左心房大小与左心室舒张功能相关性的实验研究  

An Experimental Investigation on Correlations of Left Atrial Size with Left Ventricular Diastolic Dyfunction

作　　者：阮琴韵[1] 廖书生[1] 鄢磊[1] 

机构地区：[1]福建医科大学附属第一医院超声科,福建福州350005

出　　处：《中华高血压杂志》2009年第1期24-27,共4页Chinese Journal of Hypertension

基　　金：福建省教育厅三项费资助(2006F5038)

摘　　要：背景临床研究表明，左心房大小可以作为评价左心室舒张功能和预测心血管事件的重要指标。目的建立左室射血分数（LVEF）正常的舒张功能不全动物模型，分析左心房大小与超声心动图及心导管压力指标的相关性，探讨左心房大小评价舒张功能不全模型的价值。方法通过缩窄兔腹主动脉方法建立18只左心室压力超负荷动物模型（模型组），超声心动图监测心脏结构与功能变化，根据左心大小、室壁厚度及射血分数（确保LVEF值正常）变化于造模6～12周后记录超声心动图指标与心导管测量的左心室舒张末压（LVEDP）。另选8只健康兔作为LVEDP对照。超声心动图指标：左心室内径及室壁厚度，左心房内径及容量，舒张早、晚期二尖瓣口血流速度（E，A）及二尖瓣环组织运动速度（Ea，Aa）。结果1）模型组6～12周后左心房左心室发生重构（房室增大，室壁增厚），多普勒指标Ea降低、E／Ea增高，而E／A无明显变化，心导管检查示LVEDP明显高于对照组[（17．2±5．0）比对照组（4．1±3．0）mmHg，P〈0．01）；2）左心房容积与左心室内径及室壁厚度等结构指标呈正相关（r=0．32～0．53，P〈0．05），与左心室舒张功能指标Ea（r=-0．66）、E／Ea（r=0．79）及LVEDP（r=0．52，P〈0．05）等相关（P〈0．01）。结论在LVEF正常的心功能不全动物模型中，左心房大小与左心室重构及舒张功能指标相关，是评价左心室舒张功能的重要指标之一。Background Left atrium size was reported as a marker for ventricular diastolic dysfunction and predictive risk factors for cardiovascular disease. Objective To analyze the relations between left atrial （LA） size and left ventricular （LV） diastolic function echocardiographically in rabbit model with LV dysfunction while with normal LVEF. Methods LV pressure overloaded animal model was established by abdominal aorta constriction in 18 New-Zealand rabbits （model group） which developed LVH with normal EF with 8 healthy rabbits as normal controls. LA dimension and volume （LAD, LAV）, left ventricular dimension （LVD） and wall thickness （IVST, PWT）, Transmitral inflow E and A, and mitral annulus velocities Ea and Aa were determined by eehocardiography. LVEDP was measured within 24 hours after echo examination by catheterization. Results ① Increased LVD, IVST, PWT and LA size were found in model group （P〈0.05） with significant decreases in Ea and Ea/Aa, increases in E/Ea and LVEDP, but no difference in E and E/A. LAV correlated with LVDd （r= 0. 64, P〈0.05）, IVST （r=0.32, P〈0.05） and PWT It=0.53, P〈0.05）, and markedly related with diastolic parameters Ea（r= -0.66, P〈0.01）, E/Ea（r=0.79, P〈0. 01）andLVEDP （r=0.54, P〈0.01）. Conclusion In rabbit modelof LV dysfunction with normal LVEF, left atrial size（LAV） correlates with both LV remodeling and diastolic parameters and LVEDP. LAV is an valuable morphologic index for the estimation of LV diastolic function.

关 键 词：左心房 左心室舒张末压 左心室舒张功能 超声心动图 

分 类 号：R541[医药卫生—心血管疾病]