超声心动图观察健康人舒张功能减退与左房增大的相关性及临床意义

目的探讨健康人生理性舒张功能减退与左房增大的相关性及临床意义.方法应用超声心动图方法观察4575例年龄20～97岁健康人的心脏结构、血流及功能,其中男性2150例,女性2425例,取胸骨旁左室长轴切面测量左房、左室,计算左室射血分数.应用多普勒超声心动图测量二尖瓣舒张早期血流峰值速度（EPFV）及心房收缩期血流峰值速度（APFV）.以10岁为一年龄段分为7个年龄组,观察各年龄段心脏结构及心功能是否存在差异.同时观察年龄与心脏结构及心功能的相关性.结果各年龄段左室内径、左室射血分数无统计学差异.随年龄段增加,左房增大,EPFV减慢,APFV增快,E/A比值减小,除80年龄组外,左房内径、EPFV及APFV各年龄段均有统计学差异（均P＜0.05）.年龄与EPFV及E/A比值呈显著负相关,与左房内径、APFV呈显著正相关;左房内径与EPFV及E/A比值呈显著负相关,与APFV呈显著正相关（均P＜0.01）.结论随年龄增长,左房增大,左室舒张功能减退,而左室内径及左室收缩功能无明显变化.左房内径与左室舒张充盈的各项指标具有良好的相关性,提示左房增大可能是左室舒张功能减退的重要表现之一.

The correlation between enlarged left atrium and decreased left ventricular diastolic function by echocardiography in healthy subjects

Objective To investigate the correlation between enlarged left atrium and decreased left ventricular diastolic function in healthy subjects. Methods The cardiac structure and left ventricular function were examined by echocardiography in 4575 healthy volunteers. The subjects were divided into 8 groups according to their ages. The early peak flow velocity (EPFV),atrium peak flow velocity (APFV), left ventricular ejection fraction(LVEF), diameter of left atrium (LAD)and end diastolic diameter of left ventricle (EDD) were measured. The relationships between age and cardiac structure, left ventricular function were calculated. Results There were no differences in LVEF and EDD in different age groups. With increasing age,LAD enlarged, EPFV decreased and APFV increased. The ratio between EPFV and APFV (E/A) significantly decreased (P <0.05 between every two groups except the group aged over 80 years). There were significant positive correlation between LAD and EPFV and negative correlation between LAD and APFV (P <0.01). Conclusions Age is one of the important physiologic factors influencing the diameter of left atrium and left ventricular diastolic function. There was good correlation between enlarged left atrium and decreased left ventricular diastolic function with increasing age. It is suggested that enlarged left atrium is an important indicator for predicting decreased left ventricular diastolic function.