慢性心力衰竭患者左心室几何形态及功能变化研究

LEFT VENTRICULAR GEOMETRIC SHAPE AND FUNCTION IN PATIENTS WITH CHRONIC HEART FAILURE

目的 观察窦性心律慢性心力衰竭患者心电图、左心室几何形态、左心室收缩功能及二尖瓣反流的变化 ,探讨心电图、左心室几何形态对左心室收缩功能的影响。方法 选择 2 2例慢性心力衰竭患者 ,NYHA分级Ⅱ～Ⅲ级 ,均符合Framingham心力衰竭诊断标准。平均年龄 (59.1 1± 1 6 .0 1 )岁。对照组 1 6例 ,平均年龄 (54 .81± 9.1 6)岁。进行心电图及超声心动图检查分别获得相关参数。结果 二组间心电图参数QRS间期、P -R间期差异有统计学意义 (P均 <0 .0 5)。超声心动图测量的左心室几何构型参数Cole’s指数及面积长度指数差异有统计学意义 (P均 <0 .0 5)。左心室射血分数 (LVEF)明显不同 (P <0 .0 1 )。结论 慢性心力衰竭患者的心电图、心脏几何构型、左心室射血分数存在着明显异常 ,有显著的二尖瓣反流 ,说明心电图、左心室几何形态的改变与左心室收缩功能不良有关。

Objective To observe alterations of electrocardiography and left ventricular geometric shape and function and mitral regurgitation and to explore influence of these parameters on heart function in patients with chronic congestive heart failure in sinus rhythm. Methods 22 patients(mean age, 59.11±16.01, 72% male )in sinus rhythm with chronic congestive heart failure who fulfilled the Framingham heart failure diagnostic criteria (NYHA class Ⅱ-Ⅲ) and sixteen control subjects (mean age 54.81±9.16 years) were studied by standard 12-lead electrocardiography and two dimensional echocardiography. Related parameters were obtained respectively. Results There were significant differences between ECG parameters (QRS duration, P-R duration)(P<0.05),left ventricular geometric parameters (Cole's Index, Area-length Index) at end-systolic and at end-diastolic by echocardiography (P<0.05) and left ventricular ejection fraction (P<0.01) and mitral regurgitation in patients with CHF and control subjects. Conclusion The patients with chronic heart failure have significant abnormal electrocardiography,heart geometric shape,left ventricular systolic function, and severe mitral regurgitation. Left ventricular systolic dysfunction is related to alteration of electrocardiography and heart geometric shape.