前降支单纯性心肌桥与左心结构及功能关系研究

Assesses of Left Heart Structure and Function in Patients with Isolated Left Anterior Descending Coronary Artery Myocardial Bridge

目的探讨单纯性心肌桥周期性压迫壁冠状动脉对左心结构和功能的影响。方法以43例明确诊断而且不合并其他器质性心脏病的单纯前降支心肌桥患者为研究对象,根据壁冠状动脉收缩期管腔狭窄程度将患者分为两组:A组:Noble1Ⅰ级,直径狭窄<50%,B组:Noble,Ⅱ或Ⅲ级,直径狭窄>50%。用二维及多普勒超声心动图测量反映左心结构指标、左室舒张功能和收缩功能的各项指标。结果 A组与B组在性别、年龄、血压、高血压、糖尿病、吸烟等基线治疗上没有统计学意义(P>0.05);在反映左心结构的指标:左房内径、左室收缩末内径、左室舒张末内径、室间隔厚度和左室后壁厚度两组也无统计学差异。在反映左室收缩功能的指标:左室短轴缩短率、左室射血分数(LV EF)无统计学差异。在反映舒张功能的二尖瓣多普勒频谱E/A上,两组统计学差异有显著性(P<0.05)。结论单纯性心肌桥严重狭窄时,可以影响左室舒张功能。

Objective To evaluate the impact of myocardial bridge on left heart structure and function. Methods a total of 43 consecutive patients who were detected as isolated myocardial bridges in left anterior descending Coronary Artery by angiography were enrolle.according to the percentage of systolic compression of the epicardial coronary artery lumen,the patients were subdivide into two groups;Group A,50%（25 patients） and Group B,50%（18 patients）.The parameters of left heart structure（such as diameter of left atrium LA, diameter of left ventricular,diameter of interventricular septum and posterior left ventricular wall）,systolic function （such as left ventricular ejection fraction LVEF;left ventricular shortening fraction LVFS） and diastolic Function（E,A and E/A of Doppler flowing of mitral valve） were retrospectively analyze.Results E/A was significant difference in group A VS group B（P0.001）.The parameters of left heart structure and were systolic function were no difference between the two group.Conclusion Severe systolic stenosis of Coronary Artery caused by myocardial bridge is related to left ventricular diastolic dysfunction.