探讨320排CT下左冠状动脉前降支狭窄程度与左心功能的相关性

目的 利用320排CT探讨左冠状动脉前降支的狭窄程度与左心功能改变的相关性。方法 选择左前降支单支病变的患者108例，其中轻度狭窄患者44例，中度狭窄患者36例，重度狭窄患者28例，分别记为A组、B组、C组；另外选择健康对照组患者33例，记为D组。所有患者行CT冠状动脉造影，分析冠状动脉狭窄程度，并计算左心室射血分数（left ventricular ejection fractions，LVEF）、左心室心肌质量（left ventricular myocardial mass，LVMM）、左心室舒张末期容积（left ventricular end diastolic volume，LVEDV）、左心室收缩末期容积（left ventricular end systolic volume，LVESV）、每搏排出量（stroke volume，SV）、心排出量（cardiac output，CO）。结果 对于左前降支病变的患者，随着左前降支狭窄程度的增加，LVEF逐步下降，并且对于中度狭窄以上的患者，LVEF显著低于正常对照组患者（P<0.05）。左前降支中度狭窄以上患者，LVEDV、LVESV及LVMM高于对照组患者（P<0.05），并且LVMM随着左前降支狭窄程度的增加而升高。病变患者与对照组的SV及CO差异无统计学意义（P>0.05）。另外，左前降支病变患者中轻度狭窄的患者与对照组比较，除了LVMM外，其他心功能参数差异均无统计学意义（P>0.05）。结论 320排CT在评价冠状动脉粥样硬化狭窄与心功能的相关性具有重要价值。左冠状动脉前降支狭窄会引起左心功能降低，且会随着狭窄程度加重而下降，但左前降支轻度狭窄时左心功能下降并不明显。

320 Slice Computed Tomography for the Analysis of the Correlation between the Left Nterior Descending Coronary Artery Stenosis and Left Ventricular Function

Objective To investigate the correlation between the degree of the left anterior descending coronary artery stenosis and left ventricular function through the 320 slice CT. Methods We chosed 108 cases with the left anterior descending artery defection, including 44 cases with mild stenosis, 36 cases with moderate stenosis and 28 cases with severe stenosis. These cases were recorded as group A (mild cases), group B (moderate cases), group C (severe cases). And we also chosed some healthy cases (33 cases) whoh denoted as D group. All the patients underwent the CT coronary artery angiography. We analyzed the degree of coronary artery stenosis and calculated the left ventricular ejection fraction (left ventricular their differences fractions, LVEF), left ventricular mass (left ventricular myocardial mass, LVMM), left ventricular end diastolic and end systolic volume (left ventricular end diastolic volume, LVEDV), left ventricular end systolic volume (left ventricular end systolic volume, LVESV), cardiac output (stroke volume (SV), output per minute (cardiac output CO). Results For the patients with left anterior descending artery disease, the LVEF would gradually decrease with raise of the degree of stenosis of the left anterior descending artery, and the LVEF was significantly lower than that of the control group (P<0.05). LVEDV, LVESV and LVMM were higher than the control group (P<0.05) in the patients with moderate and severe stenosis. And LVMM would raise with the increase of the degree of stenosis of the left anterior descending artery. No statistically significant differences existed in SV and CO. In addition, the statistically significant differences did not exist between the mild stenosis patients and the healthy patients except the LVMM. Conclusion The 320 slice CT has a great value of evaluating the correlation between the coronary artery stenosis and the cardiac function. The stenosis of the left anterior descending coronary artery can cause the left ventricular function decreased. And it will descend with the raise of the degree of the stenosis. But mild stenosis will not affect the left ventricular function.