冠状动脉病变与左室功能关系的临床观察

Study Clinical Investigation the Relationship between Coronary Angiographic Findings and the Left Ventricular Function

目的 探讨不同程度的冠状动脉病变与左室功能关系。方法 通过对 2 43例患者的冠状动脉造影的结果和超声心动图测得的心功能数值的分析 ,对比不同的冠状动脉造影结果对左室结构和功能的影响。结果 左室舒张期内径、左室心肌质量、舒张末期容积、收缩末期容积随着冠状动脉病变程度加重而增加 ,射血分数、左室短轴缩短率随着冠状动脉病变程度加重而降低 ;舒张功能参数A/E比值增加与冠状动脉病变程度相一致。结论 冠心病人早期即可出现心脏结构和左室舒张功能的改变 ,随着冠状动脉病变的加重和累及血管的增多而增加 ;收缩功能的改变与冠状动脉病变有关 ,但累及血管多少关系不明显。A/E比值反映左室舒张功能最为敏感。另外 ,血管狭窄 <5 0 %的病人应予以关注。

Objective In this study we try to determine the relationship between coronary angiographic findings and the left ventricular function. Methods We evaluated 243 patients undergoing coronary angiography and echocardiology, so as to investigate the coronary pathological changes and their influence on left ventricular structure and function. Results With the coronary pathological changes becoming more serious, end diastolic diameter of left ventricle(Dd),left ventricular mass(LVmass), end diastolic volume of left ventricle(EDV) and end systolic diameter of left ventricle(ESV) increased significantly,meanwhile,ejection fraction(EF) and fractional shortening of the minor semi axis(FS) significantly decreased,but the ratio of atrial peak flow velocity (APFV) to early peak flow velocity (EPFV) was significantly higher. Conclusion The left ventricular structure and diastolic function of those patients with coronary artery disease had significantly changed in their early stage.As coronary artery encroached by the obstruction (with critical narrowing above 50%), the left ventricular systolic disfunction would be found,The difference were significant between the normal and those patients with critical narrowing above 50%,nevertheless,there were no significant difference between the coronary single vessel disease to three vessel disease. The study suggested that the ratio of APFV to EPFV was the criteria for diagnosis in left ventricular diastolic function.Those patients with critical narrowing below 50% should be paid more attention. [