NONINVASIVE ASSESSMENT OF SYSTOLIC AND DIASTOLIC LEFT-VENTRICULAR FUNCTION IN PATIENTS WITH CHRONIC SEVERE ANEMIA - A COMBINED M-MODE, 2-DIMENSIONAL, AND DOPPLER ECHOCARDIOGRAPHIC STUDY
NONINVASIVE ASSESSMENT OF SYSTOLIC AND DIASTOLIC LEFT-VENTRICULAR FUNCTION IN PATIENTS WITH CHRONIC SEVERE ANEMIA - A COMBINED M-MODE, 2-DIMENSIONAL, AND DOPPLER ECHOCARDIOGRAPHIC STUDY
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DOI：
10.1016/0002-8703(92)90066-5
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发表时间：
1992-12-01
影响因子：
4.8
通讯作者：
SHRIVASTAVA, S
中科院分区：
文献类型：
--
作者：
BAHL, VK;MALHOTRA, OP;SHRIVASTAVA, S
通过 M 型、二维和多普勒超声心动图对 31 名病程超过 3 个月的慢性严重贫血（血红蛋白低于 7 gm/dl）且无基础心脏病的患者进行了研究；还研究了同等数量的正常对照受试者。关于慢性严重贫血对心肌收缩功能的影响存在相互矛盾的报道，但舒张功能尚未得到系统评估。目前尚不确定单独贫血是否会导致结构正常的心脏出现心力衰竭。因此，我们对这些患者左心室收缩和舒张功能的超声心动图指标进行了详细研究。我们发现贫血患者的心率明显加快，舒张压和平均血压明显低于正常人。他们的心输出量和每搏输出量也显着升高，左心室也更大。通过收缩末期应力-尺寸关系评估的左心室收缩力增强。通过二尖瓣流入的多普勒评估没有发现舒张功能障碍的系统证据。也没有充血性心力衰竭的临床证据。我们的结论是，慢性严重贫血会导致收缩功能亢进但不损害舒张功能的高动力状态。在没有潜在心脏病的情况下，贫血不会导致充血性心力衰竭。
Thirty-one patients with chronic severe anemia of more than 3 months' duration (hemoglobin less than 7 gm/dl) and no underlying heart disease were studied by means of M-mode, two-dimensional, and Doppler echocardiography; an equal number of normal control subjects was also studied. There are conflicting reports regarding the influence of chronic severe anemia on systolic myocardial function, but diastolic function has not been systematically assessed. It is also uncertain whether anemia alone can cause heart failure in a structurally normal heart. We therefore performed a detailed study of echocardiographic indexes of systolic and diastolic left ventricular function in these patients. We found that patients with anemia have significantly faster heart rates and lower diastolic and mean blood pressures than normal subjects. They also have a significantly elevated cardiac output and stroke volume and larger left ventricles. Left ventricular contractility, assessed by the end-systolic stress-dimension relationship, was enhanced. There was no systematic evidence of diastolic dysfunction by Doppler assessment of mitral inflow. There was also no clinical evidence of congestive heart failure. We conclude that chronic severe anemia leads to a hyperdynamic state with systolic hyperfunction and no impairment of diastolic function. Anemia does not lead to congestive heart failure in the absence of underlying heart disease.