高分辨力超声评价扩张型心肌病患者肱动脉内皮功能

Evaluation of brachial artery endothelial function in patients with idiopathic dilated cardiomyopathy by high-resolution ultrasonography

目的 应用高分辨力超声测量扩张型心肌病患者反应性充血前后肱动脉内径的百分变化率评价肱动脉内皮功能。方法 研究对象包括 2 1例扩张型心肌病患者和 18例健康对照者。应用高分辨力超声测量静息状态下、反应性充血后、舌下含服硝酸甘油后的肱动脉内径 ,并计算反应性充血和硝酸甘油诱发的内径百分变化率。结果 反应性充血诱发的肱动脉内径百分变化率扩张型心肌病患者 [(4 .2± 4.7) %]明显低于正常人 [(11.4± 3 .7) %,P <0 .0 0 1] ,硝酸甘油诱发的肱动脉内径百分变化率扩张型心肌病患者 [(2 7.4± 8.1) %]和健康对照者 [(2 8.3± 8.4) %,P =0 .3 2 ]差别无显著统计学意义。结论 扩张型心肌病患者肱动脉内皮功能减低。

Objective To evaluate brachial artery endothelial function in patients with idiopathic dilated cardiomyopathy using reactive hyperemia-induced percent change in the brachial artery diameter measured by high-resolution ultrasonography. Methods Measurements of brachial artery diameter were performed by high-resolution ultrasonography during baseline,reactive hyperemia and sublingual nitroglycerin administration in twenty-one patients with idiopathic dilated cardiomyopathy and eighteen healthy subjects. Reactive hyperemia-induced and nitroglycerin-induced percent changes in brachial artery diameter were calculated. Results The percent change in the brachial artery diameter induced by reactive hyperemia in patients with idiopathic dilated cardiomyopathy [(4.2±4.7)%] was significantly less than that in healthy subjects [(11.4±3.7)%,P <0.001]. No significant difference could be found in percent change in the brachial artery diameter induced by sublingual nitroglycerin between the patients [(27.4±8.1)%] and the controls [(28.3±8.4)%, P =0.32]. Conclusion The decreased percent change in the brachial artery diameter induced by reactive hyperemia in patients with idiopathic dilated cardiomyopathy compared with the healthy subjects indicates that brachial endothelial function is impaired in patients with idiopathic dilated cardiomyopathy.