Kranidis A, Kostopoulos K, Filippatos G, Antonelis J, Kappos K, Kardaras F, Margaris N, Sideris A, Amartolos P, Kritharidou G
First Department of Cardiology, Evangelismos Hospital, Athens, Greece.
Jpn Heart J. 1995 Sep;36(5):545-56. doi: 10.1536/ihj.36.545.
The aim of the present study was to investigate the properties of diastolic left atrioventricular plane displacement (AVPD) in coronary artery disease (CAD) patients. In 125 patients (mean age 58.7 +/- 13.7) with CAD and in 51 age-matched healthy subjects, a complete transthoracic echocardiographic study was performed. The AVPD was recorded by M-mode echocardiography, from apical four and two chamber views at four sites corresponding to the septal, lateral, anterior and inferior walls of the left ventricle. Mean AVPD in early diastole (E-AVPD), mean AVPD from atrial systole (A-AVPD) and the ratio A-AVPD/E-AVPD were determined. In normal subjects, such as in 35 patients without left ventricular segmental wall motion abnormalities (SWMA), stepwise multiple regression analysis showed none of these factors to be significantly related to E-AVPD or A-AVPD. Aging was correlated negatively to the E-AVPD/A-AVPD ratio (p < 0.05). In 90 patients with left ventricular SWMA, stepwise multiple regression analysis showed that indices of left ventricular systolic function correlated positively to E-AVPD (p < 0.001) and A-AVPD (p < 0.001). The E-AVPD/A-AVPD ratio was correlated to left ventricular ejection fraction and heart rate (p < 0.005). Mean E-AVPD was significantly lower in CAD patients than in normal subjects (p 0.001), while A-AVPD was higher in patients without left ventricular SWMA in comparison to normal subjects (p = 0.02). Also, mean A-AVPD/E-AVPD was higher in CAD patients than in the control group (p < 0.001). Mean E-AVPD/A-AVPD was correlated to the E/A ratio of transmitral flow in CAD patients with (r = 0.669) and without (r = 0.771) SWMA. The E-AVPD and A-AVPD in CAD patients with SWMA is reduced according to the deterioration of left ventricular systolic function. The atrial contribution to the longitudinal distension of the left ventricle is increased in CAD patients. In CAD patients, especially those without left ventricular SWMA, the E-AVPD/A-AVPD ratio has a good correlation to left ventricular filling behavior.
本研究的目的是调查冠心病（CAD）患者舒张期左房室平面位移（AVPD）的特性。对125例CAD患者（平均年龄58.7±13.7岁）和51例年龄匹配的健康受试者进行了完整的经胸超声心动图检查。通过M型超声心动图从心尖四腔和两腔视图记录对应于左心室间隔、侧壁、前壁和下壁的四个部位的AVPD。测定舒张早期平均AVPD（E-AVPD）、心房收缩期平均AVPD（A-AVPD）以及A-AVPD/E-AVPD比值。在正常受试者中，如35例无左心室节段性室壁运动异常（SWMA）的患者，逐步多元回归分析显示这些因素均与E-AVPD或A-AVPD无显著相关性。年龄与E-AVPD/A-AVPD比值呈负相关（p<0.05）。在90例有左心室SWMA的患者中，逐步多元回归分析显示左心室收缩功能指标与E-AVPD呈正相关（p<0.001），与A-AVPD呈正相关（p<0.001）。E-AVPD/A-AVPD比值与左心室射血分数和心率相关（p<0.005）。CAD患者的平均E-AVPD显著低于正常受试者（p<0.001），而无左心室SWMA的患者的A-AVPD高于正常受试者（p = 0.02）。此外，CAD患者的平均A-AVPD/E-AVPD高于对照组（p<0.001）。CAD患者有（r = 0.669）和无（r = 0.771）SWMA时，平均E-AVPD/A-AVPD与二尖瓣血流E/A比值相关。有SWMA的CAD患者的E-AVPD和A-AVPD随左心室收缩功能恶化而降低。CAD患者中心房对左心室纵向扩张的贡献增加。在CAD患者中，尤其是无左心室SWMA的患者，E-AVPD/A-AVPD比值与左心室充盈行为有良好的相关性。
