Left Ventricular Volume-Time Relation in Patients With Heart Failure With Preserved Ejection Fraction.
Left Ventricular Volume-Time Relation in Patients With Heart Failure With Preserved Ejection Fraction.
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DOI：
10.1016/j.amjcard.2017.11.033
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发表时间：
2018-03-01
期刊：
影响因子：
--
通讯作者：
Levine BD
中科院分区：
文献类型：
--
作者：
Hieda M;Parker J;Rajabi T;Fujimoto N;Bhella PS;Prasad A;Hastings JL;Sarma S;Levine BD
射血分数保留性心力衰竭（HFpEF）患者常报告左心室（LV）充盈压升高，与舒张功能受损相关。松弛已经通过多普勒评估，但是这样做的方法是间接的，并且受载荷条件的影响很大。本研究的目的是使用心脏MRI（cMRI）评估HFpEF患者在校正左心房驱动压和腔室大小时的LV容量-时间关系。使用cMRI（1. 5 T磁体）26 Hz短轴电影视图测量LV容积。我们比较了HFpEF患者（N=10，73±7岁）和年龄匹配的对照组（N=12，70±3岁）通过cMRI计算的以下舒张参数：（PFR/舒张末期容积（PFR/EDV）; PFR/EDV/肺毛细血管楔压（PFR/EDV/PCWP）;至PFR的时间（TPFR）;心动周期的%TPFR）。HFpEF组的PCWP显著高于对照组（HFpEF vs.对照组：15.6±5.2 vs. 11.2±1.3 mmHg，P = 0.0092）。HFpEF组的PFR/EDV明显慢于对照组（2.68±0.85 vs. 3.59±0.87 s−1，P = 0.03），校正左心房驱动压后，PFR/EDV/PCWP慢近50%（0.18±0.07 vs. 0.33±0.10 s−1/mmHg，P = 0.002）。此外，HFpEF组的TPFR（246± 17.2vs.188 ± 15.7ms，P=0.04）和心动周期的%TPFR（36.4± 10.4vs.25.6 ± 5.9%，P=0.012）显著长于对照组。HFpEF患者存在异常的容量-时间关系，包括较低的PFR/EDV/PCWP和延长的PFR时间，这是由于早期舒张功能受损所致。
Elevated left ventricular (LV) filling pressures are commonly reported in patients with Heart Failure with Preserved Ejection Fraction (HFpEF) and are associated with impaired relaxation in diastole. Relaxation has been assessed by Doppler, but the methods for doing so are indirect and heavily influenced by loading conditions. The aim of this study is to assess LV volume-time relationship in patients with HFpEF, when correcting for left atrial driving pressure and chamber size, using cardiac-MRI (cMRI). Cine short-axis views by cMRI (1.5T-magnet) at 26 Hz were used for measurement of LV volume. We compared the following diastolic parameters: (PFR/end-diastolic-volume (PFR/EDV); PFR/EDV/pulmonary capillary wedge pressure (PFR/EDV/PCWP); time to PFR (TPFR); %TPFR for cardiac cycle) calculated by cMRI between HFpEF patients (N=10, 73±7 years) and age-matched controls (N=12, 70±3 years). PCWP was significantly greater in the HFpEF group than in controls (HFpEF vs. Controls: 15.6±5.2 vs. 11.2±1.3 mmHg, P = 0.0092). PFR/EDV was significantly slower in the HFpEF group than in controls (2.68±0.85 vs. 3.59±0.87 s−1, P = 0.03), and was nearly 50% slower when corrected for left atrial driving pressure: PFR/EDV/PCWP (0.18±0.07 vs. 0.33±0.10 s−1/mmHg, P = 0.002). In addition, TPFR (246±17.2 vs. 188±15.7 ms, P=0.04) and %TPFR of cardiac cycle (36.4±10.4 vs. 25.6±5.9 %, P=0.012) were significantly longer in the HFpEF group than in controls. HFpEF patients have an abnormal volume-time relationship, including lower PFR/EDV (PFR/EDV/PCWP) and prolonged time to PFR, due to the impairment of active relaxation during early diastole.
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DOI：
10.1186/1532-429x-12-46
发表时间：
2010-07-31
期刊：
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
影响因子：
--
作者：
Mendoza DD;Codella NC;Wang Y;Prince MR;Sethi S;Manoushagian SJ;Kawaji K;Min JK;LaBounty TM;Devereux RB;Weinsaft JW
通讯作者：
Weinsaft JW
影响因子：
--
作者：
Komi S;Inoue Y;Hata H;Nakajima A;Miyatake H
通讯作者：
Miyatake H
影响因子：
15.9
作者：
WEISS, JL;FREDERIKSEN, JW;WEISFELDT, ML
通讯作者：
WEISFELDT, ML
影响因子：
2.5
作者：
ENGELS, G;MULLER, E;BACHMANN, K
通讯作者：
BACHMANN, K
影响因子：
18.2
作者：
Bhella, Paul S.;Prasad, Anand;Levine, Benjamin D.
通讯作者：
Levine, Benjamin D.