Relationships among exercise capacity, hypertrophy, and left ventricular diastolic function in nonobstructive hypertrophic cardionyopathy
Relationships among exercise capacity, hypertrophy, and left ventricular diastolic function in nonobstructive hypertrophic cardionyopathy
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DOI：
10.1016/j.ahj.2004.08.021
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发表时间：
2005-07-01
影响因子：
4.8
通讯作者：
Mady, C
中科院分区：
文献类型：
--
作者：
Matsumoto, AY;Arteaga, E;Mady, C
目的探讨非梗阻性肥厚型心肌病（NOHCM）患者运动能力（EC）、心肌肥厚与心脏舒张功能的关系。采用适当的超声心动图指标判定左室肥厚（LVH）。对于舒张功能评价，测量了以下内容：二尖瓣血流的早期（E）和晚期（A）波，E/A和E的减速时间;肺静脉血流的收缩期（S）、舒张期（D）和心房逆转（AR）波，S/D和心房收缩充盈分数;以及组织多普勒成像的早期（Ea）、晚期（Aa）波，Ea/Aa和E/Ea。测定AR波与A波时限之差（DurAR-DurA）、Vo（2）峰值和无氧阈（AT）。在这些患者中，E/Ea比率为8.9 +/- 3.2，DurAR DurA为22.6 +/- 32.6毫秒。峰值Vo（2）和AT与D（r = 0.55，P = 0.003和0.51，P = 0.007）和Ea/Aa（r = 0.56，P= 0.007和0.45，P = 0.03）相关。EC与LVH无相关性。结论NOHCM患者存在左心室舒张末压升高而充盈压正常的证据，EC损害可能归因于左心室充盈不足的舒张变化。
Aim The aim of this study was to analyze the relationships among exercise capacity (EC) hypertrophy, and diastolic function in nonobstructive hypertrophic cardiomyopathy (NOHCM).Methods and Results Twenty-seven patients with NOHCM were studied. Left ventricular hypertrophy (LVH) was determined by appropriate echocardiographic indexes. For diastolic function evaluation, the following were measured: the early (E) and late (A) waves, E/A, and deceleration time of E of the mitral flow; the systolic (S), diastolic (D), and atrial reversal (AR) waves, S/D, and the atrial systolic filling fraction of the pulmonary vein flow; and the early (Ea), late (Aa) waves, Ea/Aa, and E/Ea by tissue Doppler imaging. The difference between the duration of AR and A waves (DurAR - DurA), the peak Vo(2), and anaerobic threshold (AT) were also determined. In these patients, the E/Ea ratio was 8.9 +/- 3.2 and DurAR DurA was 22.6 +/- 32.6 milliseconds. The peak Vo(2) and AT correlated with D (r = 0.55, P =.003 and .51, P =.007, respectively) and Ea/Aa (r = 0.56, P=.007 and .45, P =.03, respectively). There was no correlation between EC and LVH.Conclusions Patients with NOHCM demonstrated evidences of elevated left ventricular (LV) end-diastolic pressure with normal filling pressure EC compromise may be attributed to relaxation changes with inadequate filling of the left ventricle.