Relationship between left ventricular geometry and left ventricular systolic and diastolic functions in patients with chronic severe aortic regurgitation
Relationship between left ventricular geometry and left ventricular systolic and diastolic functions in patients with chronic severe aortic regurgitation
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DOI：
10.1111/j.1540-8175.2008.00677.x
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发表时间：
2008-07-01
影响因子：
1.5
通讯作者：
Poyrazoglu, Hakan
中科院分区：
文献类型：
--
作者：
Cayli, Murat;Kanadasi, Mehmet;Poyrazoglu, Hakan
背景：慢性主动脉瓣反流（AR）是一种导致左心室（LV）扩张的容量超负荷形式。随着疾病的进展，会出现心肌纤维化、细胞凋亡、进行性左心室扩张以及最终的左心室功能障碍。该研究的目的是评估慢性严重 AR 患者左心室几何形状与左心室收缩和舒张功能之间的关系。方法：研究人群包括 88 名慢性重度 AR 患者和 42 名健康对照。计算左心室射血分数（LVEF）。受试者分为第一组（对照组，n = 42）、第二组（LVEF > 50%，n = 47）和第三组（LVEF < 50%，n = 41）。测量经二尖瓣舒张早期和晚期的速度和减速时间。记录环形收缩（Sa）和舒张（Ea 和 Aa）速度。舒张功能分为正常、舒张受损（IR）、假正常化（PN）和限制性模式（RP）。结果：第一组和第二组的 LVEF 相似，而第三组的 LVEF 显着较低。从 I 组到 III 组，Sa 速度逐渐降低，但 LV 长轴和短轴直径逐渐增加。分别有 46 名、31 名和 11 名患者出现 IR、PN 和 RP。从 IR 患者到 RP 患者，左心室长轴收缩期和舒张期直径显着增加，而 LVEF 和 Sa 速度显着降低。左心室长轴舒张直径与左心室收缩和舒张功能独立相关。结论：慢性重度AR患者左室舒张长轴内径与左室收缩、舒张功能密切相关。
Background: Chronic aortic regurgitation (AR) is a form of volume overload inducing left ventricle (LV) dilatation. Myocardial fibrosis, apoptosis, progressive LV dilatation, and eventually LV dysfunction are seen with the progression of disease. The aim of the study was to assess the relation between LV geometry and LV systolic and diastolic functions in patients with chronic severe AR. Methods: The study population consisted of 88 patients with chronic severe AR and 42 healthy controls. The LV ejection fraction (LVEF) was calculated. Subjects were divided as Group I (controls, n = 42), Group II (LVEF > 50%, n = 47), and Group III (LVEF < 50%, n = 41). Transmitral early and late diastolic velocities and deceleration time were measured. The annular systolic (Sa) and diastolic (Ea and Aa) velocities were recorded. Diastolic function was classified as normal, impaired relaxation (IR), pseudonormalization (PN), and restrictive pattern (RP). Results: The LVEF was similar in Group I and II, while significantly lower in Group III. Sa velocity was progressively decreasing, but LV long- and short-axis diameters were increasing from Group I to Group III. Forty-six, 31 and 11 patients had IR, PN, and RP, respectively. LV long-axis systolic and diastolic diameters were significantly increasing, while LVEF and Sa velocity were significantly decreasing from patients with IR to patients with RP. The LV long-axis diastolic diameter is independently associated with LV systolic and diastolic functions. Conclusions: The LV long-axis diastolic diameter is closely related with LV systolic and diastolic functions in patients with chronic severe AR.