左室假腱索对肺动脉高压患者预后影响的观察

The relationship between the left ventricle false chordae tendinae and the prognosis of patients with pulmonary hypertension

目的观察左室假腱索(LVFT)对肺动脉高压(PAH)患者预后的影响。方法选择PAH有LVFT患者36例(研究组)和无LVFT患者48例(对照组),对肺动脉平均压、心率、房性心律失常、室性心律失常、右室游离壁厚度、晕厥和猝死的发生率等参数进行总结比较。结果研究组患者室性心律失常和晕厥的发生率(分别为86.1%和58.3%)明显高于对照组患者(分别为47.9%和27.1%),差异有统计学意义(P<0.05);在中度PAH患者中,研究组室性心律失常发生率明显高于对照组(44.4%vs 16.7%,P<0.05);在重度PAH患者中,研究组晕厥的发生率明显高于对照组(27.8%vs 12.5%,P<0.05);在所有PAH患者中,研究组患者猝死的发生率较对照组患者高,但不具有临床意义(P>0.05)。结论 PAH患者伴有LVFT可显著增加心律失常尤其室性心律失常的发生率,易导致晕厥和猝死的发生。

Objective To investigate the prognostic value of left ventricle false chordae tendinae （LVFT） in pulmo- nary artery hypertension （PAH） patients. Methods Thirty-six PAH patients with LVFT and 48 patients without LVFT were observed. The mean pulmonary artery pressure, atrial arrhythmias, ventrieular arrhythmias, heart rate, fight ventricular free wall thickness and the incidence of syncope and sudden death, other parameters were summarized comparison. Results The PAH patients with LVFT had higher incidence （86.1% and 58.3 % ） to involve the syncope and ventricular arrhythmias than that of patients without LVFT （47.9% and 27.1%, P 〈0.05 ）. In patients with moderate PAH ,ventricular arrhythmias in patients with LVFT was significantly higher in patients without LVFT （44.4% vs 16.7%, P 〈 0.05 ） ; In patients with severe PAH, the LVFT syncope patients were significantly higher than that of patients without LVFT （27.8% vs 12.5%, P 〈 0.05 ）. In all PAH patients, the incidence of sudden death in patients with LVFT was more than patients without LVFT, while no statisticalsignificance was identified （ P 〉 0.05 ）. Conclusion The PAH patients with LVFT could increase the incidences of ar- rhythmia, especially the incidence of ventricular arrhythmias, and was reliable to result in syncope and sudden death.