摘要
目的评估心肌桥(MB)-壁冠状动脉(MCA)对心功能的影响。方法以胸闷、胸痛症状就诊,经CT冠状动脉成像(CTCA)诊断为左前降支单发MB的82例患者为研究对象,测量MB厚度、长度,计算MCA收缩期狭窄率。同期选择CTCA未见异常的82例健康体检者作为正常对照组。两组均行超声心动图检查。记录年龄、性别、体质量指数(BMI)、心率及吸烟史等临床资料,比较MB组与正常对照组上述临床资料及室间隔,左心室后壁厚度,左心房内径,左心室舒张末内径、收缩末内径,左心室射血分数,E’/A’<1例数的差异。MB厚度、长度、MCA收缩期狭窄率与左心室前壁中段舒张早期及晚期峰值应变率(SRe,SRa)行相关性分析。结果两组受试者在年龄(t=0.97,P=0.65)、性别(χ~2=0.10,P=0.75)、BMI(t=1.82,P=0.07)、心率(t=0.87,P=0.39)及吸烟史(χ~2=0.43,P=0.51)方面差异均无统计学意义;在室间隔(t=1.54,P=0.13),左心室后壁厚度(t=1.47,P=0.14),左心房内径(t=1.62,P=0.11),左心室舒张末内径(t=0.49,P=0.63)、收缩末内径(t=1.29,P=0.20)和左心室射血分数(t=0.56,P=0.57)方面差异也均无统计学意义;MB组E’/A’<1的例数明显高于对照组(31比0,χ~2=38.22,P=0.00)。左心室前壁中段SRe(r=-0.97,P=0.00;r=-0.93,P=0.00)和SRa(r=-0.89,P=0.00;r=-0.90,P=0.00)与MB厚度和MCA收缩期狭窄率呈显著负相关;左心室前壁中段SRe(r=-0.09,P=0.76)和SRa(r=-0.13,P=0.66)与MB长度无显著相关性。结论 MB与心脏收缩功能无相关性,但与心脏舒张功能明显相关。随着MB厚度增加,MCA收缩期狭窄程度加重,心脏舒张功能逐渐降低,而MB长度与心脏舒张功能相关性不显著。
Objective To study the impact of myocardial bridge( MB)-mural coronary artery( MCA)on myocardial functions. Methods Totally 82 patients presenting with chest tightness and chest pain who were diagnosed with the MB in the left anterior descending artery by CT coronary angiography were enrolled as the MB group,in which the thickness and length of MB and the systolic stenosis degree of MCA were measured. In addition,82 healthy subjects,as confirmed by health check-up,were set as the control group. The age,gender,body mass index( BMI),heart rate( HR),smoking history,interventricular septal thickness,left ventricular posterior wall thickness,diameter of left atrium,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular ejection fraction,and the cases of E'/A'< 1 were compared between MB group and control group. The potential correlations among the thicken/length of MB, the systolic stenosis degree ofMCA and early diastolic peak strain rate( SRe)/late diastolic peak strain rate( SRa) were analyzed. Results The age( t = 0. 97,P = 0. 65),gender( χ~2= 0. 10,P = 0. 75),BMI( t = 1. 82,P = 0. 07),HR( t = 0. 87,P = 0. 39) and smoking history( χ~2= 0. 43, P = 0. 51) were not significantly difference between these two group. The interventricular septal thickness( t = 1. 54,P = 0. 13),left ventricular posterior wall thickness( t =1. 47,P = 0. 14),diameter of left atrium( t = 1. 62,P = 0. 11),left ventricular end-diastolic diameter( t =0. 49,P = 0. 63),left ventricular end-systolic diameter( t = 1. 29,P = 0. 20),and left ventricular ejection fraction( t = 0. 56,P = 0. 57) were also not significantly different between the normal and MB group. However,there was significant difference in the cases of E'/A'< 1( χ~2= 38. 22,P = 0. 00). The SRe( r =-0. 97,P = 0. 00; r =-0. 93,P = 0. 00) and SRa( r =-0. 89,P = 0. 00; r =-0. 90,P = 0. 00) the left ventricular anterior wall were negatively correlated with the thickness of MB and the systolic stenosis degree of MCA and were not correlated with th
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2017年第5期669-673,共5页
Acta Academiae Medicinae Sinicae
关键词
心肌桥
心功能
冠状动脉造影术
体层摄影术
超声心动图
myocardial bridge
myocardial function
coronary angiography
tomography
echocardiography
