Kowalska A, Loboz-Grudzień K, Hirnle T, Sokalski L
Oddział Kardiologiczny Dolnoślaskiego, Szpitala Specjalistycznego, T. Marciniaka we Wrocławiu.
Pol Arch Med Wewn. 1999 Oct;102(4):855-63.
The aim of the study was to assess the relationship between left ventricular (LV) diastolic dysfunction measured by Doppler mitral flow indices (D.m.f.i.) and LV systolic performance in coronary artery disease (CAD). 107 pts with confirmed CAD without or after MI in I, II NYHA class was divided into 2 groups according to ejection fraction (EF) value = 55%. 13 D.m.f.i. regarding to the time, velocity, flow volume and derivates were calculated. In the patient with CAD with normal EF, the diastolic dysfunction was characterised by the impaired relaxation. There were prolonged isovolumic relaxation time IVRT and deceleration time of early filling flow DT, reduced early filling fraction EFF and increased the atrial filling fraction AFF, decreased E/A ratio and E/A-VTI. The regression analysis revealed the positive correlation between EF and DT r = 0.35 and inverse correlation between wall motion score index WMSI and DT r = DT r = -0.33. The stepwise regression analysis revealed that EF and WMSI are independent factors influencing on DT. Our results confirm that diastolic dysfunction precedes the systolic dysfunction in CAD. The correlation between D.m.f.i. and LV systolic function parameters were obtained. The results suggest that the LV systolic function should be take to account in the Doppler mitral flow analysis.
本研究的目的是评估通过多普勒二尖瓣血流指数（D.m.f.i.）测量的左心室（LV）舒张功能障碍与冠状动脉疾病（CAD）中左心室收缩功能之间的关系。107例确诊为CAD且处于I、II级纽约心脏协会（NYHA）心功能分级、无心肌梗死或有心肌梗死病史的患者，根据射血分数（EF）值=55%分为两组。计算了13项与时间、速度、流量及衍生指标有关的D.m.f.i.。在EF正常的CAD患者中，舒张功能障碍的特征为舒张功能受损。等容舒张时间（IVRT）和早期充盈血流减速时间（DT）延长，早期充盈分数（EFF）降低，心房充盈分数（AFF）增加，E/A比值和E/A-速度时间积分（VTI）降低。回归分析显示EF与DT呈正相关（r = 0.35），室壁运动评分指数（WMSI）与DT呈负相关（r = -0.33）。逐步回归分析显示EF和WMSI是影响DT的独立因素。我们的结果证实，在CAD中舒张功能障碍先于收缩功能障碍出现。得出了D.m.f.i.与左心室收缩功能参数之间的相关性。结果表明，在多普勒二尖瓣血流分析中应考虑左心室收缩功能。
