de Bruyne B, Lerch R, Meier B, Schlaepfer H, Gabathuler J, Rutishauser W
Cardiology Center, University Hospital, Geneva, Switzerland.
Am Heart J. 1989 Mar;117(3):629-35. doi: 10.1016/0002-8703(89)90738-2.
To assess left ventricular diastolic filling in patients with single-vessel coronary artery disease, Doppler-derived transmitral velocity was studied in 22 normal subjects and in 15 patients with isolated proximal stenosis of the left anterior descending coronary artery (LAD) and normal systolic function of the left ventricle. Transmitral velocity was recorded before and after balloon inflation during coronary angioplasty. At baseline the transmitral velocity pattern in patients with LAD stenosis differed from that of normal subjects with a significant (p at least less than 0.05) decrease in the early diastolic filling phase (E area 0.094 +/- 0.022 m in normal subjects vs 0.078 +/- 0.008 m in patients) and an increase in the late diastolic filling phase (A area 0.034 +/- 0.007 m vs 0.042 +/- 0.008 m). Correspondingly the ratio E area/A area decreased (2.7 +/- 0.51 vs 1.9 +/- 0.4) and the ratio A area/total area increased (0.28 +/- 0.04 vs 0.35 +/- 0.05). During coronary occlusion the E area and the ratio E area/A area decreased further, whereas the A area and the ratio A area/total area increased. The results suggest that patients with single-vessel disease and normal systolic function often exhibit an altered pattern of transmitral velocity even in the absence of overt ischemia, and that during acute regional ischemia early diastolic filling is further compromised with compensatory enhancement of the late diastolic filling phase.
为评估单支冠状动脉疾病患者的左心室舒张期充盈情况，对22名正常受试者以及15名左前降支冠状动脉（LAD）近端孤立性狭窄且左心室收缩功能正常的患者进行了多普勒衍生的二尖瓣流速研究。在冠状动脉血管成形术期间，记录了球囊扩张前后的二尖瓣流速。基线时，LAD狭窄患者的二尖瓣流速模式与正常受试者不同，舒张早期充盈期显著降低（p至少小于0.05）（正常受试者E面积为0.094±0.022 m，患者为0.078±0.008 m），舒张晚期充盈期增加（A面积为0.034±0.007 m vs 0.042±0.008 m）。相应地，E面积/A面积比值降低（2.7±0.51 vs 1.9±0.4），A面积/总面积比值增加（0.28±0.04 vs 0.35±0.05）。冠状动脉闭塞期间，E面积和E面积/A面积比值进一步降低，而A面积和A面积/总面积比值增加。结果表明，单支血管疾病且收缩功能正常的患者即使在没有明显缺血的情况下也常常表现出二尖瓣流速模式改变，并且在急性局部缺血期间，舒张早期充盈进一步受损，舒张晚期充盈期出现代偿性增强。
