Kangro T, Jonason T, Henriksen E, Ringqvist I
Department of Clinical Physiology, Central Hospital, Västerås, Sweden.
Clin Physiol. 1997 Nov;17(6):579-90. doi: 10.1111/j.1365-2281.1997.00061.x.
Doppler indices of left ventricular diastolic filling are associated with various cardiac and extracardiac factors. Afterload is one of the extracardiac factors influencing left ventricular diastolic filling. The distensibility of the great arteries is one of the components of afterload. In this study, the relation between Doppler indices of left ventricular filling and the distensibility of the common carotid arteries was investigated. We studied 237 subjects at 50 years of age with Doppler echocardiography and ultrasound examination of the common carotid arteries. The following Doppler indices of left ventricular filling were studied: peak early diastolic velocity E-wave, peak atrial diastolic velocity A-wave and early to atrial peak velocity ratio, E/A. Carotid arterial characteristics were: distensibility coefficient, carotid arterial diameter change in systole and fractional change in the carotid arterial diameter. The relation between Doppler indices of left ventricular filling and carotid arterial characteristics was assessed by univariate and multivariate regression analysis. There was a significant univariate, positive association between E/A ratio and carotid arterial distensibility (r = 0.27, P < 0.001), carotid arterial systolic diameter change (r = 0.19, P < 0.005) and fractional change of the carotid arterial diameter (r = 0.20, P < 0.005). In multivariate analysis, E/A ratio was independently associated with carotid arterial distensibility (P < 0.005), after adjusting for heart rate, body mass index and gender. Decreased carotid arterial distensibility was associated with a reduction in E/A ratio, suggesting that arterial distensibility may have an effect on left ventricular diastolic filling or that changes in the arterial elastic properties are associated with corresponding structural changes in the left ventricle.
左心室舒张期充盈的多普勒指数与多种心脏及心外因素相关。后负荷是影响左心室舒张期充盈的心外因素之一。大动脉的可扩张性是后负荷的组成部分之一。在本研究中,探讨了左心室充盈的多普勒指数与颈总动脉可扩张性之间的关系。我们对237名50岁的受试者进行了多普勒超声心动图检查及颈总动脉超声检查。研究了以下左心室充盈的多普勒指数:舒张早期峰值速度E波、舒张期心房峰值速度A波及E/A(舒张早期峰值速度与舒张期心房峰值速度之比)。颈动脉特征包括:可扩张系数、收缩期颈动脉直径变化及颈动脉直径的分数变化。通过单因素和多因素回归分析评估左心室充盈的多普勒指数与颈动脉特征之间的关系。E/A比值与颈动脉可扩张性(r = 0.27,P < 0.001)、颈动脉收缩期直径变化(r = 0.19,P < 0.005)及颈动脉直径分数变化(r = 于0.20,P < 0.005)之间存在显著的单因素正相关。在多因素分析中,校正心率、体重指数和性别后E/A比值与颈动脉可扩张性独立相关(P < 0.005)。颈动脉可扩张性降低与E/A比值降低相关,提示动脉可扩张性可能对左心室舒张期充盈有影响,或者动脉弹性特性的改变与左心室相应的结构变化相关。