Department of Ultrasound, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, 110032, People's Republic of China.
Department of Chronic Disease, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, 110005, People's Republic of China.
Int J Cardiovasc Imaging. 2019 Dec;35(12):2205-2212. doi: 10.1007/s10554-019-01677-8. Epub 2019 Jul 24.
The relationship between subclinical left ventricular (LV) dysfunction and atherosclerosis may have been underestimated in the past, which might be responsible for the high incidence of premature death in individuals with carotid stenosis. We sought to evaluate the underlying myocardial dysfunction in asymptomatic carotid stenosis patients using speckle tracking echocardiography (STE). Fifty patients with carotid stenosis ≥ 50% and a preserved LV ejection fraction (LVEF), and 45 controls without carotid stenosis who were matched in terms of vascular comorbidities were enrolled. All participants underwent carotid ultrasound and echocardiographic examination. The global LV longitudinal strain (GLS) was measured using STE. Compared with the control group, the e' of the mitral annular velocity and GLS were decreased in asymptomatic carotid stenosis patients (p < 0.05), however, the LVEF was well preserved. Based on a predefined cutoff for subclinical LV systolic dysfunction that was defined at a GLS < - 18%, this dysfunction was detected in 22 patients with carotid stenosis (44%) and in 10 patients in the control group (22%) (p < 0.05). The GLS was negatively correlated with the levels of low-density lipoprotein cholesterol (r = - 0.356, p < 0.05) and triglyceride (r = - 0.396, p < 0.05). In conclusion, LV diastolic and systolic functioning were significantly decreased in patients with asymptomatic carotid stenosis, and dyslipidemia likely contributed to the subclinical LV dysfunction in these patients. Our findings indicated the importance of detecting LV subclinical dysfunction and early intervention in this patient population.
无症状颈动脉狭窄患者的左心室亚临床功能障碍与动脉粥样硬化的关系可能过去被低估了，这可能是颈动脉狭窄患者过早死亡发生率高的原因。我们试图使用斑点追踪超声心动图（STE）评估无症状颈动脉狭窄患者的潜在心肌功能障碍。入选了 50 名颈动脉狭窄≥50%且左心室射血分数（LVEF）正常的颈动脉狭窄患者和 45 名在血管合并症方面相匹配的无颈动脉狭窄对照者。所有参与者均接受颈动脉超声和超声心动图检查。使用 STE 测量整体左心室纵向应变（GLS）。与对照组相比，无症状颈动脉狭窄患者的二尖瓣环速度 e'和 GLS 降低（p<0.05），但 LVEF 保持良好。根据定义为 GLS<−18%的亚临床左心室收缩功能障碍的预设截断值，在 22 名颈动脉狭窄患者（44%）和 10 名对照组患者（22%）中检测到这种功能障碍（p<0.05）。GLS 与低密度脂蛋白胆固醇（r=−0.356，p<0.05）和甘油三酯（r=−0.396，p<0.05）水平呈负相关。总之，无症状颈动脉狭窄患者的左心室舒张和收缩功能明显降低，血脂异常可能导致这些患者的亚临床左心室功能障碍。我们的研究结果表明，在该患者人群中检测左心室亚临床功能障碍和早期干预的重要性。
