冠状动脉病变程度对左室功能的影响

目的　探讨冠心病患者冠状动脉病变程度与左室功能的关系。方法　 30 6例选择性冠状动脉造影 ,193例冠状动脉造影证实冠心病患者按病变程度、范围及Gensini积分分组 ,测定左室射血分数、短轴缩短分数、舒张早期充盈峰及舒张晚期充盈峰的最大峰值速度 ,并计算E/A比值。结果　冠状动脉轻度、中度病变、单支病变及Gensini积分小于 2 0分时 ,左室收缩功能改变不明显 (P >0 .0 5 ) ,舒张功能出现减退 (P <0 .0 5或P<0 .0 1)。收缩功能减退与受累血管数量、病变程度重及Gensini积分高有明显相关性。结论　冠心病患者左室舒张功能减退常先于收缩功能减退 ,舒张功能的异常是冠心病心功能受累早期改变的敏感指标

Influence of severity of coronary lesions on left ventricular function

Objective To investigate the relationship between severity of coronary lesions and left ventricular function in patients with coronary artery disease(CAD).Methods In 306 cases of coronary angiography,193 patients with CAD confirmed by coronary angiography were divided into groups according to severity and extent of coronary lesions and Gensini score and were assessed by left ventricular ejection fraction,fractional shortening of minor axis, peak-flow velocity during early diastole (EPFV),peak-flow velocity during atrial contraction (APFV) and ratio between EPFV and APFV.Results Left ventricular diastolic function(LVDF) was reduced,but left ventricular systolic function(LVSF) did not change obviously when coronary artery had mild and moderate stenosis,single vessel lesion and Gensini score was <20. A significant correlation was present between reduction of left ventricular systolic function and number of coronary lesions,coronary lesion severity,high Gensini score.Conclusions Reduction of LVDF was earlier than reduction of LVSF in the CAD patients. Abnormal LVDF is a sensitive index of ventricular dysfunction in CAD.