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[主动脉冠状动脉旁路移植术后心肌收缩及左心室舒张硬度变化的研究]

[Study of changes in myocardial contraction and left ventricular diastolic regidity after aortocoronary bypass].

作者信息

Jaillon P, Le Pailleur C, Heulin A, Di Mattéo J

出版信息

Arch Mal Coeur Vaiss. 1975 Jun;68(6):581-9.

PMID:810101
Abstract

Eighteen patients with coronary insufficiency underwent a left ventricular cineangiography before and an average of four months after aorta-to-coronary bi-pass in order to assess the post-operative changes of myocardial contractility and diastolic rigidity. The contractility indices (VCF: mean speed, and VCF max: maximum shortening speed of the equatorial diameter of the left ventricle (% delta theta) were unmodified in the group (I) of fourteen patients with at least one pervious by-pass. On the contrary, a decreased % delta theta was observed in the group (II) of four patients in whom all the by-passes were occluded. The left ventricular end-diastolic pressure (LVEDP), the end-diastolic volume (LVEDV) and the "normalized" rigidity index (K) were unmodified in both groups after operation. The cardiac rate increased in the post-operative period in the group I (p less than 0.01) and the whole of the 18 patients (p less than 0.001); there was a positive correlation (p less than 0.02) between this variation and that of VCF, VCF max. and % delta theta, the significance of which is discussed. Besides there was a negative correlation between the variations of LVEDV and the VCF, and between the equatorial end diastolic diameter of the left ventricle and VCF, VCF max. and % delta theta, both in the pre-operative and the post-operative periods.

摘要

18例冠状动脉功能不全患者在主动脉-冠状动脉搭桥术前及术后平均4个月时接受了左心室心血管造影,以评估术后心肌收缩力和舒张硬度的变化。在14例至少有一条通畅搭桥血管的患者组(I)中,收缩力指标(VCF:平均速度,以及VCF max:左心室赤道直径的最大缩短速度(%δθ))未发生改变。相反,在4例所有搭桥血管均闭塞的患者组(II)中,观察到%δθ降低。两组术后左心室舒张末期压力(LVEDP)、舒张末期容积(LVEDV)和“标准化”硬度指数(K)均未改变。术后I组(p<0.01)及全部18例患者(p<0.001)心率增加;这种变化与VCF、VCF max和%δθ的变化之间存在正相关(p<0.02),其意义将进行讨论。此外,术前和术后LVEDV的变化与VCF之间,以及左心室赤道舒张末期直径与VCF、VCF max和%δθ之间均存在负相关。

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