Insights into the mechanism of paradoxical low-flow, low-pressure gradient severe aortic stenosis: association with reduced O2 consumption by the whole body.
Insights into the mechanism of paradoxical low-flow, low-pressure gradient severe aortic stenosis: association with reduced O2 consumption by the whole body.
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深入了解矛盾的低流量、低压梯度严重主动脉瓣狭窄的机制：与全身耗氧量减少相关。
DOI：
10.1152/ajpheart.00715.2018
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Levine,RobertA
中科院分区：
文献类型：
--
作者：
Onoue,Takeshi;Iwataki,Mai;Araki,Masaru;Itoh,Hideaki;Isotani,Akihiro;Umeda,Hiromi;Fukuda,Shota;Nagata,Yasufumi;Tsuda,Yuki;Fujino,Yoshihisa;Hanyu,Michiya;Ando,Kenji;Shirai,Shinichi;Takeuchi,Masaaki;Saeki,Satoru;Levine,RobertA
反常低流量、低压梯度 (PLFLPG) 主动脉瓣狭窄 (AS) 中每搏输出量指数 (SVi) 降低的机制仍不清楚。盖顿等人。 证明在许多受试者（包括心脏病患者）中，SVi 是由全身 O2 消耗量 (V̇o2) 决定的。我们假设 PLFLPG AS 中 SVi 的减少与全身 V̇o2 的减少有关。本研究调查了 AS 患者的 V̇o2、SVi 和 AS 严重程度之间的关系，以探讨 V̇o2 降低与 PLFLPG AS 之间的关联。 59 名重度 AS 患者（24 名男性和 35 名女性，平均年龄：78±7 岁）通过超声心动图评估 SVi、AS 严重程度和类型，并通过呼出气体中 O2 的分数来测量 V̇o2。与39例非PLFLPG AS患者相比，20例PLFLPG AS患者的SVi和V̇o2显着降低（分别为30± 4 vs. 41± 7 ml/m2和2.4± 0.5 vs. 3.0 ± 0.5 ml·min−1·kg−1，P < 0.01）。两组之间的 SVi 与 V̇o2 比率没有差异（13.1±2.6 与 13.6±2.1，不显着）。 SVi与V̇o2独立相关（r= 0.74，P<0.01），但与主动脉瓣面积指数不相关。分类的 PLFLPG AS 也与 V̇o2 降低显着相关（P<0.001）。 PLFLPG AS 与全身 V̇o2 减少有关，这可能有助于深入了解 PLFLPG AS 的机制。新的和值得注意的矛盾低流量、低压梯度严重主动脉瓣狭窄 (PLFLPG AS) 是一种重要且有问题的亚型，其与每搏输出量减少相关的核心病理生理学尚未阐明。我们假设并随后澄清，PLFLPG AS 中每搏输出量的减少与全身耗氧量的减少有关。 这项研究对 PLFLPG AS 的机制提出了重要的见解，并可能进一步促进研究进一步的机制和新的治疗方法。
The mechanism of reduced stroke volume index (SVi) in paradoxical low-flow, low-pressure gradient (PLFLPG) aortic stenosis (AS) remains unclarified. Guyton et al. demonstrated that SVi is determined by whole body O2consumption (V̇o2) in many subjects, including patients with heart disease. We hypothesized that reduced SVi in PLFLPG AS is associated with reduced V̇o2by the whole body. This study investigated the relationship between V̇o2, SVi, and AS severity in patients with AS to examine the association between reduced V̇o2and PLFLPG AS. In 59 patients (24 men and 35 women, mean age: 78 ± 7 yr old) with severe AS, SVi, AS severity, and type were evaluated by echocardiography, and V̇o2was measured by the fraction of O2in expired gases. SVi and V̇o2were significantly decreased in 20 patients with PLFLPG AS compared with 39 patients with non-PLFLPG AS (30 ± 4 vs. 41 ± 7 ml/m2and 2.4 ± 0.5 vs. 3.0 ± 0.5 ml·min−1·kg−1, respectively,P< 0.01). The SVi-to-V̇o2ratio was not different between the two groups (13.1 ± 2.6 vs. 13.6 ± 2.1, not significant). SVi was independently correlated with V̇o2(r= 0.74,P< 0.01) but not with the aortic valve area index. Categorized PLFLPG AS was also significantly associated with reduced V̇o2(P< 0.001). PLFLPG AS is associated with reduced V̇o2by the whole body, which may offer insights into the mechanism of PLFLPG AS.NEW & NOTEWORTHYParadoxical low-flow, low-pressure gradient severe aortic stenosis (PLFLPG AS) is an important and problematic subtype, and its central pathophysiology with reduced stroke volume is yet to be clarified. We hypothesized and subsequently clarified that reduced stroke volume in PLFLPG AS is associated with reduced O2consumption by the whole body. This study suggests important insights into the mechanism of PLFLPG AS and may further promote studies to investigate further mechanisms and novel treatment.
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AVR 对保留 LVEF 的反常低流量、低梯度主动脉瓣狭窄的 LV 重塑和功能的影响。
DOI：
--
发表时间：
2017
期刊：
JACC Cardiovascular Imaging
影响因子：
--
作者：
A. Dahou;M. Clavel;J. Dumesnil;R. Capoulade;H. Ribeiro;K. O’Connor;P. Mathieu;J. Beaudoin;É. Larose;J. Rodés‐Cabau;P. Pibarot
通讯作者：
P. Pibarot
影响因子：
37.8
作者：
Mohty, Dania;Magne, Julien;Virot, Patrice
通讯作者：
Virot, Patrice
DOI：
10.1093/ajcn/58.2.141
发表时间：
1993-08
期刊：
The American journal of clinical nutrition
影响因子：
--
作者：
K. Turley;P. McBride;J. Wilmore
通讯作者：
K. Turley;P. McBride;J. Wilmore
影响因子：
37.8
作者：
STRATTON, JR;LEVY, WC;ABRASS, IB
通讯作者：
ABRASS, IB
正常受试者和心脏病患者对最大直立运动的循环反应特征
影响因子：
37.8
作者：
S. Epstein;G. Beiser;M. Stampfer;B. Robinson;E. Braunwald
通讯作者：
E. Braunwald