应用多普勒超声心动图评价心得安对冠心病左室舒张功能不全的治疗作用

Doppler Echocardiography in Evaluation of Therapeutic Effect of Propanolol in CHD Left Ventricular Diastolic Dysfunction

26例冠心病,合并高血压病21例,心功能Ⅱ级17例,Ⅲ级9例。超声心动图检查示左室舒张功能不全,4例同时存在左室收缩功能不全。经一次性给予心得安10 mg口服,用药前后用M-型和脉冲多普勒超声心动图观察左室收缩和舒张功能变化,发现服心得安一小时后心率减慢,左室收缩功能抑制,左室舒张功能明显改善,多普勒血流图E峰增高,A峰降低,A/E比值变小,舒张早期充盈时间延长,差异非常显著(P<0.001),本研究结果提示冠心病及高血压患者合并左室舒张功能不全为主的心力衰竭,可以安全地使用β-阻滞剂心得安进行治疗。

Twenty six patients with coronary artery disease were examined with the historyof hypertension present in 21 patients. Seventeen were in functional class Ⅱ(NYHA)and nine were in functional class Ⅲ. Left ventricular(LV) diastiolic dysfunctionwas defined by echocardiography. Four had poor systolic function. Before and onehour after propranolol 10mg intake LV diastolic function and systolic function wereassessed with M-mode and pulsed Doppler echocardiography. All patients toleratedpropranolol well. The heart rate decreased significantly. The systolic blood presuredecreased slightly. The marked improvements in LV diastolic function was mainlyshown by higher E, lower A, smaller A/E ratio and longer early diastolic fillingtime. However, the LV systolic performance was depressed. These data indicatedthat oral administration of the β-blocker propranolol could be an useful addition forthe treatment of pure diastolic heart failure in patients with coronary disease orhypertension.