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首页> 外文期刊>The American Journal of Cardiology >Usefulness of carvedilol to abolish myocardial postsystolic shortening in patients with idiopathic dilated cardiomyopathy.
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Usefulness of carvedilol to abolish myocardial postsystolic shortening in patients with idiopathic dilated cardiomyopathy.

机译：卡维地洛对特发性扩张型心肌病患者取消心肌收缩后缩短的作用。

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摘要

Postsystolic shortening (PSS), a positive myocardial velocity after aortic valve closure as assessed by Doppler tissue imaging, is a common pathologic finding in patients with myocardial disease. Beta-blocker therapy can improve global and regional myocardial function. The aim of the present study was to examine whether the beta-blocker carvedilol might reduce the incidence and magnitude of PSS in patients with idiopathic dilated cardiomyopathy. Before and 2 months after carvedilol therapy, 19 patients (7 men, 12 women; mean age 59 +/- 13 years) underwent conventional echocardiographic assessment and Doppler tissue imaging. Time-velocity curves were constructed at the 12 basal and mid myocardial segments of the left ventricular (LV) walls. PSS was defined if positive myocardial velocity after aortic valve closure was greater than the ejection peak. The number of segments showing PSS was assessed before and after carvedilol therapy. Carvedilol decreased LV end-diastolic dimension (from 66 +/- 5 to 62 +/- 7 mm, p <0.01), increased the LV ejection fraction (from 28 +/- 9% to 36 +/- 8%, p <0.01), and increased early diastolic mitral annular velocity (Ea) (from 5.0 +/- 1.6 to 5.5 +/- 1.7 cm/ms, p <0.01). This was associated with significant reductions in the number of segments showing PSS (from 2.8 +/- 3.0 to 0.8 +/- 1.4, p <0.01). There was a correlation between changes in the number of segments showing PSS and changes in Ea (r = -0.56, p = 0.01). In conclusion, PSS may reflect the severity of LV diastolic function during pharmacologic reverse remodeling in patients with idiopathic dilated cardiomyopathy. These data provide new insights into the mechanisms by which carvedilol improves cardiac function and symptoms in these patients.
机译：收缩期缩短（PSS）是通过多普勒组织成像评估的主动脉瓣关闭后的积极心肌速度，是心肌病患者的常见病理发现。 β受体阻滞剂治疗可以改善整体和局部心肌功能。本研究的目的是检查β-受体阻滞剂卡维地洛是否可以降低特发性扩张型心肌病患者的PSS发生率和幅度。卡维地洛治疗前后2个月，对19例患者（男7例，女12例;平均年龄59 +/- 13岁）进行了常规超声心动图评估和多普勒组织成像。在左心室（LV）壁的12个基础和中段心肌中绘制时间-速度曲线。如果主动脉瓣关闭后心肌正速度大于射血峰值，则定义为PSS。卡维地洛治疗前后评估显示PSS的节段数。卡维地洛可降低左室舒张末期尺寸（从66 +/- 5毫米增至62 +/- 7毫米，p <0.01），增加左室射血分数（从28 +/- 9％增至36 +/- 8％，p < 0.01），并提高舒张早期二尖瓣环速度（Ea）（从5.0 +/- 1.6到5.5 +/- 1.7 cm / ms，p <0.01）。这与显示PSS的节段数量显着减少有关（从2.8 +/- 3.0降低到0.8 +/- 1.4，p <0.01）。显示PSS的片段数量变化与Ea的变化之间存在相关性（r = -0.56，p = 0.01）。总之，PSS可能反映了特发性扩张型心肌病患者药理学逆向重构期间左室舒张功能的严重程度。这些数据为卡维地洛改善这些患者心脏功能和症状的机制提供了新见解。

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