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根据2016年美国超声心动图学会/欧洲心血管影像学会建议评估扩张型心肌病的左室舒张功能

Evaluation of Left Diastolic Function in Dilated Cardiomyopathy According to the 2016 ASE/EACVI Recommendations.

作者信息

Pham Quang Tuan, Tran Thua Nguyen, Le-Thi Thanh Thuy, Phan Anh Khoa, Nguyen Anh Vu

机构信息

Cardiology Department, Hue Central Hospital, Hue City, Vietnam.

Department of General Internal Medicine and Geriatrics, Hue Central Hospital, Hue City, Vietnam.

出版信息

Int J Gen Med. 2022 Apr 30;15:4527-4533. doi: 10.2147/IJGM.S359248. eCollection 2022.

Abstract

OBJECTIVES

To assess left ventricular diastolic function by using echocardiography in patients with dilated cardiomyopathy, and the relationship between left ventricular diastolic function and left ventricular dilatation, New York Heart Association (NYHA) heart failure index, left ventricular ejection fraction, and left ventricular fractional shortening.

METHODS

A descriptive cross-sectional study was conducted on patients with primary dilated cardiomyopathy hospitalized in Hue Central Hospital from April 2018 to August 2020.

RESULTS

The mean end-diastolic left ventricular volume was 133.57±31.58 mL and the mean end-systolic left ventricular volume was 99.9±26.03 mL. The mean left atrial volume was 61.63±27.13 mL. The mean end-diastolic and end-systolic left ventricular diameters were 66.11±7.3 mm and 57.7±8.02 mm, respectively. The mean left ventricular ejection fraction was 24.68±5.97%. The mean left ventricular fractional shortening was 12.91±4.55%. The highest rate was grade II diastolic dysfunction (44.6%), followed by grade III diastolic dysfunction (35.8%) and grade I diastolic dysfunction at 19.6%. There was a moderate positive correlation between the left ventricular diastolic dysfunction and the NYHA class of heart failure with r=0.445, <0.001. All dilated cardiomyopathy patients in the study group had mainly grade II-III severe diastolic dysfunction.

CONCLUSIONS

Routine evaluation of diastolic function in patients with heart failure can help in elucidation of pathogenesis and management of patients. This dysfunction was clearly demonstrated by the change in the parameters of the evaluation of left ventricular diastolic function on echocardiography according to the 2016 ASE/EACVI recommendations, a new recommendation introduced to approach the assessment of diastolic function in a more convenient and easier way.

摘要

目的

运用超声心动图评估扩张型心肌病患者的左心室舒张功能,以及左心室舒张功能与左心室扩张、纽约心脏病协会(NYHA)心力衰竭指数、左心室射血分数和左心室缩短分数之间的关系。

方法

对2018年4月至2020年8月在顺化中心医院住院的原发性扩张型心肌病患者进行描述性横断面研究。

结果

左心室舒张末期平均容积为133.57±31.58 mL,左心室收缩末期平均容积为99.9±26.03 mL。左心房平均容积为61.63±27.13 mL。左心室舒张末期和收缩末期平均直径分别为66.11±7.3 mm和57.7±8.02 mm。左心室平均射血分数为24.68±5.97%。左心室平均缩短分数为12.91±4.55%。舒张功能障碍发生率最高的是Ⅱ级(44.6%),其次是Ⅲ级舒张功能障碍(35.8%),Ⅰ级舒张功能障碍为19.6%。左心室舒张功能障碍与NYHA心力衰竭分级之间存在中度正相关,r = 0.445,P<0.001。研究组所有扩张型心肌病患者主要为Ⅱ-Ⅲ级严重舒张功能障碍。

结论

对心力衰竭患者进行舒张功能的常规评估有助于阐明发病机制和患者管理。根据2016年美国超声心动图学会/欧洲心血管影像学会(ASE/EACVI)建议,通过超声心动图评估左心室舒张功能参数的变化清楚地显示了这种功能障碍,这是一项新建议,旨在以更方便、更容易的方式进行舒张功能评估。

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