早搏后心阻抗微分图A波变化评定左心室舒张功能

ASSESSMENT OF LEFT VENTRICULAR DIASTOLIC FUNCTION BY THE POSTEXTRASYSTOLIC ATRIAL WAVE CHANGE OF THE DIFFERENTIAL IMPEDANCE CARDIOGRAM

用食道心房调搏诱发早搏,结合心阻抗微分图观察不同早搏后代偿间期时正常人(22例)及冠心病人(21例)A波振幅变化。结果表明:早搏后代偿间期延长,两组A波振幅逐渐变小,而早搏前A波最大振幅(Adz/dtmax)和早搏后比值(RA)逐渐增大,相同的早搏后间期正常人RA明显大于冠心病人(P<0.01)。冠心病组的Adz/dt/A/C(A波振幅和C波振幅的比值)及RA各指标的阳性率明显高于正常组,且以RA阳性率最高。提示:RA能敏感反映左心室舒张期顺应性,为临床提供一种安全、简便、敏感的无创性评定左心室舒张功能的新方法,

Atrial wave change amplitudes (Adz/dt) at a variable postextrasystolic interval ( PESI) were observed in 21 patients with coronary heart disease (CHD) and 22 normal subjects using extrasystole induced by transesophageal pacing combined with differential impedance cardio-ra m. The results showed that the postextrasystolic compensatory interval was prolonged and the atrial wave change amplitudes gradually decreased, but the ratio of pre- and post-extrasystolic Adz/dt (RA) gradually increased in two groups. RA of the normal was obviously larger than that of the patients with CHD (P<0.01) at the same P ESI. The positive rates of Adz/dt max, A/C (ratio of A wave to C wave amplitude ) and RA in the CHD group were obviously higher than those in the normal group. The RA positive rate was the highest. It suggested that RA can sensitively reflect the left ventricular diastolic compliance and this method be a safe, simple, sensitive and atraumatic one clinically to assess the left ventricular diastolic function.