多普勒超声心动图评价肺动脉高压病人左心室舒张功能

目的：探讨肺动脉高压（ＰＨ）对左心室舒张功能（ＬＶＤＦ）的影响及其发生机理。方法：用彩色多普勒超声心动图结合右心导管检测观察２８例继发有ＰＨ先心病（ＣＨＤ）病人的ＬＶＤＦ，并与２０例无ＰＨ的ＣＨＤ病人对比分析。结果：继发有ＰＨ的病人二尖瓣口血流频谱Ａ峰流速（ＡＶ）、速度时间积分（ＡＶＩ）较对照组明显增高（Ｐ＜０．０５～０．０１），Ｅ峰流速（ＥＶ）、速度时间积分（ＥＶＩ）无明显改变（Ｐ＞０．０５），ＡＶ／ＥＶ、ＡＶＩ／ＥＶＩ增大（Ｐ＜０．０１），左室等容舒张期（ＬＩＶＲＴ）延长（Ｐ＜０．０５），且肺动脉压与ＡＶ／ＥＶ比值成中等相关（ｒ＝０．４１８９～０．４２４６，Ｐ＜０．０１）。结论：ＰＨ可致ＬＶＤＦ减退，并推测其机理可能与ＰＨ所引起的室间隔运动异常、肥厚、两室间充盈的相互影响及左室三维几何形态的改变等因素有关。

Doppler Echocardiographic Assessment of Left Ventricular Diastolic Function in Patients with Pulmonary Hypertension

Objective:To examine the effects of pulmonary hypertension (PH) on left ventricular diastolic function (LVDF) and its mechanisms.Methods:The LVDF in 28 congenital heart disease (CHD) patients complicated with PH and 20 CHD patients without PH for controls were surveyed by color Doppler echocardiography in the wake of cardiac catheterization.Results:The atrial filling velocity(AV) (P< 0.01 ),velocity time integral (AVI)(P<0.05) as well as the ratio of AV/EV,AVI/EVI (P<0.01) on the transmitral Doppler spectrum were increased in patients with PH compaired with controls,the early diastolic filling velocity (EV),velocity time integral(EVI) had no changes(P>0.05).Isovolumic relaxation time of left ventricle (LIVRT) was prolonged (P<0.05) in pulmonay hypertensive patients compaired with controls.The weak correlation was existed between pulmonary artery pressure and AV/EV ratio (r=0.4189～0.4246.P<0.01).Conclusion:It is concluded that secondary PH could make LVDF impaired,probably due to abnormal motion and hypertrophy of the interventricular septum,the interaction of both ventricular fillings as well as the changes of the left ventricular three dimensional geometric shape,etc.