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心肌工作评估在动脉高血压和心血管疾病中的临床应用

Clinical utility of myocardial work assessment in arterial hypertension and cardiovascular diseases.

作者信息

Vitali Andrea, Zouein Fouad A, Booz George W, Altara Raffaele

机构信息

Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, School of Medicine, Sapienza University, Rome, Italy -

Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.

出版信息

Minerva Cardiol Angiol. 2025 Aug;73(4):400-409. doi: 10.23736/S2724-5683.24.06654-7. Epub 2025 Jan 30.

Abstract

In clinical practice, ventricular ejection fraction (EF) and global longitudinal strain (GLS) are the most often used parameters for evaluating left ventricular systolic function, despite the impact that variable loading conditions have. Alternatively, the myocardial efficiency (ME) of the heart, encompassing cardiac energy formation and dissipation, along with myocardial oxygen consumption (MVO2), is a useful surrogate for assessing myocardial work (MW), a parameter correlated with the pressure-strain loop (PSL), arterial pressure, and cardiac output (CO). This refinement proves especially practical in defining cardiac work across various clinical contexts, including arterial hypertension and heart failure (HF), the primary conditions associated with cardiovascular mortality. In this review, we explore how many invasive and non-invasive studies have shown that MW and consequently ME are correlated with the state of cardiovascular wellbeing and myocardial performance, allowing it to be integrated with other parameters present in clinical practice.

摘要

在临床实践中,尽管存在可变负荷条件的影响,但心室射血分数(EF)和整体纵向应变(GLS)是评估左心室收缩功能最常用的参数。另外,心脏的心肌效率(ME),包括心脏能量的产生和消耗,以及心肌耗氧量(MVO₂),是评估心肌功(MW)的一个有用替代指标,心肌功是一个与压力-应变环(PSL)、动脉压和心输出量(CO)相关的参数。这种细化在定义各种临床情况下的心脏功时特别实用,包括动脉高血压和心力衰竭(HF),这是与心血管死亡率相关的主要病症。在本综述中,我们探讨了许多侵入性和非侵入性研究如何表明心肌功以及因此的心肌效率与心血管健康状况和心肌性能相关,从而使其能够与临床实践中存在的其他参数相结合。

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