冠脉循环对左室舒张功能影响的研究

探讨心肌肥厚患者冠脉血流与左室舒张功能障碍各项指标的相关关系。方法采用经胸和经食管超声心动图技术，测量３０例心肌肥厚患者和１０例正常人冠状窦、二尖瓣及肺静脉血流频谱。结果与正常人相比，收肌肥厚患者冠状窦直径、前向血流和净前向血流流速积分明显增加，并且冠状窦前向血流和ＶＴＩｎｅｔ与左室舒张功能障碍的多项指标存在相关关系。

Effect of coronary circulation on left ventricular diastolic function

Objective To study relationship between coronary circulation and left ventricular diastolic function in patients with left ventricular hypertrophy(LVH).Methods Mitral,pulmonary venous and coronary sinus flow velocity variables were measured by transthoracic and multiplane transesophageal echocardiography in thirty patients with LVH and ten control subjects.Results Patients with LVH had higher peak velocity of late transmitral blood flow (A wave),velocity time integral (VTI) of A wave and lower index of early versus late transmitral flow (E/A ratio) than those of control subjects.Patients with LVH had lower peak diastolic velocity of pulmonary vein than that of control subjects.The ratio of pulmonary venous diastolic and systolic flow velocities(S/D ratio),pulmonary venous A wave velocity and its duration were higher in patients with LVH compared with control subjects.The net forward flow velocity time integral (VTInet),forward flow and diameter of coronary sinus were higher in patients with LVH compared with control subjects.There were significant positive linear correlation between coronary sinus forward flow and E,E/A,VTI E,VTI E/A,and pulmonary venous A wave velocity.(r= 0.50 , 0.47 , 0.43 , 0.42 , 0.41 ,P< 0.05 ).There were also significant positive linear correlation between coronary sinus VTInet and E,E/A,VTI E,VTI E/A,and pulmonary venous A wave velocity.(r= 0.38 , 0.55 , 0.43 , 0.47 , 0.37 ,P< 0.05 ).Conclusions Left ventricular diastolic function was impaired in patients with LVH.A significant correlation existed between coronary sinus flow and diastolic function in patients with LVH.The change of coronary circulation may represent a mechanism for impaired diastolic function in patients with LVH.