Noninvasive Measurement Of Coronary Perfusion Pressure In Patients Of Dilated Cardiomyopathy With Chronic Systolic Heart Failure

Objective: To estimate the coronary perfusion in the dilated cardiomyopathy(DCM) with the chronic systolic heart failure, the study evaluated the end-diastolic aortic regurgitant pressure gradients in the DCM with mild aortic regurgitant by the continuous-wave Dopperecho.Methods: Twenty healthy individuals and the eighty DCM patients with mild aortic regurgitant were selected in 1st Affiliated Hospital of Dalian Medical University from April 2006 to February 2007. The eighty patients were divided into two groups: The idiopathic dilated cardiomyopathy group(n=40), the ischemic cardiomyopathy group(n=40). Using 2-dimentional guide M-mode, pulse wave and continuous-wave, transthoracic echocardiograms was recorded at rest by HP Sonos 5500 color echocardiographic diagnostic system. We acquired interventricular septal thickness(IVST), left ventricular internal diastolic dimension(LVIDd), left ventricular internal systolic dimension (LVIDs), left ventricular posterior wall thickness(PWT), left atrial diameter(LA) and left ventricular ejection fraction(EF). From the five-chamber view of left ventricular, the blood flow signal of aortic regurgitant was recorded by the continuous-wave Dopperecho. we acquired the early-diastolic, mean, end-diastolic aortic regurgitant pressure gradients. The end-diastolic aortic regurgitant pressure, equivalently coronary perfusion pressure, was measured at the point of electrocardiographic Q wave.Results:1. There were significant differences in cardiac structure, function and coronary perfusion pressure between patients with chronic systolic heartfailure and the healthy control group(p<0.01). The former had larger chambers heart,lower heart function, and lower coronary perfusion pressure.2. There were not difference in cardiac structure, function and coronary perfusion pressure between the idiopathic dilated cardiomyopathy group and ischemic cardiomyopathy group.Conclusion:1. The patients of ischemic cardiomyopathy or non-ischemic cardiomyo- pathy with systolic heart failure have low coronary perfusion pressure. The main reason is the higher left ventricular end-diastolic pressure.2. coronary perfusion pressure is a general index to reflect myocardial perfusion. Cardiac function has a main effect on coronary perfusion pressure.3. Our method offers a reliable approach to the noninvasive estimation of coronary perfusion pressure.