缺血性心肌病患者血浆心钠素与左房血流动力学变化的关系

目的：探讨缺血性心肌病患者血浆心钠素（ＡＮＦ）与左房血流动力学变化的关系。方法：应用二维多普勒超声技术和放射性免疫测定法，对３６例缺血性心肌病（ＩＣＭ）患者左房血流动力学变化与ＡＮＦ水平进行分析。结果：ＩＣＭ组ＡＮＦ水平显著高于正常对照（ＮＣ）组（Ｐ＜０．００１）；ＡＮＦ水平与左房功能指标：左房张力（ＬＡＴ）、左房收缩期最大容积（ＬＡＶ）、左房压力（ＬＡＰ）、左房射血力（Ｆ）、左房内径（ＬＡＤ）、Ａ峰和收缩期左室壁应力（ＥＳＳ）呈显著线性相关（ｒ值依次为０．８２、０．８０、０．７９、０．７８、０．７５、０．７２和０．７０，Ｐ＜０．０１～０．００１）；与左室功能指标：左室舒张末容积（ＬＶＶ）、左室射血分数（ＥＦ）及峰值充盈速度（ＰＦＲ）呈中度相关（ｒ值依次为０．６８、０．６７和０．６６，Ｐ＜０．０１）。随着心力衰竭的加重，ＡＮＦ水平有增高趋势。结论：测定ＡＮＦ将有助于全面客观地评价左房室血流动力学异常变化的程度。

Relationship between plasma atrial natriuretic factor levels and changes of left atrial hemodynamics in patients with ischemic cardiomyopathy/

Objective:To investigate the relationship between plasma atrial natriuretic factor (ANF) levels and changes of left atrial hemdynamics in patients with ischemic cardiomyopathy(ICM).Methods:plasma ANF levels and left atrial function as well as the changes of hemodynamics in 36 patients with ICM and 40 normal controls (NC) were measured by two dimensional Doppler echocardiography and radioimmunoassay.Results:ANF levels in ICM group were higher than in NC group( P <0 001).The significant correlations were found between ANF levels and the indexes of the left function,including left atrial tension (LAT),left atrial volume(LAV),left atrial pressure(LAP),left atrial ejection force (F),left atrial diameters (LAD),peak velocity A and left ventricular end systolic stress (ESS).The correlation coefficients r were 0 82,0 80,0 79,0 78,0 75,0 72,0 70( P <0 01-0 001)respectively.Moderate correlations were also observed between ANF levels and left ventricular volume(LVV),eject fraction(EF),peak filling rate (PFR) and the correlation coefficients r were 0 68,0 67,0 66( P <0 01) respectively.The parallel increase in degree of cardiac dysfunction was followed by a continous elevation of ANF levels.Conclusions:It is suggested that detection the levels of ANF was useful in estimation of left atrial ventricular hemodynamic changes in patients with ICM.