背景:功能性二尖瓣反流和2型糖尿病(T2DM)对非缺血性扩张型心肌病(NIDCM)患者左心室(LV)应变的影响尚不清楚。
目的:评估二尖瓣反流严重程度对左心室劳损的影响,并探讨T2DM对NIDCM患者二尖瓣反流严重程度不同的LV功能的累加效应。
方法:回顾性。
方法:352名NIDCM(T2DM-)患者(49.1±14.6年,67%男性)(207、85和60无/轻度,中度,重度二尖瓣反流)和96例NIDCM(T2DM+)患者(55.2±12.4年,77%男性)(47、30和19无/轻度,中度,和严重的二尖瓣反流)。
■3.0T/平衡稳态自由进动序列。
结果:测量并比较各组间的LV几何参数和应变。研究了LV菌株的决定因素。
方法:学生t检验,Mann-WhitneyU测试,单向方差分析,Kruskal-Wallis测试,单变量和多变量线性回归。P<0.05被认为具有统计学意义。
结果:NIDCM合并T2DM患者的LVGLPS和纵向PDSR随着二尖瓣反流严重程度的增加而逐渐降低(GLPS:-5.7%±2.1%vs.-4.3%±1.6%与-2.6%±1.3%;纵向PDSR:0.5±0.2秒-1vs.0.4±0.2秒-1vs.0.3±0.1秒-1)。NIDCM(T2DM+)在无/轻度亚组显示GCPS和GLPS降低,降低LVGCPS,GLPS,和中度亚组的纵向PDSR,减少了GRPS,GCPS,GLPS,与NIDCM(T2DM-)患者相比,重度亚组的纵向PDSR。多变量回归分析确定了二尖瓣反流的严重程度(GRPS的β=-0.13、0.15和0.25,GCPS,和GLPS)和T2DM的存在(GCPS和GLPS的β=0.14和0.13)是NIDCM患者LV菌株的独立决定因素。
结论:在患有T2DM的NIDCM患者中,二尖瓣反流严重程度增加与LV应变降低相关。T2DM的存在加剧了NIDCM患者各种二尖瓣反流水平的LV功能下降,导致LV菌株减少。
方法:
■阶段3.
BACKGROUND: The impact of functional mitral regurgitation and type 2 mellitus diabetes (T2DM) on left ventricular (LV) strain in nonischemic dilated cardiomyopathy (NIDCM) patients remains unclear.
OBJECTIVE: To evaluate the impact of mitral regurgitation severity on LV strain, and explore additive effect of T2DM on LV function across varying mitral regurgitation severity levels in NIDCM patients.
METHODS: Retrospective.
METHODS: 352 NIDCM (T2DM-) patients (49.1 ± 14.6 years, 67% male) (207, 85, and 60 no/mild, moderate, and severe mitral regurgitation) and 96 NIDCM (T2DM+) patients (55.2 ± 12.4 years, 77% male) (47, 30, and 19 no/mild, moderate, and severe mitral regurgitation).
UNASSIGNED: 3.0 T/balanced steady-state free precession sequence.
RESULTS: LV geometric parameters and strain were measured and compared among groups. Determinants of LV strain were investigated.
METHODS: Student\'s t-test, Mann-Whitney U test, one-way ANOVA, Kruskal-Wallis test, univariable and multivariable linear regression. P < 0.05 was considered statistically significant.
RESULTS: LV GLPS and longitudinal PDSR decreased gradually with increasing mitral regurgitation severity in NIDCM patients with T2DM(GLPS: -5.7% ± 2.1% vs. -4.3% ± 1.6% vs. -2.6% ± 1.3%; longitudinal PDSR:0.5 ± 0.2 sec-1 vs. 0.4 ± 0.2 sec-1 vs. 0.3 ± 0.1 sec-1). NIDCM (T2DM+) demonstrated decreased GCPS and GLPS in the no/mild subgroup, reduced LV GCPS, GLPS, and longitudinal PDSR in the moderate subgroup, and reduced GRPS, GCPS, GLPS, and longitudinal PDSR in the severe subgroup compared with NIDCM (T2DM-) patients. Multivariable regression analysis identified that mitral regurgitation severity (β = -0.13, 0.15, and 0.25 for GRPS, GCPS, and GLPS) and the presence of T2DM (β = 0.14 and 0.13 for GCPS and GLPS) were independent determinants of LV strains in NIDCM patients.
CONCLUSIONS: Increased mitral regurgitation severity is associated with reduced LV strains in NIDCM patients with T2DM. The presence of T2DM exacerbated the decline of LV function across various mitral regurgitation levels in NIDCM patients, resulting in reduced LV strains.
METHODS: UNASSIGNED: Stage 3.