Nemes Attila, Kormányos Árpád, Ruzsa Zoltán, Achim Alexandru, Ambrus Nóra, Lengyel Csaba
Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, 6725 Szeged, Hungary.
J Clin Med. 2023 Feb 3;12(3):1235. doi: 10.3390/jcm12031235.
: As has been established, the left ventricle (LV) and the left atrium (LA) form an organic unit of the left heart; however, little is known about the dependence of LV rotational parameters on LA volumes, even in healthy circumstances. Therefore, the present study aimed to assess the associations between basal and apical LV rotations and LA volumes and volume-based functional properties throughout the cardiac cycle in healthy adults by three-dimensional speckle-tracking echocardiography. : The present study comprised 167 healthy adults (age: 33.4 ± 12.6 years, 77 males) with normally directed LV rotational mechanics. All subjects underwent complete two-dimensional Doppler echocardiography with three-dimensional speckle-tracking echocardiography (3DSTE)-derived data acquisition. The 3DSTE-derived LA volumes and LV rotational parameters were determined at a later date. : An increasing end-systolic maximum LA volume (Vmax) was associated with increasing pre-atrial-contraction early (VpreA) and minimum end-diastolic (Vmin) LA volumes, and all stroke volumes were increased as well. Systolic basal left ventricular rotation (LVrot) was highest in the case of the highest systolic Vmax and early-diastolic VpreA. Apical LVrot did not show obvious associations with any increasing LA volumes. The highest systolic basal LVrot was associated with significantly increased diastolic VpreA and Vmin. Reduced diastolic LA volumes (VpreA, Vmin) were seen in the case of increased apical LVrot. An increasing basal LVrot was associated with the tendentious lowering of the apical LVrot and the significant elevation of LV twist. Similarly, an increasing apical LVrot was associated with the tendentious lowering of basal LVrot and the significant elevation of LV twist. : Strong associations and adaptations between 3DSTE-derived LA volumes throughout the cardiac cycle and LV rotational mechanics were evidenced, even in healthy circumstances.
如前所述,左心室(LV)和左心房(LA)构成左心的一个有机单元;然而,即使在健康情况下,关于左心室旋转参数对左心房容积的依赖性也知之甚少。因此,本研究旨在通过三维斑点追踪超声心动图评估健康成年人在整个心动周期中左心室基底和心尖旋转与左心房容积及基于容积的功能特性之间的关联。
本研究纳入了167名左心室旋转力学方向正常的健康成年人(年龄:33.4±12.6岁,男性77名)。所有受试者均接受了完整的二维多普勒超声心动图检查及三维斑点追踪超声心动图(3DSTE)数据采集。之后确定了3DSTE得出的左心房容积和左心室旋转参数。
收缩末期最大左心房容积(Vmax)增加与心房收缩前早期(VpreA)和舒张末期最小(Vmin)左心房容积增加相关,且所有搏出量也增加。收缩期基底左心室旋转(LVrot)在收缩期Vmax和舒张早期VpreA最高的情况下最高。心尖LVrot与任何增加的左心房容积均未显示出明显关联。收缩期基底LVrot最高与舒张期VpreA和Vmin显著增加相关。在心尖LVrot增加的情况下,舒张期左心房容积(VpreA、Vmin)减少。基底LVrot增加与心尖LVrot有降低趋势及左心室扭转显著升高相关。同样,心尖LVrot增加与基底LVrot有降低趋势及左心室扭转显著升高相关。
即使在健康情况下,也证明了整个心动周期中3DSTE得出的左心房容积与左心室旋转力学之间存在强烈关联和适应性。