摘要
目的探讨射血分数保留充血性心力衰竭(HFp EF)与射血分数降低充血性心力衰竭(HFr EF)患者的左室结构和左室收缩功能的变化。方法入选HFp EF及HFr EF患者各40例。入组者行超声心动图检查。经核素心血池显像测定分级小剂量多巴酚丁胺负荷后心率(HR)及左室收缩功能指标左室射血分数(LVEF)、高峰射血率(PER)、高峰射血时间(TPER)最大变化率。比较HFp EF及HFr EF患者6个月预后,观测HFp EF患者6个月后LVEF变化。结果 HFp EF组患者左房内径(LAD)、左室收缩期末内径(LVESD)、左室舒张期末内径(LVEDD)显著小于HFr EF组(均P<0.05);HFp EF组患者室间隔厚度(IVST)、左室后壁厚度(LVPWT)大于HFr EF组(P<0.05);HFp EF组LVEF在静息及各负荷值较HFr EF组高(P<0.05),但LVEF最大变化率与HFr EF组比较无统计学意义。两组间PER最大变化率及TPER最大变化率比较无统计学意义。两组6个月内病死率无显著差异。HFp EF组6个月后存活患者有3例LVEF低于50%,发生率为9%。结论两组左房室结构存在明显差异,HFr EF组静息LVEF明显低于HFp EF组,但两组左室收缩功能储备基本一致,部分HFp EF患者可演变为HFr EF患者。
AIM To investigate the similarities and differences in left ventricular structures and left ventricular systolic functions between heart failure patients with preserved ejection fraction （HFpEF） or reduced ejection fraction （HFrEF）. METHODS Forty HFpEF patients and 40 HFrEF patients were included in the study. Echocardiograghy was performed. Left ventricular systolic function indices inclu- ding left ventricular ejection fraction （LVEF）, peak ejection rate （PER） and peak ejection time （TPER） were measured using radionuclide ventriculography under resting condition and dobutamine stress. The maximal change rate （MCR） of HR, LVEF, PER and TPER were calculated. The 6-month mortality rate in HFpEF patients and HFrEF patients was recorded. LVEF in survivors of HFpEF patients was measured after 6 months. RESULTS LAD, LVESD and LVEDD in HFpEF patients were much lower than in HFrEF patients （ P 〈 0. 05 ）. IVST and LVPWT in HFpEF patients were higher than in HFrEF patients （P 〈 0. 05 ）. LVEF at rest and dobutamine stress in HFpEF patients was higher than in HFrEF patients （P 〈 0. 05 ）. There were no significant differences in MCR of LVEF, PER, TPER and 6-month mortality rate between groups. Three out of 34 （9%） survivors with HFpEF developed HFrEF in 6 months. CONCLUSION Significant difference in left atrial and ventricular structures is observed between HFpEF patients and HFrEF patients. LVEF at rest and stress in HFpEF patients was higher than in HFrEF patients. There is no significant difference in contractile reserve. Some HFpEF patients may develop HFrEF.
出处
《心脏杂志》
CAS
2015年第5期588-591,共4页
Chinese Heart Journal
关键词
心力衰竭
射血分数保留
射血分数降低
超声心动图
核素心室显像
收缩功能储备
预后
heart failure
preserved ejection fraction
reduced ejection fraction
echocardiograghy
radionuclide ventriculography
left ventricular systolic function reserve
prognosis
