左室射血分数正常的心力衰竭患者左心形态和左室舒张功能与心功能分级的相关性  

Correlation between left ventricular morphology,left ventricular diastolic function and cardiac function grading in heart failure patients with normal left ventricular ejection fraction

作　　者：林芳 吴屹 熊鹿 LIN Fang;WU Yi;XIONG Lu(Department of Geriatrics,Mianyang Hospital Affiliated to Medical College of University of Electronic Science and Technology of China/Mianyang Central Hospital,Mianyang Sichuan 621000,China)

机构地区：[1]电子科技大学医学院附属绵阳医院·绵阳市中心医院老年综合科,四川绵阳621000

出　　处：《中国急救复苏与灾害医学杂志》2024年第3期281-284,289,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：四川省卫生健康委员会科研课题(编号:20PJ264);四川省医学会高血压疾病(施慧达)专项科研课题(编号:2018SHD5-2);绵阳市卫健委课题(编号:201912);绵阳市中心医院孵化课题(编号:2019FH16)。

摘　　要：目的分析左室射血分数(LVEF)正常的心力衰竭患者左心形态,左室舒张功能与心功能分级的相关性。方法回顾性选取2021年1月—2022年7月电子科技大学医学院附属绵阳医院收治的40例LVEF正常的心力衰竭患者作为观察组,同期选取50例健康体检者作为对照组。观察组患者根据纽约心脏病学会心功能分级标准又分为Ⅱ级组(14例)、Ⅲ级组(19例)、Ⅳ级组(7例)。比较各组3个心动周期的左心房内径(LAD)、左心室舒张末期内径(LVDD)、室间隔厚度(IVST)、左心室收缩末期内径(LVDs)。利用多普勒成像程序测定二尖瓣环侧壁部舒张早期峰速度(Elat)、二尖瓣环间隔部舒张早期峰速度(Esep)、E峰减速时间(DT),检测舒张晚期A峰速度、二尖瓣E峰速度、二尖瓣环舒张早期运动峰速度(Ea)并计算E/A、E/Ea。采用Spearman相关性检验分析LVEF正常的心力衰竭患者左心形态、左室舒张功能与心功能分级的相关性。结果观察组LAD、LVDD和LVDs均长于对照组,IVST厚于对照组,差异有统计学意义(P<0.05)。观察组Elat、Esep均快于对照组,DT短于对照组,E/A、E/Ea均高于对照组,差异有统计学意义(P<0.05)。三组LAD、LVDD、IVST、LVDs比较,差异有统计学意义(P<0.05)。Ⅲ级组、Ⅳ级组LAD、LVDD和LVDs均长于Ⅱ级组,IVST厚于Ⅱ级组,差异有统计学意义(P<0.05)。Ⅳ级组LAD、LVDD和LVDs均长于Ⅲ级组,IVST厚于Ⅲ级组,差异有统计学意义(P<0.05)。三组Elat、Esep、DT、E/A、E/Ea比较,差异有统计学意义(P<0.05)。Ⅲ级组、Ⅳ级组Elat、Esep均快于Ⅱ级组,DT短于Ⅱ级组,E/A、E/Ea均高于Ⅱ级组,差异有统计学意义(P<0.05)。Ⅳ级组Elat、Esep均快于Ⅲ级组,DT短于Ⅲ级组,E/A、E/Ea均高于Ⅲ级组,差异有统计学意义(P<0.05)。LAD、LVDD、IVST、LVDs与LVEF正常的心力衰竭患者心功能分级呈明显正相关关系(r=0.712、0.656、0.689、0.693,P<0.001),Elat、Esep、E/A、E/Ea与LVEF正常的心力衰竭�Objective To analyze the correlation between left ventricular morphology,left ventricular diastolic function and cardiac function grading in heart failure patients with normal left ventricular ejection fraction(LVEF).Methods Forty heart failure patients with normal LVEF admitted to Mianyang Hospital Affiliated to Medical College of University of Electronic Science and Technology of China from January 2021 to July 2022 were retrospectively selected as observation group,50 healthy examinees were selected as control group during the same period.observation group patients were further divided into classⅡgroup(14 cases),classⅢgroup(19 cases)and classⅣgroup(seven cases)according to New York Heart Association cardiac function grading standards.Left atrial diameter(LAD),left ventricular end diastolic diameter(LVDD),interventricular septum thickness(IVST)and left ventricular diameter in systole(LVDs)of each group in three cardiac cycles were compared.Early diastolic peak velocity of the lateral wall of the mitral annulus(Elat),early diastolic peak velocity of mitral annulus septum(Esep)and E-peak deceleration time(DT)were measured by using Doppler imaging program.Late diastolic A-peak velocity,mitral E-peak velocity and early diastolic peak velocity of mitral annulus(Ea)were detected,and E/A and E/Ea were calculated.The correlation between left ventricular morphology,left ventricular diastolic function and cardiac function grading in heart failure patients with normal LVEF were analyzed by using Spearman correlation test.Results LAD,LVDD and LVDs of observation group were longer than those of control group,IVST of LVEF normal group was thicker than that of control group,the differenceswere statistically significant(P<0.05).Elat and Esep of the observation group were faster than those of control group,DT of LVEF normal group was shorter than that of control group,and E/A and E/Ea of LVEF normal group were higher than those of control group,the differenceswere statistically significant(P<0.05).There were statistically

关 键 词：左室射血分数正常的心力衰竭 左室舒张功能 心功能分级 心脏超声 

分 类 号：R541.6[医药卫生—心血管疾病]