■二尖瓣狭窄(MS)患者的功能能力降低。先前的研究表明,该人群的左心房应变与功能能力之间存在相关性。然而,目前,MS患者的左心室(LV)超声心动图参数与功能能力无关。无创性左心室压力-应变环分析是一种评价左心室功能的新的超声心动图方法。整合斑点追踪分析的纵向应变和非侵入性测量的血压,以估计心肌功(MW),该心肌功通过整合后负荷来克服与前负荷相关的常规参数。本研究旨在评估重度MS和保留LV射血分数(LVEF)的患者使用运动试验测量的MW与功能容量之间的关联。
■有症状的重度风湿性MS(二尖瓣面积<1.5cm2)的成年患者,纳入2019年至2021年在我院接受超声心动图和运动负荷试验的LVEF保留(>50%)和窦性心律。排除标准是心肌变形分析的图像质量欠佳,显著的二尖瓣返流或主动脉瓣病变,冠状动脉疾病,心内分流术,和心房颤动。测量标准超声心动图参数,并包括所有MW参数。使用改良的Bruce方案进行运动跑步机测试。
■本研究共纳入33例孤立性严重风湿性MS窦性心律患者(年龄39.8±9.8岁)。与正常参考值相比,患有严重孤立性MS的患者的LV全局纵向应变值显着受损。此外,重度MS患者的整体工作指数值明显较低,全球建设性工作,与正常值相比,效率和更高的浪费工作。整体工作效率与运动持续时间显著相关(P=0.025,Pearson'sr=0.389)。
■在孤立的重度二尖瓣狭窄的稳定患者中,MW效率与通过运动测试客观测量的功能容量显着相关。
UNASSIGNED: Functional capacity is reduced in mitral stenosis (MS) patients. Previous studies showed a correlation between left atrial strain and functional capacity in this population. However, currently, no left ventricle (LV) echocardiographic parameters were associated with functional capacity in patients with MS. Noninvasive LV pressure-strain loop analysis is a new echocardiographic method for evaluating LV function, integrating longitudinal strain from speckle-tracking analysis and noninvasively measured blood pressure to estimate myocardial work (MW) that overcomes the preload-dependent characteristics conventional parameters by integrating afterload. This study aimed to evaluate the association between MW and functional capacity measured using exercise tests in patients with severe MS and preserved LV ejection fraction (LVEF).
UNASSIGNED: Adult patients with symptomatic severe rheumatic MS (mitral valve area <1.5 cm2), and preserved LVEF (>50%) and sinus rhythm who underwent echocardiography and exercise stress test in our hospital from 2019 to 2021 were included. Exclusion criteria were suboptimal image quality for myocardial deformation analysis, significant mitral regurgitation or aortic valve lesions, coronary artery disease, intracardiac shunt, and atrial fibrillation. Standard echocardiographic parameters were measured, and all MW parameters were included. Exercise treadmill testing was performed using the modified Bruce protocol.
UNASSIGNED: A total of 33 individuals with isolated severe rheumatic MS in sinus rhythm (age 39.8 ± 9.8 years) were included in the study. Patients with severe isolated MS showed significantly impaired LV-global longitudinal strain values compared to normal reference values. Furthermore, patients with severe MS showed significantly lower values of global work index, global constructive work, and efficiency compared to normal values and higher wasted work. Global work efficiency was significantly correlated to the duration of exercise (P = 0.025, Pearson\'s r = 0.389).
UNASSIGNED: In stable patients with isolated severe mitral stenosis, MW efficiency significantly correlated with functional capacity measured objectively through exercise testing.