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目的 探讨肺动脉高压对冠状静脉窦血流动力学的影响。方法 正常对照组和肺动脉高压组各30例。应用多平面经食管超声心动图技术测量冠状静脉窦收缩期、舒张期、心房收缩期冠状静脉窦血流速度峰值(CSS、CSD、CSA )及流速积分( VTI CSS、VTI CSD、VTI CSA),并计算冠状静脉窦净前向血流流速积分(VTInet)、净前向血流量(CSF)。结果 与正常对照组比较,肺动脉高压组冠状静脉窦内径明显增宽[(12.24±2.93)mm 对 (7.22±0.89) mm, P < 0.001 ]; CSS、CSA、VTI CSS、VTI CSA、VTInet、CSF 明显增加[ CSS(74.07±21.58)cm/s 对 (37.01±23.41)cm/s,P<0.001;CSA(36.89±9.62)cm/s 对 (20.69±6.17)cm/s, P<0.001;VTI CSS (9.79±3.82)cm 对 (4.73±2.38) cm, P < 0.001; VTI CSA (2.14±0.69) cm 对 (1.50±0.30)cm,P<0.01;VTInet (13.98±4.55)cm 对 (8.56±2.41)cm, P<0.001;CSF (1272.1±439.24)cm 对(738.2±245.02)cm,P<0.001],CSD、VTI CSD差异无显著性意义。结论 肺动脉高压时冠状循环血流动力学发生了显著改变,表现为冠状静脉窦扩张,血流速度和流量增加。
Objective To investigate the effects of pulmonary hypertension on coronary sinus hemodynamics. Methods Normal control group and pulmonary hypertension group of 30 cases. The multi-plane transesophageal echocardiography was used to measure the peak value of coronary sinus blood flow velocity (CV, CSD, CSA) and velocity integral (VTI CSD, VTI CSA) of coronary sinus in systole, diastole and atrial systole, Coronary sinus mean net forward flow velocity (VTInet) and net forward flow (CSF) were calculated. Results Compared with the normal control group, the diameter of coronary sinus significantly increased in pulmonary hypertension group [(12.24 ± 2.93) mm vs (7.22 ± 0.89) mm, P <0.001]; CSS, CSA, VTI CSS, VTI CSA, (P <0.001); CSA (36.89 ± 9.62) cm / s vs (20.69 ± 6.17) cm / s, P <0.001; VTI P <0.001 for CSS (9.79 ± 3.82) cm vs (4.73 ± 2.38) cm for VTI CSA vs (1.50 ± 0.30) cm vs (P <0.01) for VTI CSA vs (8.56 ± 2.41) cm, P <0.001; CSF (1272.1 ± 439.24) cm vs (738.2 ± 245.02) cm, P <0.001]. There was no significant difference between CSD and VTI CSD. Conclusions Coronary circulation hemodynamics has been significantly altered in patients with pulmonary hypertension, manifested by coronary sinus dilatation, increased blood flow velocity and flow rate.