冠心病舒张性心力衰竭与左房扩大的相关分析

Analysis of relationship between left atrium enlargement and diastolic heart failure in patients with coronary heart disease

目的:对冠心病舒张性心力衰竭患者左房内径变化及其临床意义进行研究。方法:用彩色多普勒超声心动图仪测定44例冠心病舒张性心力衰竭患者(DHF组)左房内径(LAD)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左心室射血分数(LVEF)、E峰、A峰及E/A比值,并与30例冠心病心功能正常者(对照组)比较。结果:DHF组左房内径(33.5±4.5)mm较对照组(28.4±4.4)mm显著增加(P<0.01),左房内径扩大者(>30mm)36例,占80.0%。DHF组中,E/A>1(伪正常化)患者LAD(35.93±9.78)mm较E/A<值的增加和降低与NYHA心功能分级相关性不明显,左房扩大程度与心功能分级相关性不明显。结论:DHF患者存在左房扩大,左房扩大是舒张性心功能不全的病情发展标志。

Objective： To study the alteration and its clinical significance of left atrium enlargement in patients with coronary heart disease（CHD） with diastolic heart failure（DHF）. It was examined the left atrium diameter（LAD）, left ventricular end - diastolic volume （LVEDV）, left ventricular end - systolic volume（LVESV）, left ventricular eject fraction（LVEF）, ratio（E/A） of early filling phase peak transmitral flow velocity（peak E） and late diastolic filling phase peak transmltral flow velocity（peak A） by echocardiograph in 44 CHD patients with DHF atn ^1 30 CHD patients without DHF. Results： In CHD patients with DHF, LAD（33. 4±4.5mm） increased, enlarged left atria were observed in 80.0%. The patients with E/A〉1 had larger LAD（35 . 93±9. 78 mm） than those with E/A〈1, but the difference was not obvious. The changes of ratio of E/A were not related to the classification of left ventricular function. Conclusion： LAD increased in CHD patients with DHF, the enlargement degree of LAD was not related to the classification of left ventricular function. Left atrium enlargemen ight be a marker of development of diastolic failure.