风心病二尖瓣狭窄合并窦性心律患者经皮球囊二尖瓣成形术后即刻P波离散度变化与左房平均压变化之间的关系

Relationship between changes of P wave dispersion and left mean atrial pressure in patients with rheumatic mitral stenosis and sinus rhythm immediately after percutaneous balloon mitral valvuoplasty

目的探讨风心病二尖瓣狭窄合并窦性心律患者经皮球囊二尖瓣成形术(PBMV)后即刻P波离散度(Pd)变化与左心房(左房)平均压(LMAP)变化之间的关系。方法选取成功进行PBMV风心病二尖瓣狭窄合并窦性心律患者32例,测量PBMV术前、术后即刻Pd、LMAP、二尖瓣口面积(MVA)及左房大小(LAS),计算Pd变化值,并与LMAP、MVA和LAS变化值行相关性分析。结果PBMV术后即刻Pd与LMAP明显减小(P<0.05)、MVA明显增加(P<0.05)、LAS无明显变化(P>0.05);Pd变化值仅与LMAP变化值之间具有相关性。结论风心病二尖瓣狭窄合并窦性心律患者PBMV术后即刻Pd变化与LMAP变化可能有关,提示心房牵张可能是引起风心病二尖瓣狭窄合并窦性心律患者Pd变化的原因。

Objective To evaluate the relationship between changes of P wave dispersion（Pd） and left mean atrial pressure（LMAP） in patients with rheumatic mitral stenosis and sinus rhythm immediately after percutaneous balloon mitral valvuoplasty（PBMV）. Methods 32 cases of rheumatic mitral stenosis and sinus rhythm who have undergone PBMV successfully were selected. Pd,LMAP,mitral valve area （MVA） and left atrial size （LAS） before and after PBMV were measured. Changes of Pd were correlated with changes of LMAP,MVA and LAS. Results Immediately after PBMV,Pd and LMAP both decreased significantly（ P 〈 0.05 ）, MVA increased obviously（ P 〈 0.05 ） and LAS did not change apparently（P 〉 0. 05 ）. The changes of Pd correlated significantly with changes of LMAP. Conclusion Changes of Pd in patients with rheumatic mitral stenosis and sinus rhythm immediately after PBMV might be correlation with changes of LMAP,which might be due to atrial stretch.