舒张功能障碍患者左心室等容舒张期心肌做功的无创评估。
Noninvasive assessment of myocardial work during left ventricular isovolumic relaxation in patients with diastolic dysfunction.
机构信息
Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 Dahua Road, Beijing, P.R. China.
出版信息
BMC Cardiovasc Disord. 2023 Mar 10;23(1):129. doi: 10.1186/s12872-023-03156-4.
BACKGROUND
This study aims to investigate the value of myocardial work (MW) parameters during the isovolumic relaxation (IVR) period in patients with left ventricular diastolic dysfunction (LVDD).
METHODS
This study prospectively recruited 448 patients with risks for LVDD and 95 healthy subjects. An additional 42 patients with invasive measurements of left ventricular (LV) diastolic function were prospectively included. The MW parameters during IVR were noninvasively measured using EchoPAC.
RESULTS
The total myocardial work during IVR (MW), myocardial constructive work during IVR (MCW), myocardial wasted work during IVR (MWW), and myocardial work efficiency during IVR (MWE) of these patients were 122.5 ± 60.1 mmHg%, 85.7 ± 47.8 mmHg%, 36.7 ± 30.6 mmHg%, and 69.4 ± 17.8%, respectively. The MW during IVR was significantly different between patients and healthy subjects. For patients, MWE and MCW were significantly correlated with the LV E/e' ratio and left atrial volume index, MWE exhibited a significant correlation with the maximal rate of decrease in LV pressure (dp/dt per min) and tau, and the MWE corrected by IVRT also exhibited a significant correlation with tau.
CONCLUSIONS
MW during IVR significantly changes in patients with risks for LVDD, and is correlated to LV conventional diastolic indices, including dp/dt min and tau. Noninvasive MW during IVR may be a promising tool to evaluate the LV diastolic function.
背景
本研究旨在探讨左心室舒张功能障碍（LVDD）患者等容舒张期（IVR）心肌做功（MW）参数的价值。
方法
本研究前瞻性招募了 448 例 LVDD 风险患者和 95 例健康受试者。另外前瞻性纳入了 42 例接受左心室（LV）舒张功能有创测量的患者。使用 EchoPAC 无创测量 IVR 期间的 MW 参数。
结果
这些患者的 IVR 期间总心肌做功（MW）、IVR 期间心肌构形功（MCW）、IVR 期间心肌废功（MWW）和 IVR 期间心肌做功效率（MWE）分别为 122.5±60.1mmHg%、85.7±47.8mmHg%、36.7±30.6mmHg%和 69.4±17.8%。IVR 期间的 MW 在患者和健康受试者之间存在显著差异。对于患者，MWE 和 MCW 与 LV E/e' 比值和左心房容积指数显著相关，MWE 与 LV 压力下降最大速率（每分钟 dp/dt）和 tau 显著相关，经 IVRT 校正的 MWE 也与 tau 显著相关。
结论
LVDD 风险患者的 IVR 期间 MW 明显改变，与包括 dp/dt min 和 tau 在内的 LV 常规舒张指数相关。IVR 期间的无创 MW 可能是评估 LV 舒张功能的一种很有前途的工具。
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