Jeserich M, Ruffmann K, Kübler W
Abteilung Innere Medizin III (Kardiologie, Angiologie), Pulmonologie, Medizinische Universitätsklinik Heidelberg.
Z Kardiol. 1990 Oct;79(10):677-82.
Impaired ventricular diastolic filling may be an early sign of myocardial ischemia. To study the influence of coronary angioplasty (PTCA) on diastolic filling, 40 patients with coronary heart disease (CHD) were studied by pulsed two-dimensional Doppler echocardiography (2DDE) before and after PTCA. In six patients PTCA was not successful and 2DDE indices of ventricular filling did not change significantly. In 34 patients with successful PTCA, peak early diastolic velocity (E) increased by 8.5% (p less than 0.03), the ratio (E/A) of peak early vs peak late diastolic velocity by 11.2% (p less than 0.005) and the diastolic filling time per minute (diast.-t/min) by 4.6% (p less than 0.01). In patients with impaired diastolic filling before PTCA (group I, n = 28) the changes in diastolic filling were even more pronounced. Patients with unimpaired diastolic filling properties before PTCA did not show significant alterations (group II, n = 6). Seventeen patients were examined 3 h and 24 h after PTCA. The changes in diastolic filling parameters apparent already 3 h after PTCA were even more pronounced after 24 h. According to these data, PTCA improves left ventricular diastolic filling. These changes are more pronounced 24 h compared to 3 h after PTCA.
心室舒张期充盈受损可能是心肌缺血的早期迹象。为研究冠状动脉血管成形术(PTCA)对舒张期充盈的影响,对40例冠心病(CHD)患者在PTCA前后进行了脉冲二维多普勒超声心动图(2DDE)检查。6例患者PTCA未成功,心室充盈的2DDE指标无明显变化。34例PTCA成功的患者,舒张早期峰值速度(E)增加了8.5%(p<0.03),舒张早期与舒张晚期峰值速度之比(E/A)增加了11.2%(p<0.005),每分钟舒张期充盈时间(diast.-t/min)增加了4.6%(p<0.01)。PTCA前舒张期充盈受损的患者(I组,n = 28)舒张期充盈的变化更为明显。PTCA前舒张期充盈特性未受损的患者无明显改变(II组,n = 6)。17例患者在PTCA后3小时和24小时接受检查。PTCA后3小时已明显的舒张期充盈参数变化在24小时后更为明显。根据这些数据,PTCA可改善左心室舒张期充盈。与PTCA后3小时相比,这些变化在24小时时更为明显。