二尖瓣球囊扩张术患者左心功能的超声心动图评价

目的　探讨超声心动图评价二尖瓣球囊扩张术患者左心功能的价值。方法　对 80例二尖瓣球囊扩张术 (PBMV)患者手术前后左心功能进行比较。结果　PBMV术后 1周左室舒张末期容积 (EDV)、心输出量 (CO)、每搏输出量 (SV)和射血分数 (EF)均明显增高 (P <0 0 1) ,而左室收缩末期容积 (ESV)却无明是改变 (P >0 0 5 ) ;EF随二尖瓣瓣口面积 (MVA)扩大而显著增高 ,但不随二尖瓣舒张末期平均跨瓣压差 (PG)减低而变化 ;PBMV术 3个月后左心功能无进一步改善。结论　大部分患者的左心功能在扩瓣前处在代偿期 ,PBMV术后MVA扩大 ,EDV增高 ,左心功能得以改善 ,尤以早期更为显著。MVA是使左心功能改变的重要因素 ,而扩瓣后的PG改变与左心功能无明显相关性。

Echocardiographic Evaluation of Left Ventricular Function before and after Percutaneous Balloon Mitral Valvuloplasty

Objective To evaluate left ventricular function before and after percutaneous balloon mitral valvuloplasty (PBMV) by echocardiography. Methods Left ventricular function of 80 patients who underwent PBMV were estimated by echocardiography before and after operation. Results Left ventricular end-diastolic volume (EDV), cardiac output(CO), systolic volume (SV)and ejection fraction (EF) significantly increased 1 week after PBMV, but Left ventricular end-systolic volume (ESV) had no change. EF improved as mitral valve area(MVA)increased, But it had no change while the pressure gradient across the mitral valve(PG)reduced. Left ventricular function had no further improvement 3 months after PBMV. Conclusion Left ventricular function of most of the patients was improved as EDV increased after PBMV, especially early stage after PBMV. MVA was the most important factor which influenced the left ventricular function. There was no significant correlation between EF and the PG reduction after PBMV.