左房功能指数评价左室射血分数正常心力衰竭的价值

目的 评价左房功能指数（LAFI）在左室射血分数正常心力衰竭（HFNEF）诊断中的价值.方法 选取HFNEF患者110例,按纽约心脏病协会（NYHA）心功能分级分为NYHAⅡ级组（43例）、NYHAⅢ级组（40例）和NYHAⅣ级组（27例）,另选择健康体检者33例作为对照组.均行超声心动图检查,并计算LAFI和舒张早期二尖瓣血流速度/舒张早期二尖瓣环运动速度（E/E’）,同期行血浆脑钠肽（BNP）测定,观察LAFI与NYHA心功能分级之间的关系,及LAFI与血浆BNP、E/E,的相关性.结果 心功能越差,血浆BNP、E/E’越高,LAFI越低,差异均有统计学意义[对照组：（40.9±26.1） ng/L,6.4±2.0,0.73±0.10,NYHAⅡ级组：（230.1±85.9） ng/L,10.0±3.7,0.46±0.30,NYHAⅢ级组：（398.6±98.7） ng/L、16.9±4.0,0.26±0.30,NYHAⅣ级组：（680.3±146.6） ng/L,23.8±3.9,0.17±0.20,P＜0.05].相关性分析结果显示HFNEF患者LAFI与血浆BNP、E/E’均呈负相关（r＝-0.868,-0.873,P＜0.01）.结论 HFNEF患者LAFI与左室舒张功能障碍有很好的相关性,LAFI能够很好地早期诊断和评价左室舒张功能.

Clinical diagnostic value of left atrial function index for heart failure with normal left ventricular ejection fraction

Objective To assess the clinical diagnostic value of left atrial function index （LAFI） for heart failure with normal left ventricular ejection fraction （HFNEF）.Methods One hundred and ten patients with HFNEF were divided into 3 groups by New York Heart Association （NYHA） cardiac functional grading：NYHA Ⅱ grade group （43 cases）,NYHA Ⅲ grade group （40 cases） and NYHA Ⅳ grade group （27 cases）,and another 33 healthy subjects were selected as control group.The 4 groups were examined by ultrasoundcardiogram,LAFI and E/E＇ were calculated,and the plasma brain natriuretic peptide （BNP）levels were determined.The relation between LAFI and NYHA cardiac functional grading and the correlation between LAFI and plasma BNP,E/E＇ were observed.Results The worse heart function,the higher plasma BNP and E/E＇,and the lower LAFI,and there were statistical differences [control group：（40.9 ± 26.1） ng/L,6.4 ± 2.0,0.73 ± 0.10,NYHA Ⅱ grade group：（230.1 ± 85.9） ng/L,10.0 ± 3.7,0.46 ± 0.30,NYHA Ⅲ grade group：（398.6 ±98.7） ng/L,16.9 ±4.0,0.26 ± 0.30,NYHA Ⅳ grade group：（680.3 ± 146.6） ng/L,23.8 ± 3.9,0.17 ± 0.20,P ＜ 0.05].The correlation analysis results showed that LAFI and plasma BNP,E/E＇ were negatively correlated in patients with HFNEF （r =-0.868,-0.873,P ＜ 0.01）.Conclusions In HFNEF patients,there is significant correlation between LAFI and left ventricular diastolic dysfunction.LAFI can well diagnose diastolic heart failure early and evaluate the diastolic function of the left ventricle.