室壁径向应力-中层径向缩短关系对高血压不同左心室构型心肌收缩力的研究

Relation between circumferential wall stress and midwall shortening for assessing myocardial contractility in essential hypertention of different remoldings

目的 应用室壁中层径向缩短率 (mFs)、室壁中层径向缩短率与收缩末期径向室壁应力关系(mFs cEss)指标探讨原发性高血压不同左室构型心肌收缩力情况。方法 在二维图像指导的M型测值下 ,计算 115例原发性高血压患者 4种构型及正常对照组 2 9例的射血分数 (EF)、收缩末期径向室壁应力(cEss)、短轴缩短率 (Fs)及mFs ,对有关参数进行t检验、直线相关分析、直线回归分析及多元回归分析。结果 EF、短轴缩短率与收缩末期径向室壁应力关系 (Fs cEss)评价高血压 4种左室构型患者的心室排空功能 ,除离心性肥厚者外 ,其余 3种构型存在高估现象。mFs评估高血压 4种构型患者的心肌收缩力时 ,发现其均值均小于正常对照组 (P <0 .0 0 1) ,以向心性构型尤其向心性肥厚者为甚 ;mFs cEss关系估测心肌收缩力时 ,60 .3 %向心性肥厚者、3 8.5 %向心性构型者的回归点落于对照组 95 %回归区间下限外。结论mFs ,mFs

Objective To assess myocardial contractility in essential hypertention(EH) of different remoldings by means of circumferential midwall fractional shortening (mFs), relation between mFs and circumferential end-systolic stress(mFs-cEss). Methods The eject fraction(EF), circumferential end-systolic stress(cEss), fractional shortening(Fs), mFs was calculated in 115 EH patients and 29 normal controls. Relations in mFs-cEss, Fs-cEss between the subjects were analysed with linear correlation and linear regression. Results In using EF,Fs,Fs-cEss to assess chamber function of the patients with hypertension of four left ventricular remoldings, it shows apart from eccentric hypertrophy, the rest three remoldings were overestimative. MFs assessing myocardial contractility in four remoldings was lower than that of the controls, especially obvious in concentric hypertrophy patients(P< 0.001). In assessing myocardial contractility by the relation between mFs and cEss, 60.3% concertric hypertrophy and 38.5% concentric remolding patients were below the lower limits of normal control 95% confidence interval. Conclusions MFs,mFs-cEss can reflect sensitively left ventricular myocardial contractility in EH of different remoldings.