Leung W H, Wong K L, Lau C P, Wong C K, Cheng C H, Tai Y T
Department of Medicine, University of Hong Kong, Queen Mary Hospital.
Cardiology. 1990;77(2):93-100. doi: 10.1159/000174589.
Left ventricular diastolic function was assessed in 17 patients (2 males and 15 females; mean age 44 +/- 9 years) with mixed connective tissue disease (MCTD) and 18 sex- and age-matched healthy control subjects (2 males and 16 females; mean age 44 +/- 8 years) by means of M-mode and pulsed Doppler echocardiography. None had clinical evidence of overt myocardial disease or abnormal left ventricular systolic function. Compared with the control group, patients with MCTD had a significantly longer isovolumic relaxation time (IVRT) (59 +/- 7 versus 70 +/- 12 ms; p less than 0.01), a lower peak early diastolic flow velocity (E) (0.79 +/- 0.10 versus 0.70 +/- 0.07 m/s; p less than 0.005), a higher peak late diastolic flow velocity due to atrial contraction (A) (0.47 +/- 0.08 versus 0.54 +/- 0.08 m/s; p less than 0.05) and a reduced E/A ratio (1.72 +/- 0.37 versus 1.33 +/- 0.26; p less than 0.005). Although there was no significant correlation of left ventricular diastolic filling indexes with age, heart rate, left ventricular end-diastolic and end-systolic dimensions, interventricular septal and left ventricular posterior wall thickness, and fractional shortening, the duration of illness was significantly related to IVRT (r = 0.62; p less than 0.01), peak A (r = 0.79; p less than 0.001) and velocity half-time (r = 0.54; p less than 0.05). The results suggest the presence of an abnormal left ventricular diastolic filling pattern in patients with MCTD and may represent myocardial involvement in this disease.
通过M型和脉冲多普勒超声心动图对17例混合性结缔组织病（MCTD）患者（2例男性和15例女性；平均年龄44±9岁）和18例年龄及性别匹配的健康对照者（2例男性和16例女性；平均年龄44±8岁）的左心室舒张功能进行了评估。所有人均无明显心肌疾病或左心室收缩功能异常的临床证据。与对照组相比，MCTD患者的等容舒张时间（IVRT）明显延长（59±7对70±12毫秒；p<0.01），舒张早期峰值流速（E）较低（0.79±0.10对0.70±0.07米/秒；p<0.005），心房收缩导致的舒张晚期峰值流速（A）较高（0.47±0.08对0.54±0.08米/秒；p<0.05），E/A比值降低（1.72±0.37对1.33±0.26；p<0.005）。虽然左心室舒张期充盈指标与年龄、心率、左心室舒张末期和收缩末期内径、室间隔和左心室后壁厚度以及缩短分数之间无显著相关性，但病程与IVRT（r = 0.62；p<0.01）、峰值A（r = 0.79；p<0.001）和流速减半时间（r = 0.54；p<0.05）显著相关。结果提示MCTD患者存在左心室舒张期充盈模式异常，可能代表该病存在心肌受累。
