Paniczko Marlena, Chlabicz Małgorzata, Jamiołkowski Jacek, Sowa Paweł, Szpakowicz Małgorzata, Łapińska Magda, Kondraciuk Marcin, Ptaszyńska-Kopczyńska Katarzyna, Raczkowski Andrzej, Szpakowicz Anna, Kamiński Karol Adam
Department of Population Medicine and Civilization Diseases Prevention, Medical University of Bialystok, 15-269 Bialystok, Poland.
Department of Invasive Cardiology, Medical University of Bialystok, 15-269 Bialystok, Poland.
J Clin Med. 2020 Dec 3;9(12):3924. doi: 10.3390/jcm9123924.
Left ventricular diastolic dysfunction (LVDD) is caused by a decreased left ventricle relaxation and is associated with an increased risk of symptomatic heart failure (HF) and excessive mortality.
To evaluate the frequency and factors related to LVDD in the population with chronic coronary syndromes (CCS).
200 patients (mean age 63.18 ± 8.12 years, 75.5% male) with CCS were included. LVDD was diagnosed based on the recent echocardiography guidelines.
LVDD was diagnosed in 38.5% of CCS population. From the studied factors, after adjustment for age, sex, and N-terminal pro-brain natriuretic peptide (NT-proBNP), LVDD associated positively with android/gynoid (A/G) fat mass ratio, left ventricular mass index (LVMI), and negatively with Z-score and left ventricular ejection fraction (LVEF). In stepwise backward logistic regression analysis, the strongest factors associated with LVDD were pulse wave velocity value, handgrip strength and waist to hip ratio (WHR).
LVDD is common among CCS patients and it is associated with parameters reflecting android type fat distribution regardless of NT-proBNP and high-sensitivity troponin T concentrations. Deterioration in diastolic dysfunction is linked with increased aortic stiffness independently of age and sex. Further studies evaluating the effects of increasing physical fitness and lowering abdominal fat accumulations on LVDD in CCS patients should be considered.
左心室舒张功能障碍（LVDD）由左心室舒张功能减退引起，与有症状心力衰竭（HF）风险增加及死亡率过高相关。
评估慢性冠状动脉综合征（CCS）人群中LVDD的发生率及相关因素。
纳入200例CCS患者（平均年龄63.18±8.12岁，男性占75.5%）。根据最新超声心动图指南诊断LVDD。
38.5%的CCS人群被诊断为LVDD。在研究的因素中，校正年龄、性别和N末端脑钠肽前体（NT-proBNP）后，LVDD与男性/女性（A/G）脂肪量比值、左心室质量指数（LVMI）呈正相关，与Z评分和左心室射血分数（LVEF）呈负相关。在逐步向后逻辑回归分析中，与LVDD相关的最强因素是脉搏波速度值、握力和腰臀比（WHR）。
LVDD在CCS患者中很常见，且与反映男性型脂肪分布的参数相关，与NT-proBNP和高敏肌钙蛋白T浓度无关。舒张功能障碍的恶化与主动脉僵硬度增加有关，独立于年龄和性别。应考虑进一步研究评估增强体质和减少腹部脂肪堆积对CCS患者LVDD的影响。
