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应用三维斑点追踪超声心动图评估不适当窦性心动过速患者的左房力学和左心室功能。

Assessment of left atrial mechanics and left ventricular functions using 3D speckle-tracking echocardiography in patients with inappropriate sinus tachycardia.

机构信息

Department of Cardiology, Training and Research Hospital, Usak University, 64100, Usak, Turkey.

Department of Cardiology, Samsun Training and Research Hospital, University of Health Sciences, 55090, Samsun, Turkey.

出版信息

Int J Cardiovasc Imaging. 2020 Aug;36(8):1489-1495. doi: 10.1007/s10554-020-01858-w. Epub 2020 Apr 23.

Abstract

PURPOSE

Inappropriate sinus tachycardia (IST) is defined as a sinus heart rate > 100 bpm at rest (with a mean 24-h heart rate > 90 bpm not due to primary causes) and is associated with distressing symptoms of palpitations. The effect of IST on left atrial (LA) and left ventricular (LV) myocardial dynamics is uncertain. Thus, the aim of this study was to identify early changes in LA mechanics and LV myocardial functions in patients with IST using 3D-STE.

METHODS

Sixty patients with IST and 65 age- and gender-matched controls were enrolled into the study. Conventional 2D echocardiography and 3D-STE were performed, and LAS-r, LAS-active, LAS-passive, LAEF, LAEF-active, LAEF-passive, LV-GLS, LV-GCS, LV-GAS, and LV-GRS were obtained for every patient.

RESULTS

The LAS-r and LAS-active were significantly decreased in the IST group than in the control group (p < 0.001, p = 0.004, respectively). The multivariate logistic regression models revealed that LAS-r (p = 0.008, Odds ratio (OR) 5.98, 95% confidence interval (CI) 2.36-11.18), and LAS-active (p = 0.032, OR 2.16, 95% CI 1.97-4.69) were found to be independent factors for predicting IST.

CONCLUSIONS

The present study is the first to evaluate the left atrial mechanics and left ventricular functions in the patients with IST using 3D-STE. We found that IST had a negative effect on left atrial mechanics. According to our findings, we can say that IST is not a completely innocent, benign clinical condition, but rather, it causes subclinical left atrial dysfunction.

摘要

目的

不适当窦性心动过速(IST)定义为静息状态下窦性心率>100 次/分(平均 24 小时心率>90 次/分,且非原发性原因所致),并伴有心悸等令人不适的症状。IST 对左心房(LA)和左心室(LV)心肌动力学的影响尚不确定。因此,本研究旨在使用 3D-STE 确定 IST 患者 LA 力学和 LV 心肌功能的早期变化。

方法

本研究纳入 60 例 IST 患者和 65 例年龄和性别匹配的对照组。对所有患者进行常规 2 维超声心动图和 3D-STE 检查,并获取 LAS-r、LAS-active、LAS-passive、LAEF、LAEF-active、LAEF-passive、LV-GLS、LV-GCS、LV-GAS 和 LV-GRS。

结果

与对照组相比,IST 组的 LAS-r 和 LAS-active 明显降低(p<0.001,p=0.004)。多变量逻辑回归模型显示,LAS-r(p=0.008,比值比(OR)5.98,95%置信区间(CI)2.36-11.18)和 LAS-active(p=0.032,OR 2.16,95% CI 1.97-4.69)是预测 IST 的独立因素。

结论

本研究首次使用 3D-STE 评估 IST 患者的左心房力学和左心室功能。我们发现 IST 对左心房力学有负面影响。根据我们的发现,可以说 IST 不是一种完全无害的良性临床情况,而是会导致亚临床左心房功能障碍。

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