摘要
目的探讨冠状动脉慢血流患者超声心电图的心脏结构、功能指标以及心肌能量消耗水平(MEE)的改变及其意义。方法选取2019年1月至2020年1月在佛山市第二人民医院因胸痛住院行冠脉造影并确诊冠状动脉慢血流的患者78例作为冠脉慢血流组(CSF组),冠脉造影正常者77例作为正常对照组(CNF组)。应用超声心动图、组织多普勒技术分别测量心脏结构指标、左室收缩、舒张功能指标(LVEF,Mitral E/A,Mitral e'),计算左室收缩末周向室壁应力(cESS)、MEE。结果CSF组与CNF组间左心室质量指数(LVMI)、收缩期左室后壁厚度(PWTs)、主动脉瓣瓣环直径(AD)比较,差异无统计学意义(P>0.05)。CSF组收缩期左心室内径(LVIDs)大于正常对照组,主动脉瓣射血速度(AV)减慢,射血时间(LVET)延长,差异有统计学意义(P<0.05);两组间左心室收缩功能比较、左心室射血分数(LVEF)比较,差异无统计学意义;左心室舒张功能指标E/A比值两组间差异无统计学意义(P>0.05),但反映左心室舒张功能更灵敏的指标二尖瓣游离壁及室间隔瓣环舒张早期峰值速度均值(e'),两组差异有统计学意义(P<0.05)。与CNF组相比,CSF组心肌能量消耗指标(cESS、MEE)均有增加,差异有统计学意义(P<0.05)。结论冠状动脉慢血流患者由于心肌灌注不足,导致部分心脏结构指标改变,伴随一定程度的舒张功能减退,左心室射血时间延长,主动脉瓣血流速度减低,心肌能量消耗增加。
Objective To investigate the changes of the cardiac structure,functional indexes and myocardial energy expenditure level(MEE)in patients with coronary artery slow flow and their significance by ECG.Methods Seventy-eight patients who were hospitalized for coronary angiography with chest pain and diagnosed with coronary artery slow flow in the Second People's Hospital of Foshan City from January 2019 to January 2020 were selected as the coronary artery slow flow group(the CSF group),and 77 patients with normal coronary angiography were selected as the normal control group(the CNF group).The cardiac structural index,left ventricular systolic index and diastolic function index(LVEF,Mitral E/A,Mitral e')were measured by echocardiography and tissue Doppler technique.The circumferential ventricular wall stress(cESS)and MEE at the end of left ventricular systolic were calculated.Results No significant differences were observed in the left ventricular mass index(LVMI),left ventricular posterior wall thickness(PWTS)and aortic valve annular diameter(AD)between the CSF group and the CNF group(P>0.05).In the CSF group,the systolic left ventricular diameter(LVIDs)was larger than that in the normal control group;the aortic valve ejection velocity(AV)was decreased;the left ventricular ejection time(LVET)was prolonged;the differences were statistically significant(P<0.05).When comparing the left ventricular systolic function between the two groups,no statistically significant differences were observed between the two groups in the left ventricular ejection fraction(LVEF)and E/A ratio,an index of left ventricular diastolic function(P>0.05).The mean value of early peak velocity of mitral valve free wall and ventricular septal valve annulus(e')was more sensitive to left ventricular diastolic function,and the difference between the two groups was statistically significant(P<0.05).Compared with the CNF group,the myocardial energy consumption indexes(cESS and MEE)in the CSF group were increased,and the differences were statistically si
作者
白书昌
马观海
李琛
夏张青
蒋殿虎
梁健球
BAI Shuchang;MA Guanhai;LI Chen;XIA Zhangqing;JIANG Dianhu;LIANG Jianqiu(Department of Cardiology,Foshanthe Second People's Hospital,Foshan 528000,China)
出处
《中国现代医生》
2021年第22期8-12,共5页
China Modern Doctor
基金
广东省佛山市科技局自筹经费类科技计划项目(2020001005626)
广东省佛山市卫生健康局医学科研项目(20210320)。
关键词
冠状动脉慢血流
超声心动图
左心室功能
心肌能量消耗
Coronary artery slow flow
Ultrasonic cardiogram(UCG)
Left ventricular function(LVF)
Myocardial energy expenditure
