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[缺血性心脏病合并左心室功能减退患者右心室功能状态与心力衰竭严重程度的相互关系]

[Interrelationship between functional state of the right ventricle and severity of heart failure in patients with ischemic heart disease and depressed left ventricular function].

作者信息

Buslenko N S, Buziashvili Iu I, Koksheneva I V, Asymbekova E U, Sherstiannikova O M

出版信息

Kardiologiia. 2005;45(12):25-30.

Abstract

Dobutamine Doppler echocardiography was carried out in 56 patients (n=56) with ischemic heart disease and depressed left ventricular function (left ventricular ejection fraction <40%) and chronic heart failure. Clinical signs of heart failure were moderate (NYHA class I-II) in 34 and severe (NYHA class III-IV) in 22 patients. Patients with moderate and severe clinical heart failure had similar degree of left ventricular myocardium impairment however those with severe symptoms had more pronounced right ventricular (RV) dysfunction (greater suppression of global and local RV contractility, greater percentage of irreversibly dysfunctional RV myocardium, lower RV contractile response to dobutamine infusion, more pronounced disturbances of RV diastolic filling). Dependence of RV pump function on pulmonary artery pressure was more evident in patients with severe clinical heart failure and marked dysfunction of RV myocardium than in patients with moderate symptoms and moderate RV myocardial dysfunction.

摘要

对56例缺血性心脏病且左心室功能降低(左心室射血分数<40%)并伴有慢性心力衰竭的患者进行了多巴酚丁胺超声心动图检查。34例患者心力衰竭的临床体征为中度(纽约心脏协会心功能分级I-II级),22例为重度(纽约心脏协会心功能分级III-IV级)。中度和重度临床心力衰竭患者的左心室心肌损害程度相似,但症状严重者右心室(RV)功能障碍更明显(整体和局部RV收缩力抑制更明显、不可逆功能障碍的RV心肌百分比更高、多巴酚丁胺输注时RV收缩反应更低、RV舒张期充盈障碍更明显)。与中度症状和中度RV心肌功能障碍的患者相比,重度临床心力衰竭和明显RV心肌功能障碍的患者中,RV泵功能对肺动脉压力的依赖性更明显。

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