肥厚性心肌病患者左室总纵应变的预后价值

V. Tseluyko, Olena Butko, K. Kinoshenko
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摘要

摘要肥厚性心肌病(HCM)是一种广泛存在的遗传性心肌疾病,它伴随着心肌舒张和随后的收缩功能障碍的发展。本研究的目的是评估肥厚性心肌病合并左心室总纵应变(GLS)受损患者的临床和仪器特征及其对乌克兰肥厚性心肌病患者心血管事件发展的预后价值。材料和方法。对35例肥厚性心肌病患者进行了全面的临床和仪器检查,并在斑点跟踪超声心动图上确定了绝对的整体纵向应变。将患者分为两组:I组(GLS< 14.5)和II组(GLS≥14.5)。结果。总体纵向应变的降低与病程延长(8(5-11)年vs 3(2-5)年,p=0.003)、对心律差的抱怨增加(66.7% vs 23.5%, p= 0.018)和虚弱(61.1% vs 23.5%, p=0.04)、收缩压(SBP)升高(130 (120-140)vs 110 (100-120) mm Hg, p= 0.009)、无心力衰竭症状患者的缺失(0 vs 29.4%, p=0.019)、IVRT增加(106.19±28.62 vs 84.57±27.54 ms)相关。P =0.044),室性早搏较多(17例(4-69)vs 2例(0.5-3),P =0.014)。根据Kaplan-Meier分析致命性和非致命性心血管事件或合并心力衰竭住院的生存率,他们的生存率明显更差(Log-Rank, p=0.016和p=0.003)。结论。总体纵向应变评分较差的肥厚性心肌病患者的特点是临床和仪器数据较差,心血管预后不良。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prognostic value of left ventricular global longitudinal strain in patients with hypertrophic cardiomyopathy
ABSTRACT. Hypertrophic cardiomyopathy (HCM) is one of the widespread genetically determined diseases of the myocardium, which is accompanied by the development of diastolic and, subsequently, systolic dysfunction of the myocardium. The aim of our study was to evaluate the clinical and instrumental features of patients with hypertrophic cardiomyopathy with impaired left ventricular global longitudinal strain (GLS) and its prognostic value for the development of cardiovascular events in the Ukrainian population of patients with hypertrophic cardiomyopathy. Materials and methods. The data of 35 patients with hypertrophic cardiomyopathy who underwent a comprehensive clinical and instrumental examination with determination of the absolute global longitudinal strain on speckle-tracking echocardiography were retrospectively analyzed. The patients were divided into two groups: Group I (GLS< 14.5) and Group II (GLS≥ 14.5). Results. A decrease in global longitudinal strain was associated with a longer disease duration (8 (5-11) vs 3 (2-5) years, p=0.003), increasing of complaints on irregularity of heart beat (66.7% vs 23.5%, p= 0.018) and weakness (61.1% vs 23.5%, p=0.04), increased systolic blood pressure (SBP) (130 (120-140) vs 110 (100-120) mm Hg, p= 0.009), the absence of patients without signs of heart failure (0 vs 29.4%, p=0.019), an increase in IVRT (106.19±28.62 vs 84.57±27.54 ms, p=0.044) and a greater number of ventricular extrasystoles (17 (4-69) vs 2 (0.5-3), p=0.014). According to the Kaplan-Meier analysis of survival in relation to fatal and non-fatal cardiovascular events or their combination with hospitalization for heart failure, they had significantly worse survival rates (Log-Rank, p=0.016 and p=0.003). Conclusions. Hypertrophic cardiomyopathy patients with poor global longitudinal strain scores were characterized by worse clinical and instrumental data and an unfavorable cardiovascular prognosis.
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