Enrico Vizzardi , Giorgio Caretta , Ivano Bonadei , Riccardo Rovetta , Edoardo Sciatti , Natalia Pezzali , Carlo M. Lombardi , Filippo Quinzani , Francesca Salghetti , Antonio D'Aloia , Marco Metra
{"title":"非缺血性扩张型心肌病患者升主动脉超声心动图弹性特性及其与运动能力的关系","authors":"Enrico Vizzardi , Giorgio Caretta , Ivano Bonadei , Riccardo Rovetta , Edoardo Sciatti , Natalia Pezzali , Carlo M. Lombardi , Filippo Quinzani , Francesca Salghetti , Antonio D'Aloia , Marco Metra","doi":"10.1016/j.ijchv.2014.03.009","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>: Aortic stiffness, an independent predictor of mortality and cardiovascular events, is common among patients affected by non-ischemic dilated cardiomyopathy (NIDC) and heart failure (HF).</p></div><div><h3>Methods</h3><p>: A total of 55 patients with diagnosis of NIDC (aged 60 ± 11 years, mean ejection fraction (EF) 35.2% ± 7.7%) admitted consecutively to our department for mild to moderate HF (NYHA class II–III) underwent an echocardiographic study and cardiopulmonary exercise test (CPX). We evaluated elastic properties of ascending aorta, i.e. aortic stiffness and aortic distensibility (mm Hg<sup>− 1</sup>), derived from ascending aorta systolic and diastolic diameter (mm/m<sup>2</sup>) measured 3 cm above the valvular plane through 2D-guided M-mode echocardiography.</p></div><div><h3>Results</h3><p>: Mean aortic stiffness was 15.63 ± 14.53 and aortic distensibility was 2.61 ± 2.39 mm Hg<sup>− 1</sup>. Collected parameters at CPX were peak oxygen consumption (pVO<sub>2</sub>) (ml/kg/min), anaerobic threshold (AT) and the slope of the relation between minute ventilation (VE) and carbon dioxide production (VCO<sub>2</sub>). Mean pVO<sub>2</sub> was 15.4 ± 3.9 ml/kg/min, VE/VCO<sub>2</sub> ratio at AT was 36.1 ± 6.1. Functional capacity measured through peak VO<sub>2</sub> was found to be directly correlated with aortic distensibility (r = 0.47, p = − 0.0002) and negatively correlated to aortic stiffness index (r = − 0.51, p = − 0.0001). These results were the same at multivariate analysis, corrected by age, hypertension, diabetes mellitus and ejection fraction (respectively r = 0.27, p = 0.008 and r = − 1.75, p = 0.0002).</p></div><div><h3>Conclusions</h3><p>: HF patients due to NIDC elastic properties of ascending aorta, evaluated by echocardiography, are correlated with a reduced functional capacity.</p></div>","PeriodicalId":90542,"journal":{"name":"International journal of cardiology. 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Lombardi , Filippo Quinzani , Francesca Salghetti , Antonio D'Aloia , Marco Metra\",\"doi\":\"10.1016/j.ijchv.2014.03.009\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>: Aortic stiffness, an independent predictor of mortality and cardiovascular events, is common among patients affected by non-ischemic dilated cardiomyopathy (NIDC) and heart failure (HF).</p></div><div><h3>Methods</h3><p>: A total of 55 patients with diagnosis of NIDC (aged 60 ± 11 years, mean ejection fraction (EF) 35.2% ± 7.7%) admitted consecutively to our department for mild to moderate HF (NYHA class II–III) underwent an echocardiographic study and cardiopulmonary exercise test (CPX). We evaluated elastic properties of ascending aorta, i.e. aortic stiffness and aortic distensibility (mm Hg<sup>− 1</sup>), derived from ascending aorta systolic and diastolic diameter (mm/m<sup>2</sup>) measured 3 cm above the valvular plane through 2D-guided M-mode echocardiography.</p></div><div><h3>Results</h3><p>: Mean aortic stiffness was 15.63 ± 14.53 and aortic distensibility was 2.61 ± 2.39 mm Hg<sup>− 1</sup>. Collected parameters at CPX were peak oxygen consumption (pVO<sub>2</sub>) (ml/kg/min), anaerobic threshold (AT) and the slope of the relation between minute ventilation (VE) and carbon dioxide production (VCO<sub>2</sub>). Mean pVO<sub>2</sub> was 15.4 ± 3.9 ml/kg/min, VE/VCO<sub>2</sub> ratio at AT was 36.1 ± 6.1. Functional capacity measured through peak VO<sub>2</sub> was found to be directly correlated with aortic distensibility (r = 0.47, p = − 0.0002) and negatively correlated to aortic stiffness index (r = − 0.51, p = − 0.0001). 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引用次数: 2
摘要
背景:主动脉僵硬是死亡率和心血管事件的独立预测因子,在非缺血性扩张型心肌病(NIDC)和心力衰竭(HF)患者中很常见。方法:对55例诊断为NIDC(60±11岁,平均射血分数(EF) 35.2%±7.7%)的轻中度心衰(NYHA II-III级)患者连续入科,行超声心动图检查和心肺运动试验(CPX)。我们评估了升主动脉的弹性特性,即主动脉硬度和主动脉扩张性(mm Hg−1),通过2d引导的m型超声心动图测量升主动脉收缩期和舒张期直径(mm/m2)。结果:主动脉僵硬度平均值为15.63±14.53,主动脉扩张度平均值为2.61±2.39 mm Hg−1。CPX收集的参数为峰值耗氧量(pVO2) (ml/kg/min)、厌氧阈值(at)和分钟通气量(VE)与二氧化碳产量(VCO2)之间的关系斜率。平均pVO2为15.4±3.9 ml/kg/min, at时VE/VCO2比为36.1±6.1。通过峰值VO2测量的功能容量与主动脉扩张率直接相关(r = 0.47, p = - 0.0002),与主动脉僵硬指数负相关(r = - 0.51, p = - 0.0001)。经年龄、高血压、糖尿病和射血分数校正后,多因素分析结果相同(分别r = 0.27, p = 0.008和r = - 1.75, p = 0.0002)。结论:超声心动图评价因NIDC引起的升主动脉弹性特性与功能容量降低相关。
Echocardiographic elastic properties of ascending aorta and their relationship with exercise capacity in patients with non-ischemic dilated cardiomyopathy
Background
: Aortic stiffness, an independent predictor of mortality and cardiovascular events, is common among patients affected by non-ischemic dilated cardiomyopathy (NIDC) and heart failure (HF).
Methods
: A total of 55 patients with diagnosis of NIDC (aged 60 ± 11 years, mean ejection fraction (EF) 35.2% ± 7.7%) admitted consecutively to our department for mild to moderate HF (NYHA class II–III) underwent an echocardiographic study and cardiopulmonary exercise test (CPX). We evaluated elastic properties of ascending aorta, i.e. aortic stiffness and aortic distensibility (mm Hg− 1), derived from ascending aorta systolic and diastolic diameter (mm/m2) measured 3 cm above the valvular plane through 2D-guided M-mode echocardiography.
Results
: Mean aortic stiffness was 15.63 ± 14.53 and aortic distensibility was 2.61 ± 2.39 mm Hg− 1. Collected parameters at CPX were peak oxygen consumption (pVO2) (ml/kg/min), anaerobic threshold (AT) and the slope of the relation between minute ventilation (VE) and carbon dioxide production (VCO2). Mean pVO2 was 15.4 ± 3.9 ml/kg/min, VE/VCO2 ratio at AT was 36.1 ± 6.1. Functional capacity measured through peak VO2 was found to be directly correlated with aortic distensibility (r = 0.47, p = − 0.0002) and negatively correlated to aortic stiffness index (r = − 0.51, p = − 0.0001). These results were the same at multivariate analysis, corrected by age, hypertension, diabetes mellitus and ejection fraction (respectively r = 0.27, p = 0.008 and r = − 1.75, p = 0.0002).
Conclusions
: HF patients due to NIDC elastic properties of ascending aorta, evaluated by echocardiography, are correlated with a reduced functional capacity.