Roscani Meliza Goi, Duarte Juliana da Cunha, Augusto Gustavo Nicolodi, Salgueiro Thaysa Rodrigues de Moraes, Meireles Mariana N, Gobbi Juliana I F, Okoshi Katashi, Hueb João Carlos
Consultant, Department of Medical Medicine, São Carlos Federal University, São Carlos, São Paulo, Brazil.
Consultant, Department of Internal Medicine, Botucatu Medical School, Botucatu, São Paulo, Brazil.
J Clin Diagn Res. 2017 Jun;11(6):OC09-OC11. doi: 10.7860/JCDR/2017/23463.9974. Epub 2017 Jun 1.
The presence of symptoms, systolic dysfunction and Left Ventricle (LV) dilation are considered unfavourable prognostic markers in Aortic Valve Insufficiency (AVI). The role of diastolic dysfunction, which is considered unfavourable outcome marker in cardiac pathologies, is not well established in AVI.
To evaluate if the presence of diastolic dysfunction may be associated with unfavourable prognostic markers in AVI patients.
A cross-sectional prospective study was performed on 22 patients with moderate or severe AVI. They underwent clinical evaluation and transthoracic echocardiography. Associations between clinical, epidemiological and echocardiographic were evaluated by Student t-test for normally distributed variables or Mann-Whitney test for non-normal distribution. Comparison between proportions was performed by Chi-square test.
There was an association between increased LV filling pressure, assessed by E' and E/E' of Mitral Tissue Doppler, and impaired LV systolic function, respectively: R = 0.563, R2 = 0.281; p = 0.008 and R = 0.639, R2 = 0.378; p = 0.002. The LV indexed mass also was inversely associated with the LV ejection fraction (R = 0.62, R2 = 0.35 and p = 0.003).
There was an association of LV diastolic dysfunction and ventricular hypertrophy with impaired left ventricle systolic function. Increased LV filling pressure and LV indexed mass should be considered in the management of AVI patients.
症状、收缩功能障碍和左心室（LV）扩张的存在被认为是主动脉瓣关闭不全（AVI）患者预后不良的标志物。舒张功能障碍在心脏疾病中被视为不良预后标志物，但其在AVI中的作用尚未明确。
评估舒张功能障碍的存在是否可能与AVI患者的不良预后标志物相关。
对22例中重度AVI患者进行了一项横断面前瞻性研究。他们接受了临床评估和经胸超声心动图检查。通过Student t检验评估正态分布变量或Mann-Whitney检验评估非正态分布变量的临床、流行病学和超声心动图之间的关联。比例之间的比较通过卡方检验进行。
通过二尖瓣组织多普勒的E'和E/E'评估的左心室充盈压升高与左心室收缩功能受损之间存在关联，分别为：R = 0.563，R2 = 0.281；p = 0.008和R = 0.639，R2 = 0.378；p = 0.002。左心室指数质量也与左心室射血分数呈负相关（R = 0.62，R2 = 0.35，p = 0.003）。
左心室舒张功能障碍和心室肥厚与左心室收缩功能受损有关。在AVI患者的管理中应考虑左心室充盈压升高和左心室指数质量增加。
