冠状动脉粥样硬化程度与左室收缩功能的关系

目的：探讨冠状动脉粥样硬化程度与左室收缩功能之间的关系。方法：回顾性分析复旦大学附属中山医院心导管室的冠状动脉造影病例205例，将其冠脉病变程度按Gensini积分系统进行评定，将Gensini积分及各危险因素与短轴缩短分数，左室射血分数之间行二变量的Spearman相关性分析及控制影响Gensini积分与短轴缩短分数、左室射血分数相关的其它变量的偏相关分析，再将左室射血分数与Gensini积分及各危险因素作多元逐步回归分析。结果：Gensini积分与短轴缩短分数（r=一0．32，P〈0．01），左室射血分数（r=一0．33，P〈0．01）之间呈负相关，在控制了影响相关的其它变量后Gensini积分仍与短轴缩短分数（r=一0．26，P〈0．01），左室射血分数（r=一0．28，P〈0．01）之间呈负相关，多元逐步回归显示冠状动脉粥样硬化程度为左室收缩功能的独立影响因子（B=一0．378，P〈0．01）。结论：冠状动脉粥样硬化程度与左室收缩功能是独立相关的。

Relationship between severity of coronary atherosclerosis and left ventricular systolic function

AIM： To investigate the relationship between the severity of coronary atherosclerosis and left ventricular systolic function （LVSF）. METHODS： The study population consisted of 199 consecutive patients who underwent coronary angiography for suspected or known coronary atherosclerosis. The severity of coronary atherosclerosis was defined by Gensini score. Spearman two-way test and partial correlation analysis were used to assess the relation between the quantitative variables. Multivariate stepwise linear regression analysis was employed to explore the relationship between Gensini score and left ventricular ejection fraction （LVEF）. RESULTS： Spearman＇s correlation analysis indicated that the Gensini score was negatively correlated with LVEF （r = -0. 33, P 〈0.01 ） and fractional shortening of the minor axis （ r = - 0.32, P 〈 0.01 ） Partial correlation analysis showed that Gensini score was also negatively correlated with LVEF （r = -0.28, P 〈 0.01 ） and fractional shortening of the minor axis （r = -0. 26, P 〈 0.01 ） , whereas the disturbant variables were under control. Multiple stepwise linear regression analysis demonstrated that the severity of coronary atherosclerosis was significantly independently associated with LVSF （ [3 = -0. 378, P 〈 0. 01 ）. CONCLUSION： The severity of coronary atherosclerosis as measured by Gensini score is independently associated with LVSF. There is a distinct direct dose-dependent correlation between the severity of coronary atherosclerosis and LVSF.