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冠心病患者左心室功能的决定因素:多变量研究方法

Determinants of the left ventricular function in patients with coronary heart disease: a multivariate approach.

作者信息

Dragoichev C, Savova A, Stoichev S, Finkov B

出版信息

Cor Vasa. 1984;26(5):353-60.

PMID:6509991
Abstract

251 patients with coronary heart disease (CHD) and a control group of 32 normal persons were examined with the purpose of establishing the determinants of the left ventricular function and comparing these determinants with the functional significance of coronary stenosis. The subjects were divided into four groups: I--controls; II--patients with normal left ventricular function (EF more than 60%); III--patients with impaired LV function (EF less than 60%) and Group IV--patients with left ventricular aneurysm. Nine parameters were obtained by multivariate discriminant analysis, which characterize and classify the left ventricular function: the ejection fraction (EF), angina pectoris, exercise ECG, left ventricular end-diastolic pressure, mean velocity of circumferential fibre shortening, left ventricular functional index, longitudinal shortening, LV systolic pressure/systolic volume ratio, and coronary index. On the basis of these parameters, all the normal persons, 88% of Group II, 92% of Group III and 72% of Group IV were classified correctly. The study proves that there is a good correlation between the EF and the haemodynamic and angiocardiographic parameters. The complex left ventricular function index facilitates the prognosis of surgical results. Abnormalities in left ventricular function cannot be reliably assessed by the coronary index values alone.

摘要

对251例冠心病患者及32名正常人组成的对照组进行了检查,目的是确定左心室功能的决定因素,并将这些决定因素与冠状动脉狭窄的功能意义进行比较。受试者被分为四组:I组——对照组;II组——左心室功能正常(射血分数超过60%)的患者;III组——左心室功能受损(射血分数低于60%)的患者;IV组——左心室室壁瘤患者。通过多变量判别分析获得了九个参数,这些参数可对左心室功能进行表征和分类:射血分数(EF)、心绞痛、运动心电图、左心室舒张末期压力、圆周纤维缩短平均速度、左心室功能指数、纵向缩短、左心室收缩压/收缩容积比以及冠状动脉指数。基于这些参数,所有正常人、II组的88%、III组的92%和IV组的72%被正确分类。该研究证明,EF与血流动力学和心血管造影参数之间存在良好的相关性。综合左心室功能指数有助于评估手术结果的预后。仅通过冠状动脉指数值无法可靠地评估左心室功能异常。

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