Nemes Attila, Kormányos Árpád, Ruzsa Zoltán, Achim Alexandru, Ambrus Nóra, Lengyel Csaba
Department of Medicine, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary.
Int J Cardiol Heart Vasc. 2023 Jul 6;47:101236. doi: 10.1016/j.ijcha.2023.101236. eCollection 2023 Aug.
Cardiac haemodynamics is described by the Frank-Starling law, which states that the strength of the left ventricular (LV) systolic contraction is related to the LV diastolic filling, with other words LV stroke volume increases as LV volume increases due to the stretching of the myocyte. The purpose of the present study was to examine how the increasing LV volumes affect LV contractility represented by three-dimensional (3D) speckle-tracking echocardiography (3DSTE) -derived LV strains in healthy adults.
This is post-hoc analysis of the MAGYAR-Healthy Study employing a novel method for technical analysis of echocardiographic datasets. The present study consisted of 301 healthy adults. Due to inferior image quality, 127 subjects have been excluded, therefore the remaining population included 174 subjects (mean age: 32.9 ± 12.1 years, 80 males). All cases have undergone complete two-dimensional Doppler echocardiography extended with 3DSTE.
LV global longitudinal (gLS) and area (gAS) strains were lowest in case of the highest LV end-diastolic volume (EDV). LV global radial (gRS) and 3D (g3DS) strains tendentiously increased with increasing LV-EDV. When segmental analysis was performed, increased LV-EDV was associated with increase of basal LV-RS and LV-3DS. Increased LV strains were associated with increased LV ejection fraction (EF) due to higher LV-EDV for LV-gRS (and LV-g3DS), lower LV-ESV for LV-gCS and lower LV-EDV and LV-ESV for LV-gLS (and LV-gAS). With increasing LV-gRS, LV-gCS and LV-g3DS, all LV strains increased except LV-gLS. With increasing LV-gLS, LV-gRS did not show any increase, LV-gCS and LV-g3DS were the highest when LV-gLS was the highest, while LV-gAS increased simultaneously. With increasing LV-gAS, all LV strains increased.
There is a complex contractility pattern of LV segments/regions in response to elevated LV volumes in healthy circumstances.
心脏血流动力学由弗兰克 - 斯塔林定律描述，该定律指出左心室（LV）收缩期收缩强度与LV舒张期充盈有关，换句话说，由于心肌细胞的拉伸，LV每搏输出量随着LV容积增加而增加。本研究的目的是探讨LV容积增加如何影响健康成年人中由三维（3D）斑点追踪超声心动图（3DSTE）得出的LV应变所代表的LV收缩性。
这是对MAGYAR - 健康研究的事后分析，采用了一种用于超声心动图数据集技术分析的新方法。本研究包括301名健康成年人。由于图像质量较差，排除了127名受试者，因此其余人群包括174名受试者（平均年龄：32.9±12.1岁，80名男性）。所有病例均接受了扩展3DSTE的完整二维多普勒超声心动图检查。
在LV舒张末期容积（EDV）最高的情况下，LV整体纵向（gLS）和面积（gAS）应变最低。LV整体径向（gRS）和三维（g3DS）应变随着LV - EDV的增加而呈上升趋势。进行节段分析时，LV - EDV增加与基底LV - RS和LV - 3DS增加相关。LV应变增加与LV射血分数（EF）增加相关，这是由于LV - gRS（和LV - g3DS）的LV - EDV较高，LV - gCS的LV - ESV较低，以及LV - gLS（和LV - gAS）的LV - EDV和LV - ESV较低。随着LV - gRS、LV - gCS和LV - g3DS增加，除LV - gLS外所有LV应变均增加。随着LV - gLS增加，LV - gRS未显示任何增加，当LV - gLS最高时LV - gCS和LV - g3DS最高，而LV - gAS同时增加。随着LV - gAS增加，所有LV应变均增加。
在健康情况下，LV容积升高时LV节段/区域存在复杂的收缩性模式。
