扩张型心肌病患者冠状动脉内皮功能的超声心动图研究

Echocardiographic study of epicardial coronary endothelial function in patients with idiopathic dilated cardiomyopathy

目的:应用二维超声心动图测量扩张型心肌病(DCM)患者冷加压试验前后左冠状动脉主干内径的 百分变化率来评价冠状动脉内皮功能。方法:DCM患者21例和健康对照组18例,应用超声心动图测量静息状 态下、冷加压试验前后、舌下含服硝酸甘油后的左冠状动脉主干内径,并计算冷加压试验和硝酸甘油诱发的左冠 状动脉主干内径百分变化率。结果:硝酸甘油诱发的左冠状动脉主干内径百分变化率DCM组[(25.9± 11.1)%]和健康对照组[(27.9±10.8)%]差异无统计学意义(P>0.05),而冷加压试验前后左冠状动脉主干内 径百分变化率DCM组[(1.4±3.7)%]明显低于健康对照组[(15.9±7.3)%,P<0.01]。结论:DCM患者心外 膜冠状动脉内皮功能减低。

Objective: To evaluate coronary endothelial function in patients with idiopathic dilated cardiomyopathy using the cold pressor test-induced percent change in the left main coronary diameter determined by transthoracic echocardiography. Method: Measurements of cold pressor test-induced and nitroglycerin-induced percent changes in the left main coronary diameter by transthoracic echocardiography were performed in twenty-one patients with idiopathic dilated cardiomyopathy and eighteen healthy subjects. Result: No significant difference could be found in percent change in the left main coronary diameter induced by sublingual nitroglycerin between the patients [( 25.9± 11.1)%] and the controls [( 27.9± 10.8)%,P> 0.05], whereas the percent change in the left main coronary diameter induced by cold pressor test in patients with idiopathic dilated cardiomyopathy [( 1.4± 3.7)%] was significantly less than that in healthy subjects [( 15.9± 7.3)%, P< 0.01]. Conclusion: The decreased percent change in the left main coronary diameter induced by cold pressor test in patients with idiopathic dilated cardiomyopathy compared with the healthy subjects indicates that coronary endothelial function is impaired in patients with idiopathic dilated cardiomyopathy.