Left ventricular concentric remodeling is associated with decreased global and regional systolic function: the Multi-Ethnic Study of Atherosclerosis.
Left ventricular concentric remodeling is associated with decreased global and regional systolic function: the Multi-Ethnic Study of Atherosclerosis.
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左心室同心重塑与整体和局部收缩功能下降相关：动脉粥样硬化的多种族研究。
DOI：
10.1161/circulationaha104.500488
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发表时间：
2005
期刊：
影响因子：
37.8
通讯作者：
Lima,JoaoAC
中科院分区：
文献类型：
--
作者：
Rosen,BoazD;Edvardsen,Thor;Lai,Shenghan;Castillo,Ernesto;Pan,Li;Jerosch-Herold,Michael;Sinha,Shantanu;Kronmal,Richard;Arnett,Donna;Crouse3rd,JohnR;Heckbert,SusanR;Bluemke,DavidA;Lima,JoaoAC
背景-从代偿性向心性重构到心肌衰竭的转变在人类中并不完全清楚。为了研究早期心肌功能障碍的决定因素，我们研究了多种族动脉粥样硬化研究（梅萨）中无症状参与者的向心性重构和局部LV功能之间的相关性。在441项连续研究中，通过HARP（谐波相位）工具分析了以收缩期峰值中壁周向应变（Ecc）表示的局部心肌功能。Ecc峰值与向心性重构程度相关，向心性重构程度由左心室质量与舒张末期容积的比值（M/V比值）确定。在男性中，随着M/V比的增加，Ecc峰值逐渐下降（趋势检验，P<0.001）。然而，在女性中，Ecc仅在M/V比的第五个五分位数中低于第一个五分位数（P=0.1）。较低的Ecc与M/V比值增加的相关性具有区域异质性，但在男性（趋势检验，P<0.001）和女性（趋势检验，P=0.02）的LAD区域尤为突出。在右冠状动脉和左回旋支动脉的领土，这些协会在两个genders. Conclusions，在这个横断面研究的无症状的个人，同心左心室重构与区域收缩功能下降。左前降支冠状动脉区域的局部功能降低更为明显，可能反映了从代偿性重塑到心肌功能障碍的局部过渡。
Background—The transition from compensatory concentric remodeling to myocardial failure is not completely understood in humans. To investigate determinants of incipient myocardial dysfunction, we examined the association between concentric remodeling and regional LV function in asymptomatic participants of the Multi-Ethnic Study of Atherosclerosis (MESA).Methods and Results—Myocardial tagged MRI was performed. Regional myocardial function expressed as peak systolic midwall circumferential strain (Ecc) was analyzed in 441 consecutive studies by HARP (Harmonic Phase) tool. Peak Ecc was correlated with the extent of concentric remodeling determined by the ratio of left ventricular mass to end-diastolic volume (M/V ratio). In men, a gradual decline in peak global Ecc was seen with increasing M/V ratio (test for trend,P<0.001). Among women, however, Ecc tended to be lower only in the fifth compared with the first quintile of M/V ratio (P=0.1). The association of lower Ecc with increasing M/V ratio was regionally heterogeneous but was particularly prominent in the LAD region in men (test for trend,P<0.001) and in women (test for trend,P=0.02). In the right coronary and left circumflex artery territories, these associations were less marked in both genders.Conclusions—In this cross-sectional study of asymptomatic individuals, concentric left ventricular remodeling was related to decreased regional systolic function. The reduction in regional function, which was more pronounced in the left anterior descending coronary artery territory, may reflect the local transition from compensatory remodeling to myocardial dysfunction.