Hult Lina, Kylhammar David, Engvall Jan, Östgren Carl Johan, Nyström Fredrik, Blomstrand Peter, Hedman Kristofer
Department of Clinical Physiology and, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Wallenberg Centre for Molecular Medicine, Linköping University, Linköping, Sweden.
Echo Res Pract. 2025 Sep 1;12(1):21. doi: 10.1186/s44156-025-00085-0.
Post-systolic shortening (PSS) has emerged as a method for evaluating left ventricular dysfunction. We aimed to determine whether pathological PSS, alone or in combination with global longitudinal strain (GLS), is a prognostic factor for major adverse cardiovascular events (MACEs) in patients with type 2 diabetes. We prospectively investigated 364 patients with type 2 diabetes aged 55-65 years in the CARDIPP study. All patients underwent echocardiography between 2005 and 2009. PSS, measured by speckle tracking echocardiography, was defined as myocardial contraction after aortic valve closure. Pathological PSS was defined as a post-systolic index > 5% and was calculated as follows: [(maximum longitudinal strain - peak systolic longitudinal strain)/(maximum longitudinal strain)]. The endpoint was any MACE, defined as hospitalization or death due to heart failure, myocardial infarction, or stroke. Cox proportional hazard ratios (HR) with 95% confidence intervals (CI) were calculated and adjusted for sex, age, body mass index, hypertension, smoking, previous cardiovascular events, and HbA1c level. The mean follow-up time was 11.2 ± 2.3 years.
Pathological PSS was associated with an increased risk of MACEs after adjustment for other cardiovascular risk factors (HR 2.20, 95% CI 1.11-4.37). Subjects with reduced GLS, PSS and GLS combined in a risk prediction model, had an adjusted HR for MACEs of 2.94 (95% CI 1.33-6.52).
Our results suggest that PSS may provide additional prognostic information for patients with T2D when used alone or in combination with GLS.
收缩期后缩短（PSS）已成为评估左心室功能障碍的一种方法。我们旨在确定病理性PSS单独或与整体纵向应变（GLS）联合使用时，是否为2型糖尿病患者主要不良心血管事件（MACE）的预后因素。我们在CARDIPP研究中对364例年龄在55 - 65岁的2型糖尿病患者进行了前瞻性调查。所有患者在2005年至2009年间接受了超声心动图检查。通过斑点追踪超声心动图测量的PSS定义为主动脉瓣关闭后的心肌收缩。病理性PSS定义为收缩期后指数>5%，计算方法如下：[（最大纵向应变 - 收缩期峰值纵向应变）/（最大纵向应变）]。终点为任何MACE，定义为因心力衰竭、心肌梗死或中风住院或死亡。计算Cox比例风险比（HR）及95%置信区间（CI），并对性别、年龄、体重指数、高血压、吸烟、既往心血管事件和糖化血红蛋白水平进行校正。平均随访时间为11.2±2.3年。
在对其他心血管危险因素进行校正后，病理性PSS与MACE风险增加相关（HR 2.20，95% CI 1.11 - 4.37）。在风险预测模型中，GLS降低、PSS以及GLS与PSS联合的受试者，MACE的校正HR为2.94（95% CI 1.33 - 6.52）。
我们的结果表明，PSS单独或与GLS联合使用时，可能为2型糖尿病患者提供额外的预后信息。
