Title社区高危人群左心室舒张功能与扭转及解旋运动的关系
Other TitlesAssociation between left ventricular twist/untwist and diastolic dysfunction of high cardiovascular risk population in the community
Authors吴国祥
杨颖
张宝娓
齐丽彤
陈峰
王淑玉
刘力生
赵锋
霍勇
Affiliation福建医科大学附属南平市第一医院心内科
100034,北京大学第一医院心内科
北京市高血压联盟
Keywords超声心动描记术
心室功能,左
扭转
Echocardiography
Ventricular function,left
Twist
Issue Date2012
Publisher中华心血管病杂志
Citation中华心血管病杂志.2012,40,(8),667-671.
Abstract目的 评价社区心血管疾病高危人群随左心室舒张功能障碍进展,左心室扭转及解旋运动的变化规律,探讨扭转及解旋运动与左心室舒张功能的关系.方法 横断面调查北京首钢社区620例具有心血管疾病高危因素的人群.行超声心动图测量左心室射血分数(LVEF),并依据二尖瓣口血流多普勒、二尖瓣环组织多普勒、肺动脉血流多普勒对LVEF正常者进行左心室舒张功能分级:舒张功能正常组(n =305)、轻度减低组(n=266)和中/重度减低组(n=49).采用二维斑点追踪技术,于胸骨旁心底短轴及心尖短轴切面分析测量峰值旋转角度及峰值左心室扭转角度(心底与心尖旋转角度之差)、峰值扭转速度、解旋速度、解旋率.比较各级舒张功能障碍间扭转-解旋参数.结果 舒张功能正常、轻度减低、中/重度减低组间比较,左心室扭转角度差异无统计学意义.与舒张功能正常组比较,轻度舒张功能减低组扭转速度[(129.3 ±45.3)./s比(118.0 ±36.2)o/s]及解旋速度绝对值[(- 132.9±50.4)./s比(- 121.2±41.4)./s]较大(P<0.01),解旋率差异无统计学意义.而中/重度舒张功能减低组扭转速度及解旋速度绝对值与舒张功能正常组比较,差异无统计学意义(P>0.05);中/重度舒张功能减低组解旋率为(41.9±32.9)./s,低于舒张功能正常组[(57.7±36.2)./s]及轻度舒张功能减低组[(60.9±39.9)./s,P均<0.01].结论 左心室扭转-解旋参数在轻度左心室舒张功能不全者中增强或维持,而在中/重度舒张功能不全者中恢复“正常”或降低.扭转-解旋运动的增强或维持可能是早期舒张功能障碍的代偿机制.
Objective To assess the association between left ventricular (LV) twist and untwist with the severity of diastolic dysfunction of high cardiovascular risk population in the community.Methods This cross-sectional survey was performed in high cardiovascular risk people with normal left ventricular (LV) ejection fraction in an urban community of Beijing (n =620 ). Normal LV diastolic function was defined in 305 subjects,mild diastolic dysfunction in 266 subjects and moderate/severe diastolic dysfunction in 49 subjects.Peak LV twist,peak twist velocity,peak untwist velocity and untwist rate were measured in apical and basal short-axis images using speckle tracking echocardiography.Results Peak LV twist was similar among subjects with normal diastolic function, mild diastolic dysfunction and moderate/severe diastolic dysfunction.Peak twist velocity [ ( 129.3 ±45.3 ) °/s vs.( 118.0 ±36.2) °/s ] and untwist velocity [ ( -132.9 ±50.4) °/s vs.( -121.2 ±41.4)°/s were significantly higher in mild diastolic dysfunction group than in normal diastolic function group ( all P < 0.01 ) and similar between normal diastolic function and moderate/severe diastolic dysfunction group (P > 0.05 ). Untwist rate of moderate/severe diastolic dysfunction decreased significantly than that of normal diastolic function [ (41.9 ± 32.9)°/s vs.(57.7 ± 36.2) °/s,P < 0.01 ] and mild diastolic dysfunction group [ (41.9 ± 32.9 ) °/s vs.( 60.9 ± 39.9 ) °/s,P < 0.01 ].Conclusions Twist and untwist parameters are increased/preserved in population with normal systolic function and mild diastolic dysfunction and “normalized” or reduced in those with advanced diastolic dysfunction.The maintaining (if not increasing) of LV twist in early diastolic dysfunction might serve as a compensatory mechanism in case of reduced myocardial relaxation in these subjects.
URIhttp://hdl.handle.net/20.500.11897/190722
ISSN0253-3758
DOI10.3760/cma.j.issn.0253-3758.2012.08.009
IndexedPubMed
中文核心期刊要目总览(PKU)
中国科技核心期刊(ISTIC)
中国科学引文数据库(CSCD)
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