原发性系统性高血压患者心肌功测量与功能能力评估:左心室有无肥厚的比较。

IF 2 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of Thoracic Imaging Pub Date : 2024-05-01 Epub Date: 2022-12-06 DOI:10.1097/RTI.0000000000000690
Hong Ran, Xiao-Wu Ma, Lin-Lin Wan, Jun-Yi Ren, Jian-Xin Zhang, Ping-Yang Zhang, Matthias Schneider
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引用次数: 0

摘要

目的:无创心肌功(MW)测量包含左心室(LV)压力,因此可以根据后负荷的变化校正整体纵向应变。我们试图研究将心肌功作为检测原发性系统性高血压患者左心室功能障碍早期征兆的工具,特别是不同的预测指数:无左心室肥厚(NLVH)和左心室肥厚(LVH)患者均为射血分数保留的原发性全身性高血压。根据左心室舒张末期质量指数(LVEDmassI),40 名 NLVH 和 40 名 LVH 患者被纳入前瞻性研究。对以下工作效率指数进行了评估:全局工作指数、全局建设性工作、全局浪费工作(GWW)和全局工作效率(GWE)。全局工作指数(P=0.348)和全局建设性工作(P=0.225)在 NLVH 中均有所增加,而在 LVH 中则有所减少,全局浪费工作(GWW)(P0.85):结论:由MW得出的GWW和GWE是检测原发性系统性高血压患者早期左心室功能障碍的更准确、敏感和可重复的预测指标,尤其是在区分NLVH和LVH的潜在功能异常方面,即使射血分数保持不变。
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Myocardial Work Measurement With Functional Capacity Evaluation in Primary Systemic Hypertension Patients: Comparison Between Left Ventricle With and Without Hypertrophy.

Objective: Noninvasive measurement of myocardial work (MW) incorporates left ventricular (LV) pressure, and, therefore, allows correction of global longitudinal strain for changing afterload conditions. We sought to investigate MW as a tool to detect early signs of LV dysfunction in primary systemic hypertension patients, particularly with different predictive indices.

Methods and results: None left ventricular hypertrophy (NLVH) and left ventricular hypertrophy (LVH) patients established were all primary systemic hypertension with preserved ejection fraction. Forty in NLVH and forty in LVH according to left ventricular end-diastolic mass index (LVEDmassI) were prospectively enrolled. The following indices of MW were assessed: global work index, global constructive work, global wasted work (GWW), and global work efficiency (GWE). Both global work index ( P =0.348) and global constructive work ( P =0.225) were increased in NLVH and decreased in LVH, and GWW ( P <0.001) was increased significantly in NLVH and increased more in LVH, while GWE ( P <0.001) was decreased significantly in NLVH and decreased more in LVH. The clinical utility of GWW (95% CI: 0.802-0.951) and GWE (95% CI: 0.811-0.950) were verified by receiver-operating characteristic curve analysis showing larger net benefits as evaluated with LVH and control comparisons. In multivariate linear regression analysis, 4-dimenaional LVEDmassI was independently associated with GWE ( P =0.018) in systemic hypertension patients. Assessment of intraobserver and interobserver variability in the MW echocardiographic data documented good interclass correlation coefficients (all >0.85).

Conclusion: GWW and GWE derived from MW are more accurate, sensitive, and reproducible predictors to detect early LV dysfunction in primary systemic hypertension patients, especially in distinguishing the potential functional abnormality of NLVH and LVH, even though the ejection fraction is preserved.

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来源期刊
Journal of Thoracic Imaging
Journal of Thoracic Imaging 医学-核医学
CiteScore
7.10
自引率
9.10%
发文量
87
审稿时长
6-12 weeks
期刊介绍: Journal of Thoracic Imaging (JTI) provides authoritative information on all aspects of the use of imaging techniques in the diagnosis of cardiac and pulmonary diseases. Original articles and analytical reviews published in this timely journal provide the very latest thinking of leading experts concerning the use of chest radiography, computed tomography, magnetic resonance imaging, positron emission tomography, ultrasound, and all other promising imaging techniques in cardiopulmonary radiology. Official Journal of the Society of Thoracic Radiology: Japanese Society of Thoracic Radiology Korean Society of Thoracic Radiology European Society of Thoracic Imaging.
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