中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2009年
4期
314-319
,共6页
夏淑东%吴必锋%金建美%陈君柱
夏淑東%吳必鋒%金建美%陳君柱
하숙동%오필봉%금건미%진군주
心肌病,扩张型%心脏室壁瘤%心律失常
心肌病,擴張型%心髒室壁瘤%心律失常
심기병,확장형%심장실벽류%심률실상
Cardiomyopathy,dilated%Heart aneurysm%Arrhythmia
目的 观察特发性扩张型心肌病(idiopathic dilated cardiomyopathy,IDCM)合并左心室室壁瘤(left ventricular aneurysm,LVA)形成的发生率及其血液动力学和心脏电生理的特点.方法 回顾我院2003年至今诊断为IDCM的患者的病历资料,经冠状动脉造影排除缺血性心肌病同时经左心室造影证实合并LVA形成者入选为研究组.随机入选12例性别、年龄及左心室内径大小匹配的IDCM患者作为对照组.两组的临床资料和检查结果进行对比分析.结果 998例IDCM患者中有6例患者证实同时合并LVA形成,发生率为0.60%.研究组的左心室收缩期最大压力显著高于对照组[(130±10)mm Hg(1 mm Hg=0.133 kPa)比(117±9)mm Hg,P<0.05].研究组左心室舒张末期容积显著高于对照组[(272±57)ml比(207±60)ml,P<0.05].研究组左心室射血分数略低于对照组[(27±9)%比(35±6)%,P=0.09].室性心律失常在研究组的发生率更高.结论 IDCM合并LVA在临床上较为少见.合并LVA的IDCM患者左心室舒张末期容积增大,左心室收缩期压力升高,而左心室收缩功能下降,更容易发生室性心律失常.
目的 觀察特髮性擴張型心肌病(idiopathic dilated cardiomyopathy,IDCM)閤併左心室室壁瘤(left ventricular aneurysm,LVA)形成的髮生率及其血液動力學和心髒電生理的特點.方法 迴顧我院2003年至今診斷為IDCM的患者的病歷資料,經冠狀動脈造影排除缺血性心肌病同時經左心室造影證實閤併LVA形成者入選為研究組.隨機入選12例性彆、年齡及左心室內徑大小匹配的IDCM患者作為對照組.兩組的臨床資料和檢查結果進行對比分析.結果 998例IDCM患者中有6例患者證實同時閤併LVA形成,髮生率為0.60%.研究組的左心室收縮期最大壓力顯著高于對照組[(130±10)mm Hg(1 mm Hg=0.133 kPa)比(117±9)mm Hg,P<0.05].研究組左心室舒張末期容積顯著高于對照組[(272±57)ml比(207±60)ml,P<0.05].研究組左心室射血分數略低于對照組[(27±9)%比(35±6)%,P=0.09].室性心律失常在研究組的髮生率更高.結論 IDCM閤併LVA在臨床上較為少見.閤併LVA的IDCM患者左心室舒張末期容積增大,左心室收縮期壓力升高,而左心室收縮功能下降,更容易髮生室性心律失常.
목적 관찰특발성확장형심기병(idiopathic dilated cardiomyopathy,IDCM)합병좌심실실벽류(left ventricular aneurysm,LVA)형성적발생솔급기혈액동역학화심장전생리적특점.방법 회고아원2003년지금진단위IDCM적환자적병력자료,경관상동맥조영배제결혈성심기병동시경좌심실조영증실합병LVA형성자입선위연구조.수궤입선12례성별、년령급좌심실내경대소필배적IDCM환자작위대조조.량조적림상자료화검사결과진행대비분석.결과 998례IDCM환자중유6례환자증실동시합병LVA형성,발생솔위0.60%.연구조적좌심실수축기최대압력현저고우대조조[(130±10)mm Hg(1 mm Hg=0.133 kPa)비(117±9)mm Hg,P<0.05].연구조좌심실서장말기용적현저고우대조조[(272±57)ml비(207±60)ml,P<0.05].연구조좌심실사혈분수략저우대조조[(27±9)%비(35±6)%,P=0.09].실성심률실상재연구조적발생솔경고.결론 IDCM합병LVA재림상상교위소견.합병LVA적IDCM환자좌심실서장말기용적증대,좌심실수축기압력승고,이좌심실수축공능하강,경용역발생실성심률실상.
Objective To examine the hemodynamic and electrephysiological influence of left ventricular aneurysm(LVA)formation in patients with idiopathic dilated cardiomyopathy(IDCM).Methods All hospital records were retrospectively reviewed from IDCM patients admitted to our hospital between 2003 and 2008.Patients with coronary angiography evidenced ischemic cardiomyopathy were excluded.IDCM patients with LVA(I+L)diagnosed by left ventriculography were enrolled.Twelve age-,gender-and left-ventricular-diameter-matched patients with IDCM without LVA served as control group(I-L).Results Six out of 998 patients with IDCM were confirmed to have LVA(0.60%).The LV peak-systolic pressure was higher in the I+L group than in I-L group[(130±10)mm Hg(1 mm Hg=0.133 kPa)vs.(117±9)mm Hg,P<0.05].The LV end-diastolic volume Was significandy larger in the I+L group than in I-L group[(272 ±57)ml vs.(207±60)ml,P<0.05].The LV ejection fraction was slightly lower in the I+L group than in I-L group[(27±9)%vs.(35±6)%,P=0.09].Ventricular arrhythmia occurred more frequently in I+L group than in I-L group.Conclusion LVA formation in IDCM was a rare phenomenon.IDCM patients with LVA seem to have higher LV peak-systolic pressure,larger end-diastolie volume,worse LV systolic function and more frequent ventricuLar arrhythmia than those without LVA.
