健康成年人左心室血流动力学参数的参考范围：一项斑点追踪超声心动图研究

Reference Ranges of Left Ventricular Hemodynamic Forces in Healthy Adults: A Speckle-Tracking Echocardiographic Study.

作者信息

Ferrara Francesco, Capuano Francesco, Cocchia Rosangela, Ranieri Brigida, Contaldi Carla, Lacava Graziella, Capone Valentina, Chianese Salvatore, Rega Salvatore, Annunziata Roberto, Sepe Chiara, Salzano Andrea, Citro Rodolfo, D'Andrea Antonello, Mauro Ciro, Cademartiri Filippo, Pedrizzetti Gianni, Bossone Eduardo

机构信息

Cardio-Thoracic-Vascular Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", 84125 Salerno, Italy.

Department of Mechanics, Mathematics and Management, Polytechnic University of Bari, 70126 Bari, Italy.

出版信息

J Clin Med. 2021 Dec 17;10(24):5937. doi: 10.3390/jcm10245937.

BACKGROUND

The normal limits of left ventricular (LV) hemodynamic forces (HDFs) are not exactly known. The aim of this study was to explore the full spectrum of HDF parameters in healthy subjects and determine their physiologic correlates.

METHODS

269 healthy subjects were enrolled (mean age: 43 ± 14 years; 123 (45.7%) men). All participants underwent an echo-Doppler examination. Tri-plane tissue tracking from apical views was used to measure 2D global endocardial longitudinal strain (GLS), circumferential strain (GCS), and LV HDFs. HDFs were normalized with LV volume and divided by specific weight.

RESULTS

LV systolic longitudinal HDFs (%) were higher in men (20.8 ± 6.5 vs. 18.9 ± 5.6, = 0.009; 22.0 ± 6.7 vs. 19.8 ± 5.6, = 0.004, respectively). There was a significant correlation between GCS (increased) (r = -0.240, < 0.001) and LV longitudinal HDFs (reduced) (r = -0.155, = 0.01) with age. In a multivariable analysis age, BSA, pulse pressure, heart rate and GCS were the only independent variables associated with LV HDFs (β coefficient = -0.232, < 0.001; 0.149, = 0.003; 0.186, < 0.001; 0.396, < 0.001; -0.328, < 0.001; respectively).

CONCLUSION

We report on the physiologic range of LV HDFs. Knowledge of reference values of HDFs may prompt their implementation into clinical routine and allow a more comprehensive assessment of the LV function.

背景

左心室（LV）血流动力学力（HDFs）的正常范围尚不完全清楚。本研究的目的是探索健康受试者HDF参数的全谱，并确定其生理相关性。

方法

纳入269名健康受试者（平均年龄：43±14岁；123名（45.7%）男性）。所有参与者均接受了超声多普勒检查。采用心尖视图的三平面组织追踪技术测量二维整体心内膜纵向应变（GLS）、圆周应变（GCS）和左心室HDFs。HDFs用左心室容积进行标准化，并除以比重。

结果

男性的左心室收缩期纵向HDFs（%）更高（分别为20.8±6.5对18.9±5.6，P = 0.009；22.0±6.7对19.8±5.6，P = 0.004）。GCS（增加）（r = -0.240，P < 0.001）与左心室纵向HDFs（降低）（r = -0.155，P = 0.01）与年龄之间存在显著相关性。在多变量分析中，年龄、体表面积、脉压、心率和GCS是与左心室HDFs相关的唯一独立变量（β系数分别为-0.232，P < 0.001；0.149，P = 0.003；0.186，P < 0.001；0.396，P < 0.001；-0.328，P < 0.001）。