| Objective: Cardiac diastolic function plays an important role in the whole cardiac cycle,and cardiac diastolic dysfunction has gradually received clinical attention,so it has important clinical practical significance for the identification of diastolic dysfunction and the search for the cause.In this study,left ventricular end-diastolic volume(EDV),endsystolic volume(ESV),peak filling rate(PFR),and peak ejection rate(PER)and other parameters were measured by Gated-myocardial perfusion imaging(G-MPI).And the ratio of transient ischemic dilation(TID)of the left ventricle was calculated,expressed by s/r EDV,s/r ESV,and SIVR,to study the correlation between them and with diastolic function.Methods: The data of 126 patients(104 males and 22 females,with an average age of 66years)who completed stress/rest(s/r)G-MPI and transthoracic echocardiography at the First Affiliated Hospital of China Medical University from January 2020 to December2021 were analyzed retrospectively.The data collected included baseline characteristics of patients,fasting laboratory indicators,echocardiographic results,and G-MPI results.126 patients were divided into two groups(51 cases with normal diastolic function and 75 cases with abnormal diastolic function)according to the ultrasound evaluation of whether the patient had diastolic dysfunction.SPSS software was used to compare the differences between the groups,univariate and multivariate logistic regression analysis,and ROC curve analysis,and the correlation between the left ventricular function parameters obtained by G-MPI and the diastolic function was obtained.Then,the subgroup analysis was carried out according to age.People older than 60 years old were divided into the elderly group,and people younger than or equal to 60 years old were divided into the nonelderly group.Compare the difference between the elderly group and the non-elderly group in describing the cardiac diastolic function using the TID ratio.Finally,Pearson correlation analysis was used to study the correlation of TID ratio with other factors.Results: 1.Compared with the group with normal diastolic function,the patients in the group with diastolic dysfunction were significantly older,the level of cystatin C was higher,the glomerular filtration rate was lower,that is,the renal function was worse,the level of serum uric acid and serum troponin were higher(P<0.05).However,there was no significant difference in sex,body mass index,hemoglobin,granulocyte ratio,glutamic oxaloacetic transaminase,glutamic pyruvic transaminase,low-density lipoprotein cholesterol,glycosylated hemoglobin levels(P>0.05).In addition,in the diastolic dysfunction group,the patient’s smoking history,drinking history,the use of beta receptor blockers,nitrates,and antiplatelet drugs were statistically significant differences(P<0.05),but there were no statistically significant differences in the 2 type diabetes,hypertension,the use of statins,ACEI/ARB/ARNI drugs(P>0.05).2.The comparison of echocardiographic results between groups showed that there was no significant difference in septal thickness,left ventricular mass,and peak A(P>0.05),while there was a significant difference in peak E and E/A value between the two groups(P<0.05).Compared with the group with normal diastolic function,there was no significant difference in the total myocardial perfusion defect,left ventricular end diastolic volume,left ventricular end systolic volume,and peak ejection rate(P>0.05),regardless of whether the myocardium was loading or resting state,compared with the group with normal diastolic function(P>0.05),while the left ventricular peak filling rate and the TID ratio calculated by three methods,the difference between the two groups was statistically significant(P<0.05).3.Univariate regression analysis showed that SIVR was a risk factor for cardiac diastolic function,and the risk of cardiac diastolic dysfunction increased by 1.237 times for every 0.1 unit increase.The s/r EDV and s/r ESV were negatively correlated with cardiac diastolic,and the difference was not statistically significant.Through the comparison of the differences between the two groups,it was found that there were statistical differences in the personal history and medication history of the two groups.Because the medication history will affect the accuracy of the G-MPI results of patients,the multivariate binary logistic regression analysis after correcting the confounding factors showed that s/r EDV(OR=1.476,95% CI: 1.064,2.047,P=0.02),s/r ESV(OR=1.23,95%CI: 1.024,1.477,P=0.027),SIVR(OR=1.342,95% CI: 1.059,1.701,P=0.015)were independent risk factors for cardiac diastolic dysfunction.Considering the age of the patient,when using s/r EDV,s/r ESV,and SIVR to diagnose left ventricular diastolic dysfunction,the area under the curve was 69.8%,70.1%,and 70.2% respectively(P<0.001).4.The results showed that there was no significant difference in the ratio of TID between the elderly and the non-elderly,whether in the group with normal diastolic function or in the group with abnormal diastolic function(P>0.05).The bivariate Pearson correlation analysis showed that there was a strong positive correlation among s/r EDV,s/r ESV,and SIVR(r>0.6,P<0.01);There was no significant correlation with cardiac structural changes.Conclusion: Age,renal insufficiency,elevated uric acid level,troponin level,and TID ratios are risk factors for cardiac diastolic dysfunction;Cardiac peak filling rate is the protective factor of cardiac diastolic function;The TID ratio will be higher in patients with ventricular diastolic dysfunction.Considering patients’ age and TID ratio,the combined diagnosis of cardiac diastolic dysfunction is a reliable method,and the value of the TID ratio for different age groups does not need to be adjusted,which expands the comprehensiveness of the G-MPI examination. |
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