| Objectives:Objective to investigate the value of left ventricular systolic pressure and end diastolic pressure in left ventricular reserve before and after left ventricular angiography.Methods:A total of 172 patients(107 male,65 female,61±6.8 years)who underwent left ventriculography in the Second Affiliated Hospital of Nanchang University from December 2015 to December 2016 were collected and screened.The patients condition for Age more than 16 years of age,blood routine,renal function,electrolyte,blood coagulation function,normal ECG examination,row Circumcenter AF,atrial flutter and other arrhythmias.A total of 148 eligible patients(97 male,51 female,60.8±7.4 years)in clinical research.The age,sex,and cardiac function classification of 148 patients were collected.The use of angiography machine and high pressure injector for left ventricular angiography detection,pigtail catheter sent to the left ventricular apex near the central position,ask the patient to keep quiet breathing,the pressure curve was smooth after recording before angiography of left ventricular systolic pressure and diastolic pressure S1 and D1,at a speed of high voltage 15ml/s(900KPa)injection of contrast agent(iodixanol)35ml immediately,after injection,10 ml patients were asked to draw blood;keep quiet breathing,the pressure curve is smooth,1 minutes was recorded after the left ventricular systolic pressure S2 and left ventricular end diastolic pressure D2.calculation of left ventricular angiography after left ventricular systolic pressure difference with?S(S2-S1),end diastolic pressure difference with ?D(D2-D1)said.The left ventricular ejection fraction(LVEF)was calculated by the single plane Simpson method,and left ventricular end systolic and left ventricular end diastolic patterns were recorded.For the follow-up of the patients enrolled in the study.The follow-up time was 6 months after discharge(6month±7day);follow-up content for patients with active tolerance;tolerance assessment questionnaire according to the activity of VSAQ findings,the patients with active tolerance is divided into I,II,III,IV four grades,of all the patients enrolled in the study.For the evaluation questionnaire.According to the activities of tolerance to evaluate left ventricular function reserve,the activities of tolerance I,II defined as left ventricular reserve,activity tolerance III,IV defined as left ventricular reserve dysfunction.The patients were divided into two groups according to whether the cardiac function was normal or not,And the left ventricular pressure changes were grouped according to left ventricular angiography,To compare the relationship between pressure changes and cardiac function and left ventricular reserve function.All the collected data were analyzed by SPSS21.0 analysis.Results:1.Among two groups of patients with different cardiac functions,Normal heart function group were 57,which ?S increased 45,?S constant 8,?S reduce 4;?D increased 7,?D constant or slightly decreased 50.Abnormal heart function group were 91,which ?S increased 13,?S constant 33,?S decreased 45;?D increased 72,?D no change or slight decline in 19.?S different changes in heart function overall significant differences(Pearson chi square test c2=28.712,P< 0.01),The ?S increased group the abnormal cardiac function was significantly lower than the ?S in drop group(22.4% vs 91.8%);The different changes of ?S values were compared between the two groups,The ?S increased there are great differences in heart function and no change ?S(Pearson chi square test c2=32.567,P < 0.01),The ?S increased both have significant difference in heart function and a decrease of ?S(Pearson chi square test c2=51.569,P<0.01),The different changes of ?D in heart function had significant differences(Pearson chi square test c2=62.918,P<0.01),The ?D increased group the abnormal cardiac function was significantly higher than that of ?D unchanged or slightly decreased group(91.1% vs 27.5%).2.Two groups of patients with different left ventricular function in reserve,There were 84 patients with good left ventricular reserve function,The ?S increased 50,?S constant 27,?S decreased 7;?D increased 20,?D no change or slight decline in 64.There were 64 patients with abnormal left ventricular reserve function,The ?S increased 8,?S constant 14,?S decreased 42;?D increased 59,?D no change or slight decline in 5.?S different changes in left ventricular functional reserve overall significant differences(Pearson chi square test c2=57.890,P < 0.01),The ?S increased group left ventricular reserve function abnormal rate was significantly lower than that of ?S in lower group(13.8% vs 85.7%);The different changes of ?D in left ventricular functional reserve had significant differences(Pearson chi square test c2=68.246,P < 0.01),The ?D increased group left ventricular reserve function abnormal rate was significantly higher than that of ?D unchanged or slightly decreased group(74.7% vs 7.2%).3.Different changes in groups ?S and ?D of the delta delta after left ventricular angiography,There were 84 patients with good left ventricular reserve function,Among the four changes,A was 16,B was 23,C was 23,and D was 22;There were 64 patients with abnormal left ventricular reserve function,Among them,A was 31,B was 20,C was 3,and D was 10;Four changes of ?S and ?D group in the left ventricular functional reserve overall significant difference(Pearson chi square test c2=22.591,P < 0.01),In A group,left ventricular function reserve abnormal rate was significantly higher than C group(66.0% vs 11.5%);The follow-up showed that the C group had good activity tolerance,and the proportion of the patients was higher than the baseline level(80.8% vs 35.6%).Conclusions:Left ventricular pressure changes after left ventricular angiography can be used to assess left ventricular reserve function,The decrease or decrease of the left ventricular systolic pressure and the increase of diastolic terminal pressure are sensitive indexes reflecting the poor reserve function of the left ventricle;Left ventricular systolic pressure increases with left ventricular end diastolic pressure unchanged or decreased after angiography,which is a sensitive index reflecting left ventricular reserve function. |
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