肢端肥大症患者左心室舒张功能的超声心动图和阻抗心动图分析

IF 3.1 4区 医学 Q1 Medicine Medical Science Monitor Pub Date : 2024-11-22 DOI:10.12659/MSM.946196
Agnieszka Włochacz, Paweł Krzesiński, Beata Uziębło-Życzkowska, Przemysław Witek, Grzegorz Zieliński, Grzegorz Gielerak
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引用次数: 0

摘要

背景由于过量生长激素(GH)和胰岛素样生长因子-1(IGF-1)的长期作用,肢端肥大症(AC)患者可能会出现双心室肥大、收缩和舒张功能障碍的肢端肥大性心肌病,从而导致充血性心力衰竭。本研究旨在评估肢端肥大症患者左心室舒张功能的超声心动图参数和心血管血流动力学的阻抗心动图(ICG)参数。材料与方法 本观察性队列研究共纳入 33 名根据血液激素水平和影像学检查结果新诊断为 AC 的患者(男女比例:1.2;平均年龄 47 岁)。左心室舒张功能的超声心动图参数包括二尖瓣环平均舒张早期速度(e'avg)、舒张早期二尖瓣口血流速度与舒张早期二尖瓣环组织速度之比(E/e'ratio)、二尖瓣血流早期(E)与晚期(A)之比(E/A)。ICG 参数包括每搏量指数(SI)、心脏指数(CI)、加速指数(ACI)、全身血管阻力指数(SVRI)、总动脉顺应性指数(TACI)和胸腔积液含量(TFC)。结果 左心室舒张功能较差的参数与通过 ICG 评估的参数相对应:1)较低的 E/A 比值与较低的 SI 相关(P<0.05)。
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Echocardiographic and Impedance Cardiography Analysis of Left Ventricular Diastolic Function in Acromegaly Patients.

BACKGROUND Due to the chronic effects of excess growth hormone (GH) and insulin-like growth factor-1 (IGF-1), patients with acromegaly (AC) may develop acromegalic cardiomyopathy with biventricular hypertrophy, systolic and diastolic dysfunction, resulting in congestive heart failure. This study aimed to evaluate the echocardiographic parameters of left ventricular (LV) diastolic function and impedance cardiography (ICG) parameters of cardiovascular hemodynamics in patients with AC. MATERIAL AND METHODS A total of 33 patients (male to female ratio: 1.2; mean age 47 years) newly diagnosed with AC based on the blood hormone levels and imaging study findings were included into this observational cohort study. The echocardiographic parameters of LV diastolic function included early diastolic velocity of the average mitral annulus (e'avg), ratio of early diastolic mitral inflow velocity to early diastolic mitral annular tissue velocity (E/e'ratio), mitral flow early (E) and late (A) phase ratio (E/A). The ICG parameters included stroke volume index (SI), cardiac index (CI), acceleration index (ACI), systemic vascular resistance index (SVRI), total arterial compliance index (TACI) and thoracic fluid content (TFC). RESULTS Poorer parameters of LV diastolic function corresponded to the parameters assessed via ICG: 1) lower ratio E/A was associated with lower SI (P<0.001), CI (P=0.007), VI (P=0.04), ACI (P=0.02), TACI (P=0.005) and higher SVRI (P<0.001), 2) lower E/e' ratio was associated with higher TFC (P=0.03); 3) lower e'avg was associated with lower SI (P=0.01) and CI (P=0.048) and higher SVRI (P=0.03), despite normal LV ejection fraction. CONCLUSIONS Impaired LV diastolic function in AC is associated with impaired pumping function of the heart and higher afterload as assessed on ICG.

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来源期刊
Medical Science Monitor
Medical Science Monitor MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
6.40
自引率
3.20%
发文量
514
审稿时长
3.0 months
期刊介绍: Medical Science Monitor (MSM) established in 1995 is an international, peer-reviewed scientific journal which publishes original articles in Clinical Medicine and related disciplines such as Epidemiology and Population Studies, Product Investigations, Development of Laboratory Techniques :: Diagnostics and Medical Technology which enable presentation of research or review works in overlapping areas of medicine and technology such us (but not limited to): medical diagnostics, medical imaging systems, computer simulation of health and disease processes, new medical devices, etc. Reviews and Special Reports - papers may be accepted on the basis that they provide a systematic, critical and up-to-date overview of literature pertaining to research or clinical topics. Meta-analyses are considered as reviews. A special attention will be paid to a teaching value of a review paper. Medical Science Monitor is internationally indexed in Thomson-Reuters Web of Science, Journals Citation Report (JCR), Science Citation Index Expanded (SCI), Index Medicus MEDLINE, PubMed, PMC, EMBASE/Excerpta Medica, Chemical Abstracts CAS and Index Copernicus.
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