冠心病左心室能量和能量效率与心脏功能之间的关系

目的：研究冠心病左心室能量（LVE）及能量效率（EE）与心力储备之间的关系。方法：根据心导管压力-容积势能理论建立心超声技术下LVE和EE的改良模型，采用心超声法与心导管法对比对70例冠心病人（按冠脉造影病变血管支数分3组和按NYHA心功能分级分4组）和28例正常人的LVE指标和射血分数（EF）进行对比研究，绘制不同NYHA分级的压力-容积环能量图。结果：超声法与导管法测得总能量（TE）、搏功（SW）、收缩末势能（ESE）、充盈能（FE）和EE均高度吻合及相关（r=0.80~0.91），随病变血管支数和心功能分级增加ESE、FE、TE逐渐递增、EE和EF逐渐降低，P-V环右上移位，EE在不同心功能分级异常的敏感性较EF显著增高（P<0.05）。结论：超声法LVE和EE评价冠心病人心力储备功能可靠易行，且较EF具有更大的优势。

Relationship between left ventricular energy and energy efficiency in coronary heart disease and cardiac function

Objective: To study the relationship between left ventricular energy(LVE) and energy efficiency(EE) in patients with coronary heart disease and cardiac reserve. Methods: Modified models of LVE and EE under Doppler echocardiography were constructed according to pressure-volume potential energy theory based on cardiac catheter. LVE index and ejection fraction(EF) in 70 patients with different numbers of diseased coronary artery based on coronary angiography and various cardiac function classification of NYHA and 28 normal individuals were investigated by comparison of echo-method with catheter-method, different cardiac function classification of pressure-volume loop energy figures were drawn. Results: Total energy(TE), stroke work(SW), end-systolic potential energy(ESE), filling energy(FE) and EE determined by echo-method were highly coincided and related with those by catheter-method(r=0.80~0.91). Increase of ESE, FE and TE, decrease of EE and EF and right-up shift of P-V loops showed gradually as numbers of diseased vessels increasing and NYHA classification enlarged. Sensitivity of prediction of abnormal EE for different NYHA classification is significantly higher than that of abnormal EF(P<0.05). Conclusion: LVE and EE by echo-method are reliable and feasible and have higher advantage of EF to evaluating cardiac reserve of coronary heart disease.