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目的 :探讨心肌肥厚患者冠脉血流储备 ( CFR)对左室舒张功能的影响。 方法 :应用经胸和经食管超声心动图技术 ,测量 42例心肌肥厚患者和 1 0例正常对照静脉注射潘生丁前后冠状窦血流动力学的改变及二尖瓣和肺静脉血流频谱。 结果 :心肌肥厚患者 CFR明显低于正常对照组 ( 1 .85± 0 .53vs3.0±0 .55,P<0 .0 0 1 ) ;心肌肥厚患者 CFR与舒张功能障碍的多项指标存在相关关系 ,CFR与 IVRT、肺静脉血流频谱 PVD、VTI- PVS、VTI- PVA存在正相关 ( r=0 .43,0 .31 ,0 .37,0 .32 ,P均 <0 .0 5) ,与二尖瓣血流频谱 A波持续时间和肺静脉血流频谱 A波持续时间之差存在负相关 ( r=- 0 .36,P<0 .0 5)。 结论 :CFR减低可能是心肌肥厚患者舒张功能受损的机制之一。
Objective: To investigate the effect of coronary flow reserve (CFR) on left ventricular diastolic function in patients with cardiac hypertrophy. Methods: The transthoracic and transesophageal echocardiographic techniques were used to measure the changes of coronary sinus hemodynamics and mitral and pulmonary venous flow in 42 patients with cardiac hypertrophy and 10 normal controls. Results: The CFR of patients with cardiac hypertrophy was significantly lower than that of the control group (1.85 ± 0.53 vs 3.0 ± 0.55, P <0.01). There was correlation between CFR and diastolic dysfunction in patients with cardiac hypertrophy There was a positive correlation between CFR and IVRT, pulmonary venous flow spectrum PVD, VTI-PVS and VTI-PVA (r = 0.43,0.31,0.37,0.32, P <0.05) There was a negative correlation between the duration of A wave in mitral flow spectrum and the duration of A wave in pulmonary venous flow (r = - 0.36, P <0.05). Conclusion: The decreased CFR may be one of the mechanisms of impaired diastolic function in patients with cardiac hypertrophy.