Association between Left Ventricular Postsystolic Shortening and Diastolic Relaxation in Asymptomatic Patients with Systemic Hypertension.
Association between Left Ventricular Postsystolic Shortening and Diastolic Relaxation in Asymptomatic Patients with Systemic Hypertension.
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无症状全身性高血压患者左心室收缩后缩短与舒张期舒张之间的关联。
DOI：
10.1111/echo.13022
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Ishizaka N
中科院分区：
文献类型：
--
作者：
Nogi S;Ito T;Kizawa S;Shimamoto S;Sohmiya K;Hoshiga M;Ishizaka N
背景心肌收缩后缩短（PSS）是导致高血压左室舒张功能不全的重要原因，但这方面的研究很少。我们研究了这种关系，沿着与临床和其他心脏参数，在无症状的患者hypertension.MethodsWe分析了104例药物治疗高血压谁没有任何迹象或症状的心脏衰竭的常规和斑点跟踪超声心动图。计算多个LV节段的收缩后指数（总PSI）和整体纵向应变（GLS）的总和，并分别用作整体PSS和心肌收缩功能的测量。获得组织多普勒e'和斑点追踪导出的早期舒张期全局应变率（e' sr）作为LV舒张的指标。周向收缩末期应力也被确定为非侵入性和替代的心肌后负荷的测量。ResultsMain变量，与e'和e' SR被证明是年龄，LV质量指数，左心房容积指数，GLS，和总PSI。多变量分析包括性别、环周收缩末期应力和钙通道阻滞剂的使用作为可能的协变量，结果显示年龄（β = −0.29，P = 0.002），总PSI（β =-0.26，P = 0.008），左心室质量指数（β =-0.25，P = 0.017）是e'和年龄的重要独立决定因素，（β =-0.34，P < 0.001）和GLS（β =-0.28，P = 0.006）的e 'sr.ConclusionsOur的研究结果表明，虽然取决于GLS的程度，PSS可能会影响无症状，但治疗，高血压患者的舒张期舒张功能。
BackgroundFew data have existed on myocardial postsystolic shortening (PSS) accounting for left ventricular (LV) diastolic dysfunction in systemic hypertension. We examined this relationship, along with clinical and other cardiac parameters, in asymptomatic patients with hypertension.MethodsWe analyzed 104 patients on pharmacological treatment for hypertension who had no signs or symptoms of heart failure for conventional and speckle tracking echocardiography. The sum of the postsystolic index for multiple LV segments (total PSI) and global longitudinal strain (GLS) was computed and used as measures for global PSS and myocardial systolic function, respectively. The tissue Doppler e’ and the speckle tracking–derived global strain rate during early diastole (e'sr) were obtained as indicators of LV relaxation. The circumferential end‐systolic stress was also determined noninvasively and substituted for a measure of myocardial afterload.ResultsMain variables that correlated with the e’ and e'sr were shown to be age, LV mass index, left atrial volume index, GLS, and the total PSI. Multivariate analysis including gender, circumferential end‐systolic stress, and the use of calcium channel blockers as possible covariates revealed that age (β = −0.29, P = 0.002), total PSI (β = −0.26, P = 0.008), and LV mass index (β = −0.25, P = 0.017) were significant independent determinants of e’ and that age (β = −0.34, P < 0.001) and GLS (β = −0.28, P = 0.006) were of e'sr.ConclusionsOur findings indicate that while depending on the degree of GLS, PSS may affect diastolic relaxation in patients with asymptomatic, but treated, hypertensive patients.