冠心病左室大小和功能变化的二维超声心动图定量研究

QUANTITATIVE ASSESSMENT OF CHANGES OF LEFT VENTRICULAR SIZE AND FUNCTION IN PATIENTS WITH CORONARY HEART DISEASE BY 2 DE

应用二维超声心动图(2DE)对22例正常人、20例心绞痛和56例陈旧性心肌梗塞患者左心室大小和功能定量分析的结果显示:心绞痛患者左室无明显扩大,其功能轻度受损,陈旧心肌梗塞患者左室显著扩大,其功能明显受损且前壁梗塞较下壁梗塞显著为重(P<0.001),广泛前壁梗塞并有室壁瘤患者左室高度扩大,平均左室舒张末容积是正常人的2.3倍,其功能严重受损,平均左室射血分数低至31.9%,仅为正常人的49.0%。提示2DE对冠心病患者左室大小和功能的定量评价符合其实际变化规律,是切实可行的无创方法。

Quantitative analyses of left ventricular size and function by two-dimensional echocardiography (2DE) were carried out in 22 normals, 20 cases of angina pectoris (AP) and 56 cases with old myocardial infarction (OMI) including inferior wall MI (IWMI) of 15, anterior wall MI (AWMI) of 23 and extensive anterior wall MI with ventricular aneurysm (EAWMI with Aneu) of 18. The results showed, 1. In patients with AP, the left ventricle (LV) was not significantly enlarged and its function was mildly damaged, mean left ventricular ejection fraction (LVEF) was decreased by 8.0% (-5.2%) as compared with normals (P<0.01). 2. In patients with OMI, LV was significantly enlarged, mean left ventricular end-diastolic volumes (LVEDV) in patients with IWMI, AWMI and EAWMI with Aneu were enlarged by 30.1%, 50.2% and 128.4%, respectively in comparing with normals (P<0.05-0.001); its function was severely damaged, mean LVEF was decreased by 19.9% (-13.0%), 33.7% (-22.0%) and 51.0% (-33.2%), respectively (all P<0.001), mean LVEF in EAWMI with Aneu was as low as 31.9% which was only 49.0% of normal value, and the percentage of patients complicated by left ventricular failure in this group was as high as 88.9%. 3. Mean LVEF in OMI patients with and without left ventricular failure was 30.4±8.0% and 47.9±8.8%, respectively (P<0.001). The changes of left ventricular size and function in patients with coronary heart disease (CHD) evaluated quantitatively with 2DE were in accordance with the clinical status, so 2DE is an accurate and feasible method for noninvasive quantitation of left ventricular size and function in patients with CHD.