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左心室射血分数保留和未保留的患者中左心室舒张功能与右心室功能之间的关联。

Associations between left ventricular diastolic function and right ventricular function in patients with and without preserved left ventricular ejection fraction.

作者信息

Oki Tsumugi, Tanaka Hidekazu, Imanishi Takamitsu, Nakamachi Yuji, Saegusa Jun, Kawano Seiji, Hirata Ken-Ichi, Nishimura Yoshihiro

机构信息

Division of Laboratory Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.

Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan.

出版信息

J Echocardiogr. 2018 Jun;16(2):81-86. doi: 10.1007/s12574-017-0363-3. Epub 2017 Dec 11.

Abstract

BACKGROUND

The purpose of this study was to investigate associations between right ventricular (RV) function and left ventricular (LV) diastolic function in patients with reduced LV ejection fraction (LVEF) and preserved LVEF.

METHODS

A total of 139 patients who had undergone echocardiography were recruited. LV diastolic function was determined as the ratio of mitral inflow E to mitral e' lateral annular velocities (E/e'). RV function was determined as the RV index of myocardial performance (RIMP). Patients were divided into two groups: the preserved LVEF group (n = 100, LVEF ≥ 50%) and the reduced LVEF group (n = 39, LVEF <  50%).

RESULTS

Associations between RV function and LV diastolic function in patients with reduced LVEF and preserved LVEF differed significantly. RIMP correlated significantly with E/e' in patients with reduced LVEF (r = 0.47, p = 0.003), but not in those with preserved LVEF (r = 0.04, p = 0.68). An important finding of the multivariate regression analysis showed that RIMP was the only independent determinant of E/e' in patients with reduced LVEF, whereas age and gender (not RIMP) was the independent determinant of E/e' in patients with preserved LVEF.

CONCLUSIONS

Associations between RV function and LV diastolic function in patients with reduced LVEF and preserved LVEF differed significantly, and RV function showed a close correlation with LV diastolic function in patients with reduced LVEF, but not in those with preserved LVEF. Thus, these findings may well have clinical implications for better management of patients with reduced LVEF.

摘要

背景

本研究旨在调查左心室射血分数(LVEF)降低和保留的患者右心室(RV)功能与左心室(LV)舒张功能之间的关联。

方法

共招募了139例接受过超声心动图检查的患者。左心室舒张功能通过二尖瓣流入E与二尖瓣外侧环e'速度之比(E/e')来确定。右心室功能通过右心室心肌性能指数(RIMP)来确定。患者分为两组:LVEF保留组(n = 100,LVEF≥50%)和LVEF降低组(n = 39,LVEF < 50%)。

结果

LVEF降低和保留的患者右心室功能与左心室舒张功能之间的关联存在显著差异。在LVEF降低的患者中,RIMP与E/e'显著相关(r = 0.47,p = 0.003),而在LVEF保留的患者中则无相关性(r = 0.04,p = 0.68)。多变量回归分析的一个重要发现表明,RIMP是LVEF降低患者中E/e'的唯一独立决定因素,而年龄和性别(而非RIMP)是LVEF保留患者中E/e'的独立决定因素。

结论

LVEF降低和保留的患者右心室功能与左心室舒张功能之间的关联存在显著差异,右心室功能在LVEF降低的患者中与左心室舒张功能密切相关,而在LVEF保留的患者中则不然。因此,这些发现可能对更好地管理LVEF降低的患者具有临床意义。

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