左室舒张末期压力与冠心病及其严重程度的关系

The association between left ventricular end-diastolic pressure and coronary heart disease as well as its severity

目的：评估左室舒张末期压力（LVEDP）与冠心病（CHD）及冠状动脉（冠脉）病变严重程度之间的关系。方法：连续入选同时行冠脉造影（CAG）及左心导管检查的患者912例,根据CAG结果分为CHD组（599例）和非CHD组（313例）。依据Gensini评分及病变血管数目评估冠脉病变严重程度。分析LVEDP与CHD及冠脉病变严重程度之间的关系。结果：与非CHD组患者相比较,CHD组患者LVEDP明显升高[（10.9±5.46）mmHg︰（9.58±5.78）mmHg,P〈0.001],且LVEDP与CHD独立相关（OR=1.11,95%CI：1.02～1.29,P=0.02）。随着病变血管数目增加,LVEDP逐渐增加（P〈0.001）。多因素线性相关分析显示,LVEDP与Gensini评分明显相关（β=0.034,P=0.001）。在非CHD组患者中,LVEDP仅与年龄相关（r=0.123,P=0.030）。结论：LVEDP的增加与CHD及严重程度明显相关;在非CHD患者中,LVEDP的增加仅与年龄相关。LVEDP的测量可对CHD及非CHD患者提供额外的临床价值。

Objective：To evaluate the relationship between left ventricular end-diastolic pressure （LVEDP） and coronary heart disease （CHD） as well as its severity. Method： All 912 patients who underwent CAG and left car- diac catheterization were enrolled. Three hundred and thirteen patients without CHD were included into non-CHD group and 599 with CHD were included into CHD group. The severity of coronary artery was evaluated by Gensini score and the number of stenotic vessls. The correlation between LVEDP and CHD as well as its severity was analyzed. Result： LVEDP was significantly higher in CHD group than that in non-CHD group [-（10.9±5.46） mmHg vs. （9.58±5.78）mmHg, P〈0. 001]. LVEDP was correlated independently with the presence of CHD （OR= 1.11,95%CI： 1.02--1.29,P=0.02） . LVEDP was increased with the increasing number of vessels. Linear re- gression analysis showed that LVEDP was significantly associated with Gensini score （β=0. 034, P= 0. 001）. In non-CHD group, LVEDP was only correlated with age （r= 0. 123, P = 0. 030）. Conclusion： LVEDP is significantly associated with CHD as well as its severity,and only correlated with age in non-CHD patients. LVEDP maybe provide incremental clinical value for CHD and non-CHD patients.