冠心病患者冠状动脉病变与心脏功能的相关性

目的: 探讨冠状动脉病变范围及狭窄程度与心脏功能的关系。方法: 选择性冠状动脉造影387例，冠状动脉造影证实冠心病患者252例，按病变范围、狭窄程度分组，术前行心脏超声检查，对比分析冠状动脉病变范围及狭窄程度与功能的关系。结果: 冠状动脉轻、中度狭窄、1支病变时，左室收缩功能改变不明显，舒张功能出现减退(P<0.05或P<0.01)。冠状动脉重度狭窄、完全闭塞时，舒张功能明显减退(P<0.01)，收缩功能与受累血管数量、病变程度有明显相关性。结论: 冠状动脉病变对心脏的功能有一定影响，冠心病患者心脏舒张功能减退先于收缩功能。

Relationship between severity of coronary artery lesions and cardiac function

AIM: To investigate the relationship between the scope and degree of coronary artery stenosis and the function of the heart. METHODS: We studied 387 patients who underwent selective coronary arteriography (CAG). The 252 patients who had been diagnosed as having coronary heart disease (CAD) by CAG were divided into different groups according to the extent of the lesion and the stenosis of the artery. All patients were examined by heart ultrasonography before CAG. On the basis of the CAG and heart ultrasonography results, we analyzed the correlation between the scope and degree of coronary artery stenosis and the function of the heart. RESULTS: In the patients with low- to medium-grade stenosis or with one stenosed coronary artery, only the diastolic function of the left ventricle decreased (P<0.05 or P<0.01). In patients with high-grade stenosis and total occlusion, both the diastolic and systolic function of the left ventricle decreased and the decreased degree of contractile function had a significant correlation with the number and severity of involved coronary arteries (P<0.01). CONCLUSION: The severity of coronary stenosis influences the function of the heart. In patients with CAD, the diastolic function of the heart decreases before the systolic function.