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接受冠状动脉造影患者有创测量的主动脉压力与左心室舒张末期压力之间的相关性。

Correlations between invasively measured aortic pressures and left ventricular end-diastolic pressure in patients undergoing coronary angiography.

作者信息

Kim Kyung-Jin, Kim Hack-Lyoung, Kang Do-Yoon, Park Seong-Hoon, Lim Woo-Hyun, Seo Jae-Bin, Kim Sang-Hyun, Zo Joo-Hee, Kim Myung-A

机构信息

Division of Cardiology, Department of Internal Medicine, Ewha Womans University Medical Center, Ewha Womans University School of Medicine.

Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine.

出版信息

Blood Press Monit. 2019 Oct;24(5):241-247. doi: 10.1097/MBP.0000000000000399.

Abstract

OBJECTIVE

Data on ventricular-arterial coupling using invasive hemodynamic studies are limited. This study was performed to clarify the interaction between aortic pressures and left ventricular end-diastolic pressure (LVEDP) using invasive catheterization.

PATIENTS AND METHODS

A total of 104 consecutive stable patients (mean age, 65.8 ± 10.0 years; 56% men) undergoing invasive coronary angiography (ICA) were prospectively evaluated. LVEDP and central aortic pressures [systolic blood pressure (aSBP) and diastolic blood pressure (aDBP)] were sequentially measured using a pigtail catheter before ICA. Aortic pulse pressure (aPP) was defined by the difference between aSBP and aDBP.

RESULTS

A total of 82 patients (79%) had obstructive coronary artery disease (≥50% stenosis). The mean LVEDP value was 18.7 ± 6.4 mmHg. Univariable analyses showed that aSBP (r = 0.309, P = 0.001) and aPP (r = 0.286, P = 0.003) significantly correlated with LVEDP, whereas aDBP was not correlated with LVEDP (P > 0.05). Multivariable analysis revealed that aSBP (β = 0.345, P = 0.001) and aPP (β = 0.276, P = 0.018) remained independent predictors of LVEDP even after controlling for potential confounders.

CONCLUSION

Invasively measured aSBP and aPP were independently associated with invasively measured LVEDP in patients undergoing ICA. This result provides additional evidence of a close interaction between central aortic pressure and LV diastolic function in this population.

摘要

目的

利用有创血流动力学研究获取的心室 - 动脉耦合数据有限。本研究旨在通过有创导管插入术阐明主动脉压力与左心室舒张末期压力(LVEDP)之间的相互作用。

患者与方法

前瞻性评估了104例连续接受有创冠状动脉造影(ICA)的稳定患者(平均年龄65.8±10.0岁;56%为男性)。在ICA之前,使用猪尾导管依次测量LVEDP和中心主动脉压力[收缩压(aSBP)和舒张压(aDBP)]。主动脉脉压(aPP)定义为aSBP与aDBP之差。

结果

共有82例患者(79%)患有阻塞性冠状动脉疾病(狭窄≥50%)。LVEDP的平均值为18.7±6.4 mmHg。单变量分析显示,aSBP(r = 0.309,P = 0.001)和aPP(r = 0.286,P = 0.003)与LVEDP显著相关,而aDBP与LVEDP无相关性(P>0.05)。多变量分析显示,即使在控制了潜在混杂因素后,aSBP(β = 0.345,P = 0.001)和aPP(β = 0.276,P = 0.018)仍然是LVEDP的独立预测因素。

结论

在接受ICA的患者中,有创测量的aSBP和aPP与有创测量的LVEDP独立相关。该结果为该人群中心主动脉压力与左心室舒张功能之间的密切相互作用提供了额外证据。

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