Department of Ultrasound, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People's Republic of China.
Int J Cardiovasc Imaging. 2023 Sep;39(9):1657-1666. doi: 10.1007/s10554-023-02879-x. Epub 2023 May 26.
Many patients with ischaemia with non-obstructive coronary arteries (INOCA) have a poor prognosis. This study aims to explore the diagnostic value of left ventricular hypertrophy (LVH)-related ultrasound parameters in INOCA patients. The study group consisted of 258 patients with INOCA in this retrospective cross-sectional study, and these patients were free of obstructive coronary artery disease, previous revascularization, atrial fibrillation, ejection fraction < 50%, major distortions of left ventricular geometry, suspected non-ischaemic causes. Control individuals were matched 1:1 with study group according to age, sex, cardiovascular risk factors, and time of hospital stay. According to left ventricular mass index (LVMI) and relative wall thickness, left ventricular geometry was composed of concentric hypertrophy, eccentric hypertrophy, concentric remodeling and normal geometry. LVH-related parameters, left ventricular geometry, demographic characteristics, laboratory parameters and other echocardiographic indicators were compared between the two groups. Subgroup analysis was performed based on sex. LVMI in the study group was higher than that in the control group (86.86 ± 18.83 g/m vs 82.25 ± 14.29 g/m, P = 0.008). The ratio of LVH was higher in the study group (20.16% vs 10.85%, P = 0.006). After subgroup analysis based on sex, LVMI differences (85.77 ± 18.30 g/m vs 81.59 ± 14.64 g/m, P = 0.014) and the ratio of LVH differences (25.00% vs 14.77%, P = 0.027) still existed in females between the two groups. There was no difference in the constituent ratio of left ventricular geometry between the two groups (P = 0.157). Sex-based subgroup analysis showed no difference in the constituent ratio of left ventricular geometry between the two groups in females (P = 0.242). The degree of LVH in the study group was higher than that in the control group, suggesting that LVH may play an important role in the occurrence and development of INOCA. Moreover, LVH-related ultrasound parameters may be of higher diagnostic value for female INOCA patients than for male INOCA patients.
许多非阻塞性冠状动脉疾病（INOCA）伴缺血的患者预后较差。本研究旨在探讨左心室肥厚（LVH）相关超声参数在 INOCA 患者中的诊断价值。该研究为回顾性横断面研究，纳入 258 例 INOCA 患者，这些患者无阻塞性冠状动脉疾病、既往血运重建、心房颤动、射血分数<50%、左心室几何结构严重扭曲、疑似非缺血性病因。对照组按照年龄、性别、心血管危险因素和住院时间与研究组 1:1 匹配。根据左心室质量指数（LVMI）和相对室壁厚度，左心室几何形状由向心性肥厚、偏心性肥厚、向心性重构和正常几何形状组成。比较两组间 LVH 相关参数、左心室几何形状、人口统计学特征、实验室参数和其他超声心动图指标。根据性别进行亚组分析。研究组的 LVMI 高于对照组（86.86±18.83 g/m2 vs 82.25±14.29 g/m2，P=0.008）。研究组的 LVH 比例更高（20.16% vs 10.85%，P=0.006）。根据性别进行亚组分析后，两组女性间的 LVMI 差异（85.77±18.30 g/m2 vs 81.59±14.64 g/m2，P=0.014）和 LVH 比例差异（25.00% vs 14.77%，P=0.027）仍存在。两组间左心室几何形状的构成比例无差异（P=0.157）。性别亚组分析显示，两组女性间左心室几何形状的构成比例无差异（P=0.242）。研究组的 LVH 程度高于对照组，提示 LVH 可能在 INOCA 的发生和发展中起重要作用。此外，LVH 相关超声参数对女性 INOCA 患者的诊断价值可能高于男性 INOCA 患者。
