心脏负荷改变对多普勒超声左室舒张功能指标的影响

INFLUENCE OF HEART LOAD ALTERATION ON PULSED DOPPLER INDEXES OF LEFT VENTRICULAR DIASTOLIC FUNCTION

本文用脉冲多普勒超声对30名正常人和30例高血压病患者,做了握力试验和硝酸甘油试验前后的左室舒张功能测定。结果表明,53%(16/30)的早、中期高血压病患者存在左室舒张期充盈形式异常,表现为E/A之比<1。心脏前负荷降低和后负荷增加,使舒张功能正常和异常者的E/A之比降低,呈现与左室舒张功能减退相似或舒张功能减退加重的二尖瓣血流频谱。

We studied the influence of alteration of heart preload and afterload on pulsed Doppler idexes of left ventricular diastolic ftlhction in 60 subjects: 30 hypertensive patients and 30 normal subjects of similar age. Handgrip test were performed to increase left ventricular afterload and nitroglycerin test to decrease left ventricular preload. The results showed that the peak early filling velocity (VE) and the ratio of E/A were decreased in 53% of the hypertensives compared with normal subjects and abnormal left ventricular diastolic filling pattern could be detected in the early and middle stage hypertensives. An increase in afterload and a decrease in preload may decreased the ratio of E/A in subjects with normal and abnormal left ventricular diastolic function. It may induce a diastolic filling patternthat minics diastolic dysfunction. This suggests that load conditions need to be accounted for when the status of diastolic function is extrapolated from the pulsed Doppler mitral inflow velocity profile.