摘要目的 探讨心肌肥厚患者冠脉血流与左室舒张功能障碍各项指标的相关关系.方法 采用经胸和经食管超声心动图技术,测量30例心肌肥厚患者和10例正常人冠状窦、二尖瓣及肺静脉血流频谱.结果 与正常人相比,心肌肥厚患者冠状窦直径、前向血流和净前向血流流速积分(VTInet)明显增加,并且冠状窦前向血流和VTInet与左室舒张功能障碍的多项指标存在相关关系.与二尖瓣E峰最大流速及流速积分、E峰与A峰最大流速之比及流速积分之比、肺静脉舒张末期逆行血流最大流速之间均存在明显正相关,相关系数分别为0.50、0.47、0,43、0.42、0.41和0.38、0.55、0.43、0.47、0.37(P均<0.05).结论 心肌肥厚患者冠脉血流的增加与舒张功能异常存在着明显相关性,冠脉循环血流动力学的改变可能是心肌肥厚患者舒张功能受损的机制之一.

abstractsObjective To study relationship between coronary circulation and left ventricular diastolic function in patients with left ventricular hypertrophy(LVH).Methods Mitral,pulmonary venous and coronary sinus flow velocity variables were measured by transthoracic and multiplane transesophageal echocardkNraphy in thirty patients with LVH and ten control subjects.Results Patients with LvH had higher peak velocity of late transrnitral blood flow(A wave),velocity time integral(VTI)of A wave and lower index of early versus late transmitral flow(E/A ratio)than those of control subjects.Patients with LVH had lower peak diastolic velocity of pulmonary vein than that of control subjects.The ratio of pulmonary venous diastolic and systolic flow velocities(S/D ratio),pulmonary venous A wave velocity and its duration were higher in patients with LVH compared with control subjects.The net forward flow velocity time integral(VTInet),forward flow and diameter of coronary sinus were higher in patients with LVH compared with control subjects.There were significant positive linear correlation between coronary sinus forward flow and E,E/A,VTI-E,、VTI-E/A,and pulmonary venous A wave velocity.(r=0.50,0.47,0.43,0.42,0.41,P<0.05).There were also significant positive linear correlation betweencoronary sinus VTInet and E,E/A,VTI-E,VTI-E/A,and pulmonary venous A wave velocity.(r:O.38,0.55,0.43,0.47,O.37,P<0.05).Conclusions Left ventricular diastolic function Was impaired in patients with LVH.A significant correlation existed between coronary sinus flow and diastolic function in patients with LVH.The change of coronary circulation may represent a mechanism for impaired diastolic function in patientswith LVH.