JAHA:射血分数正常的心衰患者左心室结构和功能与血压的关联

2020-07-28 MedSci原创 MedSci原创

在舒张性心力衰竭中,LV壁的厚度和LV质量指数随收缩压的升高而增加,但不随舒张压的升高而增加,而反映舒张期LV功能的指标随舒张压的升高而降低,与收缩压无关。

收缩压和舒张压与射血分数(EF)正常的心力衰竭心脏的结构和功能之间相关性的数据很少。

近日,血管疾病领域权威杂志JAHA上发表了一篇研究文章,该研究纳入了935名EF正常(≥45%)的心力衰竭患者(49.4%的女性;平均年龄为69.9岁),他们参加了TOPCAT(用醛固酮拮抗剂治疗心脏功能正常的心力衰竭)试验。超声心动图检查评估了左心室(LV)结构(大小、壁厚和质量指数)、舒张功能(左心房容积指数、跨膜血流和二尖瓣环速度)和收缩功能(EF和纵向应变)。

在多变量调整分析中,收缩压每增加1个SD(14.8 mmHg)左室间隔和后壁厚度分别增加0.020 cm(P=0.003)和0.018 cm(P=0.004),LV质量指数增加2.42mg/m2(P=0.018)。与舒张压的相关性不显著(P≥0.067)。在经过类似调整的分析中,舒张压每增加1-SD(10.7mmHg),E/A为-0.15(P<0.001),E/e'为-0.76(P=0.006), EF为-0.62%(P=0.024)。

由此可见,在舒张性心力衰竭中,LV壁的厚度和LV质量指数随收缩压的升高而增加,但不随舒张压的升高而增加,而反映舒张期LV功能的指标随舒张压的升高而降低,与收缩压无关。这些观察结果突出了控制收缩压和舒张压作为可改变的危险因素以降低LV重塑和舒张性LV功能障碍风险的重要性。

原始出处:

Fang‐Fei Wei.et al.Associations of Left Ventricular Structure and Function With Blood Pressure in Heart Failure With Preserved Ejection Fraction: Analysis of the TOPCAT Trial.J AM HEART ASSOC.2020.https://www.ahajournals.org/doi/10.1161/JAHA.119.016009

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encryptionId=1d7e48033f5, topicName=左心室)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=15012955474, createdName=wushaoling, createdTime=Thu Jul 30 11:45:00 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1446660, encodeId=de1c14466608b, content=<a href='/topic/show?id=26b9468137a' target=_blank style='color:#2F92EE;'>#射血分数正常的心衰#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46813, encryptionId=26b9468137a, topicName=射血分数正常的心衰)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=13435269915, createdName=bugit, createdTime=Thu Jul 30 11:45:00 CST 2020, time=2020-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=804978, encodeId=e0a18049e8e5, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d5142645505, createdName=619103330, createdTime=Tue Jul 28 23:30:01 CST 2020, time=2020-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=804976, encodeId=56718049e633, content=不错的, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=07c72615170, createdName=565183108, createdTime=Tue Jul 28 23:29:21 CST 2020, time=2020-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=804971, encodeId=00be8049e18a, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=53dd2037011, createdName=tainyxixixi, createdTime=Tue Jul 28 23:06:11 CST 2020, time=2020-07-28, status=1, ipAttribution=)]
    2020-07-30 zhaohui6731
  5. 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  6. 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  7. 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  8. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d5142645505, createdName=619103330, createdTime=Tue Jul 28 23:30:01 CST 2020, time=2020-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=804976, encodeId=56718049e633, content=不错的, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=07c72615170, createdName=565183108, createdTime=Tue Jul 28 23:29:21 CST 2020, time=2020-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=804971, encodeId=00be8049e18a, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=53dd2037011, createdName=tainyxixixi, createdTime=Tue Jul 28 23:06:11 CST 2020, time=2020-07-28, status=1, ipAttribution=)]
    2020-07-28 619103330

    不错

    0

  9. 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topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d5142645505, createdName=619103330, createdTime=Tue Jul 28 23:30:01 CST 2020, time=2020-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=804976, encodeId=56718049e633, content=不错的, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=07c72615170, createdName=565183108, createdTime=Tue Jul 28 23:29:21 CST 2020, time=2020-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=804971, encodeId=00be8049e18a, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=53dd2037011, createdName=tainyxixixi, createdTime=Tue Jul 28 23:06:11 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    2020-07-28 565183108

    不错的

    0

  10. 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    2020-07-28 tainyxixixi

    了解

    0

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