中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2011年
8期
725-729
,共5页
高晓津%康连鸣%张健%江勇%赵世华%陆敏杰%程怀兵%罗晓亮%蒋文%吕蓉%祝捷%杨跃进
高曉津%康連鳴%張健%江勇%趙世華%陸敏傑%程懷兵%囉曉亮%蔣文%呂蓉%祝捷%楊躍進
고효진%강련명%장건%강용%조세화%륙민걸%정부병%라효량%장문%려용%축첩%양약진
心肌疾病%冠状动脉疾病%利钠肽,脑%预后
心肌疾病%冠狀動脈疾病%利鈉肽,腦%預後
심기질병%관상동맥질병%리납태,뇌%예후
Left ventricular noncompaction%Coronary disease%Natriuretic peptide,brain%Prognosis
目的 总结左室心肌致密化不全(LVNC)患者的冠状动脉病变特点,并对LVNC预后的影响因素进行分析.方法 连续入选自2006年1月至2010年8月经超声心动图和(或)心脏磁共振成像确诊为LVNC并进行了冠状动脉造影或多排螺旋CT(MDCT)检查的患者共51例,总结其冠状动脉病变特点,并分析冠状动脉病变对LVNC预后的影响.结果 20例(39.22%)患者合并冠心病,其中单支病变9例,双支病变3例,三支病变5例,合并左主干病变3例;4例行冠状动脉旁路移植术(CABG)和(或)经皮冠状动脉介入治疗(PCI).合并冠心病组(20例)与非冠心病组(31例)比较,前者平均年龄及合并糖尿病、高血压病、高脂血症的比例均高于后者(P＜0.05);前者氨基末端B型利钠肽前体(NT-proBNP)水平低于后者(中位数:1078.3 pmol/L比1211.0 pmol/L);两组之间的心原性死亡和(或)心脏移植事件及心原性再住院的发生率差异无统计学意义;logNT-proBNP是LVNC预后的独立危险因素(HR=3.993,95%CI:1.140～13.988,P=0.030).结论 应当对LVNC患者常规进行冠状动脉检查;NT-proBNP是LVNC预后的独立危险因素;合并冠心病对LVNC预后没有显著影响.
目的 總結左室心肌緻密化不全(LVNC)患者的冠狀動脈病變特點,併對LVNC預後的影響因素進行分析.方法 連續入選自2006年1月至2010年8月經超聲心動圖和(或)心髒磁共振成像確診為LVNC併進行瞭冠狀動脈造影或多排螺鏇CT(MDCT)檢查的患者共51例,總結其冠狀動脈病變特點,併分析冠狀動脈病變對LVNC預後的影響.結果 20例(39.22%)患者閤併冠心病,其中單支病變9例,雙支病變3例,三支病變5例,閤併左主榦病變3例;4例行冠狀動脈徬路移植術(CABG)和(或)經皮冠狀動脈介入治療(PCI).閤併冠心病組(20例)與非冠心病組(31例)比較,前者平均年齡及閤併糖尿病、高血壓病、高脂血癥的比例均高于後者(P＜0.05);前者氨基末耑B型利鈉肽前體(NT-proBNP)水平低于後者(中位數:1078.3 pmol/L比1211.0 pmol/L);兩組之間的心原性死亡和(或)心髒移植事件及心原性再住院的髮生率差異無統計學意義;logNT-proBNP是LVNC預後的獨立危險因素(HR=3.993,95%CI:1.140～13.988,P=0.030).結論 應噹對LVNC患者常規進行冠狀動脈檢查;NT-proBNP是LVNC預後的獨立危險因素;閤併冠心病對LVNC預後沒有顯著影響.
목적 총결좌실심기치밀화불전(LVNC)환자적관상동맥병변특점,병대LVNC예후적영향인소진행분석.방법 련속입선자2006년1월지2010년8월경초성심동도화(혹)심장자공진성상학진위LVNC병진행료관상동맥조영혹다배라선CT(MDCT)검사적환자공51례,총결기관상동맥병변특점,병분석관상동맥병변대LVNC예후적영향.결과 20례(39.22%)환자합병관심병,기중단지병변9례,쌍지병변3례,삼지병변5례,합병좌주간병변3례;4례행관상동맥방로이식술(CABG)화(혹)경피관상동맥개입치료(PCI).합병관심병조(20례)여비관심병조(31례)비교,전자평균년령급합병당뇨병、고혈압병、고지혈증적비례균고우후자(P＜0.05);전자안기말단B형리납태전체(NT-proBNP)수평저우후자(중위수:1078.3 pmol/L비1211.0 pmol/L);량조지간적심원성사망화(혹)심장이식사건급심원성재주원적발생솔차이무통계학의의;logNT-proBNP시LVNC예후적독립위험인소(HR=3.993,95%CI:1.140～13.988,P=0.030).결론 응당대LVNC환자상규진행관상동맥검사;NT-proBNP시LVNC예후적독립위험인소;합병관심병대LVNC예후몰유현저영향.
Objective To analyze the incidence of coronary artery disease (CAD) and outcome of patients with left ventricular noncompaction (LVNC). Methods Fifty-one patients with LVNC evaluated by echocardiography and/or cardiac magnetic resonance (CMR) from January 2006 to August 2010 were retrospectively reviewed. Coronary angiography or MDCT was performed for detecting coronary artery disease. Predictors of the cardiac events were analyzed by Cox regression analysis. Results There were 31 LVNC patients without CAD and 20 LVNC patients with CAD including single vessel coronary disease in 9 cases, double vessel coronary disease in 3 cases, three vessel coronary disease in 5 cases and left main coronary disease in 3 cases. Coronary artery bypass graft and percutaneous coronary intervention (PCI) were performed in 4 patients. Compared to LVNC patients without CAD, mean age ( P = 0. 008 ), incidence of hypertension (65.0% vs. 19. 4% , P = 0. 001 ), diabetes mellitus (40. 0% vs. 12. 9% , P = 0. 026) and hyperlipidemia ( 55.0% vs. 25. 8%, P = 0. 035 ) were significantly higher while NT-proBNP level was significantly lower( P = 0. 049 ) in LVNC patients with CAD. Incidence of major cardiac events was similar in LVNC patients with or without CAD. LogNT-proBNP is the independent prognostic factor for adverse cardiac events in patients with LVNC( HR 3.993,95% CI 1. 140-13. 988 ,P =0. 030). Conclusions Coronary artery disease is common in patients with LVNC and associated with traditional risk factors for CAD. Poor prognosis is associated with increased NT-proBNP but not with CAD in this patient cohort.
