颈-股脉搏波传导速度与冠心病患者左室舒张功能的相关性及诊断价值  

Correlation between carotid-femoral pulse wave conduction velocity and left ventricular diastolic function in patients with coronary artery disease and its diagnostic value

作　　者：梁国良 阚珊珊 马江伟 张文豪 杨立国 刘安康 Liang Guoliang;Kan Shanshan;Ma Jiangwei;Zhang Wenhao;Yang Liguo;Liu Ankang(Medical School of Anhui University of Science and Technology,Huainan,Anhui 232001,China;Jinshan Hospital Affiliated to Fudan University,Jinshan,Shanghai 201500,China;Central Hospital of Fengxian District,Shanghai 201400,China)

机构地区：[1]安徽理工大学医学院,安徽淮南232001 [2]复旦大学附属金山医院,上海金山201500 [3]上海市奉贤区中心医院,上海奉贤201400

出　　处：《齐齐哈尔医学院学报》2024年第20期1919-1924,共6页Journal of Qiqihar Medical University

摘　　要：目的通过无创检测动脉弹性指数探讨外周动脉弹性与心室舒张功能变化的相关性。方法回顾性分析2020年6月—2021年6月上海市XX区中心医院就诊的390例疑似冠心病(Coronary heart disease,CHD)并完善冠状动脉造影(Coronary angiography,CAG)患者的临床资料,根据冠状动脉病变程度分为对照组(n=73)、冠状动脉粥样硬化组(n=128)和CHD组(n=189)三组。采用相关性分析及多元线性回归分析动脉弹性指数与心功能指标的关系。结果冠状动脉粥样硬化组二尖瓣舒张早期血流峰值与二尖瓣环速度之比(Ratio of peak mitral valve blood flow during early diastolic period to mitral ring velocity,E/e')、颈-股脉搏波传导速度(Carotid-femoral pulse wave conduction velocity,cfPWV)、左心室等容舒张松弛时间常数T均高于对照组,左心室射血分数(Left ventricular ejection fraction,LVEF)低于对照组,差异有统计学意义(P<0.05);CHD组LVEF低于对照组,左心室压力上升最大速度(Maximum velocity of left ventricular rise,LV+dp/dtmax)、左心室压力下降最大速度(Maximum velocity of left ventricular descent,LV-dp/dtmax)均慢于对照组,差异有统计学意义(P<0.05);E/e'、左心房容积指数(Left atrial volume index,LAVI)、左心室质量指数(Left ventricular mass index,LVMI)、E峰减速时间(Deceleration time,DT)、T均高于对照组,cfPWV快于对照组,差异有统计学意义(P均<0.05);CHD组LVEF、左心室舒张末期容积(Left ventricular end-diastolic volume,LVEDV)低于冠状动脉粥样硬化组,LV+dp/dtmax、LV-dp/dtmax均慢于冠状动脉粥样硬化组,E/e'、LAVI、DT、T均高于冠状动脉粥样硬化组,cfPWV快于冠状动脉粥样硬化组,差异有统计学意义(P均<0.05)。调整性别、年龄、吸烟史、高血压病史、糖尿病病史、血脂指标、肌酐、肌钙蛋白I(Cardiac troponin,cTnI)、B型利尿钛(B-type natriuretic peptide,BNP)、体表面积(Body surface area,BSA)评分等相关因子后,Partial分析显示,cObjective To investigate the correlation between peripheral arterial elasticity and changes in ventricular diastolic function by testing arterial elasticity indexes through non-invasive technology.Methods A retrospective analysis was conducted on 390 patients with suspected coronary artery disease(CHD)who underwent coronary angiography(CAG)at Shanghai Fengxian Central Hospital from June 2020 to June 2021.Patients were divided into a control group(n=73),coronary atherosclerosis group(n=128),and CHD group(n=189)based on the degree of coronary artery lesions.Correlation and multiple linear regression analyses were used to examine the relationship between arterial elasticity indexes and cardiac function indices.Results The coronary atherosclerosis group had higher values of the ratio of peak mitral valve blood flow during early diastolic period to mitral ring velocity(E/e'),carotid-femoral pulse wave conduction velocity(cfPWV),and left ventricular isovolumic diastolic relaxation time constant(T)compared to the control group,with a lower left ventricular ejection fraction(LVEF),differences were statistically significant(P<0.05).In the CHD group,LVEF was lower than the control group,and the maximum velocity of left ventricular rise(LV+dp/dtmax)and descent(LV-dp/dtmax)were slower than the control group,differences were statistically significant(P<0.05).The CHD group also had higher values of E/e',left atrial volume index(LAVI),left ventricular mass index(LVMI),deceleration time(DT),and T,and a faster cfPWV than the control group,differences were statistically significant(P<0.05).After adjusting for gender,age,smoking history,hypertension,diabetes,lipid profiles,creatinine,cardiac troponin I(cTnI),B-type natriuretic peptide(BNP),and body surface area(BSA),partial correlation analysis showed that cfPWV was positively correlated with T,E/e',and LAVI,and negatively correlated with LV-dp/dtmax.Linear regression analysis indicated that E/e',LAVI,T,and LV+dp/dtmax were influencing factors of cfPWV.Conclusions cfPWV is signific

关 键 词：动脉弹性 冠心病 舒张功能 颈—股脉搏波传导速度 

分 类 号：R541.4[医药卫生—心血管疾病]