背景:高血压(HTN)和2型糖尿病(T2DM)均与左心室(LV)和左心房(LA)结构和功能异常有关;然而,该人群左心房和心室之间的关系尚不清楚。
目的:确定有和没有T2DM的高血压患者之间的差异,作为进一步研究房室耦合关系的基础。
方法:横截面,回顾性研究。
方法:89例无T2DM[HTN(T2DM-)]的高血压患者(年龄:58.4+/-11.9岁,48男),62例T2DM高血压患者[HTN(T2DM+)](年龄:58.5+/-9.1岁,32名男性)和70名匹配的对照(年龄:55.0+/-9.6岁,37男)。
■3.0T的2D平衡稳态自由进动电影序列
结果:洛杉矶水库,导管,和助推器应变(εs,εe,和εa)和应变率(SRs,SRe,和SRa),低压径向,从LA和LV电影图像得出周向和纵向峰值应变(PS)以及收缩期峰值应变率和舒张期峰值应变率(PSSR和PDSR),并进行组间比较。
方法:卡方或Fisher精确检验,单向方差分析,协方差分析,皮尔森的相关性,多元线性回归分析,和组内相关系数。P值<0.05被认为是显著的。
结果:与对照组相比,εs,εe,SRe和PS-纵向,PDSR-径向,在HTN(T2DM-)组中,PDSR-纵向显著降低,HTN(T2DM+)组甚至低于对照组和HTN(T2DM-)组。SRs,εa,SRa,以及PS-径向,PS-圆周,PSSR-径向,与对照组相比,HTN(T2DM)和PSSR圆周显着降低。多因素回归分析表明:T2DM和PS周向和PS纵向(分别为β=-4.026,-0.486和-0.670)与εs显着相关;T2DM和PDSR径向和PDSR周向与εe显着相关(分别为β=-3.406,-3.352和-6.290);T2DM和PDSR-径向分别与εPDe和0.215显着相关(=β=1.70-SR-
结论:在高血压患者中,合并T2DM的患者存在更严重的LA功能障碍,这可能与更严重的LV功能障碍有关,并提示不良房室耦合。
方法:3.
■第三阶段。
BACKGROUND: Hypertension (HTN) and type 2 diabetes mellitus (T2DM) are both associated with left ventricular (LV) and left atrial (LA) structural and functional abnormalities; however, the relationship between the left atrium and ventricle in this population is unclear.
OBJECTIVE: To identify differences between hypertensive patients with and without T2DM as the basis for further investigation the atrioventricular coupling relationship.
METHODS: Cross-sectional, retrospective study.
METHODS: 89 hypertensive patients without T2DM [HTN (T2DM-)] (age: 58.4 +/- 11.9 years, 48 male), 62 hypertensive patients with T2DM [HTN (T2DM+)] (age: 58.5 +/- 9.1 years, 32 male) and 70 matched controls (age: 55.0 +/- 9.6 years, 37 male).
UNASSIGNED: 2D balanced steady-state free precession cine sequence at 3.0 T.
RESULTS: LA reservoir, conduit, and booster strain (εs, εe, and εa) and strain rate (SRs, SRe, and SRa), LV radial, circumferential and longitudinal peak strain (PS) and peak systolic strain rate and peak diastolic strain rate (PSSR and PDSR) were derived from LA and LV cine images and compared between groups.
METHODS: Chi-square or Fisher\'s exact test, one-way analysis of variance, analysis of covariance, Pearson\'s correlation, multivariable linear regression analysis, and intraclass correlation coefficient. A P value <0.05 was considered significant.
RESULTS: Compared with controls, εs, εe, SRe and PS-longitudinal, PDSR-radial, and PDSR-longitudinal were significantly lower in HTN (T2DM-) group, and they were even lower in HTN (T2DM+) group than in both controls and HTN (T2DM-) group. SRs, εa, SRa, as well as PS-radial, PS-circumferential, PSSR-radial, and PSSR-circumferential were significantly lower in HTN (T2DM+) compared with controls. Multivariable regression analyses demonstrated that: T2DM and PS-circumferential and PS-longitudinal (β = -4.026, -0.486, and -0.670, respectively) were significantly associated with εs; T2DM and PDSR-radial and PDSR-circumferential were significantly associated with εe (β = -3.406, -3.352, and -6.290, respectively); T2DM and PDSR-radial were significantly associated with SRe (β = 0.371 and 0.270, respectively); T2DM and PDSR-longitudinal were significantly associated with εa (β = -1.831 and 5.215, respectively); and PDSR-longitudinal was significantly associated with SRa (β = 1.07).
CONCLUSIONS: In hypertensive patients, there was severer LA dysfunction in those with coexisting T2DM, which may be associated with more severe LV dysfunction and suggests adverse atrioventricular coupling.
METHODS: 3.
UNASSIGNED: Stage 3.