Left ventricular systolic performance, function, and contractility in patients with diastolic heart failure
Left ventricular systolic performance, function, and contractility in patients with diastolic heart failure
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DOI：
10.1161/01.cir.0000164273.57823.26
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发表时间：
2005-05-10
期刊：
影响因子：
37.8
通讯作者：
Gaasch, WH
中科院分区：
文献类型：
--
作者：
Baicu, CF;Zile, MR;Gaasch, WH
背景-舒张性心力衰竭 (DHF) 患者左心室 (LV) 舒张功能明显异常，包括舒张缓慢和延迟以及心室硬度增加。这些舒张功能异常是否以及在多大程度上与左心室收缩性能、功能和收缩性异常相关，尚未得到彻底研究。方法和结果——对 75 名射血分数正常的心力衰竭患者和 75 名没有心血管疾病证据的正常对照受试者进行了左心室收缩特性的检查。通过超声心动图和心导管数据评估左心室收缩特性。检查每搏功（左心室收缩性能指数）、预负荷可复张每搏功和射血分数（左心室收缩功能指数）、收缩压-缩短关系、收缩末期压力-容量关系以及峰值（+）dP/dt（左心室收缩力指数）。 DHF 患者的 LV 收缩特性正常。 DHF 组的每搏功为 8.4 +/- 2.3，而对照组为 8.8 +/- 2.5 kg cm（P = 0.26）。 DHF 中的预负荷可复张中风功为 99 +/- 22，而对照组为 109 +/- 18 g/cm(2)（P = 0.13）。 DHF 和对照组的每搏功和舒张末期容积之间的关系相似。 DHF 中的峰值 (+) dP/dt 为 1596 +/- 362，而对照组为 1664 +/- 305 mm Hg/s（P = 0.54）。 DHF 时收缩末期压力-容量关系增加。 DHF 和对照组的收缩压与心内膜缩短分数的关系相似。结论：DHF 患者的左室收缩性能、功能和收缩力正常。 DHF 的病理生理学似乎与 LV 收缩特性的显着异常无关。
Background-Patients with diastolic heart failure (DHF) have significant abnormalities in left ventricular (LV) diastolic function, including slow and delayed relaxation and increased chamber stiffness. Whether and to what extent these abnormalities in diastolic function occur in association with abnormalities in LV systolic performance, function, and contractility has not been investigated thoroughly.Methods and Results-The systolic properties of the LV were examined in 75 patients with heart failure and a normal ejection fraction (ie, DHF) and 75 normal control subjects with no evidence of cardiovascular disease. LV systolic properties were assessed with echocardiographic and cardiac catheterization data. Stroke work (an index of LV systolic performance), preload recruitable stroke work and ejection fraction (indices of LV systolic function), systolic stress-shortening relationship, end-systolic pressure- volume relationship, and peak (+) dP/dt (indices of LV contractility) were examined. The systolic properties of the LV were normal in patients with DHF. Stroke work was 8.4 +/- 2.3 in DHF versus 8.8 +/- 2.5 kg cm in controls (P = 0.26). Preload recruitable stroke work was 99 +/- 22 in DHF versus 109 +/- 18 g/cm(2) in controls (P = 0.13). The relationship between stroke work and end-diastolic volume was similar in DHF and controls. Peak (+) dP/dt was 1596 +/- 362 in DHF versus 1664 +/- 305 mm Hg/s in controls (P = 0.54). The end-systolic pressure-volume relationship was increased in DHF. The systolic stress versus endocardial fractional shortening relationship was similar in DHF and controls.Conclusions-Patients with DHF had normal LV systolic performance, function, and contractility. The pathophysiology of DHF does not appear to be related to significant abnormalities in these systolic properties of the LV.