扩张型心肌病冠状动脉血流储备功能的超声研究  

Evaluation of coronary flow reserve in patients with dilated cardiomyopathy by transesophageal echocardiography

作　　者：张薇[1] 白晨[1] 张运[1] 张学义[1] 季晓平[1] 葛志明[1] 魏来临[1] 

机构地区：[1]山东大学齐鲁医院心内科,济南250012

出　　处：《中国心血管杂志》2001年第3期131-133,共3页Chinese Journal of Cardiovascular Medicine

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,探讨扩张型心肌病患者的冠状动脉循环特点及血流储备(CFR)功能。方法 正常对照组15例,扩张型心肌病组12例。应用TEE测定冠状动脉前降支血流频谱,以基础状态下(R)和潘生丁负荷后(D)冠状动脉舒张期最大流速比值(D/R PDV)为CFR的指标。结果 与对照组比较,扩张型心肌病D/R PDV明显减低(3.43±0.62 vs 2.15±O.75,P<0.01)。扩张型心肌病组D/R PDV与心率负相关(r=-O.73,P<O.01);与基础状态时PDV负相关(r=-O.59,P<0.05);与左心室射血分数(EF)、二尖瓣血流频谱E峰与A峰比值(E/A)和左心室末期容量指数(LVEDVI)无相关。结论 扩张型心肌病患者CFR减低,可能与心肌重量增加、基础状态时前降支血流速度加速、心率增快和冠状动脉微循环血管功能损伤有关。Objective To evaluate coronary flow reserve(CFR) in patients with dilated cardiomyopathy. Method Transesophageal echocardiography were performed in 15 control subjects and 12 patients with dilated cardiomyopathy. The peak diastolic coronary flow velocity (PDV) was recorded in the proximal part of the left descending artery with use of 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 dipyridamoie to rest PDV (D/R PDV). Results D/R RDV was significantly lower in patients with dilated cardiomyopathy than that in control subjects (2. 15±0. 75cm/s vs 3. 43±0. 62cm/s,P<0. 001). In patients with dilated cardiomyopathy,D/R PDV was correlated with resting PDV (r=-0.59,P<0.05) and with heart rate (r=-0. 73,P<0. 01). Conclusion The CFR was impaired in patients with dilated cardiomyopathy. The mechanism of its reduction may be multifactors. TEE is a feasible and reliable method to evaluate CFR.

关 键 词：经食管超声心动图 冠状动脉血流储备 扩张型心肌病 TEE 

分 类 号：R445.1[医药卫生—影像医学与核医学]