Gu Haojie, Liang Guoliang, Zhang Wenhao, Gu Xinxin, Zhang Qiong, Ma Jiangwei
Intensive Care Unit, Fudan University Shanghai Cancer Center, Shanghai, China.
Department of Cardiovascular Medicine, Fengxian Central Hospital, Shanghai, China.
Front Cardiovasc Med. 2025 Aug 22;12:1575077. doi: 10.3389/fcvm.2025.1575077. eCollection 2025.
Arterial compliance is an independent predictor of diastolic dysfunction. Invasive catheterization can accurately reflect diastolic function. However, studies on the invasive assessment of diastolic function are currently limited. This study aimed to determine whether the diastolic function of the heart can be predicted by combining noninvasive detection of arterial elasticity indicators.
This cross-sectional study included 390 hospitalized patients suspected of having coronary heart disease and underwent coronary angiography (CAG) at the South Hospital of the Sixth People's Hospital Affiliated to Shanghai Jiaotong University from June 2020 to June 2021. According to the degree of coronary artery stenosis, they were divided into group A (control, = 73), group B (coronary stenosis < 50%; = 128), and group C (coronary stenosis ≥ 50%; = 189). Data of all enrolled patients, such as clinical information as well as noninvasive ultrasound and invasive cardiac catheterization results, were registered.
Significant differences in Left ventricular ejection fraction (LVEF), Ratio of peak mitral valve blood flow during early diastolic period to mitral ring velocity (E/e'), Left atrial volume index (LAVI), Deceleration time (DT), Carotid-femoral pulse wave velocity (cfPWV), Maximum velocity of left ventricular rise (LV + dp/dtmax), Maximum velocity of left ventricular descent (LV-dp/dtmax) and the left ventricular isovolumic relaxation time constant T were observed among the three groups ( < 0.01). Bivariate correlation analysis showed that cfPWV was positively correlated with T ( = 0.69, < 0.01), E/e'( = 0.59, < 0.01), LAVI ( = 0.47, < 0.01). Multiple linear regression analysis showed that cfPWV was correlated with T ( = 0.44, < 0.01), E/e' ( = 0.24, < 0.01), LAVI ( = 0.17, < 0.01). Binary Logistic regression analysis showed that elevated cfPWV was associated with an increased risk of left ventricular hypodiastolic function [odds ratio (OR) = 3.30, 95% confidence interval (CI): 2.18-4.98, < 0.01]. ROC curve analysis showed that the area under the curve of cfPWV response to diastolic dysfunction was 0.88 (95% CI: 0.85-0.91).
cfPWV is significantly associated with left ventricular diastolic dysfunction in patients with coronary heart disease, and may also be used as a sensitive indicator to predict left ventricular diastolic dysfunction.
动脉顺应性是舒张功能障碍的独立预测指标。有创导管检查可准确反映舒张功能。然而，目前关于舒张功能的有创评估研究有限。本研究旨在确定通过联合无创检测动脉弹性指标能否预测心脏舒张功能。
本横断面研究纳入了2020年6月至2021年6月在上海交通大学附属第六人民医院南院疑似患有冠心病并接受冠状动脉造影（CAG）的390例住院患者。根据冠状动脉狭窄程度，将他们分为A组（对照组，n = 73）、B组（冠状动脉狭窄<50%；n = 128）和C组（冠状动脉狭窄≥50%；n = 189）。记录所有纳入患者的临床信息、无创超声及有创心导管检查结果等数据。
三组间左心室射血分数（LVEF）、舒张早期二尖瓣血流峰值与二尖瓣环速度比值（E/e'）、左心房容积指数（LAVI）、减速时间（DT）、颈股脉搏波速度（cfPWV）、左心室上升最大速度（LV + dp/dtmax）、左心室下降最大速度（LV - dp/dtmax）及左心室等容舒张时间常数T存在显著差异（P < 0.01）。双变量相关性分析显示，cfPWV与T（r = 0.69，P < 0.01）、E/e'（r = 0.59，P < 0.01）、LAVI（r = 0.47，P < 0.01）呈正相关。多元线性回归分析显示，cfPWV与T（r = 0.44，P < 0.01）、E/e'（r = 0.24，P < 0.01）、LAVI（r = 0.17，P < 0.01）相关。二元Logistic回归分析显示，cfPWV升高与左心室舒张功能减退风险增加相关[比值比（OR）= 3.30，95%置信区间（CI）：2.18 - 4.98，P < 0.01]。ROC曲线分析显示，cfPWV对舒张功能障碍反应的曲线下面积为0.88（95%CI：0.85 - 0.91）。
cfPWV与冠心病患者左心室舒张功能障碍显著相关，也可能作为预测左心室舒张功能障碍的敏感指标。
