Evaluation of left ventricular diastolic functions in patients with frequent premature ventricular contractions from right ventricular outflow tract
Evaluation of left ventricular diastolic functions in patients with frequent premature ventricular contractions from right ventricular outflow tract
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DOI：
10.1007/s00380-007-0978-9
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发表时间：
2007-09-01
影响因子：
1.5
通讯作者：
Korkmaz, Sule
中科院分区：
文献类型：
--
作者：
Topaloglu, Serkan;Aras, Dursun;Korkmaz, Sule
本研究旨在探讨重复单形性室性早搏(PVCs)对左心室(LV)舒张期功能的影响。33例有症状的患者(研究组，男性10例，平均年龄40±8岁)和30例健康对照组(对照组，男性9例，平均年龄37±9岁)。所有患者均无器质性心脏病。通过超声心动图、二尖瓣血流频谱和组织多普勒成像评价舒张期功能。研究组E/A比值较低，等容舒张期(IVRT)较长，E波减速时间(EDT)较长。研究组有13例患者出现松弛功能减退。收缩期血流速度(Sa)、舒张期早期血流速度(Ea)、舒张期早期/晚期血流速度(Ea/Aa)平均值明显低于研究组，而Aa速度、E/Ea比值明显高于对照组。7例患者的电针传导速度为10m/S。所有对照组二尖瓣血流频谱和二尖瓣血流速度均正常。室性早搏百分率与二尖瓣血流早、晚期血流速度比值、EDT、IVRT、EA速度、Ea/Aa比值、Ea/Ea比值呈显著正相关。在多变量分析中，总的PVC计数和年龄被发现是松弛受损的独立预测因素。这些结果提示，重复的单形性RVOT-PVCs导致左室舒张功能异常，这可能导致心脏结构正常的患者的临床症状。
This study was sought to examine the effects of repetitive monomorphic premature ventricular contractions (PVCs) on left ventricular (LV) diastolic function. Thirty-three symptomatic patients (Study group, 10 males, mean age 40 +/- 8 years) with normal LV systolic function and repetitive PVCs originating from the right ventricular outflow tract (RVOT-PVCs) on 24-h Holter monitoring, and 30 healthy controls (Control group, 9 males, mean age 37 +/- 9 years) were enrolled in the study. None of the patients had structural heart disease. Diastolic function was assessed by echocardiographic mitral inflow pattern and tissue Doppler imaging. The study group displayed a lower E/A ratio, longer isovolumetric relaxation time (IVRT), and longer E-wave deceleration time (EDT). In the study group 13 patients showed impaired relaxation. While mean values of the systolic velocity (Sa), early diastolic velocity (Ea), and early/late diastolic velocity (Ea/Aa) ratio were significantly lower in the study group, the Aa velocity and E/Ea ratio were significantly higher. Ea velocity was < 10 m/s in 7 study patients. Mitral inflow pattern and Ea velocity was normal in all controls. Significant correlations were found between ventricular premature beats percentage and early to late transmitral flow velocity ratio, EDT, IVRT, Ea velocity, the Ea/Aa ratio, and the E/Ea ratio. In multivariate analysis, total PVC count and age were found to be independent predictors of impaired relaxation. These results suggest that repetitive monomorphic RVOT-PVCs lead to abnormalities of LV diastolic function that may contribute to clinical symptoms in patients with structurally normal hearts.