冠状动脉病变程度对左心室舒张末压的影响

Impact of severity of coronary lesion on left ventricular end diastolic pressure

目的 :探讨冠状动脉病变不同严重程度对左心室舒张末压的影响。 方法 :连续性冠状动脉造影 6 83例 ,分别按冠状动脉病变支数、狭窄程度和狭窄总积分分组 ,测定左心室造影前及造影后左心室舒张末压 (LVEDP)。结果 :与各自正常对照组比较 ,冠状动脉病变为单支病变、2 5 %～ 5 0 %狭窄或狭窄总积分 1～ 3分时LVEDP略有下降 ;双支病变、5 0 %～ 99%狭窄或狭窄总积分 4～ 9分时LVEDP稍有升高 ,超过 15mmHg ,但均无统计学意义 ;三支病变、10 0 %完全闭塞、狭窄总积分≥ 10分时LVEDP有显著意义升高 (P 0 .0 1或P 0 .0 5 )。造影后LVEDP与造影前比较 ,各组均有显著升高 (P 0 .0 1) ,但LVEDP上升幅度组间比较均无统计学意义。 结论 :在冠状动脉病变严重时 。

Objective: To investigate the impact of severity of coronary lesion on left ventricular end diastolic pressure(LVEDP) in patients with coronary artery disease(CAD). Methods: 683 cases of consecutive coronary angiography were adopted for study according to the criteria and grouped in terms of extent and severity of coronary lesion and AHA coronary arterial lesion score respectively. The LVEDP were measured ventriculographically. Results: Comparing with the accordant contrast group, LVEDP was slightly decreased without statistical significance in the single vessel group in the (25%-50%) stenosis group, and the (1-3) scores group; while slightly increased without statistical significance in the double vessel group in (26%-50%) and (51%-75%) stenosis groups and (4-6) scores and (7-9) scores groups. There was a significant increase in the triple vessel group, in the 100% stenosis group, and the ≥10 scores group(P<0.01 or 0.05). The difference of LVEDP before and after ventriculography was significant(P<0.01)in each group. The increased amounts of LVEDP after ventriculography showed no difference among different groups. Conclusion: Left ventricular diastolic compliance is undermined and LVEDP increases in cases of severe coronary lesion.