Myreng Y, Ihlen H, Nitter-Hauge S
Medical Department B, National Hospital, University of Oslo, Norway.
Eur Heart J. 1988 Nov;9(11):1167-74. doi: 10.1093/oxfordjournals.eurheartj.a062425.
Left ventricular (LV) filling as assessed by Doppler transmitral flow velocity measurements was studied in 20 male patients with coronary artery disease (CAD) and in 18 normal individuals. Stroke volume, blood pressure and heart rate in the two groups were not significantly different. Compared to normals, the ratio between early and atrial-induced peak velocities was significantly lower in the patients (1.2 +/- 0.3 vs. 1.40 +/- 0.3, P = 0.01), as was the fraction of transmitral filling during the first 1/3 of diastole (45 +/- 7% vs. 50 +/- 4%, P less than 0.001). Isovolumic relaxation time (IV R) was 96 +/- 13 ms in patients vs. 74 +/- 12 ms in normals (P less than 0.001). The CAD patients were treated with atenolol for 13-24 days. The velocity ratio increased by 30% (P less than 0.001) due to a 12% increase in early (P = 0.004) and an 11% decrease in atrial-induced peak velocities (P = 0.01). Filling fraction and deceleration rate of early inflow both increased by 22% (P less than 0.001). IV R decreased by 8% (P = 0.01). After atenolol treatment, heart rate and blood pressure decreased by 23% and 10% (P less than 0.001), respectively, whereas stroke volume increased by 14% (P less than 0.001). Thus, CAD was associated with Doppler indices of retarded LV filling and myocardial relaxation. After atenolol treatment, significant increases in velocity ratio and filling fraction indicated a shift of filling from late towards early diastole, suggesting improved diastolic function. However, different factors related to beta-adrenergic blockade may have contributed to the observed changes.
通过多普勒二尖瓣血流速度测量评估左心室（LV）充盈情况，对20例冠心病（CAD）男性患者和18名正常个体进行了研究。两组的每搏输出量、血压和心率无显著差异。与正常人相比，患者早期与心房诱导的峰值速度之比显著降低（1.2±0.3对1.40±0.3，P = 0.01），舒张期前1/3期间二尖瓣充盈分数也降低（45±7%对50±4%，P<0.001）。等容舒张时间（IVR）患者为96±13毫秒，正常人为74±12毫秒（P<0.001）。CAD患者接受阿替洛尔治疗13 - 24天。由于早期峰值速度增加12%（P = 0.004）和心房诱导的峰值速度降低11%（P = 0.01），速度比增加了30%（P<0.001）。早期流入的充盈分数和减速速率均增加22%（P<0.001）。IVR降低8%（P = 0.01）。阿替洛尔治疗后，心率和血压分别降低23%和10%（P<0.001），而每搏输出量增加14%（P<0.001）。因此，CAD与左心室充盈延迟和心肌松弛的多普勒指标相关。阿替洛尔治疗后，速度比和充盈分数显著增加，表明充盈从舒张晚期向早期转移，提示舒张功能改善。然而，与β - 肾上腺素能阻滞剂相关的不同因素可能导致了观察到的变化。
