冠状动脉病变与左室功能的关系

Relationship between coronary artery lesion and left ventricular dysfunction in coronary heart disease patients

目的:探讨冠状动脉(冠脉)病变患者的冠脉病变程度与左心室功能的关系。方法:对127例冠脉造影确诊的,至少存在一支病变狭窄程度大于75%的冠心病患者的心功能进行分析,并比较经皮冠脉介入治疗(PCI)患者治疗前后心功能的改变,以循证冠脉病变与左心室功能之间的相互关系。结果:冠脉病变愈严重,则其心功能损失愈大(P<0.001)。就收缩功能而言,冠脉单支病变者与双支病变者间变化无显著差异,单支、双支病变心功能显著好于三支病变(P<0.01);而舒张功能改变在单支、双支病变间即存在显著差异(P<0.05),但在双支病变与三支病变者间则无显著差异。冠脉病变部位与心功能亦有关系,以前降支病变者心功能损失最大(P<0.01)。其心功能于PCI后有显着改善(P<0.05～<0.001)。结论:冠脉病变程度及部位与左心室功能有关,PCI可改善患者的心功能。

Objective：To explore the relationship between severity of coronary artery lesion and left ventricular dysfunction in patients with coronary heart disease（CHD）.Methods：One hundred and twenty seven consecutive CHD patients who have at least one coronary vessel 〉75 percent luminal diameter stenosis documented with coronary artery angiography were enrolled in the study.The characteristic of coronary lesion and left ventricular（LV）function before and after PCI were analyzed.Results：The more severe the coronary lesion,the worst the LV dysfunction（P〈0.001）.There was no significantly difference in systolic dysfunction between patients with single branch and double branches lesion,but LV function of single,and double branches lesion was better than that of triple branches lesion（P〈0.01）.There was also no significantly difference on E/A between double branches and triple branches lesion,but the E/A of single branch lesion was better than that of double branches lesion（P〈0.05）.The LV function of patient with LAD were the worst（P〈0.01）but improved significantly after PCI（P〈0.05～0.001）.Conclusion：Stenosis severity and location of the coronary artery lesion correlate well with the LV dysfunction;LV dysfunction will improve after PCI.