心脏收缩时间间期与冠状动脉狭窄程度或范围的相关性研究

心脏收缩时间间期(STI)通过单笔心电图机叠加记录ECG、心音图和颈动脉图后测得。对83例患者进行了STI均值与选择性冠状动脉造影(CAG)及左室造影的相关研究。患者除陈旧性心肌梗塞及室壁瘤外,根据冠状动脉(CA)狭窄程度而分组。STI随CA狭窄程度及范围的增加而显著异常,提示心功能随心肌缺血程度加重而进行性恶化。左室射血分数(LVEF)的降低也支持这一点。CA狭窄程度、范围与射血前时间/左室射血时间(PEP/LVET)呈正相关。在决定左室功能的异常方面,PEP/LVET和LVEF的临床意义完全相同。提示STI在评价冠心病心功能上是有用的。排除影响STI的某些因素后,PEP/LVET≥0.38可作为判断冠心病左心功能减退的标志。但轻度CA狭窄患者的STI可正常,这可能与静息时尚有足够的CA贮备力有关。

STUDY ON THE CORRELATION BETWEEN SYSTOLIC TIME INTERVALS AND DEGREE OR EXTENT OF CORONARY STENOSIS

Systolic time intervals (STI) were measured by the superposed recording of electrocardiogram and phonocardiogram or/and carotid artery pulse tracing, and the correlation between mean values of STI and the selective coronary arteriography and left vetriculography was studied in 83 patients. Except those with myocardial infarction and ventricular aneurysm, the patients were divided into groups according to the extent of coronary stenosis. The results showed that greater abnormalities of STI were observed in patients with increased degree and extent of coronary stenosis, suggesting a progressive deterioration of cardiac performance with increasing severity of myocardial ischemia. The reduction of heart function was also evidenced by the decrease in LVEF. The degree and extent of coronary stenosis were positively correlated with PEP/LVET and negatively correlated with LVEF, but PEP/ LVET and LVEF showed same clinical significance in reflecting left ventricular performance.It is suggested that after excluding some factors influencing STI, STI may be used for evaluating cardiac performance in coronary artery disease with PEP/LVET>0.38 as a marker of deterioration of cardiac function in coronary artery disease. However, some patients, with mild coronary stenosis have normal STI which may be related with adequate blood flow provided by coronary reserve at rest.