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冠状动脉搭桥术前后患者左心室舒张功能的特点

[Characteristics of Left Ventricular Diastolic Function in Patients before and after Coronary Artery Bypass Grafting].

作者信息

Khlopina I A, Shatsova E N, Lupachev V V, Plakuev A N, Chernozemova A V, Kubasov R V

出版信息

Vestn Ross Akad Med Nauk. 2015(2):196-202. doi: 10.15690/vramn.v70i2.1313.

Abstract

UNLABELLED

Diastolic heart dysfunction occurs essentially in patients who suffer from chronic heart failure. In this context an investigation and application of different methods for diastolic function improvement remain a priority in the therapy of cardiovascular diseases.

OBJECTIVE

Our ain was to estimate coronary artery bypass grafting effect on the left ventricularfunctionality in patients with coronaty heart disease.

METHODS

Patients (30 men without myocardial infarction and 44 - with myocardial infarction) were investigated by Doppler Echocardiography before and after coronary artery bypass grafting for left ventricular diastolic function assessment. In addition, during the year after operation examinations were carried out. Analysis of the data allowed detecting two types of disorders of transmitral flow: rigid and pseudononnal.

RESULTS

Our investigation showed that transinitral parameters improved in patients after operation. Patients without myocardial infarction in anamnesis had a myocardium cell relaxation improvement (IVRT decreasing; p =0,046), but an active myocardium relaxation turned for the better (increasing of E/A (p <0,001) by component A lowering (p =0, 003). Changes of pulmonary veins parameters were followed by the improvement of left heart ventricle relaxation: active - PVD decreasing, p =0,051; and passive - PVA decreasing, p =0,028. Patients with myocardial infarction in anamnesis had an IVRT decreasing (p =0,040) and A decreasing (p =0,041). In addition, in this group left atrial function improved (PVS decreasing; p =0,037).

CONCLUSION

Coronary artery bypass grafting is effective in left ventricular diastolic function improvement and Doppler Echocardiography method can become an important criterion to estimate the treatment adequacy.

摘要

未标注

舒张性心功能不全主要发生在慢性心力衰竭患者中。在此背景下,研究和应用不同方法改善舒张功能仍是心血管疾病治疗的重点。

目的

我们的目的是评估冠状动脉旁路移植术对冠心病患者左心室功能的影响。

方法

对患者(30例无心肌梗死男性和44例有心肌梗死男性)在冠状动脉旁路移植术前和术后进行多普勒超声心动图检查,以评估左心室舒张功能。此外,在术后一年进行检查。对数据的分析发现了两种二尖瓣血流紊乱类型:僵硬型和假性正常型。

结果

我们的研究表明,术后患者的二尖瓣参数有所改善。既往无心肌梗死的患者心肌细胞松弛得到改善(等容舒张时间缩短;p = 0.046),但主动心肌松弛好转(E/A增加(p < 0.001),A成分降低(p = 0.003))。肺静脉参数的变化伴随着左心室松弛的改善:主动 - 肺静脉舒张期血流速度降低,p = 0.051;被动 - 肺静脉心房收缩期血流速度降低,p = 0.028。既往有心肌梗死的患者等容舒张时间缩短(p = 0.040),A降低(p = 0.041)。此外,该组左心房功能改善(肺静脉收缩期血流速度降低;p = 0.037)。

结论

冠状动脉旁路移植术在改善左心室舒张功能方面有效,多普勒超声心动图方法可成为评估治疗充分性的重要标准。

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