冠状动脉慢血流现象患者的超声心动图特点

Characteristics of echocardiography in patients with coronary slow flow phenomenon

目的研究冠状动脉慢血流现象(CSFP)患者心脏结构和功能的特点。方法本研究为回顾性病例对照研究,研究对象包括254例CSFP患者(CSFP组)和作为对照的251例冠状动脉血流正常(NCF)者(NCF组)。收集研究对象信息,并计算心肌梗死溶栓血流帧数(TFC)。结果CSFP组患者的男性比例、体质量指数(BMI)、高血压比例、吸烟比例、TFC和平均TFC值均显著高于NCF组(P均<0.05)。CSFP组患者的室间隔厚度、左心室后壁厚度、右心室内径、左心室舒张末内径、肺动脉内径均显著大于NCF组(P均<0.05),而CSFP组患者的二尖瓣E峰血流速度、主动脉瓣血流速度显著低于NCF组(P=0.035和P=0.005)。多因素logistic回归分析结果显示,BMI(OR=1.077,P=0.011)、室间隔厚度(OR=1.180,P=0.044)与CSFP呈独立正相关,而主动脉瓣血流速度(OR=0.311,P=0.016)与CSFP呈独立负相关。结论与BMI升高相关的代谢异常可能在CSFP中发挥作用。室间隔增厚可能伴随着冠状动脉微循环受损,从而导致CSFP。CSFP患者可能有一定程度的心脏功能受损,从而导致收缩期流经主动脉瓣血流速度减慢。

Objective To study the characteristics of cardiac structure and function in patients with coronary slow flow phenomenon(CSFP).Methods This retrospective case-control study included 254 patients with CSFP(CSFP group)and 251 patients with normal coronary flow(NCF)as controls(NCF group).The patients’data were collected and thrombolysis in myocardial infarction frame count(TFC)was calculated.Results The CSFP group had a significantly higher prevalence of male patients,hypertension,and tobacco use(all P<0.05).The CSFP patients had a higher body mass index(BMI)and TFC value(all P<0.05).The interventricular septal thickness(IVST),left ventricular posterior wall thickness,right ventricular diameter,left ventricular end-diastolic dimension,and pulmonary artery diameter were greater in the CSFP group(all P<0.05).However,the mitral valve E peak velocity and aortic valve velocity(AV)were significantly lower in the CSFP group than in the NCF group(P=0.035 and P=0.005,respectively).In the multivariate analysis,BMI(OR=1.077,P=0.011)and IVST(OR=1.180,P=0.044)were independently and positively correlated with CSFP,while AV(OR=0.311,P=0.016)was independently and negatively correlated with CSFP.Conclusion Metabolic abnormalities associated with elevated BMI may play a role in the development of CSFP.Secondary to ventricular septal hypertrophy,the coronary microcirculation is impaired and causes CSFP.Patients with CSFP may have cardiac dysfunction and a slowed aortic valve velocity.