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学科主题: 临床医学
题名:
Importance of dynamic dyssynchrony in the occurrence of hypertensive heart failure with normal ejection fraction
作者: Lee, Alex Pui-Wai1; Song, Jae-Kwan2; Yip, Gabriel Wai-Kwok1; Zhang, Qing1,3; Zhu, Tian-Gang4; Li, Chunmei1; Chan, Anna1; Yu, Cheuk-Man1
关键词: Heart failure ; Echocardiography ; Hypertension ; Stress test
刊名: EUROPEAN HEART JOURNAL
发表日期: 2010-11-01
DOI: 10.1093/eurheartj/ehq248
卷: 31, 期:21, 页:2642-2649
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Cardiac & Cardiovascular Systems
研究领域[WOS]: Cardiovascular System & Cardiology
关键词[WOS]: LEFT-VENTRICULAR DYSSYNCHRONY ; CARDIAC RESYNCHRONIZATION THERAPY ; EXERCISE-ECHOCARDIOGRAPHY ; SYSTOLIC FUNCTION ; AORTIC-STENOSIS ; CARDIOMYOPATHY ; ABNORMALITIES ; DYSFUNCTION ; ASYNCHRONY ; RESERVE
英文摘要:

The impact of haemodynamic stress on left ventricular (LV) dyssynchrony in heart failure with normal ejection fraction (HFNEF) remains unknown. We sought to evaluate the relationship and predictive value of dynamic changes of LV dyssynchrony on hypertensive HFNEF.

A total of 131 subjects including 47 hypertensive HFNEF patients, 34 hypertensive patients with left ventricular hypertrophy (LVH) without HFNEF, and 50 normal controls were studied by dobutamine stress echocardiography with tissue Doppler imaging. Systolic and diastolic dyssynchrony were assessed using the LV six-basal-six-mid-segment model and cut-off values were derived from normal controls. The mean basal segments longitudinal systolic (mean Sm) and early diastolic (mean Em) velocities were measured. In normal controls, systolic and diastolic dyssynchrony did not develop during stress. The prevalence of resting systolic (36.2% vs. 38.2%, P = 0.85) and diastolic (34.0% vs. 29.4%, P = 0.66) dyssynchrony was similar in HFNEF and LVH groups. During stress, the prevalence of systolic and diastolic dyssynchrony increased dramatically to 85.1% and 87.2%, respectively, in HFNEF group, but only 52.9% and 58.8% in LVH group (P < 0.005). In HFNEF group, stress-induced increase in mean Sm was significantly blunted (2.8 +/- 2.0 vs. 4.2 +/- 2.4 cm/s, P = 0.004), and the increase was abolished for mean Em (-0.3 +/- 2.5 vs. 2.4 +/- 3.4 cm/s, P < 0.001). On multivariate analysis, stress-induced changes in mean Em (OR = 0.69, P = 0.004) and mean Sm (OR = 0.56, P = 0.004), and diastolic (OR = 4.6, P = 0.005) and systolic dyssynchrony during stress (OR = 4.3, P = 0.038) were independent determinants for occurrence of HFNEF.

Dynamic dyssynchrony during stress and impaired myocardial longitudinal function reserve are characteristics of HFNEF.

语种: 英语
所属项目编号: 477907
项目资助者: Research Grant Council of Hong Kong (RGC)
WOS记录号: WOS:000283926500018
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/62439
Appears in Collections:北京大学第二临床医学院_期刊论文

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作者单位: 1.Peking Univ, Peoples Hosp, Beijing 100871, Peoples R China
2.Chinese Univ Hong Kong, Prince Wales Hosp, Div Cardiol, Dept Med & Therapeut, Hong Kong, Hong Kong, Peoples R China
3.Univ Ulsan, Asan Med Ctr, Coll Med, Seoul, South Korea
4.Sichuan Univ, W China Hosp, Dept Cardiol, Chengdu, Sichuan, Peoples R China

Recommended Citation:
Lee, Alex Pui-Wai,Song, Jae-Kwan,Yip, Gabriel Wai-Kwok,et al. Importance of dynamic dyssynchrony in the occurrence of hypertensive heart failure with normal ejection fraction[J]. EUROPEAN HEART JOURNAL,2010,31(21):2642-2649.
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