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异丙肾上腺素超声负荷试验对二尖瓣球囊扩张术后疗效的评价 |
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傅向阳 吕俊豪 吴群 刘品明 杨福庆 唐晓明
【摘要】 目的 对24例二尖瓣狭窄患者行球囊扩张术前后作异丙肾上腺素超声心动负荷试验，拟进一步评价经皮穿刺二尖瓣球囊扩张术的疗效。方法 在患者安静休息的基础心率及应用异丙肾上腺素静脉点滴后不同心率状态下测定二尖瓣口面积(MVA)、二尖瓣跨瓣压差(MVG)及心排血量(CO)。结果 二尖瓣球囊扩张使得静息状态下的瓣口面积（0.91±0.28升至1.87±0.23cm2，P＜0.01），跨瓣压差（12.5±6.3降至3.9±1.9mmHg，P＜0.05)，及心排血量（3.93±1.44升至4.73±1.01 l/min，P＜0.05)发生明显变化。在球囊扩张前做异丙肾上腺素试验时，虽然随着心率加快，跨瓣压差明显升高(P＜0.01)，但瓣口面积及心排血量并无显著改善(P>0.05)。但球囊扩张术后再做异丙肾上腺素试验时，随着心率加快，跨瓣压差升高，瓣口面积（从1.85±0.48升至2.32±0.36cm2, P＜0.01）及心排血量（从4.48±1.98升至7.55±1.90 L/min, P＜0.01）均明显进一步改善。结论 异丙肾上腺素超声负荷试验能进一步评价二尖瓣球囊扩张术后的贮备功能，且该法安全、重复性强。
【关键词】 二尖瓣狭窄 气囊扩张术 异丙肾上腺素
Isoproterenol stress echocardiography in assessing mitral valve reserve capacity after percutaneous balloon valvuloplasty
Fu Xiangyang, Lü Junhao, Wu Qun, et al. Department of Cardiology, Zhu Jiang Hospital, First Military Medical University, PLA, Guangzhou 510282
【Abstract】 Objective The aim of this study was to assess mitral valve area and cardiac reserve in patients with mitral stenosis after successful and uncomplicated percutaneous balloon valvuloplasty by isoproterenol stress echocardiography. Methods Twenty-four patients suffering from pure rheumatic mitral stenosis with sinus rhythm (18) or FA(6) who were scheduled to receive valvulotomy underwent isoproterenol stress echocardioraphy before and after valvulplasty. Mitral valve area by direct planimetry of two-dimensional echocardiography, mean transmitral pressure gradient by continuous-wave Doppler echocardiography , and cardiac output by M-mode echocardiography were measured at rest and after stress by isoproterenol infusion to a different heart rate. Results After valvuloplasty vitral valve area (0.91±0.28 to 1.87±0.23cm2, P<0.01), mean transmitral pressure gradient (12.5±6.3 to 3.9±1.9mmHg, P<0.05) and cardiac output (3.93±1.44 to 4.73±1.01 L/min, P<[1] [2] 下一页
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