Health Management Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China.
Department of Echocardiography, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China.
Int J Cardiovasc Imaging. 2024 Oct;40(10):2193-2202. doi: 10.1007/s10554-024-03211-x. Epub 2024 Aug 7.
The aim of the study is to analyze ventricular-vascular properties with different ventricular-arterial coupling (VAC) ratio in the preeclamptic women. Seventy-seven pregnant women with preeclampsia and eighty-nine with normal pregnancy were performed echocardiography. VAC was defined as the ratio between aortic elastance (Ea) and left ventricular (LV) end-systolic elastance (Ees). Using the VAC value of 0.8 as the cut-off near uncoupling, the preeclampsia cases were divided into two subgroups: VAC ratio ≥ 0.8 and <0.8. Cardiac structure and function, VAC properties, as well as four components of the LV pressure-strain loop, including global myocardial work index (GWI), constructive work (GCW), wasted work (GWW), and work efficiency (GWE) were determined. The preeclampsia with VAC ≥ 0.8 had an enlarger indexed ventricular volume and a thicker relative ventricular wall than the VAC < 0.8. The Ees significantly increased in the subgroup with VAC < 0.8 and decreased in the VAC ≥ 0.8, while the Ea increased in both of them. The preeclampsia with VAC ≥ 0.8 showed an obvious augmentation in GWI, GCW and GWE, along with a similar GWW compared to those with VAC < 0.8. There were variable relationships between the LV pressure-strain components and VAC properties. Thus, the preeclampsia with VAC ≥ 0.8 undergoes a more adverse remodeling and a greater impact on cardiac contractility. The increased stiffness of the heart and arterial system, and increased resistance of peripheral vessels net lead to the deteriorative ventricular efficiency with elevated myocardial oxygen consumption during a preeclampsia pregnancy.
本研究旨在分析不同心室-动脉偶联（VAC）比值的子痫前期女性的心室血管特性。对 77 例子痫前期孕妇和 89 例正常妊娠孕妇进行超声心动图检查。VAC 定义为主动脉弹性（Ea）与左心室（LV）收缩末期弹性（Ees）的比值。使用 VAC 值为 0.8 作为接近去偶联的截止值，将子痫前期病例分为 VAC 比值≥0.8 和<0.8 两组。测定心脏结构和功能、VAC 特性以及 LV 压力应变环的四个组成部分，包括整体心肌做功指数（GWI）、构建功（GCW）、无效功（GWW）和工作效率（GWE）。VAC≥0.8 的子痫前期患者的指数化心室容积较大，相对室壁较厚。Ees 在 VAC<0.8 亚组中显著增加，而在 VAC≥0.8 亚组中则降低，而 Ea 在两组中均增加。VAC≥0.8 的子痫前期患者的 GWI、GCW 和 GWE 明显增加，而 GWW 与 VAC<0.8 的子痫前期患者相似。LV 压力应变成分与 VAC 特性之间存在可变关系。因此，VAC≥0.8 的子痫前期患者经历更不利的重构，对心脏收缩力的影响更大。心脏和动脉系统的僵硬度增加以及外周血管阻力增加导致子痫前期妊娠期间心肌耗氧量增加，心室效率恶化。
