左心房内径与左心室充盈压多普勒指标的相关性  

Association Between Left Atrial Diameter and the Doppler-derived index of Left Ventricular Filling Pressure

作　　者：鄢磊[1] 阮琴韵[1] 廖书生[1] 屈朝阳[1] 林晓燕[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》2010年第8期749-752,共4页Chinese Journal of Hypertension

基　　金：福建省教育厅三项费基金(2006F5038)

摘　　要：目的探讨左心室舒张功能不全(DD)患者左心房内径(LAD)与左室充盈压多普勒指标二尖瓣血流舒张早期最大流速与瓣环最大运动速度的比值(E/Ea)的相关性。方法回顾性分析DD患者188例,其中左室松弛减退(IR)组106例,假性正常化(PN)组41例,限制性充盈(Res)组41例。所有患者均接受系统超声心动图检查,指标包括LAD、二尖瓣口血流舒张早期最大流速(E)、二尖瓣环舒张早期最大运动速度(Ea)以及E/Ea。结果在IR组、PN组和Res组中,LAD逐渐增大、Ea逐渐降低而E/Ea逐渐增高(P<0.05),以PN和Res组最为显著;相关分析显示本组188例DD病例的LAD与E/Ea呈中低度相关(r=0.51,P<0.05),其中在PN+Res(E/A>1且Ea<8cm/s,n=82)、E/Ea>8(n=157)及E/Ea8～15(n=108)的病例中,LAD与E/Ea的r值分别为0.56、0.48和0.41(均P<0.05),而在IR组及E/Ea<8的病例中二者间无明显相关(P>0.05)。结论左心房大小与左室舒张功能受损程度及E/Ea相关,与E/Ea结合有助于临床对单纯舒张性心力衰竭或舒张功能不全的诊断。Objective To assess the relationship of left atrial （LA） diameter and the doppler-derived index ratio of mitral diastolic early peak flow velocity and mitral annulus diastolic end peak flow velocity （E/Ea） of left ventricular filling pressure among patients with left ventricular diastolic dysfunction （DD）.Methods We assessed 188 patients with left ventricular DD retrospectively in this study.They were classified into 3 groups according to different LV filling patterns：impaired left ventricular relaxation group （IR,106 cases）;pseudo-normal filling group （PN,41 cases） and restrictive filling group （Res,41 cases）.All the patients received systemic echocardiographic screening.The echocardiographic index included left atrial diameter （LAD）,mitral infloe velocity（E,E/A）,mitral annulus velocities of early diastolic wave （Ea） and E/Ea.Results DD patients had gradually increased LAD with significant difference among IR,PN and Res group,gradually decreased Ea and increased E/Ea （P0.05）,especially in PN group and Res group.By Pearson correlation analysis,medium correlation was observed between LAD and E/Ea in all the patients（n=188,r=0.51,P0.01）,in the PN group＋Res group （n=82,E/A1 and Ea8 cm/s,r=0.56,P0.01）and in the E/Ea8（n=157,r=0.48,P0.01）,while insignificant correlation was found in IR group and E/Ea8 （P0.05）.Conclusion Left atrial diameter increases with the development of LV diastolic dysfunction and correlates with E/Ea,and therefore can work as an important index in the estimation of LV diastolic function or LV filling pressure,and the diagnosis of diastolic heart failure or diastolic dysfunction.

关 键 词：超声心动图 左心房 二尖瓣血流舒张早期最大流速与瓣环最大运动速度的比值 左室舒张功能 左室充盈压 

分 类 号：R540.45[医药卫生—心血管疾病]