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卡托普利治疗单支冠状动脉疾病后左心室舒张不同步性降低

Reduced left ventricular diastolic asynchrony after captopril in single vessel coronary artery disease.

作者信息

Nii T, Nakashima Y, Kawano T, Arakawa K

机构信息

Second Department of Internal Medicine, Fukuoka University School of Medicine, Japan.

出版信息

Cardiology. 1992;81(2-3):115-20. doi: 10.1159/000175785.

Abstract

Impaired left ventricular diastolic function is often found preceding systolic functional abnormality in coronary artery disease. To assess whether captopril improves diastolic function, radionuclide ventriculography was performed before and 1 h after captopril administration in 10 stable effort angina patients with severe isolated stenosis of the left anterior descending coronary artery and in 8 controls. Resting global peak filling rate (PFR) was significantly (p < 0.05) reduced in association with significantly (p < 0.01) increased left ventricular diastolic asynchronous index (delta t) in patients with angina pectoris. Neither global PFR nor regional cardiac function was affected by captopril, although delta t was significantly (p < 0.05) reduced from 70 +/- 18 (SD) to 51 +/- 25 ms in patients with angina pectoris. A significant (p < 0.01) correlation was observed between percentage changes in peak ejection rate and in PFR in all subjects. Thus, captopril improves left ventricular asynchrony in patients with stable angina, although global diastolic function affected by systolic function remains unchanged.

摘要

在冠状动脉疾病中,左心室舒张功能受损通常先于收缩功能异常出现。为评估卡托普利是否能改善舒张功能,对10例患有严重孤立性左前降支冠状动脉狭窄的稳定型劳力性心绞痛患者和8例对照者在服用卡托普利前及服药后1小时进行了放射性核素心室造影。心绞痛患者静息时整体峰值充盈率(PFR)显著降低(p<0.05),同时左心室舒张异步指数(δt)显著升高(p<0.01)。卡托普利对整体PFR和局部心脏功能均无影响,尽管心绞痛患者的δt从70±18(标准差)显著降低(p<0.05)至51±25毫秒。在所有受试者中,峰值射血率和PFR的百分比变化之间观察到显著(p<0.01)相关性。因此,卡托普利可改善稳定型心绞痛患者的左心室异步性,尽管受收缩功能影响的整体舒张功能保持不变。

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