超声评价冠心病患者PCI后左心室功能与左心房压力和左心室心肌做功参数的关系
Evaluation the correlation between left ventricular function/left atrial pressure and left ventricular work parameters by echocardiography in patients with coronary heart disease after PCI
耿戟 1傅群峰 1李晓青1
作者信息
- 1. 保定市第一中心医院超声科,河北保定 071003
- 折叠
摘要
目的 探讨冠心病(CHD)患者经皮冠状动脉介入术(PCI)后左心室功能与左心房压力和左心室心肌做功(LVMW)参数的关系.方法 选择2020年6月至2022年6月于保定市第一中心医院行PCI治疗后的CHD患者200例(CHD组),其中男性102例,女性98例;年龄45～71岁,平均年龄59.98岁;身体质量指数18.56～25.82 kg/m2,平均身体质量指数23.71 kg/m2;101例有吸烟史,99例有饮酒史.另纳入200例健康体检者(对照组),其中男性104例,女性96例;年龄44～70岁,平均年龄60.42岁;身体质量指数18.42～25.41 kg/m2,平均身体质量指数23.61 kg/m2;吸烟史98例,饮酒史102例.比较两组患者的左心室功能相关参数[二尖瓣舒张早期速度峰值(E)及晚期速度峰值(A)、左心室射血分数(LVEF)和左心室整体纵向应变(GLS)]和左心房压力相关参数[二尖瓣环舒张早期速度(e')、E/e'和左心房平均压力(mLAP)]差异,并采用Pearson相关性分析法分析以上参数与LVWM参数之间的相关性.结果 CHD组E/A、LVEF、E和e'值均显著低于对照组[1.23±0.08 vs 0.81±0.21、(53.71±2.54)％vs(61.58±3.52)％、(71.03±10.01)cm/s vs(78.74±7.25)cm/s、(8.22±1.56)cm/s vs(10.54±0.73)cm/s],GLS、E/e'和 mLAP 值高于对照组[(-17.54±1.08)％vs(-21.98±1.68)％、(9.31±0.17)％vs(7.53±0.18)％、(13.39±0.21)mmHg vs(11.03±0.15)mmHg].与对照组相比,CHD组整体做功指数(GWI)、整体有用功(GCW)和整体做功效率(GWE)更低[(2 088.42±387.73)mmHg％vs(1 116.73±401.21)mmHg％、(2 294.51±306.73)mmHg％vs(1 456.19 土 418.42)mmHg％、(97.34±1.45)mmHg％vs(83.22±5.07)mmHg％],整体无用功(GWW)偏高[(70.83±23.04)mmHg％vs(132.65±44.32)mmHg％](均P＜0.05).相关性分析结果显示,GWI、GCW和GWE与E/A、LVEF均呈正相关,与GLS呈负相关(均P＜0.05);GWW与E/A、LVEF均呈负相关,与GLS呈正相关(均P＜0.05).GWI、GCW和GWE与E/e、mLAP均呈负相关,GWW与E/e、mLAP均呈正相关(均P＜0.05).结论 CHD患者PCI后左心室功能与左心房压力和左心室心肌做功参数存在一定的相关性,可辅助临床医师更好地评估患者术后心功能的变化情况.
Abstract
Objective To investigate the correlation between left ventricular work(LVMW)parameters and left ventricular function as well as left atrial pressure in patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods From June 2020 to June 2022,a total of 200 patients with CHD after PCI were enrolled as CHD group,which included 102 males and 98 females,aged 45-71 years old with mean age of 59.98 years old;body mass index(BMI)was 18.56-25.82 kg/m2 with mean BMI of 23.71 kg/m2;101 cases with smoking history and 99 with drinking history.The 200 healthy were set as control group,which included 104 males and 96 females,aged 44-70 years old with mean age of 60.42 years old;BMI was 18.42-25.41 kg/m2 with mean BMI of 23.61 kg/m2;98 cases with smoking history and 102 with drinking history.The differences of left ventricular function related parameters[early diastolic velocity peak(E)and late dias tolic velocity peak(A),left ventricular ejection fraction(LVEF)and left ventricular global longitudinal strain(GLS)]and left atrial pressure related parameters[early diastolic velocity of mitral annulus(e'),E/e'and left atrial mean pressure(mLAP)]were compared between 2 groups,and Pearson correlation analysis was used to analyze the correlation between the above parame-ters and LVWM parameters.Results The E/A,LVEF,E and e'in CHD group were significantly lower than those in control group[1.23±0.08 vs 0.81±0.21,(53.71±2.54)％vs(61.58±3.522)％,(71.03±10.01)cm/s vs(78.74±7.25)cm/s,(8.22±1.56)cm/s vs(10.54±0.73)cm/s],and GLS,E/e'and mLAP were higher in CHD group than those in control group[(-17.54±1.08)％vs(-21.98±1.68)％,(9.31±0.17)％vs(7.53±0.18)％,(13.39±0.21)mmHg vs(11.03±0.15)mmHg].The global work index(GWI),global constructive work(GCW)and global work efficiency(GWE)in CHD group were significantly lower than those in control group[(2 088.42±387.73)mmHg％vs(1 116.73±401.21)mmHg％,(2 294.51±306.73)mmHg％vs(1 456.19±418.42)mmHg％,(97.34±1.45)mmHg％vs(83.22±5.07)mmHg％],and global wasted work(GWW)was signifi-cantly higher in CHD than those in control group[(70.83±23.04)mmHg％vs(132.65±44.32)mmHg％](P＜0.05).The cor-relation analysis showed that GWI,GCW and GWE were positively correlated with E/A and LVEF,and negatively correlated with GLS(P＜0.05).GWW was negatively correlated with E/A and LVEF,and positively correlated with GLS(P＜0.05).Con-clusion It is demonstrated that there is certain correlation between left ventricular function and left atrial pressure and left ven-tricular myocardial work parameters in CHD patients after PCI,which could assist the clinician to preferably evaluate the changes of postoperative cardiac function.
关键词
冠心病/经皮冠状动脉介入术/左心室功能/左心房压力/左心室心肌做功参数/相关性分析Key words
coronary heart disease/percutaneous coronary intervention/left ventricular function/left atrial pressure/left ventricular myocardial work parameter/correlation analysis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据