经食管超声技术评价左室心肌肥厚患者冠脉血流储备功能  

EVALUATION OF CORONARY FLOW RESERVE IN PATIENTS WITH LEFT VENTRICULAR HYPERTROPHY BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY

作　　者：张薇[1] 白晨[1] 张运[1] 李继福[1] 朱式娟[1] 陈玉国[1] 张学义[1] 钟明[1] 

机构地区：[1]山东医科大学附属医院心内科

出　　处：《山东医科大学学报》2000年第1期7-9,共3页Acta Academiae Medicinae Shandong

基　　金：山东省科委资助课题

摘　　要：目的 :应用多平面经食管多普勒超声心动图 ( TEE)潘生丁负荷试验 ,探讨左室心肌肥厚患者的冠脉循环特点及血流储备 ( CFR)功能。 方法 :53例受试者分为 A组 (对照组 )、B组 (冠心病组 )、C组(左室心肌肥厚组 )。应用 TEE测定冠脉前降支血流参数 ,以基础状态 ( R)和潘生丁负荷后 ( D)冠脉舒张期最大流速比值 ( D/R PDV)为 CFR的指标。结果 :B组和 C组与 A组比较 ,D/R PDV明显减低〔( 1 .55± 0 .43)cm/s vs ( 3.43± 0 .71 ) cm/s P<0 .0 0 1 ;( 2 .1 6± 0 .65) cm/s vs ( 3.43± 0 .71 ) cm/s P<0 .0 0 1〕B组 D/R PDV与冠脉狭窄程度负相关 ( r=- 0 .83,P<0 .0 0 1 )。C组 D/R PDV与基础状态时 PDV负相关 ( r=- 0 .63,P<0 .0 1 )。结论 :冠心病和左室心肌肥厚者的 CFR均减低 ,但发生机理不同 ;TEE潘生丁负荷试验是检测 CFR的重要方法。Objective: To evaluate coronary flow reserve(CFR) in patients with left ventricular hypertrophy(LVH). Methods: Transesophageal echocardiography was performed in 10 control subjects (group A), 15 patients with coronary artery disease(CAD) that involved only the left anterior descending artery (group B) and 28 patients with LVH(group C). The peak diastolic coronary flow velocity (PVD) was recorded in the proximal part of the left descending artery with pulsed Doppler guided by color flow imaging before and after an intravenous dipyridamole infusion (0.56mg/kg in 4 min). CFR was calculated as the ratio of the dipyridamole to rest PVD( D/R PDV).Results: D/R PDV was significantly lower in group B and C than that in group A 〔(1.55±0.43)cm/s vs (3.43±0.71)cm/s, P<0.001;(2.16±0.65)cm/s vs (3.43±0.71)cm/s,P< 0.001 〕. A linear relation was found between D/R PDV and degree of coronary artery stenosis (r=-0.83, P<0 001) in group B. In left LVH patients, D/R PDV was correlated with resting PDV(r=-0.63,P<0 01). Conclusion: The CFR was reduced in both LVH patients and CAD patients but the mechanism of reduction may differ . TEE is a feasible and reliable method to evaluate CFR.

关 键 词：心肌肥厚 冠脉血流储备 超声心动图 TEE 

分 类 号：R542.2[医药卫生—心血管疾病]