二维超声心动图评价肺动脉高压患者心脏结构与功能关系的临床研究

目的：探讨心室间相互作用的机制。方法：用超声方法测量了４２例肺动脉高压患者的心功能和心脏结构参数，并与右心导管术检查结果做比较。结果：肺动脉高压患者右心输出量增加，但射血分数明显低于正常对照组，而左室射血分数在正常范围。二尖瓣及三尖瓣均表现为Ｅ峰流速降低，Ｅ／Ａ＜１及心室等容舒张时间间期（ＩＶＲＴ）明显延长，但二尖瓣Ａ峰流速变化不明显，而三尖瓣Ａ峰流速明显增高。室间隔左移，使左室内径减小，且与肺动脉压升高的程度相关显著，整个心动周期左室偏心指数（ＥＩ）明显增大（ｐ＜０．００１）。右室游离壁明显增厚，室间隔及左室游离壁也增厚（ｐ＜０．０１；ｐ＜０．０１）。结论：肺动脉高压患者右室收缩及舒张功能均减低，而左室收缩功能正常，主要是舒张功能降低且与舒张期左室几何形状即室间隔的移位及肺动脉压增高的程度有关

2-DE Study of the Relationship of the Heart Function and the Ventricular Configuration in Pulmonary Hypertension

Objective:To investigate the mechanism of the interaction of the heart function and the ventricular configuration alteration in 42 pulmonary hypertension patients.Method:Echocardiograms were analyzed and interviewed with the results obtained by catheterization.Results:It demonstrated that cardiac output of RV increased,RVEF decreased,LVEF remained normal.Both MV and TV manifested E wave velocity decreased,E/A<1,isovolume relaxation time(LVRI)prolonged,TV A wave velocity increased,but no change of MV.Masked septal shift of LV in both systolic and diastolic phases compressing LV cavity and high pulmonary pressure resulted in augmentation of the eccentric index(EI)( p <0 001).Conclusion:As a result of increased pulmonary pressure,it ilicited systolic and diastolic dysfumction of the heart.On the other hand,diastolic dysfunction of the LV might be eventually produced by geometric change of LV cavity and the insistently increased pulmonary pressure.