频发室性期前收缩的频次及负荷对患者心脏结构及功能的影响

Effect of premature ventricular contraction frequency and burden on heart structure and function

目的探讨频发室性期前收缩(PVC)患者的期前收缩频次及负荷与心脏结构及心功能的关系。方法选择PVC患者67例,根据期前收缩频次及负荷,采用四分位数间距法分为频次A组和负荷A组17例,频次B组和负荷B组17例,频次C组和负荷C组17例,频次D组和负荷D组16例;另选择无PVC患者20例为对照组。分析期前收缩频次及负荷与心功能的关系。结果与对照组比较,期前收缩频次C组、频次D组左心房内径、左心室心肌重量、左心室舒张末内径(LVIDD)、期前收缩负荷C组LVIDD、负荷D组LVIDD、左心室舒张末容积和收缩末客积、每搏心输出量明显升高(P<0.05,P<0.01),LVEF明显降低(P<0.05)。期前收缩负荷与左心室心肌重量、LVIDD、左心房内径呈正相关(r=0.41 5、r=0.426、r=0.269,P<0.05,P<0.01);期前收缩频次与LVEF呈负相关(r=-0.432,P<0.01),与LVIDD呈正相关(r=0.390,P<0.01)。结论期前收缩频次与PVC心脏结构及左心室收缩功能显著相关,提示随着期前收缩频次增加其功能下降、左心室扩大;随着期前收缩负荷增大,左心室肥厚程度增加。

Objective To study the relation of premature contraction frequency（PCF） and burden with heart structure and function. Methods Sixty-seven patients with frequent PVC were divided into group A（n=17） ,group B（n= 17）,group C（n= 17）,and group D（n= 16）. Twenty patients with occasional or no PVC served as a control group. Relation of PCF and contraction burden with heart function was analyzed. Results The inner diameter of left atrium, the weight of left ventricle,the LVIDD, the LVEDV and LVESV,and the cardiac output pet beat were significantly hig er whereas the LVEF was significantly lower in groups C and D than in control group（P〈0.05, P〈0.01）. The premature contraction burden was positively related with the myocardial mass, LVIDD and the inner diameter of left atrium（r=0.415,r=0. 426,r=0. 269,P〈0.05,P,0.01）. The PCF was negatively related with the LVEF（r=-0. 432 ,P〈0. 01）and positively related with the LVIDD（r=0. 390,P〈0.01） . Conclusion PCF is closely related with heart structure and left ventrieular systolic function, suggesting that the left ventricular systolic function decreases with the increasing PCF and the enlarging left ventricle, whereas the left ventricular septum becomes thicker with the increasing premature contraction burden.