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|本期目录/Table of Contents|

左心室局部收缩及舒张不协调性对左心室整体舒张功能的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
1999年第4期
页码:
225-227
栏目:
论著
出版日期:
1999-07-01

文章信息/Info

Title:
Effect of left ventricular regional mechanical nonuniformity on global diastolic function
作者:
董少红
深圳市人民医院心内科, 深圳 518020
Author(s):
Dong Shaohong
Division of Cardiology, People′s Hospital of Shenzhen, Shenzhen 518020
关键词:
舒张功能;  左心室整体　局部心肌机械不协调性　收缩不协调分数　舒张不协调性
Keywords:
left ventricular global diastolic function 　　regional mechanical nonuniformity　　systolic synchronous fraction　　diastolic asynchronous fraction
分类号:
-
DOI:
-
文献标识码:
-
摘要:
作者用放射性核素左心室造影方法,研究了正常人心绞痛及心肌梗死患者左心室局部收缩(局部射血分数, REF)及舒张功能(高峰充盈率,PFR),对比不同患者的左心室局部收缩及舒张不协调分数对整体左心室舒张功能的影响。结果显示正常人组的左心室各局部存在着机械功能的不协调性,其中以舒张不协调性明显;心绞痛组左心室内部舒张不协调性比正常人增加, 而心肌梗死患者, 特别是有室壁瘤形成的患者,左心室内部收缩及舒张不协调性均明显增加,局部不协调分数与左心室PFR 呈负相关。提示:正常人的左心室局部各个区域的心肌收缩及舒张均存在着不一致性。当心肌缺血发生后, 随着缺血程度的加重;室壁运动异常也加重,当矛盾性室壁运动出现后,更加重了心肌的不协调性, 局部机械功能的不协调性是影响左心室舒张功能的重要因素。
Abstract:
Radionuclide left ventricular imaging was used to evaluate the regional systolic and diastolic function(Regional Ejection Fraction, REF) and the global diastolic function (Peak Filling Rate, PFR)of the left ventricle in both normal controls in both regional contractible and relaxant synchronous fractions and their relation to global relaxant function. The results showed that in the normal controls, there was mechanical nonuniformity in the left ventricle,with the diastolic synchronous fraction more obvious. The diastolic nonuniformity was more significant in patients with angina pectoris than in the normal controls. In patients with myocardial infarction,especially in those with aneurysm , the systolic and diastolic nonuniformity was severer and the regional asynchronous fraction was negatively related to left ventricular PFR. It is concluded that there was nonuniformity in different regions of the left ventricle in the normal, and that when myocardial ischemia occurred, necrosis grew increasingly worse with the aggravation of the ischemia, thus further increasing the regional myocardial nonuniformity. The results may also suggest that the regional asynchronous fraction is an important factor affecting left ventricular diastolic function.

参考文献/References

［1］Grossmann W. Diastolic dysfunction and congestive heart failure.Circulation, 1990; 81 (Suppl Ⅲ) :Ⅲ-1.

［2］Antonell G, Richard BD,Mary J , et al. Patterns of left ventricular hypertrophy and geometric remodeling in essential hypertension. J Am Coll Cardiol, 1992; 19: 1550.

［3］Klausner S, Shapio JM ,Bush D, et al. Quantitative analysis of segmental wall motion throught systole and diastole in the normal human left ventricle. Circulation, 1982; 65: 80.

［4］Haenodchen RV ,Quantitation of regional cardiac function by twodimensional echocardiography. Circulation, 1983; 67: 1234.

［5］Keung ECH. Non-uniform electrophysiologic properties and electronic interaction in hypertrophied rat myocardium. Circ Res,1981; 49: 150.

［6］Lew YW , Brutseant DL.Influence of nonuniformity on rate left ventricular pressure fall in the dog. Am J Physiol, 1989; 256:H1222.

［7］Sasayama S,Weisfeldt ML , Huntsman LL , et al. Analysis of asynchronous wallmotion by regional p ressure-length loops in patients with CAD. J Am Coll Cardiol, 1984; 4: 259.

备注/Memo

备注/Memo:
(收稿1998-09-25　修回1999-04-01)
更新日期/Last Update: 1999-07-01