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首页> 外文期刊>Circulation journal >Myocardial Stretch in Early Systole is a Key Determinant of the Synchrony of Left Ventricular Mechanical Activity in vivo
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Myocardial Stretch in Early Systole is a Key Determinant of the Synchrony of Left Ventricular Mechanical Activity in vivo

机译：早期收缩期的心肌舒张是体内左心室机械活动同步的关键决定因素

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Background: ? Recent in-vitro observations suggest that left ventricular (LV) contraction is powered by ‘stretch activation’, an intrinsic mechanism by which the stretching of an activated cardiomyocyte causes delayed force redevelopment. We hypothesized that mechanical dyssynchrony is related to prolonged early systolic stretch that delays the timing of peak segmental shortening. Methods and Results: ?The time intervals from R wave to segmental longitudinal stretch in early systole (Tstretch) and peak shortening (Tpeak) and the respective standard deviations (σTstretch and σTpeak) were measured by speckle-tracking echocardiography in 57 patients undergoing cardiac resynchronization therapy (CRT). The percentage of time spent in shortening, normalized to Tpeak duration [corrected ΔT=(Tpeak–Tstretch)/Tpeak] correlated with LV reverse remodeling (reduction in end-systolic volume ≥15%). Of the 57 patients, 40 (70.2%) demonstrated LV reverse remodeling at an average follow-up of 263±125 days after CRT. At baseline, Tstretch and σTstretch correlated with Tpeak and σTpeak, respectively. Though there was no difference in Tstretch, Tpeak, σTstretch and σTpeak between responders and non-responders, corrected ΔT in the mid-lateral and mid-septal segments was shorter in the responders (P
机译：背景： ？最近的体外观察表明，左心室（LV）收缩是由“舒张激活”驱动的，“舒张激活”是一种内在机制，通过该内在机制，激活的心肌细胞的拉伸会导致力的重建延迟。我们假设机械不同步与延长的早期收缩期舒张有关，延缓了节段性缩短的高峰。方法和结果：？从R波到早期收缩的节段纵向拉伸（T stretch ）和峰缩短（T peak ）的时间间隔以及各自的标准差（σT）通过斑点跟踪超声心动图测量了57例接受心脏再同步治疗（CRT）的患者的 stretch 和σT peak 。缩短时间的百分比，以T peak 持续时间标准化[校正后的ΔT=（T peak –T stretch ） / < / sub> T peak ]与左室反向重构有关（收缩末期容积减少≥15％）。在这57例患者中，有40例（70.2％）表现出LV逆重塑，在CRT后平均随访263±125天。在基线，T stretch 和σT stretch 分别与T peak 和σT peak 相关。尽管响应者与非响应者之间的T stretch ，T peak ，σT stretch 和σT peak 没有差异。应答者中，中外侧和中隔段的校正后的ΔT较短（P

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