不同负荷室性期前收缩患者心脏结构及左心室几何构型的比较分析

doi:10.3969/j.issn.1006-7795.2016.06.005

首都医科大学学报 ›› 2016, Vol. 37 ›› Issue (6): 740-745.doi: 10.3969/j.issn.1006-7795.2016.06.005

• 心血管疾病的病理生理机制 • 上一篇下一篇

不同负荷室性期前收缩患者心脏结构及左心室几何构型的比较分析

罗鸿宇¹, 华琦², 朱玮玮², 侯海霞², 刘荣坤²

1. 首都医科大学宣武医院老年病(综合)科, 北京 100053;
2. 首都医科大学宣武医院心脏科, 北京 100053

收稿日期:2016-10-03 出版日期:2016-12-21 发布日期:2016-12-16
通讯作者: 华琦 E-mail:huaqi5371@medmail.com.cn
基金资助:
国家高技术研究发展计划（863计划）资助项目（2012AA02A516）

Comparative analysis of heart structure and left ventricular geometric pattern in patients with different premature ventricular contractions burden

Luo Hongyu¹, Hua Qi², Zhu Weiwei², Hou Haixia², Liu Rongkun²

1. Department of Geriatric Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
2. Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China

Received:2016-10-03 Online:2016-12-21 Published:2016-12-16
Supported by:
This study was supported by National High Technology Research and Development Program of China(2012AA02A516).

摘要/Abstract

摘要： 目的探讨不同负荷室性期前收缩（premature ventricular contractions，PVCs）对患者心脏结构、功能的影响及其与心脏几何构型的相关性。方法回顾性分析PVCs患者142例，根据PVCs负荷将其分为以下3组：低负荷组（n=54）：PVCs负荷<10%；中负荷组（n=55）：PVCs负荷为10%~20%；高负荷组（n=33）：PVCs负荷>20%；分析PVCs负荷与患者心功能参数、左心室构型构成比率的关系，并通过Logistic回归分析对左心室肥厚的危险因素进行分析。结果与高负荷组比较，低负荷组、中负荷组左心房内径（left atrial diameter，LAD）、左心室流出道径（left ventricular outflow tract，LVOT）、左心室舒张末期内径（left ventricular internal dimension at end-diastole，LVIDD）、左心室舒张末期容积（left ventricular end-diastolic volume，LVEDV）、左心室心肌质量（left ventricular myocardial mass，LVM）、左心室心肌质量指数（left ventricular myocardial mass index，LVMI）明显降低，左室射血分数（left ventricular ejection fraction，LVEF）升高，差异有统计学意义（P<0.05）；PVCs负荷与右心室流出道径（right ventricular outflow tract，RVOT）、LAD、LVOT、LVIDD、LVEDV、每搏心输出量（stroke volume，SV）、LVMI呈正相关（P<0.05），与LVEF呈负相关（P<0.05）；随PVCs负荷增加，左心室正常构型比例下降，离心性肥厚比例增加，差异有统计学意义（P<0.05）。年龄、高血压、PVCs负荷为发生左心室肥厚的危险因素。结论 PVCs患者期前收缩负荷与心脏结构及功能显著相关，随期前收缩负荷增加，左心室肥厚程度加重、收缩功能减低、离心性肥厚比例增加；对于高龄、合并高血压及PVCs负荷过重的患者，应早期监测心功能，并及早对PVCs予以干预。

关键词: 室性期前收缩, 期前收缩负荷, 左心室功能, 左心室结构

Abstract: Objective To observe the influence of different premature ventricular contractions (PVCs) burden on patients' heart structure and function, and its relevance to the left ventricular geometric pattern. Methods Totally 142 patients with PVCs were retrospectively analyzed. All the patients were divided into 3 groups by the burden of PVCs:the lower burden group (<10%, n=54), the medium burden group (10%-20%, n=55), the higher burden group (>20%, n=33). The difference and correlation between the heart structure, heart function and left ventricular geometric pattern in the 3 groups were analyzed; and the Logistic regression analyses were used to find out the risk factors of left ventricular hypertrophy. Results Compared with the higher burden group, the left atrial diameter(LAD), left ventricular outflow tract(LVOT), left ventricular internal dimension at end-diastole(LVIDD), left ventricular end-diastolic volume, left ventricular myocardial(LVM) mass and left ventricular myocardial mass index(LVMI) in the lower and medium groups were decreased, the LVEF in the lower and medium groups was increased (P<0.05). The PVCs burden was positively correlated with RVOT, LVOT, LVIDD, LVEDV, SV, LVM (P<0.05,); and was negatively correlated with LVEF (P<0.05,). With the increase of PVCs burden, the ratio of left ventricle normal geometry was decreased, and the ratio of eccentric hypertrophy geometry was increased. In a binary Logistic regression analysis, age, hypertension and PVCs burden were the risk factors of left ventricular hypertrophy in patients with PVCs. Conclusion The PVCs burden was closely related to the heart structure of the patients with PVCs. With the increase of PVCs burden, the left ventricular hypertrophy was aggravated gradually, the left ventricular systolic function was decreased, and the ratio of eccentric hypertrophy geometry was increased significantly. For patients with older age, hypertension and a heavy load of PVCs burden, doctors should monitor the cardiac function on early stage, and start the clinical intervention in time.

Key words: premature ventricular contractions, contraction burden, left ventricular function, left ventricular structure

中图分类号:

R541.7

罗鸿宇, 华琦, 朱玮玮, 侯海霞, 刘荣坤. 不同负荷室性期前收缩患者心脏结构及左心室几何构型的比较分析[J]. 首都医科大学学报, 2016, 37(6): 740-745.

Luo Hongyu, Hua Qi, Zhu Weiwei, Hou Haixia, Liu Rongkun. Comparative analysis of heart structure and left ventricular geometric pattern in patients with different premature ventricular contractions burden[J]. Journal of Capital Medical University, 2016, 37(6): 740-745.

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不同负荷室性期前收缩患者心脏结构及左心室几何构型的比较分析

Comparative analysis of heart structure and left ventricular geometric pattern in patients with different premature ventricular contractions burden

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