Akcay Murat, Coksevim Metin, Ulubaşoğlu Hasan, Gedikli Omer, Yılmaz Ozcan
Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
Clinic of Cardiology, Giresun Bulancak State Hospital, Giresun, Turkey.
J Cardiovasc Imaging. 2019 Apr;27(2):137-146. doi: 10.4250/jcvi.2019.27.e22.
This study evaluated the atrial electromechanical delay (AEMD) and the left atrial (LA) mechanical functions in patients with surgical early menopause.
A total of 62 patients were included in the study: 33 patients with surgical early menopause and 29 age- and sex-matched healthy controls. The duration distance from the start of the P wave to the beginning of the A wave for the lateral mitral annulus, septal mitral annulus, and lateral tricuspid annulus was assessed by tissue Doppler echocardiography. The differences in these durations were used to calculate the inter- and intra-atrial mechanical delays. LA volumes were evaluated using the biplane area-length technique, and LA mechanical function values were measured.
The baseline laboratory and clinical characteristics were similar between the two groups. Surgical early menopause patients displayed increased static atrial electromechanical connection (PA') times for the septal mitral annulus and lateral tricuspid annulus compared to the controls. However, the lateral mitral annulus, the inter-atrial, the intra-LA, and the right atrial EMD PA' times were not significantly altered in surgical early menopause patients compared to controls. Importantly, the LA volume index (28.1 ± 8.17 vs. 24.89 ± 7.96 mL/m², p = 0.019), the maximal LA volume (49.6 ± 14.1 vs. 42.9 ± 16.1 mL, p = 0.004), the minimal LA volume (18.4 ± 7.0 vs. 15.2 ± 9.0 mL, p = 0.022), and the atrial precontraction LA volume (31.0 ± 10.9 vs. 24.9 ± 10.1 mL, p = 0.006) were higher in the patients with surgical early menopause compared to the controls. The LA reservoir, conduit and pumping functions and the total, passive, and active emptying volumes were all comparable between the two groups (p = 0.09; 0.06; 0.68; 0.06; 0.48; 0.07, respectively).
Patients with surgical early menopause demonstrated impaired atrial electrical delay and electromechanical functions.
本研究评估了手术导致早期绝经患者的心房机电延迟（AEMD）和左心房（LA）机械功能。
本研究共纳入62例患者：33例手术导致早期绝经的患者和29例年龄及性别匹配的健康对照者。采用组织多普勒超声心动图评估二尖瓣环外侧、二尖瓣环间隔及三尖瓣环外侧从P波起始至A波起始的持续时间距离。利用这些持续时间的差异计算心房内和心房间的机械延迟。采用双平面面积长度技术评估左心房容积，并测量左心房机械功能值。
两组患者的基线实验室检查和临床特征相似。与对照组相比，手术导致早期绝经的患者二尖瓣环间隔和三尖瓣环外侧的静态心房机电连接（PA'）时间增加。然而，与对照组相比，手术导致早期绝经的患者二尖瓣环外侧、心房间、左心房内及右心房的EMD PA'时间无显著改变。重要的是，手术导致早期绝经的患者的左心房容积指数（28.1±8.17 vs. 24.89±7.96 mL/m²，p = 0.019）、左心房最大容积（49.6±14.1 vs. 42.9±16.1 mL，p = 0.004）、左心房最小容积（18.4±7.0 vs. 15.2±9.0 mL，p = 0.022）及心房预收缩时左心房容积（31.0±10.9 vs. 24.9±10.1 mL，p = 0.006）均高于对照组。两组的左心房储存、管道及泵血功能以及总排空容积、被动排空容积和主动排空容积均相当（p值分别为0.09；0.06；0.68；0.06；0.48；0.07）。
手术导致早期绝经的患者表现出心房电延迟和机电功能受损。
