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论著:冠心病患者冠状动脉病变程度与左室功能的关系
Relationship between the Severity of Coronary Lesions and Left Ventricular Function in Patients with Coronary Heart Disease
穆林 王永亮 付晓宝 赵树梅 李清清 吴永全
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作者单位:首都医科大学附属北京友谊医院心血管中心
中文关键字:冠状动脉病变;冠状动脉造影;左室舒张功能;左室收缩功能
英文关键字:Coronary artery disease; Coronary angiography; Left ventricular diastolic function; Left ventricular systolic function
中文摘要:目的:研究冠心病患者的冠状动脉病变严重程度与左室收缩和舒张功能的关系。
方法:2009年6月—2010年3月因疑似冠心病行冠状动脉造影的患者223例,均进行冠状动脉造影明确冠心病诊断并评价冠状动脉病变程度;行左室造影前记录左室压力曲线,自动分析计算出左室舒张末压(left ventricular end diastolic pressure, LVEDP)和左室压力下降时间常数(the time constant of left ventricular pressure decay, tau);行超声心动检查获取左室射血分数(left ventricular ejection fraction, LVEF)。根据冠状动脉造影结果,患者分为无病变组(n=43)、单支病变组(n=76)、2支病变组(n=62)、3支病变组(n=42)。对比分析冠脉病变严重程度与心脏收缩和舒张功能的关系。结果:左室室壁厚度、左室质量指数、LVEF、LVEDP和tau值在4组间差异有统计学意义(P均<0.05);冠状动脉3支病变组患者的LVEDP较单支病变组显著升高(P=0.004)。结论:冠心病患者左室舒张功能和收缩功能受损,左室收缩舒张功能随冠脉病变程度增加而下降。
英文摘要:Objective: To explore the relationship between the severity of coronary lesions and left ventricular function in patients with coronary heart diseases (CHD). Methods:A total of 223 consecutive subjects undergoing coronary angiography (CAG) and left ventricular angiography for the assessment of suspected coronary artery diseases were enrolled in this study. All patients underwent coronary angiography (CAG) to determine the degree of coronary artery stenosis. Left ventricular pressure curve was recorded before left ventricular angiography, and left ventricular end diastolic pressure (LVEDP)and the time constant of left ventricular pressure decay (tau) were calculated automatically. Left ventricular ejection fraction (LVEF)was acquired by echocardiography. The patients were divided into four groups: control group(43 cases), single vessel coronary disease group(76 cases), double vessel coronary disease group(62 cases), multiple vessel coronary disease group(42 cases). The relationship between the severity of coronary lesions and the left ventricular function of heart was analyzed. Results: Among the four group,left ventricular posterior wall (LVPW), left ventricular mass index (LVMI), LVEF, LVEDP and tau were significantly different(all P<0.05).The value of LVEDP in the group with multiple vessel coronary disease was significantly higher than that in the group with single vessel coronary disease(P=0.004). Conclusions: In CHD patients, left ventricular diastolic and systolic function are impaired, and left ventricular systolic and diastolic function are associated with the extent of coronary artery stenosis.
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