西藏高原地区心力衰竭患者134例超声心动图特征分析

An analysis of echocardiogram features of 134 patients with heart failure in Tibet plateau

目的分析西藏高原地区心力衰竭(心衰)患者超声心动图特点。方法选取西藏高原地区心衰患者134例;其中,冠心病60例,高原性心脏病40例,高血压心脏病34例。分析不同心脏疾病所致心衰超声心动图特征及瓣膜返流情况。结果与冠心病心衰患者比较,高血压心脏病心衰患者肺动脉内径较大,主动脉瓣口血流速度较快(P<0.05),高原性心脏病和高血压心脏病心衰患者左心室舒张末内径较小,短轴缩短率较大,三尖瓣口血流速度较快(P<0.05)。高血压心脏病心衰患者左心房前后径大于冠心病和高原性心脏病心衰患者(P<0.05)。与冠心病和高血压心脏病心衰患者比较,高原性心脏病心衰患者右心房横径、右心室横径和肺动脉收缩压较大,肺动脉口血流速度较快,三尖瓣环收缩期位移较小,三尖瓣环收缩期峰值速度较慢(P<0.05)。冠心病心衰患者二尖瓣返流比例多于高原性心脏病和高血压心脏病心衰患者(P<0.05),高原性心脏病心衰患者三尖瓣返流比例多于冠心病和高血压心脏病心衰患者(P<0.05)。结论西藏高原地区心衰患者有其独特的地域特点,不同病因心衰患者超声心动图特征及瓣膜返流情况各有不同,临床上需要结合其特征做出相应的诊断。

Objective To analyze the echocardiogram features of 134 patients with heart failure in Tibet plateau.Methods The echocardiographic features and valve regurgitation were analyzed in 134 patients with heart failure in Tibet plateau,of whom 60 cases were with coronary heart disease,40 cases were with high altitude heart disease and 34 cases were with hypertensive heart disease.ResultsCompared to the coronary heart disease patients with heart failure,the pulmonary artery diameter was larger and the flow velocity of aortic valve was quicker in the hypertensive heart disease patients with heart failure,and the left ventricular end diastolic diameter was smaller,shortening fraction was higher and flow velocity of tricuspid orifice was quicker in the high altitude heart disease and hypertensive heart disease patients with heart failure(P<0.05).The anterior and posterior diameter of left atrium of heart failure patients with hypertensive heart disease was larger than those with coronary heart disease and high altitude heart disease(P<0.05).Compared to the coronary heart disease and hypertensive heart disease patients with heart failure,the right atrium transverse diameter,right ventricular transverse diameter and pulmonary arterial systolic pressure were higher and velocity of blood flow at the pulmonary artery opening was quicker,and tricuspid annulus systolic displacement was lower and peak velocity of tricuspid annulus systole was slower in high altitude heart disease patients with heart failure(P<0.05).The ratio of mitral regurgitation in the coronary heart disease patients with heart failure was higher than that in those with high altitude heart disease and hypertensive heart disease(P<0.05).The ratio of tricuspid regurgitation in the high altitude heart disease patients with heart failure was higher than those of coronary heart disease and hypertensive heart disease with heart failure(P<0.05).Conclusion The heart failure of the patients in Tibet plateau has unique geographical characteristics.The echocardiographic features and valve regurgitation are different in the patients with different causes of heart failure and clinically the diagnosis needs to be made according to the features.