冠心病射血分数正常心力衰竭患者左室舒张末压与无创指标的相关性

The correlations between LVEDP and noninvasive indicators of heart failure in patients with coronary heart disease with normal ejection fraction.

目的：通过左室舒张末压（LVEDP）与无创指标对比，探讨其在冠心病射血分数正常心力衰竭（HF－NEF）患者的诊断价值。方法对59例冠心病患者行超声检测 E／A 值、E／E′值等，血清检测 NT －proBNP 等。并行冠状动脉造影检查，评定 Gensini 积分、侧支评分，测定 LVEDP。分为左室舒张功能（LVDF）正常组（LVEDP≤16 mmHg）、LVDF 异常组（LVEDP ＞16 mmHg）。结果空腹血糖、NT －proBNP、Gensini 积分、E／E′值在 LVDF 异常组比 LVDF 正常组显著升高（P ＜0.05）。多元线性回归分析提示：LVEDP 与 NT －proBNP 显著相关（P ＝0.000），标准偏回归系数为0.490（95％CI 0.004～0.010）；LVEDP 与 E／E′值显著相关（P ＝0.001），标准偏回归系数为0.381（95％CI 0.171～0.590）。结论冠状动脉的病变程度和 LVDF 相关。 E／E′值和 NT －proBNP 能反映 LVDF，可作为临床评价 HFNEF 的有效指标。

Objective To evaluate the diagnostic value of noninvasive indicators of heart failure （HF） on HF with normal ejection fraction （HFNEF） by comparing them with left ventricular end diastolic pressure （LVEDP）.Meth-ods Fifty -nigh cases of coronary heart disease were examined with E /A and E/E′by echocardiogram, plasma NT -proBNP, and et al.Coronary angiography was performed to evaluate Gensini score , Rentrop score and LVEDP.These pa-tients were divided into two groups ： normal left ventricular diastolic function （LVDF） group （LVEDP≤16 mmHg） and abnormal LVDF group （LVEDP〉16 mmHg）.Results Significant increase in FBS, NT -proBNP, Gensini score and E/E′were observed in abnormal LVDF group （P 〈0.05）.LVEDP was significantly correlated with NT -proBNP （P =0.000） and E/E′（P =0.001）.Conclusion There is close relationship between coronary stenosis severity and LVDF . E/E′and NT -proBNP could reflect LVDF, providing valid clinical indicators to evaluate HFNEF in coronary heart disease .