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目的探讨颈动脉瞬时波强评价心功能的临床价值。方法选2009年1-9月解放军总医院心内科住院的冠心病心功能不全患者51例,其中男性34例,女性17例,年龄(66±10)岁。常规行超声心动图及瞬时波强(wave in-tensity,WI)检测,记录左室射血分数(left ventricular ejection fraction,LVEF)、左室舒张末内径(left ventricular diastojic di-mension,LVDd)、左室舒张末容积(end diastolic volume,EDV)、左室收缩末容积(end systolic volume,ESV)、左房内径(leftatril dimension,LAd)、颈动脉瞬时加速度波强(accelerating wave intensity,W1)、颈动脉瞬时减速度波强(decelerating waveintensity,W2);超声检查完毕即刻测量6 min步行距离(6 minutes walking distance,6MWD);之后在2 h内行冠状动脉造影,造影显示每位患者至少有1处病变狭窄≥50%,其中47例导管测量左室压力,记录左室最大压力变化(LV+dp/dtmax);分析51例患者上述超声指标与6MWD之间的相关性。结果线性回归分析显示W1、LVEF、LVDd、EDV、ESV、LV+dp/dtmax与6MWD均显示明显相关(r分别为0.687、0.591、-0.552、-0.450、-0.513、0.693,P<0.01);其中W1对6MWD影响程度最大(标准回归系数Beta依次为W1 0.789、ESV 0.701、LVEF 0.567、LV+dp/dtmax 0.540、EDV 0.485、LVDd 0.067)。结论作为更加简便的评价心功能的方法,WI可能较传统的超声指标具有更加准确的临床价值。
Objective To investigate the clinical value of carotid artery transient wave intensity in evaluating cardiac function. Methods Fifty-one patients with coronary heart disease and cardiac insufficiency admitted to Department of Cardiology, People’s Liberation Army General Hospital from January to September 2009 were selected, including 34 males and 17 females, with a mean age of 66 ± 10 years. Conventional echocardiography and wave in-tensity (WI) were performed to measure left ventricular ejection fraction (LVEF), left ventricular diastolic diameter (LVDd) Left ventricular end diastolic volume (EDV), left ventricular end systolic volume (ESV), leftatril dimension (LAd), carotid artery accelerating wave intensity (W1) The carotid artery decelerating wave intensity (decelerating wave intensity, W2) was measured immediately after 6-min walking distance (6MWD) at ultrasound examination. Coronary angiography was performed within 2 hours and angiography showed at least one Fifty-five percent of the lesions were stenosed. The left ventricular pressure was measured in 47 cases and the maximal left ventricular pressure (LV + dp / dtmax) was recorded. The correlation between these parameters and 6MWD was analyzed. Results The results of linear regression analysis showed that the values of W1, LVEF, LVDd, EDV, ESV and LV + dp / dtmax were all significantly correlated with 6MWD (r = 0.687,0.591,0.552,0.450,0.513,0.693, P <0.01); Among them, W1 had the greatest influence on 6MWD (standard regression coefficients Beta followed by W1 0.789, ESV 0.701, LVEF 0.567, LV + dp / dtmax 0.540, EDV 0.485, LVDd 0.067). Conclusion As a simpler method to evaluate cardiac function, WI may be more accurate than traditional ultrasound.