Left ventricular strain and strain rate: characterization of the effect of load in human subjects
Left ventricular strain and strain rate: characterization of the effect of load in human subjects
复制标题
DOI：
10.1093/ejechocard/jep214
复制
发表时间：
2010-04-01
影响因子：
--
通讯作者：
Prior, David L.
中科院分区：
文献类型：
--
作者：
Burns, Andrew T.;La Gerche, Andre;Prior, David L.
左心室（LV）应变和应变率已被提出作为收缩功能的新指标，然而，有有限的数据急性变化对这些参数的影响，同时Millar微压计LV压力和超声心动图进行评估18例。通过给予三硝酸甘油（GTN）和生理盐水液体负荷依次改变负荷。超声心动图斑点追踪成像用于量化收缩期峰值应变（S）和收缩期峰值应变率（SR S），并从微压计数据记录dp/dt max。GTN给药降低了前负荷（左室舒张末期压[LVEDP]：15.7 vs. 8.4 mmHg，P < 0.001）和后负荷（收缩末期室壁应力：74 vs. 43 x 10 3 dyn/cm 2，P < 0.001）。补液增加了前负荷（LVEDP：11.3 vs. 18.1 mmHg，P < 0.001），增加了室壁应力（53 vs. 62 x 10（3）dyn/cm（2），P < 0.003）。应用GTN后，环向SR S（-1.2vs.-1.7s（-1），P < 0.01）和纵向SR S（-0.9vs.-1.0s（-1），P < 0.001）均明显增加。灌注液体后，周向和纵向SR S分别降低（-1.5vs.-1.3s（-1），P < 0.01）和（-1.0vs.-0.9s（-1），P < 0.01）。随着前负荷和后负荷的增加，（r = 0.63，P < 0.001; r = 0.56，P < 0.001），纵向SR S（r = 0.42，P < 0.003; r = 0.49 P < 0.001）.环向和纵向峰值应变及收缩期应变率对负荷的急性变化敏感，这是在其作为收缩功能指标的应用中需要考虑的重要因素。
Left ventricular (LV) strain and strain rate have been proposed as novel indices of systolic function; however, there are limited data about the effect of acute changes on these parameters.Simultaneous Millar micromanometer LV pressure and echocardiographic assessment were performed on 18 patients. Loading was altered sequentially by the administration of glyceryl trinitrate (GTN) and saline fluid loading. Echocardiographic speckle tracking imaging was used to quantify the peak systolic strain (S) and peak systolic strain rate (SR S) and dp/dt max was recorded from the micromanometer data. GTN administration decreased preload (LV end diastolic pressure [LVEDP]: 15.7 vs. 8.4 mmHg, P < 0.001) and afterload (end systolic wall stress: 74 vs. 43 x 10(3)dyn/cm(2), P < 0.001). Administration of fluid increased preload (LVEDP: 11.3 vs. 18.1 mmHg, P < 0.001) and increased wall stress (53 vs. 62 x 10(3)dyn/cm(2), P < 0.003). Administration of GTN resulted in increased circumferential SR S (-1.2 vs. -1.7s(-1), P < 0.01) and longitudinal SR S (-0.9 vs. -1.0s(-1), P < 0.001). The administration of fluid resulted in decreased circumferential SR S (-1.5 vs. -1.3s(-1), P < 0.01) and longitudinal SR S (-1.0 vs. -0.9s(-1), P < 0.01). As preload and afterload increased, decrease in circumferential SR S (r = 0.63, P < 0.001; r = 0.56, P < 0.001) and longitudinal SR S were observed (r = 0.42, P < 0.003; r = 0.49 P < 0.001).Circumferential and longitudinal peak strain and systolic strain rate are sensitive to acute changes in load, an important factor that needs to be considered in their application as indices of systolic function.