Brainin Philip, Biering-Sørensen Sofie Reumert, Møgelvang Rasmus, de Knegt Martina Chantal, Olsen Flemming Javier, Galatius Søren, Gislason Gunnar Hilmar, Jensen Jan Skov, Biering-Sørensen Tor
Department of Cardiology, Herlev and Gentofte University Hospital, University of Copenhagen, Niels Andersens Vej 65, Post 835, 2900, Hellerup, Denmark.
Int J Cardiovasc Imaging. 2019 Feb;35(2):327-337. doi: 10.1007/s10554-018-1474-2. Epub 2018 Oct 19.
Post-systolic shortening (PSS) does not contribute to the ejection of blood and may inhibit diastolic filling. We determined normal values of PSS in healthy subjects and investigated associations with echocardiographic and invasive measures of systolic and diastolic function. We prospectively analyzed participants from the general population (n = 620, mean age 47 ± 14 years) with no cardiovascular disease. Participants underwent echocardiography, including speckle tracking assessment of the post-systolic index (PSI), strain and time. We defined the PSI as: 100 × [(peak global longitudinal strain - peak systolic longitudinal strain)/(peak global longitudinal strain)]. We also included stable patients (n = 44) referred for left ventricle (LV) catheterization and echocardiography. Normal values: median PSI 2.0% (IQR 0.7, 4.8), post-systolic strain 0.4% (IQR 0.2, 0.8) and post-systolic time 22.6 ms (IQR 10.7, 40.8). Sex modified the relationship between PSI and age (P interaction = 0.037), such that PSI increased with age in women but not in men. PSI was associated with diastolic function (e', E/e' and E/A) (P < 0.05 for all), but not with LV ejection fraction (P = 0.08). PSI was associated with invasively measured LV pressure decline in early diastole, dP/dt min ([Formula: see text] = 0.12, P = 0.010), but not with LV pressure rise in early systole, dP/dt max ([Formula: see text]= - 0.05, P = 0.30). A PSI > 5% had 82% specificity and 99% sensitivity for identifying impaired LV systolic and/or diastolic function. Normal values of PSS are modified by sex. The PSI is associated with most validated echocardiographic and invasive measures of cardiac systolic and diastolic function.
收缩期后缩短（PSS）对血液射出无贡献，且可能抑制舒张期充盈。我们测定了健康受试者的PSS正常值，并研究了其与收缩和舒张功能的超声心动图及有创测量指标之间的关联。我们对一般人群中无心血管疾病的参与者（n = 620，平均年龄47±14岁）进行了前瞻性分析。参与者接受了超声心动图检查，包括对收缩期后指数（PSI）、应变和时间的散斑追踪评估。我们将PSI定义为：100×[（整体纵向应变峰值 - 收缩期纵向应变峰值）/（整体纵向应变峰值）]。我们还纳入了因左心室（LV）导管插入术和超声心动图检查而转诊的稳定患者（n = 44）。正常值：PSI中位数为2.0%（四分位间距0.7，4.8），收缩期后应变0.4%（四分位间距0.2，0.8），收缩期后时间22.6毫秒（四分位间距10.7，40.8）。性别改变了PSI与年龄之间的关系（P交互作用 = 0.037），即PSI在女性中随年龄增加，而在男性中并非如此。PSI与舒张功能（e'、E/e'和E/A）相关（所有P均<0.05），但与左心室射血分数无关（P = 0.08）。PSI与有创测量的左心室舒张早期压力下降dP/dt min相关（[公式：见正文]=0.12，P = 0.010），但与左心室收缩早期压力上升dP/dt max无关（[公式：见正文]= - 0.05，P = 0.30）。PSI>5%对识别左心室收缩和/或舒张功能受损具有82%的特异性和99%的敏感性。PSS的正常值因性别而异。PSI与大多数经过验证的心脏收缩和舒张功能的超声心动图及有创测量指标相关。
