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冠状动脉成形术前及术后即刻应用脉冲多普勒评估冠心病患者左心室舒张期充盈情况。

Pulsed Doppler assessment of left ventricular diastolic filling in coronary artery disease before and immediately after coronary angioplasty.

作者信息

Wind B E, Snider A R, Buda A J, O'Neill W W, Topol E J, Dilworth L R

出版信息

Am J Cardiol. 1987 May 1;59(12):1041-6. doi: 10.1016/0002-9149(87)90845-9.

DOI:10.1016/0002-9149(87)90845-9
PMID:2953227
Abstract

To determine if left ventricular (LV) diastolic filling abnormalities are detectable by Doppler echocardiography in patients with coronary artery disease (CAD), 34 patients with CAD and 24 normal, age-matched control subjects underwent mitral valve pulsed Doppler examination. At catheterization, all CAD patients had typical angina, at least 70% diameter narrowing of 1 major coronary artery, ejection fraction of 50% or more and no valvular heart disease. Seventeen CAD patients underwent coronary angioplasty and had a Doppler examination 1 day before and 1 day after the procedure. Doppler diastolic time intervals, peak velocities at rapid filling (E velocity), atrial contraction (A velocity) and the ratio peak E/peak A velocities were measured. The following areas under the Doppler velocity envelope and their percentage of the total area were calculated: first third of diastole (0.33 area), triangular area under the peak E velocity (E area), and triangular area under the peak A velocity (A area). Patients with CAD and normal subjects were significantly different (p less than 0.01) in peak E velocity (CAD 0.60 +/- 0.12 m/s, normal 0.68 +/- 0.12 m/s), peak A velocity (CAD 0.59 +/- 0.12 m/s, normal 0.48 +/- 0.11 m/s), ratio peak E/peak A velocities (CAD 1.0 +/- 0.27, normal 1.5 +/- 0.32), A area (CAD 0.052 +/- 0.015 m, normal 0.036 +/- 0.010 m), ratio E area/A area (CAD 1.7 +/- 0.53, normal 2.5 +/- 0.69), and all area fractions. In the CAD patients who had undergone coronary angioplasty, no differences were found in any Doppler index before and immediately after the procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

为了确定冠状动脉疾病(CAD)患者是否可通过多普勒超声心动图检测到左心室(LV)舒张期充盈异常,对34例CAD患者和24例年龄匹配的正常对照者进行了二尖瓣脉冲多普勒检查。在导管插入术时,所有CAD患者均有典型心绞痛,至少1支主要冠状动脉直径狭窄70%以上,射血分数为50%或更高,且无瓣膜性心脏病。17例CAD患者接受了冠状动脉成形术,并在手术前1天和手术后1天进行了多普勒检查。测量了多普勒舒张期时间间隔、快速充盈时的峰值速度(E速度)、心房收缩时的峰值速度(A速度)以及峰值E/峰值A速度比值。计算了多普勒速度包络线下的以下面积及其占总面积的百分比:舒张期前三分之一(0.33面积)、峰值E速度下的三角形面积(E面积)以及峰值A速度下的三角形面积(A面积)。CAD患者和正常对照者在峰值E速度(CAD为0.60±0.12m/s,正常为0.68±0.12m/s)、峰值A速度(CAD为0.59±0.12m/s,正常为0.48±0.11m/s)、峰值E/峰值A速度比值(CAD为1.0±0.27,正常为1.5±0.32)、A面积(CAD为0.052±0.015m,正常为0.036±0.010m)、E面积/A面积比值(CAD为1.7±0.53,正常为2.5±0.69)以及所有面积分数方面存在显著差异(p小于0.01)。在接受冠状动脉成形术的CAD患者中,手术前后任何多普勒指标均未发现差异。(摘要截断于250字)

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