冠心病左室收缩功能不全患者等容舒张时间及肺静脉血流频谱变化的研究

目的：研究冠心病左室收缩功能不全患者左室等容舒张时间（IRT）和肺静脉血流频谱变化。方法：心尖双平面Simpson法测定左室射血分数（LVEF）；脉冲多普勒测右上肺静脉血流频谱（S、Si、D、Di、PA、PAi、S/D）及二尖瓣口前向血流频谱（E、Ei、A、Ai、E/A）；连续多普勒测定IRT；对各组数据进行统计学分析。结果：当左室收缩功能不全时IRT延长、肺静脉血流频谱S峰变慢、二尖瓣血流频谱假性正常化。相关分析结果表明左室收缩功能与舒张功能变化显著相关。结论：冠心病左室收缩功能不全患者存在左室舒张功能异常，IRT延长与肺静脉血流频谱S波减低比二尖瓣血流频谱更为敏感地反映了舒张功能异常。

Study of Left Ventricular Isovolume Relaxation Time and Doppler Spectrum of Pulmonary Vein in Coronary Heart Disease with Left Ventricular Systolic Dysfunction

Objective To explore the changes of isovolume relaxation time(IRT)and doppler spectrum of pulmonary vein in patients with coronary heart disease(CHD)accompanying left ventricular systolic dysfunction.Methods Echocardiography was performed in 63 patients with CHD and 32 normal persons.Left ventricular ejection fraction(LVEF)was measured by Simpson method,pulsed doppler parameters of upper right pulmonary vein(S,Si,D,Di,PA,PAi,S/D)and mitral valve(E,Ei,A,Ai,E/A) were measured,and IRT was measured by continued doppler.Results In patients with left ventricular systolic dysfunction,IRT prolonged,S wave of pulmonary vein decreased and doppler pattern of mitral valve showed pseudonormal.The change of left ventricular systolic function was significantly correlated with that of left ventricular diastolic function.Conclusions Left ventricular diastolic dysfunction is concomitant with Left ventricular systolic dysfunction in CHD.The indexs of IRT and S wave are more sensitive to reflect left ventricular diastolic function than doppler spectrum of mitral valve.