老年冠心病患者心功能改变的特点

Peculiarities of changes in the cardiac function in elderly coronary heart disease patients

对２３例老年冠心病患者，１９例非老年冠心病患者及１４例正常老年人，１７例正常非老年人进行了核素心血池显像。结果发现老年冠心病组左室高峰充盈率（ＰＦＲ）、左室射血分数（ＬＶＥＦ）、左室高峰射血率（ＰＥＲ）较老年正常组明显降低，相角程明显增大。老年冠心病组较非老年冠心病组ＰＦＲ明显降低，相角程和ＰＦＲ异常的比例明显增大。相关分析证实年龄与ＰＦＲ、ＬＶＥＦ、ＰＥＲ、相角程明显相关。提示老年冠心病患者存在着更为普遍和严重的舒张功能减退，影响舒张功能受损的主要原因有年龄因素、心室运动协调障碍等。

ECG-gated radionuclide cardiac blood pool images were studied in 27 elderly coronary heart disease(CHD) patients. Younger CHD patients and elderly and younger healthy subjects were set as the controls. Results showed that the left ventricular peak filling rate(PFR), the left ventricular ejection fraction (LVEF) and the left ventricular peak ejection rate(PER) were significantly lower and the phase angle significantly greater in the elderly patients than in the elderly healthy controls (P<0. 01 ). The PFR was lower (P<0. 05) and the abnormal rates of the phase angle and PFR greater (P<0. 01) in the elderly than in the younger patients; abnormal PFR was found in 95. 7% in elderly patients ,while only 57. 9% in the younger (P<0. 01). It was found that age was correlated with PFR,LVEF , PER and phase angle (r = - 0. 48 ,-0. 34, -0. 36 and 0. 42, respectively) (P <0. 01 ). Results suggested that abnormalities in the left ventricular diastolic function are more common and more conspicuous in the elderly CHD patients, which may be attributable to age factor and asynchronous ventricular contractions .