Assessment of Prevalence, Clinical Characteristics, and Risk Factors Associated With “Low Flow State” Using Cardiac Magnetic Resonance

Yifang Yuan MD , David Herrington MD , Joao A.C. Lima MD , R. Brandon Stacey MD , David Zhao MD , James Thomas MD , Mario Garcia MD , Min Pu MD, PhD
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Abstract

Objective

To assess prevalence, clinical characteristics, and risk factors associated with low flow state (LFS) in a multiethnic population with normal left ventricular ejection fraction (LVEF).

Patients and Methods

The study included 4398 asymptomatic participants undergoing cardiac magnetic resonance from July 17, 2000, to August 29, 2002. Left ventricular (LV) mass, volume, and myocardial contraction fraction were assessed. Low flow state was defined as stroke volume index (SVi of <35 mL/m2). Clinical characteristics, cardiac risk factors, and cardiac magnetic resonance findings were compared between LFS and normal flow state (NFS) groups (NFS: SVi of ≥35 mL/m2).

Results

There were significant differences in the prevalence of LFS in different ethnic groups. Individuals with LFS were older (66±9.6 vs 61±10 years; P<.0001). The prevalence of LFS was 19% in the group aged older than 70 years. The logistic multivariable regression analysis found that age was independently associated with LFS. The LFS group had significantly higher prevalence of diabetes (30% vs 24%; P=.001), LV mass-volume ratio (1.13±0.22 vs 0.91±0.15; P<.0001), inflammatory markers, a lower LV mass index (59±10 vs 65±11 kg/m2; P<.001), lower myocardial contraction fraction (58.1±10.6% vs 75.7±13%; P<.001), and a lower left atrial size index (32.2±4.6 vs 36.7±5.9 mm/m2; P<.0001) than NFS.

Conclusion

Low flow state may be considered an under-recognized clinical entity associated with increasing age, multiple risk factors, increased inflammatory markers, a lower LV mass index, and suboptimal myocardial performance despite the presence of normal LVEF and absence of valvular disease.

Abstract Image

Abstract Image

使用心脏磁共振评估与“低流量状态”相关的患病率、临床特征和危险因素。
目的:评估左心室射血分数(LVEF)正常的多民族人群中低流量状态(LFS)的患病率、临床特征和相关危险因素。患者和方法:该研究包括2000年7月17日至2002年8月29日接受心脏磁共振检查的4398名无症状参与者。评估左心室(LV)质量、体积和心肌收缩分数。低流量状态被定义为行程容积指数(SVi为2)。比较LFS组和正常流状态组(NFS:SVi≥35mL/m2)的临床特征、心脏危险因素和心脏磁共振结果。结果:不同种族LFS的患病率存在显著差异。LFS患者年龄较大(66±9.6 vs 61±10岁;PP=.001),左心室质量体积比(1.13±0.22 vs 0.91±0.15;PPPPC结论:低流量状态可能被认为是一种未被充分认识的临床实体,与年龄增加、多种危险因素、炎症标志物增加、左心室质量指数较低以及心肌性能次优有关,尽管存在正常的左心室射血分数和瓣膜疾病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Mayo Clinic proceedings. Innovations, quality & outcomes
Mayo Clinic proceedings. Innovations, quality & outcomes Surgery, Critical Care and Intensive Care Medicine, Public Health and Health Policy
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