心脏彩色多普勒超声检查在评估老年冠状动脉粥样硬化性心脏病合并慢性心力衰竭患者病情中的应用价值

Clinical value of color Doppler echocardiography in severity assessment of coronary heart disease com-plicated with chronic heart failure in elderly patients

目的 探讨心脏彩色多普勒超声检查在评估老年冠状动脉粥样硬化性心脏病(简称冠心病)合并慢性心力衰竭患者病情程度的应用价值。方法 选取本院2021年10月至2022年10月收治的92例老年冠心病合并慢性心力衰竭患者为本研究对象,按照美国纽约心脏协会(NYHA)分级标准分为心功能Ⅱ级组31例,Ⅲ级组34例,Ⅳ级组27例。所有患者均进行心电图检查与心脏彩色多普勒超声检查。将3组患者心电图检查结果、心脏彩色多普勒超声检查结果进行对比,分析心电图和心脏彩色多普勒超声检查指标与心功能的相关性。结果 心功能Ⅲ级、Ⅳ级组患者QRS电压值均比Ⅱ级组低,QRS时限值、QTc间期值均比Ⅱ级组高,且Ⅳ级组患者QRS电压值比Ⅲ级组低,QRS时限值、QTc间期值比Ⅲ级组高(均P<0.05);心功能Ⅲ级、Ⅳ级组患者左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、左房内径(LA)、二尖瓣舒张早期与舒张晚期血流峰值速度比值(E/A)均比Ⅱ级组高,而左心室射血分数(LVEF)均比Ⅱ级组低(均P<0.05),心功能Ⅲ级、Ⅳ级组患者LVESD、LVEDD、LA、E/A、LVEF比较,差异均无统计学意义(均P>0.05);QRS时限、QTc间期、LVESD、LVEDD、LA均与心功能呈正相关(r=0.447,P<0.05;r=0.619,P<0.05;r=0.414,P<0.05;r=0.448,P<0.05;r=0.405,P<0.05;r=0.601,P<0.05),而QRS电压、LVEF与心功能呈负相关(r=-0.609,P<0.05;r=-0.447,P<0.05)。结论 心脏彩色多普勒超声检查评估老年冠心病合并慢性心力衰竭患者病情程度的准确度较高,具有较高的应用价值。

Objective To investigate the value of color Doppler echocardiography in severity assessment of chronic heart failure(CHF)in elderly patients with coronary heart disease(CHD).Methods A total of 92 CHD elderly patients with CHF admitted to our hospital between October 2021 and October 2022 were included as study subjects,and based on New York Heart Association(NYHA)classification,divided into the classⅡgroup(n=31),classⅢgroup(n=34)and classⅣgroup(n=27).All patients underwent electrocardiogr-aphy(ECG)and color Doppler echocardiography.The results of ECG and color Doppler echocardiography were compared among the three groups of patients.The correlation of parameters on ECG and color Doppler echocar-diography with cardiac function was analyzed.Results The patients in classⅢandⅣgroups had lower QRS amplitude,but longer QRS duration and QTc interval,compared with patients in classⅡgroup;the The pa-tients in classⅣgroup had lower QRS amplitude,but longer QRS duration and QTc interval,compared with patients in classⅢgroup(all P<0.05).The patients in classⅢandⅣgroups presented greater values of left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),left atrial diameter(LA),and ratio of peak mitral flow velocity in early diastole to that in late diastole(E/A),but lower left ventric-ular ejection fraction(LVEF),compared with patients in classⅡgroup(all P<0.05).There were no significant differences in LVESD,LVEDD,LA,E/A,and LVEF between the classⅢandⅣgroups(all P>0.05).QRS duration,QTc interval,LVESD,LVEDD,and LA were positively correlated with cardiac function(r=0.447,P<0.05;r=0.619,P<0.05;r=0.414,P<0.05;r=0.448,P<0.05;r=0.405,P<0.05;r=0.601,P<0.05),whereas QRS amplitude and LVEF were negatively correlated with cardiac function(r=-0.609,P<0.05;r=-0.447,P<0.05).Conclusion Color Doppler echocardiography offers high accuracy in assessing the severity of chronic heart fail-ure in elderly CHD patients,and therefore is fairly useful in clinical practice.