老年人颈动脉内中膜厚度及斑块与左心室功能的相关性研究

Study on correlation between carotid intima-media thickness or plaque and left ventricular function in the elderly

目的通过超声心动图和颈动脉超声检查,评估左心功能与颈动脉内中膜厚度(IMT)以及斑块的形成是否相关。方法选取门诊老年病人461例,行颈动脉超声测量颈动脉IMT及斑块数量,采用超声心动图测量左室的收缩功能参数[左室射血分数(EF)、左室短轴缩短率(FS)、二尖瓣环收缩峰值速度(Sa)]以及舒张功能参数[二尖瓣口血流E峰(E)、二尖瓣口血流A峰(A)、E/A、二尖瓣环舒张早期峰值速度(Ea)、二尖瓣环舒张晚期峰值速度(Aa)、E/Ea]。结果与颈动脉超声正常组相比,颈动脉粥样硬化组病人左室EF、FS下降,Sa、Ea、E/A减小,A、E/Ea增加,差异均有统计学意义(P<0. 001)。颈动脉斑块数量与心功能减退程度具有相关性(P<0. 05)。结论颈动脉IMT增厚及斑块形成预示着心脏的收缩及舒张功能的减退,颈动脉斑块负荷增加与左室的收缩和舒张功能的减退呈明确的相关性。

Objective To evaluate whether left ventricular function is related to carotid intimamedia thickness( IMT) or burden of plaque by echocardiography and ultrasound. Methods A total of461 subjects without clinical cardiovascular disease were collected. Carotid IMT and plaque were measured by carotid ultrasound. Left ventricular systolic function parameters such as ejection fraction( EF),fraction shortening( FS),mitral annulus peak systolic flow velocity( Sa) and diastolic function parameters such as transmitral inflow E and A wave velocities,Ea,Aa,E/A,E/Ea were measured by echocardiography. Results Compared with those without carotid artery disease,subjects with carotid atherosclerosis showed lower levels of EF,FS,E/A,Sa,Ea( P<0. 001) and higher levels of A,E/Ea( P<0. 001). There was correlation between the number of plaques and the decrease of cardiac function( P<0. 05). Conclusions The increased carotid IMT and the formation of plaques might indicate the decrease of left ventricular systolic and diastolic function. The burden of carotid plaques is related with the decline of the left ventricular function.