Zhang Jing-Fang, Du Yin-Hui, Hu Hai-Yan, Han Xiu-Qing
Ultrasonic Department, The Second Affiliated Hospital of Xi'an Medical College, Xi'an 710038, Shaanxi Province, China.
Ultrasonic Department, Xi'an Fifth Hospital Shanxi Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Xi'an 710082, Shaanxi Province, China.
World J Clin Cases. 2021 Oct 6;9(28):8366-8373. doi: 10.12998/wjcc.v9.i28.8366.
Coronary heart disease (CHD) causes many adverse cardiovascular events and poses a threat to the patient's health and quality of life.
To evaluate ultrasonography for evaluation of cardiac function and lesion degree in patients with CHD.
A total of 106 patients with CHD (study group) and 106 healthy individuals (control group) in our hospital from March 2019 to September 2020 were selected for this study. All subjects were examined by ultrasound, and the mitral orifice's early-to-late diastolic blood flow velocity ratio (E/A), left ventricular end-diastolic volume (LVDd), and left atrial diameter (LAD) were measured. Values were compared between the study group and healthy group, and the correlation between the ultrasonic parameters of patients with different cardiac function grades and the degree of CHD were assessed. In addition, the ultrasonic parameters of patients with different prognoses were compared after a follow-up for 6 mo.
E/A (1.46 ± 0.34) of the study group was smaller than that of the control group (1.88 ± 0.44), while LVDd (58.24 ± 5.05 mm) and LAD (43.31 ± 4.38 mm) were larger (48.15 ± 3.93 and 34.94 ± 2.81, respectively; < 0.05). E/A for patients with grade III disease (1.41 ± 0.43) was smaller and their LVDd (60.04 ± 4.21 mm) and LA (44.16 ± 2.79 mm) were larger than those in patients with grade II disease (1.71 ± 0.48, 52.18 ± 3.67 mm, and 39.68 ± 2.37, respectively; < 0.05). Patients with grade IV disease had smaller E/A (1.08 ± 0.39) and larger LVDd (66.81 ± 5.39 mm) and LAD (48.81 ± 3.95 mm) than patients with grade II and III disease ( < 0.05). In patients with moderate disease, E/A (1.44 ± 0.41) was smaller and LVDd (59.95 ± 4.14 mm) and LAD (45.15 ± 2.97 mm) were larger than in patients with mild disease (1.69 ± 0.50, 51.97 ± 3.88 and 38.81 ± 2.56 mm, respectively; < 0.05). In patients with severe disease, E/A (1.13 ± 0.36) was smaller and LVDd (67.70 ± 6.11 mm) and LAD (49.09 ± 4.05 mm) were larger than in patients with moderate disease ( < 0.05). E/A was negatively correlated with cardiac function classification and disease severity, while LVDd and LAD were positively correlated with cardiac function classification and disease severity ( < 0.05). E/A (1.83 ± 0.51) for patients with good prognosis was higher than that for those with poor prognosis (1.39 ± 0.32), while LVDd (49.60 ± 4.39 mm) and LAD (36.13 ± 3.05 mm) were lower ( < 0.05).
The ultrasonic parameters of patients with CHD are abnormal, and differ significantly in patients with different cardiac function grades, lesion degree, and prognosis.
冠心病（CHD）引发诸多不良心血管事件，对患者健康和生活质量构成威胁。
评估超声检查在冠心病患者心功能及病变程度评估中的应用。
选取2019年3月至2020年9月我院收治的106例冠心病患者（研究组）和106例健康个体（对照组）进行本研究。所有受试者均接受超声检查，测量二尖瓣口舒张早期与晚期血流速度比值（E/A）、左心室舒张末期容积（LVDd）和左心房内径（LAD）。比较研究组与健康组各项指标，并评估不同心功能分级患者超声参数与冠心病程度的相关性。此外，随访6个月后比较不同预后患者的超声参数。
研究组E/A（1.46±0.34）低于对照组（1.88±0.44），而LVDd（58.24±5.05mm）和LAD（43.31±4.38mm）高于对照组（分别为48.15±3.93和34.94±2.81；P<0.05）。Ⅲ级病变患者的E/A（1.41±0.43）低于Ⅱ级病变患者（1.71±0.48），LVDd（60.04±4.21mm）和LA（44.16±２.79mm）高于Ⅱ级病变患者（分别为52.18±3.67mm和39.68±2.37；P<0.05）。Ⅳ级病变患者的E/A（1.08±0.39）低于Ⅱ级和Ⅲ级病变患者，LVDd（66.81±5.39mm）和LAD（48.81±3.95mm）高于Ⅱ级和Ⅲ级病变患者（P<0.05）。中度病变患者的E/A（1.44±0.41）低于轻度病变患者（1.69±0.50），LVDd（59.95±4.14mm）和LAD（45.15±2.97mm）高于轻度病变患者（分别为51.97±3.88mm和38.81±2.56mm；P<0.05）。重度病变患者的E/A（1.13±0.36）低于中度病变患者，LVDd（67.70±6.11mm）和LAD（49.09±4.05mm）高于中度病变患者（P<0.05）。E/A与心功能分级及疾病严重程度呈负相关，而LVDd和LAD与心功能分级及疾病严重程度呈正相关（P<0.05）。预后良好患者的E/A（1.83±0.51）高于预后不良患者（1.39±0.32），LVDd（49.６0±4.39mm）和LAD（36.13±3.05mm）低于预后不良患者（P<0.05）。
冠心病患者的超声参数异常，在不同心功能分级、病变程度及预后的患者中存在显著差异。
