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整体纵向应变评分可预测多发性硬化症患者的亚临床心脏受累情况。

Global Longitudinal Strain score predicts subclinical cardiac involvement of multiple sclerosis patients.

作者信息

Demir Fidel, Özbek Mehmet, Akıl Mehmet Ata, Akıl Eşref

机构信息

Department of Neurology, Selahaddin Eyyubi State Hospital, Diyarbakır, Turkey.

Department of Cardiology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey.

出版信息

Neurol Sci. 2025 May;46(5):2217-2222. doi: 10.1007/s10072-025-08041-w. Epub 2025 Feb 15.

Abstract

BACKGROUND

People with multiple sclerosis (MS) have a higher risk of cardiovascular disease than the general population, but the data are limited. Evaluation with strain echocardiography, a new echocardiographic method, can provide more objective data to evaluate global and segmental left ventricular systolic functions. Left ventricular Global Longitudinal Strain (GLS) may be useful in demonstrating subclinical myocardial dysfunction in MS, therefore we planned such a study. We aim to evaluate LV functions with GLS obtained with basal tissue doppler in people with MS.

MATERIAL AND METHODS

A comparison of the demographic laboratory and echocardiographic findings of the multiple sclerosis patients with strain echocardiography records registered in our hospital and the control group with similar age and gender was performed. 80 RRMS patients and 65 control group were compared. Those with another chronic disease, those who received exacerbation treatment within the last month, those outside the age range of 18-65, and other forms of progressive MS were excluded from the study.

RESULTS

GLS scores was significantly lower in the MS group(-17.05 ± 1.33 vs.18.99 ± 1.08, p < 0.001). The optimal GLS score predicted poor LV functional status in people with MS with high EDSS scores with cut-off value ≤ 17.10, sensitivity of 73%, specificity of 58% [AUC: 0.652 95% CI, (0.531-0.773), p = 0.023]. It was observed that as the EDSS score increased, that is, in the presence of worse clinical condition, the GLS score decreased (r = -0.245, p = 0.003).

CONCLUSIONS

We think that strain echocardiography may be useful in demonstrating subclinical myocardial damage in people with MS. We found that as the EDSS score, that is, the severity of the disease, increases, the subclinical effect on cardiac functions increases.

摘要

背景

与普通人群相比,多发性硬化症(MS)患者患心血管疾病的风险更高,但相关数据有限。应变超声心动图是一种新的超声心动图方法,其评估可为评估左心室整体和节段性收缩功能提供更客观的数据。左心室整体纵向应变(GLS)可能有助于证明MS患者存在亚临床心肌功能障碍,因此我们计划开展这样一项研究。我们旨在通过基础组织多普勒获得的GLS来评估MS患者的左心室功能。

材料与方法

对我院登记的多发性硬化症患者的人口统计学、实验室检查及应变超声心动图记录结果与年龄和性别相似的对照组进行比较。比较了80例复发缓解型多发性硬化症(RRMS)患者和65例对照组。患有其他慢性病、在过去一个月内接受过病情加重治疗、年龄不在18 - 65岁范围内以及其他形式的进展型MS患者被排除在研究之外。

结果

MS组的GLS评分显著更低(-17.05±1.33对18.99±1.08,p < 0.001)。最佳GLS评分预测EDSS评分高(截止值≤17.10)的MS患者左心室功能状态较差,敏感性为73%,特异性为58% [曲线下面积(AUC):0.652,95%置信区间(0.531 - 0.773),p = 0.023]。观察到随着EDSS评分增加,即临床状况越差,GLS评分越低(r = -0.245,p = 0.003)。

结论

我们认为应变超声心动图可能有助于证明MS患者存在亚临床心肌损伤。我们发现随着EDSS评分即疾病严重程度增加,对心脏功能的亚临床影响也增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ca6/12003605/978c2129f8dc/10072_2025_8041_Fig1_HTML.jpg

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