不稳定型心绞痛患者冠状动脉病变程度对左心室舒张功能的影响被引量：1

Effect of the severity of coronary artery on left ventricular diastolic function in patients with unstable angina

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摘要目的探讨不稳定型心绞痛患者冠状动脉病变程度对左心室舒张功能的影响。方法2010年12月至2011年8月连续入选不稳定型心绞痛患者172例，入选患者均进行冠状动脉造影、超声心动检查。根据超声心动图结果分为舒张功能正常组（Non—HFNEF组38例）、轻度舒张功能不全组（GradeI组45例）、中度舒张功能不全组（GradeII组57例）、重度舒张功能不全组（GradeⅢ组32例）。对比分析冠状动脉病变严重程度对左心室舒张功能的影响。结果以上4组左心房内径[（3．244-0．50）、（3．40．4-0．41）、（3．56±0．44）、（3．78±0．36）mm，F=21．454]、左心室室壁厚度[（0．84±0．11）、（0．90±0．12）、（0．92±O．09）、（0．944-0．15）mm，F=10．743]、左心室质量指数[（105．634-33．13）、（113．09-4-21．55）、（122．264-41．52）、（132．96±31．06）g／m^2，F=9．746]差异有统计学意义（P均〈0．001）；舒张功能与冠状动脉病变支数之间具有关联性（r=0．466，P〈0．001）。结论不稳定型心绞痛患者冠状动脉病变程度对左心室舒张功能具有显著影响。 Objective To explore the effect of the severity of coronary artery on left ventricular diastolic function in patients with unstable angina （ UA）. Methods One hundred and seventy-two patients with UA consecutively from December 2010 to August 2011 were enrolled. All patients underwent coronary angiography （CAG） and echocardiography. The patients were divided into four groups according to left ventricular diastolic function by echocardiography：Thirty-eight subjects with normal（Non-HFNEF） ,45 subjects with mild dysfunction （Grade Ⅰ ）,57 subjects with moderate dysfunction（ GradeⅡ ） and 32 subjects with severe dysfunction grade （Grade Ⅲ ）. The effect of the severity of coronary artery on the left ventricular diastolic function was analyzed. Results There were significant difference on left atrial dimension （ 3.24 ± 0. 50 ） mm vs （ 3.40 ± 0.41 ） mm vs （3.56 ±0. 44） mm vs （3.78 ± 0. 36） mm （ F = 21. 454, P 〈 0. 001 ） , left ventricular posterior wall （0.84±0.11） mmvs （0.90±0.12） mmvs （0.92＋0.09） mmvs （0.94±0.15） mm （F=10.743, P 〈 0. 001 ） and left ventricular mass index （ 105.63 ± 33.13 ） g/m2 vs （ 113.09± 21.55 ） g/m2 vs （ 122.26 ± 41.52 ） g/m2 vs （ 132.96 ± 31.06 ） g,/m2 （F = 9. 746, P 〈 0. 001 ） among the four groups. Diastolic function was significantly correlated with the severity of coronary artery （ r = 0. 466, P 〈 0. 001 ）. Conclusion In the patients with UA, left ventricular diastolic function was significantly influenced by the extent of coronary artery stenosis.

作者穆林吴永全

机构地区首都医科大学附属北京友谊医院心血管中心

出处《中国综合临床》 2013年第2期124-128,共5页 Clinical Medicine of China

基金北京市科技计划项目（Z090507006209014）北京市卫生系统高层次卫生技术人才培养计划项目（2011-3-033）

关键词不稳定型心绞痛冠状动脉造影左心室舒张功能心肌纤维化 Unstable angina Coronary angiography Left ventricular diastolic function Myocardial fibrosis

分类号 R541.4 [医药卫生—心血管疾病]

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1Warltier DC,Buck 3D, Brooks HL, et aL Coronary hemodynamics and subendocardial perfusion distal to stenoses [ J]. Int J Cardiol, 1983,4(2) :173-183.
2关秀萍,黎明丽,杨柳.多普勒超声在评价高血压患者左心室舒张功能中效果的系统评价[J].中国循证心血管医学杂志,2010,2(4):219-227. 被引量：15
3Nagueh SF,Appleton CP, Gillebert TC, er al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography [ J 1. J Am Soc E chocardiogr,2009,22 ( 2 ) : 107- 133.
4Urbicta Caceres VH, Lin J, Zhu XY, et al. Early experimental hypertension preserves the myocardial microvasculature but aggravates cardiac injury distal to chronic coronary artery obstruction [ J ]. Am J ]?hysiol Heart Circ Physiol,2011 , 300 (2) : H693-701.
5Campbell DJ, Somaratne JB, Jenkins A J, et al. Impact of type 2 diabetes and the metabolic syndrome on myocardial structure and microvaseulature of men with coronary artery disease J].Cardiovasc Diabeto1,2011,10:80.
6Turakhia MP, Schiller NB, Whooley MA. Prognostic significance of increased left ventricular mass index to mortality and sudden death in patients with stable coronary heart disease ( from the Heart and Soul Study) [ J ]. Am J Cardio1,2008,102 ( 9 ) : 1131 -1135.
7许先进,高辉,郭万锋,董旭,钟飞,汪荣,张哲峰.青年原发性高血压患者左心室和外周动脉结构与功能的改变[J].临床内科杂志,2011,28(10):699-700. 被引量：2
8Aurigemma GP, Gaascb. WH. Clinical practice. Diastolic heart failure [ J ]. N Engl J Med ,2004,351 (11 ) :1097-1105.
9Ghali JK, Liao Y, Simmons B, et al. The prognostic role of let ventricular hypertrophy in patients with or without coronary artery disease [J]. Ann Intern Med,1992,117(10) :831-836.
10Hirai T, Sasayama S, Kawasaki T, et al. Stiffness of systemic arteries in patients with myocardial infarction. A noninvasive method to predict severity of coronary, atherosclerosis [J]. Circulation, 1989,80 ( 1 ) :78-86.