冠心病患者的房室瓣环运动异常

Abnormalities of Left Atrioventricular Plane Motion in Coronary Artery Disease

目的：评价冠心病患者左房室瓣环运动的改变。方法：用Ｍ型超声心动图记录１７７例胸痛患者（冠心病组１２３例，对照组５４例）的左房室瓣环运动曲线，测量：①房室瓣环平面纵向移动的总振幅（ＡＶＰＤｔ）、舒张早期上移幅度（ＡＶＰＤｅ）和心房收缩期上移幅度（ＡＶＰＤａ）；②ＡＶＰ－Ｄａ／ＡＶＰＤｔ及ＡＶＰＤａ／ＡＶＰＤｅ的比值；③从心电图Ｑ波至左室长轴开始缩短以及Ｑ波至长轴缩至最短时的时距；④收缩期缩短速率（Ｓｈｏｒｔｒａｔｅ）及舒张早期伸长速率（Ｌｅｎｇｔｈｒａｔｅ）。结果：与对照组相比，冠心病组ＡＶＰＤｔ、ＡＶＰＤｅ、Ｌｅｎｇｔｈｒａｔｅ及室间隔侧的Ｓｈｏｒｔｒａｔｅ均显著降低（Ｐ＜０．０１）。校正年龄和性别因素后，冠心病组室间隔侧的ＡＶＰＤｔ及Ｓｈｏｒｔｒａｔｅ仍显著降低（Ｐ＜０．０５）。结论：用超声心动图测定房室瓣环运动能检出冠心病患者休息时即可存在的左室功能异常。

Purpose:To assess left atrioventricular (AV) plane motion in patients with coronary artery disease (CAD).Methods:In 177 patients (mean age 62±10) with chest pain,left AV plane motion was recorded by M mode echocardiography,from apical four chamber view at the septal (S ) and lateral sites of the AV ring.Measured were the following parameters:①AV plane displacement (AVPD),including total AVPD (AVPDt),AVPD in early diastole (AVPDe) and from atrial systole (AVPDa);②AVPDa/AVPDt and AVPDa/AVPDe ratios;③time intervals from the onset of the Q wave to the onset of shortening and from Q wave to the minimum long axis;④peak rate of systolic shortening (short rate) and of early diastolic lengthening rate (length rate).The patients were divided into CAD group (n=123) and control group (n=54) according to the results of coronary angiography.Results:AVPDt,AVPDe,length rate,and S short rate were significantly decreased in patients with CAD compared to the control group (P<0.01).Difference were still present for S AVPDt and S short rate (P<0.05) after correcting for age and gender.Conclusion:In patients with CAD,Left AV plane motion abnormalities is present at rest and can be identified by echocardiography.