中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2013年
1期
33-37
,共5页
李卫虹%李昭屏%冯新恒%高炜
李衛虹%李昭屏%馮新恆%高煒
리위홍%리소병%풍신항%고위
心室功能障碍,左%超声心动描记术,多普勒%诊断
心室功能障礙,左%超聲心動描記術,多普勒%診斷
심실공능장애,좌%초성심동묘기술,다보륵%진단
Ventricular dysfunction,left%Echocardiography,Doppler%Diagnosis
目的 通过比较超声心动图检测的左心房大小和左心室充盈压(LVFP)的关系,探讨左心房面积指数(LAAI)对收缩功能正常的高血压患者左心室舒张功能不全的诊断价值.方法 346例左心室收缩功能正常的高血压患者,常规超声心动图测量左心房内径(LAD)和左心房面积(LAA),计算左心房内径指数(LADI)和LAAI；脉冲及组织多普勒分别测量二尖瓣口舒张早期血流峰速度(E)及二尖瓣环舒张早期运动峰速度(Em),计算LVFP.根据LVFP分为左心室舒张功能不全组[LVFP＞ 15 mm Hg(1 mm Hg=0.133 kPa),n=81]和左心室舒张功能正常组(LVFP≤15 mm Hg,n=265),比较两组超声心动图参数,对左心房参数与LVFP行相关分析,采用ROC曲线分析左心房参数对左心室舒张功能不全的诊断价值.结果 与舒张功能正常组比较,舒张功能不全组左心房较大[LADI:(21.4 ±2.6)mm/m2比(19.6 ±2.4)mm/m2；LAAI:(12.1 ±2.6)cm2/m2比(10.4±1.7) cm2/m2,P均＜0.01],左心房参数均与LVFP呈正相关,其中LAAI相关系数最大(r=0.450,P＜0.01)；ROC 曲线分析显示,以LAAI≥11.4 cm2/m2为截点,诊断左心室舒张功能不全(LVFP＞ 15 mm Hg)的敏感性为63％,特异性为74％,准确性为72％.结论 左心室收缩功能正常的高血压患者左心房增大与LVFP增高有关,LAAI对检测LVFP增高的价值优于LADI,在缺乏组织多普勒时,LAAI可辅助用于左心室舒张功能不全的诊断.
目的 通過比較超聲心動圖檢測的左心房大小和左心室充盈壓(LVFP)的關繫,探討左心房麵積指數(LAAI)對收縮功能正常的高血壓患者左心室舒張功能不全的診斷價值.方法 346例左心室收縮功能正常的高血壓患者,常規超聲心動圖測量左心房內徑(LAD)和左心房麵積(LAA),計算左心房內徑指數(LADI)和LAAI；脈遲及組織多普勒分彆測量二尖瓣口舒張早期血流峰速度(E)及二尖瓣環舒張早期運動峰速度(Em),計算LVFP.根據LVFP分為左心室舒張功能不全組[LVFP＞ 15 mm Hg(1 mm Hg=0.133 kPa),n=81]和左心室舒張功能正常組(LVFP≤15 mm Hg,n=265),比較兩組超聲心動圖參數,對左心房參數與LVFP行相關分析,採用ROC麯線分析左心房參數對左心室舒張功能不全的診斷價值.結果 與舒張功能正常組比較,舒張功能不全組左心房較大[LADI:(21.4 ±2.6)mm/m2比(19.6 ±2.4)mm/m2；LAAI:(12.1 ±2.6)cm2/m2比(10.4±1.7) cm2/m2,P均＜0.01],左心房參數均與LVFP呈正相關,其中LAAI相關繫數最大(r=0.450,P＜0.01)；ROC 麯線分析顯示,以LAAI≥11.4 cm2/m2為截點,診斷左心室舒張功能不全(LVFP＞ 15 mm Hg)的敏感性為63％,特異性為74％,準確性為72％.結論 左心室收縮功能正常的高血壓患者左心房增大與LVFP增高有關,LAAI對檢測LVFP增高的價值優于LADI,在缺乏組織多普勒時,LAAI可輔助用于左心室舒張功能不全的診斷.
목적 통과비교초성심동도검측적좌심방대소화좌심실충영압(LVFP)적관계,탐토좌심방면적지수(LAAI)대수축공능정상적고혈압환자좌심실서장공능불전적진단개치.방법 346례좌심실수축공능정상적고혈압환자,상규초성심동도측량좌심방내경(LAD)화좌심방면적(LAA),계산좌심방내경지수(LADI)화LAAI；맥충급조직다보륵분별측량이첨판구서장조기혈류봉속도(E)급이첨판배서장조기운동봉속도(Em),계산LVFP.근거LVFP분위좌심실서장공능불전조[LVFP＞ 15 mm Hg(1 mm Hg=0.133 kPa),n=81]화좌심실서장공능정상조(LVFP≤15 mm Hg,n=265),비교량조초성심동도삼수,대좌심방삼수여LVFP행상관분석,채용ROC곡선분석좌심방삼수대좌심실서장공능불전적진단개치.결과 여서장공능정상조비교,서장공능불전조좌심방교대[LADI:(21.4 ±2.6)mm/m2비(19.6 ±2.4)mm/m2；LAAI:(12.1 ±2.6)cm2/m2비(10.4±1.7) cm2/m2,P균＜0.01],좌심방삼수균여LVFP정정상관,기중LAAI상관계수최대(r=0.450,P＜0.01)；ROC 곡선분석현시,이LAAI≥11.4 cm2/m2위절점,진단좌심실서장공능불전(LVFP＞ 15 mm Hg)적민감성위63％,특이성위74％,준학성위72％.결론 좌심실수축공능정상적고혈압환자좌심방증대여LVFP증고유관,LAAI대검측LVFP증고적개치우우LADI,재결핍조직다보륵시,LAAI가보조용우좌심실서장공능불전적진단.
Objective To investigate the correlation between left atrial size and left ventricular filling pressure (LVFP) and the value of left atrial size assessment on detecting diastolic dysfunction in hypertensive patients with preserved LVEF by echocardiography.Methods Echocardiography was performed in 346 hypertensive patients with preserved LVEF (≥ 50％),left atrial size including left atrial diameter (LAD) and left atrial area (LAA) was measured and indexed to body surface area (LADI,LAAI).The ratio of early diastolic transmitral velocity to early diastolic mitral annular velocity (E/Em) was determined and LVFP was calculated with the formula:LVFP =1.24 × E/Em + 1.9.Patients were divided into diastolic dysfunction group [DD group,LVFP ＞ 15 mm Hg(1 mm Hg =0.133 kPa),n =81] and normal diastolic function group (NDF group,LVFP ≤ 15 mm Hg,n =265).Results As compared to patients in NDF group,the patients in DD group had larger LA [LADI:(21.4 ±2.6) mm/m2 vs.(19.6 ±2.4) mm/m2 ；LAAI:(12.1 ±2.6) cm2/m2 vs.(10.4 ± 1.7)cm2/m2 ； all P ＜0.01].LA size parameters were positively correlated with LVFP (r =0.211-0.450,all P ＜ 0.01),LAAI was best correlated with LVFP (r =0.450,P ＜0.01).ROC analysis showed that LAAI ≥ 11.4 cm2/m2 diagnosed DD with a sensitivity of 63％,specificity of 74％ and accuracy of 72％.Conclusion Left atrium dilation correlates positively with LVFP in hypertensive patients with preserved LVEF.The LAAI is a more accurate parameter for identifying patients with diastolic dysfunction in this cohort.
