射血分数正常的充血性心力衰竭患者收缩功能储备的研究  

Assessment of left ventricular systolic function reserve in patients with heart failure and normal ejection fraction

作　　者：边长勇 李方都 尹宗宪 凌敏 胡燕华 何丽红 邵慧丽 朱成 

机构地区：[1]上海普陀区利群医院心内科,200333 [2]上海普陀区利群医院核医学科,200333

出　　处：《国际心血管病杂志》2015年第2期119-122,共4页International Journal of Cardiovascular Disease

基　　金：上海市普陀区科委课题(KW-2010-03)

摘　　要：目的:探讨射血分数正常的充血性心力衰竭(HFnEF)患者左室收缩功能的储备情况。方法:入选HFnEF患者40例,将同期40例经临床和超声心动图排除心力衰竭者设为对照组,所有入选对象行超声心动图检查、核素心血池显像测定静息及分级小剂量多巴酚丁胺负荷后心率(HR)、左室射血分数(LVEF)、高峰射血率(PER)、高峰射血时间(TPER),并计算各指标的最大变化率(ΔHR、ΔLVEF、ΔPER、ΔTPER)。结果:与对照组相比,HFnEF组左房内径、左室收缩期末内径、左室舒张期末内径明显增大,室间隔厚度、左室后壁厚度均显著增加(P<0.05);HFnEF组ΔHR、ΔLVEF、ΔPER、ΔTPER均较对照组降低,分别为54.8%±13.5%对78.8%±15.1%、29.9%±8.2%对40.7%±5.7%、83.0%±28.8%对124.5%±40.3%和46.3%±10.5%对57.3%±8.1%(P均<0.05)。结论:HFnEF患者左室收缩功能储备明显下降。Objective： To investigate left ventricular systolic function reserve in patients with heart failure and normal ejection fraction（HFnEF）. Methods： A cohort of 40 patients with HFnEF were enrolled and 40 patients without heart failure served as controls. Echocardiograghy was performed, and heart rate （HR） left ventricular ejection fraction （LVEF）, peak ejection rate（PER）and peak ejection time （TPER） were measured through radionuclide ventriculography at rest and dobutamine stress. The maximum variation rates of HR, LVEF, PER and TPER were calculated. Results： Left atrial dimension, left ventricular end-systolic and end-diastolic dimension, interventricular septum thickness and left ventricular posterior wall thickness in patients with HFnEF were significantly increased compared with controls（P〈0. 05）. The maximum variation rates of HR, LVEF, PER and TPER in patients with HFnEF were lower than those in controls, with 54. 8% ± 13.5% vs. 78.8% ± 15. 1% for HR, 29.9%±8.2% vs. 40. 7% ± 5. 7% forLVEF, 83. 0%±28.8% vs. 124. 5%±40.3% for PER, and 46. 3% ± 10. 5% vs. 57. 3% ± 8. 1 % for TPER （P〈0. 05）. Conclusion： Left ventricular systolic function reserve in patients with HFnEF declines significantly.

关 键 词：左室射血分数正常心力衰竭 核素心血池显像 心室收缩功能储备 

分 类 号：R541.6[医药卫生—心血管疾病]