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[主动脉瓣关闭不全时左心室影响的中期病程。90例患者的超声心动图研究]

[Median-term course of left ventricular effects in aortic insufficiency. Echocardiographic study of 90 patients].

作者信息

Castillo-Fenoy A, Morice M C, Royer T, Hennetier G

出版信息

Arch Mal Coeur Vaiss. 1985 Nov;78(12):1789-94.

PMID:2935108
Abstract

It is important to know the natural evolution of the changes in left ventricular dimensions and contractility in AR if one wishes to determine the critical echocardiographic values at which LV function starts to deteriorate. This was the aim of our echocardiographic study of 90 patients with chronic pure AR in whom we analysed the changes in LV dimensions, mass and contractility for 11 to 84 months (average 34.6 months). The patients were divided into 2 groups according to the degree of ventricular dilatation (delta DD): Group A: delta DD less than 30% (58 patients), Group B: delta DD greater than 30% (32 patients). The annual mean increase in diastolic and systolic LV dimensions and myocardial mass in each group was: 1.5 mm vs 3.2 mm (p less than 0.02); 0.9 mm vs 4.1 mm (p less than 0.003), 14 g vs 24 g (p = 0.07 NS) respectively. The parameters of the systolic function were normal in Group A (EF = 68 +/- 8% and % FS = 38 +/- 6%) and decreased in Group B (EF = 58 +/- 13%, % FS = 32 +/- 9%). A significant annual decrease of the mean values of these parameters was only observed in patients of Group B (EF = 1.8% per year; % FS = -1.2% per year). These results are on average of unequal individual variations: variations of DD or EF greater than the variability due to the reproducibility of the method were only observed in 43 patients. The number of patients in whom echocardiographic changes were observed was comparable in Groups A and B.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

如果想要确定左心室功能开始恶化时的关键超声心动图值,了解主动脉反流(AR)时左心室大小和收缩性变化的自然演变过程很重要。这就是我们对90例慢性单纯性AR患者进行超声心动图研究的目的,在这些患者中,我们分析了11至84个月(平均34.6个月)内左心室大小、质量和收缩性的变化。根据心室扩张程度(ΔDD)将患者分为两组:A组:ΔDD小于30%(58例患者),B组:ΔDD大于30%(32例患者)。每组左心室舒张末期和收缩末期内径以及心肌质量的年平均增加量分别为:1.5毫米对3.2毫米(p<0.02);0.9毫米对4.1毫米(p<0.003),14克对24克(p = 0.07,无统计学意义)。A组收缩功能参数正常(射血分数[EF]=68±8%,缩短分数[%FS]=38±6%),B组则下降(EF=58±13%,%FS=32±9%)。仅在B组患者中观察到这些参数的平均值有显著的年度下降(EF每年下降1.8%;%FS每年下降1.2%)。这些结果平均来看个体差异不等:仅在43例患者中观察到舒张末期内径(DD)或EF的变化大于因方法可重复性导致的变异性。A组和B组中观察到超声心动图变化的患者数量相当。(摘要截短于250字)

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