与CG相比，GIII组较低（p = 0.003），与GI组相比（p<0.001）以及与GII组相比（p<0.001）。管道功能（被动排空分数：PEF）：（p = 0.004），GIII组较低（GIII与CG，p = 0.06；GI与GII，p = 0.06；GII与GIII，p = 0.07）。泵功能（主动排空分数：AEF）：（p = 0.0001），与CG相比，GIII组较低（p = 0.05），与GI组相比（p<0.0001）以及与GII组相比（p = 0.002）。E/e'（平均值）与储存和泵功能（TEF和AEF）呈负相关，e'（平均值）与s'波（室间隔和侧壁）以及左心房的储存、管道和泵功能呈正相关。
结论
观察到恰加斯心肌病患者左心房功能受损。
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