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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2003年第4期

页码:

357-359,363

栏目:

影像学

出版日期:

2003-07-01

文章信息/Info

Title:

Evaluation on abnormalities of diastolic function and relationship between diastolic and systolic dysfunction in patients with idiopathic dilated cardiomyopathy by echocardiography

作者:

李竹琴¹; 刘凤岐¹; 孙萍²; 刘志襄²; 孙光³; 吴树亮⁴

1.哈尔滨医科大学附属第一临床医学院心内科,黑龙江 哈尔滨 150001;2.黑龙江省第五医院;3.解放军261医院;4.哈尔滨医科大学

Author(s):

LI Zhu-qin¹;  LIU Feng-qi¹;  SUN Ping²;  LIU Zhi-xiang²;  SUN Guang³;  WU Shu-liang⁴

1.Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Haerbin, Heilongjiang 150001, China

关键词:

原发性扩张型心肌病; 舒张功能障碍; 收缩功能障碍

Keywords:

idiopathic dilated cardiomyopathy;  diastolic dysfunction;  systolic function

分类号:

R542.2

DOI:

-

文献标识码:

A

摘要:

目的:探讨原发性扩张型心肌病(DCM)是否存在主动舒张功能障碍及舒张功能障碍与收缩功能障碍的关系。方法:DCM 患者56例,彩色超声诊断仪常规方法测量LVEDD,LAD,LVEF,LVEDV,LVESV,E,A,E/A,IVRT,DT。结果:①仅有舒张功能障碍8例(14%),收缩功能障碍和舒张功能障碍并存者48例(86%)。②主动舒张功能障碍,即IVRT≥100ms者21例(38%),IVRT<100ms者35例(62%),两组比较,前者LVEF高,LAD小,E低,A高,E/A大(P<0.05)。IVRT≥100ms时,控制变量LVEF情况下,IVRT与LVEDD呈正相关(r=0.39,P<0.05),未发现LVEF与E/A或E相关(均r=-0.22,P>0.05);以IVRT110ms为分界点分成两组,IVRT≥110ms组较<110ms组LVEDD大(74±9vs66±10mm,P<0.05),而LVEF无显著差别。③DT≥150ms者21例,DT<150ms者35例,两组比较,前者IVRT长,LVEDV小(P<0.05),而LVEF, LAD, LVEDD, E, A, E/A,LVESV无显著差别。结论:DCM 存在主动舒张功能障碍,随着主动舒张功能障碍加重,收缩功能下降增剧。

Abstract:

AIM: To evaluate abnormalities of diastolic function and relation ship between diastolic and systolic dysfunction in patients with idiopathic dilated cardiomyopathy (DCM). METHODS: LVEDD, LAD, LVEF, LVEDV, LVESV, E, A, E/A, IVRT, DT were measured in 56 consecutive patients with DCM by Doppler echocardiography according to routine. RESULTS: ① 8 of 56 (14%) only had diastolic dysfunction, 48 of 56(86%) had both diastolicand systolic dysfunction. ② Patients with IVRT≥100ms were 21 cases (38%) who have active diastolic dysfunction, but those IVRT<100ms were 35 cases (62%). LVEF of prior group were higher, LAD were shorter, E were slower, A were faster, E/A were biger compared with the latter group(P<0.05). While IVRT were longer than 100ms, IVRT were correlated positively with LVEDD (r=0.39,P<0.05) under control variable of LVEF. No significant correlation between LVEF and E/A or E were found (bothr= - 0.22,P> 0.05); When selected 110ms as delimitation, LVEDD with IVRT≥110ms group were larger than that with IVRT<110ms group(74±9 vs 66±10mm,P<0.05), but no significant difference of LVEF between two groups were found. ③ Patients with DT≥150ms were 21 cases, and those with DT<150ms were 35 cases. IVRT of prior group were longer, LVEDV were smaller than that of the latter group (P<0.05), but no significant difference of LVEF, LAD, LVEDD, E, A, E/A and LVESV between two groups were found. CONCLUSION: Patients with DCM have abnormalities of diastolic function, and present abnormalities of active relaxation except for systolic dysfunction. With progression of active relaxation abnormalities, systolic function decrease.

参考文献/References

[1] 张青萍. 超声诊断临床指南 [M] , 北京:科学出版社, 1999. 179-191.

[2] 布朗瓦尔德(BraunwaldE.). 心脏病学 [M] , 第五版. 北京:科学出版社, 1999. 421-444.

[3] Parthenakis FI, Kanoupakis EM, Kochiadakis GE. Left ventricular diastolic filling pattern predicts cardiopulmonary determinants of functional capacity in patients with congestive heart failure [J] . Am Heart J, 2000, 140(2):338-344.

[4] Higginbotham MB, Morris KG, Conn EH, et al. Determinants of variable exercise performance among patients with sever ventricular dysfunction [J] . Am J Cardiol, 1983, 51:52-60.

[5] Davies SW, Fussel AL, Jordan SL. Abnormal diastolic filling patterns in chronic heart failure: relationship to exercise capacity [J] . Eur Heart J, 1992, 13:749-757.

备注/Memo

备注/Memo:

收稿日期：2002-07-10.

常用功能

更新日期/Last Update: 2003-07-01