Aghajani Hasan, Faal Mohsen, Hosseinsabet Ali
Cardiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Echocardiography. 2017 Mar;34(3):397-406. doi: 10.1111/echo.13467. Epub 2017 Feb 2.
Coronary artery ectasia (CAE) is defined as the dilation of at least one segment of the coronary arteries that reaches at least 1.5 times the size of a normal neighboring segment. It has been shown that left ventricular (LV) diastolic function is impaired in patients with CAE. Also, it has been shown that LV function is impaired in vitamin D-deficient subjects compared with vitamin D-sufficient subjects and vitamin D deficiency is prevalent in CAE patients. We hypothesized that LV function is impaired in patients with CAE so we evaluated longitudinal LV myocardial function by 2D speckle tracking echocardiography (2DSTE) in patients with CAE and vitamin D deficiency without significant coronary artery stenosis and compared the results with those of subjects with vitamin D deficiency and near-normal coronary arteries.
Our study population comprised 21 consecutive patients with CAE and without significant coronary artery stenosis (<50%) and 31 control subjects with near-normal coronary arteries. All subjects had vitamin D deficiency.
All 2DSTE-derived indices of longitudinal LV function, comprised of the absolute values of systolic strain (14.0±2.7% vs 15.4±2.3%, P=.039), systolic strain rate (1.2±0.2/s vs 1.3±0.2/s, P=.015), early diastolic strain rate (1.1±0.3/s vs 1.3±0.3 s , P=.030), and late diastolic strain rate (0.8±0.2/s vs 1±0.2/s P=.005), were reduced in the patients with CAE and vitamin D deficiency.
The systolic and diastolic functions of the LV in the patients with CAE and vitamin D deficiency were impaired as evaluated by 2DSTE.
冠状动脉扩张(CAE)定义为至少一段冠状动脉的扩张,其直径达到相邻正常节段的至少1.5倍。研究表明,CAE患者的左心室(LV)舒张功能受损。此外,与维生素D充足的受试者相比,维生素D缺乏的受试者左心室功能受损,且CAE患者中维生素D缺乏很普遍。我们假设CAE患者的左心室功能受损,因此我们通过二维斑点追踪超声心动图(2DSTE)评估了CAE和维生素D缺乏且无明显冠状动脉狭窄患者的左心室心肌纵向功能,并将结果与维生素D缺乏且冠状动脉接近正常的受试者进行比较。
我们的研究人群包括21例连续的CAE患者且无明显冠状动脉狭窄(<50%)以及31例冠状动脉接近正常的对照受试者。所有受试者均有维生素D缺乏。
所有基于2DSTE得出的左心室纵向功能指标,包括收缩期应变绝对值(14.0±2.7%对15.4±2.3%,P = 0.039)、收缩期应变率(1.2±0.2/s对1.3±0.2/s,P = 0.015)、舒张早期应变率(1.1±0.3/s对1.3±0.3/s,P = 0.030)和舒张晚期应变率(0.8±0.2/s对1±0.2/s,P = 0.005),在CAE和维生素D缺乏的患者中均降低。
通过2DSTE评估,CAE和维生素D缺乏患者的左心室收缩和舒张功能受损。