左心室同心重塑与全球和区域缩功能下降有关:动脉样硬化多民族研究
Boaz D Rosen1, Thor Edvardsen, Shenghan Lai
1Cardiology Division, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Circulation
|August 17, 2005
概括
集中式左心室重塑与无症状个体的区域性缩功能减少有关. 这种下降在左前下降动脉区域最为显著,这表明早期心肌功能障碍.
科学领域:
- 心脏病学 心脏病学
- 心血管成像 - 心血管成像
- 心肌机械学 心肌机械学
背景情况:
- 从补偿性心脏重塑到心力衰竭的进展在人类中仍然不清楚.
- 调查影响早期心肌功能障碍的因素至关重要.
研究的目的:
- 为了检查同心重塑和区域左心室 (LV) 功能之间的关系.
- 了解无症状个体初始心肌功能障碍的决定因素.
主要方法:
- 在多民族动脉样硬化研究 (MESA) 的441名无症状参与者中利用心肌标记的MRI.
- 分析了区域性心肌功能,使用高峰缩中壁周围应变 (Ecc) 通过律相 (HARP) 分析.
- 通过左心室质量与末端透缩体积 (M/V比率) 的比率来评估同心重塑.
主要成果:
- 在男性中增加M/V比率和全球Ecc峰值之间观察到显著的反相关性 (P<0.001).
- 在女性中,Ecc减少仅在最高和最低的M/V比率五分位数之间显著 (P=0.1).
- 降低Ecc与更高的M/V比率的关联在两种性别的左前垂下冠状动脉 (LAD) 区域中突出 (P<0.001男性,P=0.02女性).
结论:
- 集中左心室重塑与无症状个体的区域性缩功能下降有关.
- 观察到的区域功能减弱,特别是在LAD区域,可能表明心肌功能障碍的初始阶段.
- 这些发现突出了通过在重塑心脏中的成像来早期检测心脏功能障碍的潜力.
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