摘要
目的以超声与心导管法检测冠心病左室舒张功能。方法 6 2例患者均行经胸多普勒超声检查和冠状动脉及左室造影检查。其中冠状动脉正常者 2 9例 ,年龄 (47.0± 1.8)岁 ,异常者 33例 ,年龄 (48.3± 0 .9)岁。结果冠造异常组左室舒张末压显著高于正常组 (17.6mmHgvs13 .2mmHg ,P <0 .0 5 ) ;心房收缩前左室舒张速率正常组远大于异常组 [分别为 -(2 2 4.6 3± 5 2 .18) ,-(87.81± 2 4.41) ,P <0 .0 5 ] ;心房收缩引起的左室舒张压力增加正常组远高于异常组 [(6 .6 6± 0 .92 )mmHgvs (0 .96± 1.87)mmHg ,P =0 .0 0 94] ;心房收缩肺静脉逆流加速度两组差异显著 (5 .10± 0 .31vs 4.12± 0 .2 0 ,P =0 .0 10 6 ) ;等容舒张指标左室等容舒张时间两组均有延长 ,左室最大舒张速率两组均有减少 ,但两组比较上述两指标差异均无显著性意义。等容舒张时间常数两组比较差异不显著。结论冠脉缺血是左室弛张障碍加重和心肌僵硬度增加、顺应性下降的重要因素 ;冠脉异常组无论舒张早、中、后期弛张障碍和中、后期顺应性减低均重于冠脉正常者 ;存在冠脉缺血以外因素引起左室舒张末压增高 ,主要是引起弛张障碍 。
Objective To examine the left ventricular diastolic function of patients with coronary artery diseases by noninvasive echocardiography and invasive coronary angiography.Methods Mitral and pulmonary venous Doppler signals were recorded by the continuous wave Doppler technique in 62 patients, both coronary angiography and left ventricle pressure were measured. Patients were divided into normal and abnormal groups based on coronary angiography.Results Left ventricular end diastolic pressure (LVEDP) ( 17.6 mm Hg vs 13.2 mm Hg,P< 0.05 ),the left ventricular negative Δp/Δt before atria contraction [-( 224.63 ± 52.18 ),-( 87.81 ± 24.41 ),P< 0.05 ],and the elevated value of left ventricular pressure derived from atria contraction [( 6.66 ± 0.92 )mm Hg vs ( 0.96 ± 1.87 )mm Hg,P= 0.0094 ] in abnormal group were more than those in the normal. The ratio of slope in pulmonary vein and mitral A wave peak was less in normal group than that in the abnormal ( 5.10 ± 0.31 vs 4.12 ± 0.20 ,P= 0.0106 ). But the isovolume relaxation parameters had no differences between the two groups.Conclusions Coronary arter ischemia is an important cause of left ventricular impaired relaxation aggravation and stiffness, the diastolic abnormalities existed in the whole diastolic duration. Except ischemia, other factors also could cause relaxation disfuction and even elevate the LVEDP.
出处
《中华超声影像学杂志》
CSCD
2001年第1期19-21,共3页
Chinese Journal of Ultrasonography
