首都医科大学学报 ›› 1995, Vol. 16 ›› Issue (4): 278-281.

• 论著 • 上一篇    下一篇

不同疾病状态对左室舒张功能的影响及其临床意义

华琦, 师树英, 汪家瑞   

  1. 首都医学院宣武医院心血管内科
  • 收稿日期:1994-10-12 修回日期:1900-01-01 出版日期:1995-10-15 发布日期:1995-10-15

Influences of Preload Afterload and Contractility of Myocardium on Left Ventricular Diastolic Function

Hua Qi, Shi Shuying, Wang Jiarui   

  1. Xuanwu Hospital, Capital Institute of Medicine
  • Received:1994-10-12 Revised:1900-01-01 Online:1995-10-15 Published:1995-10-15

摘要: 应用超声心动图观察134例不同疾病患者,根据其左房内径、左室舒张末期容积、平均动脉压、平均周径缩短率及射血分数的不同,判断其前后负荷的大小及心肌收缩力的强弱。将观察对象分为5组,并分别选择年龄、心率匹配的健康人为对照组,发现前负荷变化主要影响舒张早期左室充盈,随前负荷增高,跨瓣驱动压上升,舒张早期充盈峰值流速(EPFV)加快,舒张早期流速积分(ETVI)及总舒张期流速积分(TTVI)加大。后负荷变化影响舒张早期及心房收缩期左室充盈。后负荷降低使ETVI加大,心房收缩期充盈峰值流速(APFV)减慢,流通积分(ATVI)减小,A/E比值及心房充盈分数(ATVI/TTVI)下降。心肌收缩力下降则使EPFV减慢,ETVI减小,代偿性APFV加快及ATVI加大,A/E及ATVI/TTVI增加,以维持心输出量。

关键词: 超声心动图, 多普勒, 左室舒张功能, 前负荷, 后负荷, 心肌收缩力

Abstract: To investigate the influences of preload,afterload and contractility of myocardium on left ventricular diastolic function,134 patients suffering from different kinds of diseases were examined by echocardiography.The patients were divided into five subgroups according to diameter of left atrium,end diastolic volume of left ventricle,mean arterial blood pressure, mean velocity of circumferential fiber shortening and ejection fraction of left ventricle.It was found that:①Variation of preload influenced chiefly early diastolic filling parameters,peak flow velocity of early diastole(EPFV)and time-velocity integral of early diastole (ETVI) which increased with increasing preload.②Variation of afterload influenced not only early, but also late diastolic filling parameters.ETVI increased,peak flow velocity of atrial contraction(APFV) and time-velocity integral of atrial contraction(ATVI) decreased,and the ratio between APFV and EPFV and between ATVI and total time-velocity integral (TTVI) re-duced with decreasing afterload.③Decreased contractility of myocardium as manifested by a reduction of EPFV and ETVI,and a significant componsatory increase in APFV,ATVI and the ratio between APFV and EPFV and between ATVI and TTVI in order to maintain the cardiac output.

Key words: echocardiography, Doppler, left ventricular diastolic function, preload, afterload, contractility of myocazdium

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