浅析心肌肥厚患者左室舒张功能与冠脉循环的关系

目的探讨心肌肥厚患者冠脉血流与左室舒张功能障碍关系。方法采用彩色多普勒超声仪,行经胸超声心动图(TTE)测量40例心肌肥厚患者和20例正常人冠状窦、二尖瓣及肺静脉血流频谱。结果心肌肥厚患者冠状窦直径、前向血流和净前向血流流速积分(VTInet)明显高于正常对照组;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;肺静脉舒张末期逆行血流最大流速之间均存在明显正相关。结论冠脉循环血流动力学的改变可能是心肌肥厚患者舒张功能受损的机制之一.

THE CORRELATION BETWEEN CORONARY CIRCULATION AND LEFT VENTRICULAR DIASTOLIC FUNCTION IN PATIENTS WITH CARDIAC MUSCLE HYPERTROPHY (CMH)

Objective To study the correlation between coronary circulation and left ventricular diastolic function in patients with cardiac hypertrophy. Methods Mitral, pulmonary venous and coronary sinus flow velocity variables were measured by transthoracic echocardiography in 40 cases with cardiac muscle hypertrophy and 20 cases of control subjects. Results Patients with LVH had higher peak velocity of late transmittal blood flow (A wave), velocity time integral (vti) of A wave and lower index of early versus late flow (E/A ratio) than those of control subjects. Patients with LVH had lower peak diastolic velocity of pulmonary vein than those 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 (VTIne), 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 r=0.47 r=0.43 r=0.42 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). Conclusion The change of coronary circulation may represent a mechanism for impaired diastolic function in patients with CMH.