Adamyan K G, Tunyan L G, Chilingaryan A L, Tumasyan L R
Science Research Institute of Cardiology, Yerevan, Armenia.
Yerevan State Medical University, Yerevan, Armenia.
Kardiologiia. 2017 Feb;57(2):23-29.
to evaluate differences in echocardiographic parameters between patients with preclinical diastolic dysfunction (PDD) and heart failure with preserved ejection fraction (HFpEF) and to identify predictors of transition from PDD to HFpEF.
Echocardiographic parameters were recorded in 325 patients with PDD and 50 healthy subjects. PDD and HFpEF were diagnosed by tissue Doppler imaging of the left ventricle (LV) during exercise stress test and detection of symptoms of heart failure.
There were significant differences between both groups of patients and control group as well as between groups of patients with PDD and HFpEF in LV mass index, maximal left atrial (LA) volume index, systolic blood pressure, LV and LA parameters of longitudinal strain and strain rate. Patients with PDD and subsequent development of HFpEF had high values of LA stiffness and interatrial mechanical dyssynchrony. These parameters were independent predictors of HFpEF development in patients with PDD.
Predictors of HFpEF identified in this study provide an opportunity for early detection of patients with PDD with high risk of HFpEF development.
评估临床前期舒张功能障碍（PDD）患者与射血分数保留的心力衰竭（HFpEF）患者之间超声心动图参数的差异，并确定从PDD转变为HFpEF的预测因素。
记录325例PDD患者和50例健康受试者的超声心动图参数。通过运动负荷试验期间左心室（LV）的组织多普勒成像以及心力衰竭症状的检测来诊断PDD和HFpEF。
两组患者与对照组之间以及PDD患者组与HFpEF患者组之间在左心室质量指数、最大左心房（LA）容积指数、收缩压、LV和LA纵向应变及应变率参数方面存在显著差异。发生PDD并随后发展为HFpEF的患者具有较高的LA僵硬度和心房间机械不同步性。这些参数是PDD患者发生HFpEF的独立预测因素。
本研究中确定的HFpEF预测因素为早期检测有发生HFpEF高风险的PDD患者提供了机会。
