冠狀動脈慢血流患者心肌能量消耗水平變化及意義

白書昌　馬觀海　李琛　夏張青　蔣殿虎　梁健球

[關鍵詞] 冠狀動脈慢血流;超聲心動圖;左心室功能;心肌能量消耗

[中圖分類號] R541.4? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2021）22-0008-05

Changes and significance of myocardial energy consumption in patients with coronary artery slow flow

BAI Shuchang? ?MA Guanhai? ?LI Chen? ?XIA Zhangqing? ?JIANG Dianhu? ?LIANG Jianqiu

Department of Cardiology， Foshan? the Second People′s Hospital， Foshan? ? 528000， China

[Abstract] Objective To investigate the changes of the cardiac structure， functional indexes and myocardial energy expenditure level （MEE） in patients with coronary artery slow flow and their significance by ECG. Methods Seventy-eight patients who were hospitalized for coronary angiography with chest pain and diagnosed with coronary artery slow flow in the Second People′s Hospital of Foshan City from January 2019 to January 2020 were selected as the coronary artery slow flow group （the CSF group）， and 77 patients with normal coronary angiography were selected as the normal control group （the CNF group）. The cardiac structural index， left ventricular systolic index and diastolic function index （LVEF， Mitral E/A， Mitral e′） were measured by echocardiography and tissue Doppler technique. The circumferential ventricular wall stress （cESS） and MEE at the end of left ventricular systolic were calculated. Results No significant differences were observed in the left ventricular mass index （LVMI）， left ventricular posterior wall thickness （PWTS） and aortic valve annular diameter （AD） between the CSF group and the CNF group （P>0.05）. In the CSF group， the systolic left ventricular diameter （LVIDs） was larger than that in the normal control group; the aortic valve ejection velocity （AV） was decreased; the left ventricular ejection time （LVET） was prolonged; the differences were statistically significant （P<0.05）. When comparing the left ventricular systolic function between the two groups， no statistically significant differences were observed between the two groups in the left ventricular ejection fraction （LVEF） and E/A ratio， an index of left ventricular diastolic function （P>0.05）. The mean value of early peak velocity of mitral valve free wall and ventricular septal valve annulus （e′） was more sensitive to left ventricular diastolic function， and the difference between the two groups was statistically significant （P<0.05）. Compared with the CNF group， the myocardial energy consumption indexes （cESS and MEE） in the CSF group were increased， and the differences were statistically significant （P<0.05）. Conclusion Insufficiency of myocardial perfusion in patients with coronary artery slow flow leads to changes in some cardiac structural indicators， accompanied by a certain degree of diastolic dysfunction， prolonged left ventricular ejection time， decreased aortic valve flow velocity， and increased myocardial energy consumption.