经皮冠状动脉介入治疗对冠状动脉慢性完全闭塞病变患者左心室重构及心功能的影响

目的评价经皮冠状动脉介入治疗(PCI)对伴左心室收缩功能不全的冠状动脉慢性完全闭塞(CTO)患者左室重构及心功能的影响。方法选择该院心内科住院患者88例,经冠状动脉造影(CAG)证实均为伴左心室收缩功能不全的慢性冠状动脉闭塞病变,根据是否对CTO病变行PCI治疗,将患者分为PCI治疗组(n=48)和药物治疗组(n=40)。于CAG术前及术后1周、3个月、6个月分别进行超声心动图检查,计算校正的舒张末期容积指数(LVEDVI)、收缩末期容积指数(LVESVI)和左室射血分数(LVEF),比较两组患者左室重构及心功能的差异。结果两组CAG基线资料比较,差异无统计学意义。CAG术后1周时两组LVEDVI、LVESVI、LVEF比较,差异无统计学意义。3个月时PCI组LVEDVI较术前显著降低,LVEF显著提高;与药物治疗组相比,差异也有统计学意义。6个月时PCI组LVEDVI进一步降低,LVEF进一步提高。结论PCI能够改善伴左心室收缩功能不全的CTO患者左心室收缩功能,改善左心室重构。

Effects of percutaneous coronary intervention on left ventricular systolic function in patients with left ventricular dysfunction and chronic total occlusion

Objective To evaluate the effect of percutaneous coronary intervention(PCI) on left ventricular systolic function in patients with chronic total occlusion(CTO) and left ventricular dysfunction. Methods Eight-eight patients with left ventricular dysfunction and chronic total occlusion confirmed by coronary artery angiography were enrolled in this study,of those 48 cases were treated by PCI(PCI group),while 40 cases recieved medical therapy.All patients underwent ultrasonic cardiography before and 1week,3 months,6 months after PCI to calculate left ventricular end-diastolic volume index(LVEDVI),left ventricular end-systolic volume index(LVESVI) and left ventricular ejection fraction(LVEF). Results There were no significant difference of baseline coronary angiography results between PCI group and medication group.LVEDVI,LVESVI and LVEF had no significant difference between two groups before and 1 week after PCI.In PCI group,LVEDVI decreased and LVEF improved significantly 3 months after the PCI compared with those before PCI,and the improvement was more significant 6 months after PCI. Three months after PCI,LVEDVI was significantly decreased and LVEF significantly improved in PCI group compared with medication group. Conclusions PCI prevented left ventricular remodeling and improved cardiac function in patients with left ventricular dysfunction and CTO.