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评价伴右冠状动脉近段显著狭窄的糖尿病患者的右心室功能。

The evaluation of right ventricular function in patients with diabetes mellitus and significant stenosis at the proximal portion of the right coronary artery.

机构信息

Department of Internal Medicine, Qom University of Medical Sciences, Qom, Islamic Republic of Iran.

Cardiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.

出版信息

J Ultrasound. 2022 Mar;25(1):9-17. doi: 10.1007/s40477-021-00573-z. Epub 2021 Feb 18.

Abstract

PURPOSE

Previous studies have indicated that right ventricular (RV) function is damaged in diabetes mellitus (DM); however, it is not clear whether in the presence of chronic ischemia, RV function is different between patients with and without DM (DM + and DM - , respectively).

METHODS

This cross-sectional study enrolled 90 consecutive candidates for coronary artery bypass graft surgery and allocated them to 3 groups: 24 DM - patients with the absence of stenosis of more than 50% in the proximal and mid parts of the right coronary artery (the DM - RCA - group [control]), 33 DM - patients with the presence of significant stenosis (> 70%) in the proximal part of RCA (the DM - RCA + group), and 33 DM + patients with RCA + (the DM + RCA + group). RV function was evaluated based on longitudinal deformation markers, measured via the 2D speckle-tracking echocardiographic examination of right ventricular free wall (RVFW).

RESULTS

The systolic strain value, systolic strain rate, and late diastolic strain rate of RVFW were not statistically significantly different between the three groups. Our adjusted post hoc analysis showed that the early diastolic strain rate of RVFW in the DM + RCA + group was lower than that in the DM - RCA + and DM - RCA - groups (1.5 s ± 0.4 vs 1.7 s ± 0.5 vs 1.7 s ± 0.4).

CONCLUSIONS

Diastolic function in the presence of DM was impaired irrespective of RCA - or RCA + . Additionally, RCA + had no effect on systolic and diastolic RV functions at rest in our DM - patients.

摘要

目的

先前的研究表明,右心室(RV)功能在糖尿病(DM)中受损;然而,在存在慢性缺血的情况下,DM 患者和非 DM 患者(分别为 DM⁺和 DM⁻)的 RV 功能是否不同尚不清楚。

方法

本横断面研究纳入了 90 名连续接受冠状动脉旁路移植术的候选者,并将他们分为 3 组:24 名无右冠状动脉近端和中段狭窄超过 50%的 DM⁻患者(DM⁻RCA⁻组[对照组]),33 名存在 RCA 近端显著狭窄(>70%)的 DM⁻患者(DM⁻RCA⁺组),以及 33 名 DM⁺患者和 RCA⁺(DM⁺RCA⁺组)。RV 功能通过二维斑点追踪超声心动图检查右室游离壁(RVFW)的纵向变形标志物进行评估。

结果

三组之间 RVFW 的收缩期应变值、收缩期应变率和晚期舒张期应变率无统计学差异。我们的调整后事后分析显示,DM⁺RCA⁺组 RVFW 的早期舒张期应变率低于 DM⁻RCA⁺组和 DM⁻RCA⁻组(1.5 s±0.4 比 1.7 s±0.5 比 1.7 s±0.4)。

结论

在存在 DM 的情况下,舒张功能受损,而不管 RCA⁺与否。此外,在我们的 DM⁻患者中,RCA⁺对静息时的收缩和舒张 RV 功能没有影响。

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Right ventricular dysfunction and remodeling in diabetic cardiomyopathy.糖尿病性心肌病中的右心室功能障碍和重构。
Am J Physiol Heart Circ Physiol. 2019 Jan 1;316(1):H113-H122. doi: 10.1152/ajpheart.00440.2018. Epub 2018 Nov 9.

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