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Echocardiographic index E/e' in association with cerebral white matter hyperintensity progression.

超声心动图指数E/e' 与脑白质高信号进展相关。

  • 影响因子:3.02
  • DOI:10.1371/journal.pone.0236473
  • 作者列表:"Lee WJ","Jung KH","Ryu YJ","Lee ST","Park KI","Chu K","Kim M","Lee SK","Roh JK
  • 发表时间:2020-07-27
Abstract

:Cerebral white-matter hyperintensities (WMHs) on MRI is associated with reduced compliance of the cerebral arterioles. We hypothesized that an echocardiography index for left ventricular (LV) diastolic function, E/e', might reflect the cerebral arteriolar compliance and evaluated the association between E/e' and long-term progression rate of the cerebral WMH volume. This retrospective study included individuals who were ≥ 50 years of age, with a preserved LV ejection fraction (≥ 50%) and neurological function status (modified Rankin scale score ≤1), and underwent initial and follow-up MRI evaluations within intervals of 34-45 months. Baseline clinical, laboratory, and echocardiography markers such as ejection fraction, LV mass index, and E/e' were obtained. WMH volume progression rate between the baseline and follow-up MRIs was designated as the outcome factor. 392 individuals (57.1% men; mean age: 66.7±8.4 years) were followed-up for 38.2±3.4 months. The mean WMH volume progression rate was 1.35±2.65 mL/year. The log-transformed value of WMH volume progression rate was linearly associated with the log-transformed E/e' (B coefficient = 0.365; 95% confidence interval [CI] 0.180-0.551; P = 0.001), along with the log-transformed values of baseline WMH volume (B = 0.142; 95% CI 0.106-0.179; P<0.001) and glomerular filtration rate (B = -0.182; 95% CI -0.321-0.044; P = 0.010). Additionally, a subgroup with an E/e' ≥15 exhibited a significantly higher WMH progression rate compared to the subgroups with lower E/e' values (P<0.001), especially in the lower quartiles (quartiles 1 and 2) of the baseline WMH volume. We concluded that echocardiographic marker E/e' is associated with the long-term progression rate of cerebral WMHs in population with preserved LV systolic function.

摘要

: MRI上的脑白质高信号 (WMHs) 与脑小动脉的顺应性降低相关。我们假设左心室 (LV) 舒张功能的超声心动图指标E/e' 可能反映脑小动脉顺应性,并评估E/e' 与脑WMH体积长期进展率之间的关联。这项回顾性研究包括年龄 ≥ 50岁,左室射血分数 (≥ 50%) 和神经功能状态 (改良Rankin量表评分 ≤ 1分) 保留的个体,并在34-45个月的间隔内接受了初始和随访MRI评估。获得基线临床、实验室和超声心动图标志物,如射血分数、LV质量指数和E/e'。基线和随访mri之间的WMH体积进展率被指定为结局因素。392例患者 (57.1% 例男性; 平均年龄: 66.7 ± 8.4岁) 随访38.2 ± 3.4个月。平均WMH体积进展率为1.35 ± 2.65 mL/年。WMH体积进展率的对数转换值与对数转换E/e' (B系数 = 0.365; 95% 置信区间 [CI] 0.180-0.551; P = 0.001) 以及基线WMH体积的对数转换值呈线性相关 (B = 0.142; 95% CI 0.106-0.179; P<0.001) 和肾小球滤过率(B = -0.182; 95% CI -0.321-0.044; P = 0.010)。此外,与E/e' 值较低的亚组相比,E/e' ≥ 15的亚组表现出显著较高的WMH进展率 (P<0.001),尤其是在基线WMH体积的较低四分位数 (四分位数1和2) 中。我们得出结论,超声心动图标志物E/e' 与左心室收缩功能保留人群脑WMHs的长期进展率相关。

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影响因子:2.41
发表时间:2020-06-12
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METHODS:AIMS:Significant platelet activation after long stented coronary segments has been associated with periprocedural microvascular impairment and myonecrosis. In long lesions treated either with an everolimus-eluting bioresorbable vascular scaffold (BVS) or an everolimus-eluting stent (EES), we aimed to investigate (a) procedure-related microvascular impairment, and (b) the relationship of platelet activation with microvascular function and related myonecrosis. METHODS AND RESULTS:Patients (n=66) undergoing elective percutaneous coronary intervention (PCI) in long lesions were randomised 1:1 to either BVS or EES. The primary endpoint was the difference between groups in changes of pressure-derived corrected index of microvascular resistance (cIMR) after PCI. Periprocedural myonecrosis was assessed by high-sensitivity cardiac troponin T (hs-cTnT), platelet reactivity by high-sensitivity adenosine diphosphate (hs-ADP)-induced platelet reactivity with the Multiplate Analyzer. Post-dilatation was more frequent in the BVS group, with consequent longer procedure time. A significant difference was observed between the two groups in the primary endpoint of ΔcIMR (p=0.04). hs-ADP was not different between the groups at different time points. hs-cTnT significantly increased after PCI, without difference between the groups. CONCLUSIONS:In long lesions, BVS implantation is associated with significant acute reduction in IMR as compared with EES, with no significant interaction with platelet reactivity or periprocedural myonecrosis.

关键词: 暂无
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影响因子:1.67
发表时间:2020-01-01
DOI:10.2174/1573403X15666190513105231
作者列表:["Dev M","Sharma M","Rana N"]

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心脏影像技术方向

心脏结构和心脏血流的可视化,用于诊断评估或通过内窥镜、放射性核素成像等技术来指导心脏手术。

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