Left Ventricular Myocardial Contractile Reserve during Exercise Stress in Healthy Adults: A Two-Dimensional Speckle-Tracking Echocardiographic Study
Left Ventricular Myocardial Contractile Reserve during Exercise Stress in Healthy Adults: A Two-Dimensional Speckle-Tracking Echocardiographic Study
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DOI：
10.1016/j.echo.2018.06.010
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发表时间：
2018-10-01
影响因子：
6.5
通讯作者：
Poulsen, Steen Hvitfeldt
中科院分区：
文献类型：
--
作者：
Larsen, Anders Hostrup;Clemmensen, Tor Skibsted;Poulsen, Steen Hvitfeldt
背景：本研究的目的是在运动负荷试验中测定健康成人的左心室(LV)收缩储备，并评价性别和年龄对运动LV整体纵向应变(GLS)的影响。方法：研究人群包括67名健康成人(年龄23-80岁，49%女性)。受试者按性别和预先确定的年龄组进行分析(年龄35岁，n=18；年龄35-55岁，n=24；年龄55岁，n=25)。所有受试者在静息状态和症状受限的半平卧位运动试验中都接受了全面的超声心动图评估。结果：LV GLS峰值应力值为25.4+/-2.0%。数值型LV-GLS平均增加5.3%，相当于LV-GLS相对增加26.7%。高峰运动时LV GLS的大小在不同年龄组之间无显著差异(P=0.07)。不同性别间峰值运动LV GLS差异无统计学意义(P=0.48)。线性回归分析显示，LV GLS峰值与年龄呈显著负相关(r=-0.30，P=0.02)，而LV GLS峰值与最大心率(r=0.23，P=0.07)、峰值平均动脉压(r=-0.11，P=.38)、体重指数(r=0.15，P=.22)、峰值脉冲多普勒心动图指数(r=-0.06，P=.67)无关。LV-GLS与运动水平之间存在剂量-反应关系，与性别无关，年龄的影响不明显。该技术是可行的，观察者内和观察者间的变异性很小。
Background: The aims of the present study were to determine left ventricular (LV) myocardial contractile reserve during exercise stress testing in healthy adults and to evaluate the effects of gender and age on exercise LV global longitudinal strain (GLS).Methods: The study population consisted of 67 healthy adults (age range, 23-80 years; 49% women). Subjects were analyzed with respect to gender and predefined age groups (age < 35 years, n = 18; age 35-55 years, n = 24; age > 55 years, n = 25). All subjects underwent comprehensive echocardiographic assessment at rest and during symptom-limited semisupine exercise test. LV GLS was determined using two-dimensional speckle-tracking echocardiography.Results: LV GLS magnitude during peak stress was 25.4 +/- 2.0%. The average absolute numeric LV GLS increase was 5.3%, equivalent to a relative 26.7% increase of LV GLS. LV GLS magnitude at peak exercise was without clinically significant differences between age groups (P = .07). No significant difference was found in peak exercise LV GLS between genders (P = .48). Linear regression analysis revealed a significant but weak correlation between peak LV GLS and age (r = -0.30, P = .02), whereas peak LV GLS was independent of maximal heart rate (r = 0.23, P = .07), peak mean arterial blood pressure (r = -0.11, P = .38), body mass index (r = 0.15, P = .22), and peak pulsed Doppler-derived cardiac index (r = -0.06, P = .67).Conclusions: LV GLS increases significantly during exercise stress in a healthy population. A dose-response relationship was found between LV GLS and exercise level independent of gender, and the influence of age appeared marginal. The technique is feasible, with low intra- and interobserver variability.