特发性扩张型心肌病的左心室功能与运动表现：组织多普勒成像的作用
Left ventricular function and exercise performance in idiopathic dilated cardiomyopathy: role of tissue Doppler imaging.
作者信息
Zambon Elena, Iorio Annamaria, Di Nora Concetta, Carriere Cosimo, Abate Elena, Merlo Marco, Barbati Giulia, Di Lenarda Andrea, Pinamonti Bruno, Agostoni Piergiuseppe, Sinagra Gianfranco
机构信息
aCardiovascular Department, 'Ospedali Riuniti'bPostgraduate School of Cardiovascular Sciences, University of TriestecCardiovascular Center, Health Authority No. 1, TriestedCardiologic Center Monzino, IRCCS, Milano, Italy.
出版信息
J Cardiovasc Med (Hagerstown). 2017 Apr;18(4):230-236. doi: 10.2459/JCM.0000000000000411.
BACKGROUND
To examine the relationship between left ventricular (LV) function evaluated at echocardiography and exercise performance in idiopathic dilated cardiomyopathy (IDCM) patients.
METHODS AND RESULTS
We enrolled 76 consecutive IDCM patients in sinus rhythm, undergoing cardiopulmonary exercise testing and echocardiography [49 ± 13 years old; LV ejection fraction 31 ± 7%, LV end-diastolic volume 96 ± 31 ml/m; peak oxygen consumption (peak VO2/kg) 18 ± 5.6 ml/kg/min]. Linear regression analysis revealed that peak systolic velocity (S') (r = 0.46; P < 0.001) and E/E' (r = -0.43; P < 0.001), two tissue Doppler imaging derived parameters, were related to peak VO2/kg, whereas ejection fraction and mitral inflow variables were not. Considering the 69 patients (90%) without diastolic restrictive pattern (a well known index of severe diastolic dysfunction), multivariate regression analysis showed that age, E/E' and S' were the only independent variables related to peak VO2/kg. Similarly, age and E/E' were confirmed as independent parameters for the prediction of ventilation/carbon dioxide production slope in the whole population.
CONCLUSION
In IDCM patients, cardiopulmonary exercise performance variables were strongly related to E/E' and S'.
背景
研究超声心动图评估的左心室（LV）功能与特发性扩张型心肌病（IDCM）患者运动能力之间的关系。
方法与结果
我们纳入了76例连续的窦性心律IDCM患者，这些患者接受了心肺运动试验和超声心动图检查[年龄49±13岁；左心室射血分数31±7%，左心室舒张末期容积96±31ml/m；峰值摄氧量（peak VO2/kg）18±5.6ml/kg/min]。线性回归分析显示，两个组织多普勒成像衍生参数，即峰值收缩速度（S'）（r = 0.46；P < 0.001）和E/E'（r = -0.43；P < 0.001），与peak VO2/kg相关，而射血分数和二尖瓣血流变量则不然。考虑到69例（90%）无舒张期限制模式（严重舒张功能障碍的一个众所周知的指标）的患者，多变量回归分析表明，年龄、E/E'和S'是与peak VO2/kg相关的仅有的独立变量。同样，年龄和E/E'被确认为预测整个人群通气/二氧化碳产生斜率的独立参数。
结论
在IDCM患者中，心肺运动表现变量与E/E'和S'密切相关。
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