Vizzardi Enrico, Caretta Giorgio, Bonadei Ivano, Rovetta Riccardo, Sciatti Edoardo, Pezzali Natalia, Lombardi Carlo M, Quinzani Filippo, Salghetti Francesca, D'Aloia Antonio, Metra Marco
Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Study of Brescia, Italy.
Int J Cardiol Heart Vessel. 2014 Apr 18;3:78-81. doi: 10.1016/j.ijchv.2014.03.009. eCollection 2014 Jun.
: Aortic stiffness, an independent predictor of mortality and cardiovascular events, is common among patients affected by non-ischemic dilated cardiomyopathy (NIDC) and heart failure (HF).
: A total of 55 patients with diagnosis of NIDC (aged 60 ± 11 years, mean ejection fraction (EF) 35.2% ± 7.7%) admitted consecutively to our department for mild to moderate HF (NYHA class II-III) underwent an echocardiographic study and cardiopulmonary exercise test (CPX). We evaluated elastic properties of ascending aorta, i.e. aortic stiffness and aortic distensibility (mm Hg), derived from ascending aorta systolic and diastolic diameter (mm/m) measured 3 cm above the valvular plane through 2D-guided M-mode echocardiography.
: Mean aortic stiffness was 15.63 ± 14.53 and aortic distensibility was 2.61 ± 2.39 mm Hg. Collected parameters at CPX were peak oxygen consumption (pVO) (ml/kg/min), anaerobic threshold (AT) and the slope of the relation between minute ventilation (VE) and carbon dioxide production (VCO). Mean pVO was 15.4 ± 3.9 ml/kg/min, VE/VCO ratio at AT was 36.1 ± 6.1. Functional capacity measured through peak VO was found to be directly correlated with aortic distensibility (r = 0.47, p = - 0.0002) and negatively correlated to aortic stiffness index (r = - 0.51, p = - 0.0001). These results were the same at multivariate analysis, corrected by age, hypertension, diabetes mellitus and ejection fraction (respectively r = 0.27, p = 0.008 and r = - 1.75, p = 0.0002).
: HF patients due to NIDC elastic properties of ascending aorta, evaluated by echocardiography, are correlated with a reduced functional capacity.
主动脉僵硬度是死亡率和心血管事件的独立预测因素，在非缺血性扩张型心肌病（NIDC）和心力衰竭（HF）患者中很常见。
共有55例诊断为NIDC的患者（年龄60±11岁，平均射血分数（EF）35.2%±7.7%）因轻至中度HF（纽约心脏协会II-III级）连续入住我院，接受了超声心动图检查和心肺运动试验（CPX）。我们通过二维引导的M型超声心动图评估了升主动脉的弹性特性，即主动脉僵硬度和主动脉扩张性（mmHg），其由瓣膜平面上方3 cm处测量的升主动脉收缩期和舒张期直径（mm/m）得出。
平均主动脉僵硬度为15.63±14.53，主动脉扩张性为2.61±2.39 mmHg。CPX收集的参数为峰值耗氧量（pVO）（ml/kg/min）、无氧阈值（AT）以及分钟通气量（VE）与二氧化碳产生量（VCO）之间关系的斜率。平均pVO为15.4±3.9 ml/kg/min，AT时的VE/VCO比值为36.1±6.1。通过峰值VO测量的功能能力与主动脉扩张性直接相关（r = 0.47，p = - 0.0002），与主动脉僵硬度指数呈负相关（r = - 0.51，p = - 0.0001）。在多变量分析中，经年龄、高血压、糖尿病和射血分数校正后，这些结果相同（分别为r = 0.27，p = 0.008和r = - 1.75，p = 0.0002）。
通过超声心动图评估，NIDC所致HF患者升主动脉的弹性特性与功能能力降低相关。
