冠心病心脏舒张功能的多普勒超声心动图与左心导管法对比研究

Clinical use of Doppler echocardiography in the estimation of diastolic function in patients with coronary heart disease

目的通过无创伤超声心动图检查评价左心室舒张功能。方法选择因反复胸痛行冠状动脉造影患者40例,经冠状动脉造影术确认分为无显著冠状动脉狭窄组和冠状动脉粥样硬化性心脏病(CHD)组,测量并记录左心室舒张末压(LVEDP)。经胸二维超声心动图检查,测量并记录超声心动图指标。结果CHD组舒张早期二尖瓣血流速度E波与多普勒组织成像舒张早期二尖瓣环速度比值(E/Ea)(11.68±2.84)较无显著冠状动脉狭窄组E/Ea比值(8.60±1.90)增高(P<0.05);CHD组LVEDP较无显著冠状动脉狭窄组明显增高(P<0.05)。线性相关分析E/Ea与LVEDP呈正相关(r=0.8175,P<0.05)。结论严重的冠状动脉狭窄对左心室舒张功能有明显影响。在CHD中,E/Ea比值比E/A比值更能准确评价左心室舒张功能,尤其是预测LVEDP。

Objective To evaluate the left ventricular end diastolic pressure（LVEDP）by echocardiographic findings.Methods Forty patients with repeated chest pain were divided into non-obvious coronary stenosis group and coronary heart disease （CHD） group according to the the examination results by coronary artery angiography.The LVEDP was detected and recorded,and the cardiac parameters were detected by thoracic 2-dimensional echocardiography for both groups.Results The E/Ea ratio in CHD group was significantly higher than that in non-obvious coronary stenosis group（11.68±2.84 vs 8.60±1.90,P0.05）. The LVEDP was significantly increased in CHD group,as compared with that in non-obvious coronary stenosis group（P0.05）.The linear correlation was found between E/Ea ratio and LVEDP（r=0.8175,P0.05）.Conclusion The severe coronary stenosis has a great influence on left ventricular diastolic function. In CHD patients,E/Ea is more accurate in the evaluation of left ventricular diastolic function,as compared with E/A,especially for the estimation of LVEDP.