IMPAIRED LEFT-VENTRICULAR DIASTOLIC FILLING IN PATIENTS WITH CORONARY-ARTERY DISEASE - ASSESSMENT WITH RADIONUCLIDE ANGIOGRAPHY
IMPAIRED LEFT-VENTRICULAR DIASTOLIC FILLING IN PATIENTS WITH CORONARY-ARTERY DISEASE - ASSESSMENT WITH RADIONUCLIDE ANGIOGRAPHY
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DOI：
10.1161/01.cir.64.2.315
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发表时间：
1981-01-01
期刊：
影响因子：
37.8
通讯作者：
EPSTEIN, SE
中科院分区：
文献类型：
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作者：
BONOW, RO;BACHARACH, SL;EPSTEIN, SE
为了评估冠状动脉疾病（CAD）患者静息时左室（LV）舒张充血，分析了231例患者门控核素血管造影获得的高分辨率时间-活动曲线（10-20 ms/帧）。以每秒舒张末期容积（EDV/s）表示的左室峰值充盈率（PFR）在CAD患者中低于正常水平(1.8。0.6 vs.正常平均值3.3。0.6, P < 0.001)，到PFR的时间（TPFR），从收缩期末到PFR，延长（171 .+-）。41毫秒，而正常平均值为136毫秒。23 ms, P < 0.001)。141例左室静息射血分数正常的患者（PFR = 2.1 +-）上述指标均有异常。0.5产品类别/ s;TPFR = 175 .+-。心电图无Q波的123例患者(PFR = 2.1。0.5产品类别/ s;TPFR = 168。38 ms)。91%的冠心病患者、86%的静息左室射血分数正常的患者、85%的无Q波的患者和82%的静息左室射血分数正常的患者、无静息区域壁运动异常和无Q波的患者均发现静息时左室充盈异常（PFR < 2.5 EDV/s或TPFR > 180ms）。左室舒张充盈，通过放射性核素血管造影无创评估，在与左室收缩功能或既往心肌梗死无关的静止CAD患者中，有很高比例是异常的。
To assess left ventricular (LV) diastolic filling at rest in patients with coronary artery disease (CAD), high-resolution time-activity curves (10-20 ms/frame) obtained from gated radionuclide angiograms in 231 patients were analyzed. Peak LV filling rate (PFR), expressed in end-diastolic volumes per second (EDV/s), was subnormal in CAD patients (1.8 .+-. 0.6 vs. normal mean of 3.3 .+-. 0.6, P < 0.001) and time to PFR (TPFR), measured from end-systole to PFR, was prolonged (171 .+-. 41 ms vs. normal mean of 136 .+-. 23 ms, P < 0.001). These indexes were abnormal in the 141 patients with normal resting LV ejection fraction (PFR = 2.1 .+-. 0.5 EDV/s; TPFR = 175 .+-. 36 ms) and in 123 patients without Q waves on the ECG (PFR = 2.1 .+-. 0.5 EDV/s; TPFR = 168 .+-. 38 ms). Abnormal LV filling at rest (PFR < 2.5 EDV/s or TPFR > 180 ms) was found in 91% of all patients with CAD, 86% of patients with normal resting LV ejection fractions, 85% of patients without Q waves and 82% of patients with normal resting LV ejection fraction, no resting regional wall motion abnormalities and no Q waves. LV diastolic filling, evaluated noninvasively by radionuclide angiography, is abnormal in a high percentage of patients with CAD at rest independent of LV systolic function or previous myocardial infarction.