中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2017, Vol. 39 ›› Issue (5): 665-669.doi: 10.3881/j.issn.1000-503X.2017.05.011

• 论著 • 上一篇    下一篇

心肌桥-壁冠状动脉对心功能的影响

赵新斌1(), 傅昱1, 李劼2, 孙萌2, 赵鹤亮1   

  1. 1华北理工大学附属医院,CT室,河北唐山 063000
    2华北理工大学附属医院,超声科,河北唐山 063000
  • 收稿日期:2016-10-27 出版日期:2017-10-30 发布日期:2017-10-30
  • 作者简介:

    通信作者:赵新斌 电话:0315-3726398,电子邮件:zhaoxinbinchenlei@163.com

Impact of Myocardial Bridge-mural Coronary Artery on Myocardial Functions

Xinbin ZHAO1(), Yu FU1, Jie LI2, Meng SUN2, Heliang ZHAO1   

  1. 1Department of CT,the Affiliated Hospital of North China University of Science and Technology,Tangshan,Hebei 063000,China
    2Department of Ultrasonography,the Affiliated Hospital of North China University of Science and Technology,Tangshan,Hebei 063000,China
  • Received:2016-10-27 Online:2017-10-30 Published:2017-10-30

摘要:

目的 评估心肌桥(MB)-壁冠状动脉(MCA)对心功能的影响。方法 以胸闷、胸痛症状就诊,经CT冠状动脉成像(CTCA)诊断为左前降支单发MB的82例患者为研究对象,测量MB厚度、长度,计算MCA收缩期狭窄率。同期选择CTCA 未见异常的82例健康体检者作为正常对照组。两组均行超声心动图检查。记录年龄、性别、体质量指数(BMI)、心率及吸烟史等临床资料,比较MB组与正常对照组上述临床资料及室间隔,左心室后壁厚度,左心房内径,左心室舒张末内径、收缩末内径,左心室射血分数,E’/A’<1例数的差异。MB 厚度、长度、MCA收缩期狭窄率与左心室前壁中段舒张早期及晚期峰值应变率(SRe,SRa)行相关性分析。结果 两组受试者在年龄(t=0.97,P=0.65)、性别(χ2=0.10,P=0.75)、BMI(t=1.82,P=0.07)、心率(t=0.87,P=0.39)及吸烟史(χ2=0.43,P=0.51)方面差异均无统计学意义;在室间隔(t=1.54,P=0.13),左心室后壁厚度(t=1.47,P=0.14),左心房内径(t=1.62,P=0.11),左心室舒张末内径(t=0.49,P=0.63)、收缩末内径(t=1.29,P=0.20)和左心室射血分数(t=0.56,P=0.57)方面差异也均无统计学意义;MB组E’/A’<1的例数明显高于对照组(31比0,χ2=38.22,P=0.00)。左心室前壁中段SRe(r=-0.97,P=0.00;r=-0.93,P=0.00)和SRa(r=-0.89,P=0.00;r=-0.90,P=0.00)与MB厚度和MCA收缩期狭窄率呈显著负相关;左心室前壁中段SRe(r=-0.09,P=0.76)和SRa(r=-0.13,P=0.66)与MB长度无显著相关性。结论 MB与心脏收缩功能无相关性,但与心脏舒张功能明显相关。随着MB厚度增加,MCA收缩期狭窄程度加重,心脏舒张功能逐渐降低,而MB长度与心脏舒张功能相关性不显著。

关键词: 心肌桥, 心功能, 冠状动脉造影术, 体层摄影术, 超声心动图

Abstract:

Objective To study the impact of myocardial bridge (MB)-mural coronary artery (MCA) on myocardial functions.Methods Totally 82 patients presenting with chest tightness and chest pain who were diagnosed with the MB in the left anterior descending artery by CT coronary angiography were enrolled as the MB group,in which the thickness and length of MB and the systolic stenosis degree of MCA were measured.In addition,82 healthy subjects,as confirmed by health check-up,were set as the control group.The age,gender,body mass index (BMI),heart rate (HR),smoking history,interventricular septal thickness,left ventricular posterior wall thickness,diameter of left atrium,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular ejection fraction,and the cases of E’/A’<1 were compared between MB group and control group.The potential correlations among the thicken/length of MB,the systolic stenosis degree of MCA and early diastolic peak strain rate(SRe)/late diastolic peak strain rate(SRa) were analyzed.Results The age (t=0.97,P=0.65),gender (χ2=0.10,P=0.75),BMI (t=1.82,P=0.07),HR (t=0.87,P=0.39) and smoking history (χ2=0.43,P=0.51) were not significantly difference between these two group.The interventricular septal thickness (t=1.54,P=0.13),left ventricular posterior wall thickness (t=1.47,P=0.14),diameter of left atrium (t=1.62,P=0.11),left ventricular end-diastolic diameter (t=0.49,P=0.63),left ventricular end-systolic diameter (t=1.29,P=0.20),and left ventricular ejection fraction (t=0.56,P=0.57) were also not significantly different between the normal and MB group.However,there was significant difference in the cases of E’/A’<1 (χ2=38.22,P=0.00).The SRe (r=-0.97,P=0.00;r=-0.93,P=0.00)and SRa (r=-0.89,P=0.00;r=-0.90,P=0.00) the left ventricular anterior wall were negatively correlated with the thickness of MB and the systolic stenosis degree of MCA and were not correlated with the length of MB (r=-0.09,P=0.76;r=-0.13,P=0.66).Conclusions MB is not correlated with myocardial systolic function,but can affect myocardial diastolic function.When the MB thickness increases,the systolic stenosis degree of MCA increases,the myocardial diastolic function gradually decreases,but the MB length is not related to myocardial systolic function.

Key words: myocardial bridge, myocardial function, coronary angiography, tomography, echocardiography

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