定量组织速度成像技术评估高血压患者左室构型与功能关系的研究

Relationship between left ventricular geometric patterns and functions in essential hypertension assessed by quantitative tissue velocity imaging

目的应用QTVI超声心动技术评价高血压患者左室构型与功能的关系。方法120名原发性高血压患者按Ganau分类法分为4型,正常对照组32名,均行常规超声心动图及QTVI检查。比较分析QTVI所测左室壁二尖瓣环六个位点(侧壁和后间隔、前壁和下壁、前间隔和后壁)处的运动速度指标Sm、Em、Am及Em/Am的变化特点,且与常规超声心动功能指标FS、LVEF、E/A进行比较。结果①高血压各组患者左室壁二尖瓣环六个位点处的平均Sm、Em较正常对照组均显著减低(P<0.05或P<0.01);②Sm在高血压各组中数值呈递减变化,离心性肥厚组Sm最低;③在高血压各组中,向心性肥厚组Em数值最小,其次为离心性肥厚组,向心性重构组和正常构型组。结论①QTVI技术比常规超声心动图能更早、更敏感地发现高血压所致的左心室收缩、舒张功能障碍。②随着高血压时左室由正常构型向离心性肥厚的发展,QTVI能准确评估左心室收缩和舒张功能变化特点。

Objective To analyze the relation between left ventricular geometry and depressed function in essential hypertension with quantitative tissue velocity imaging （QTVI）. Methods According to Ganau＇s categories, the ventricular geometries of 120 patients with essential hypertension were divided into four groups, The peak velocities of six LV wall sites at mitral annuluses during systole, early and late diastole （Sin, Era, Am） and the Era/Am ratios were compared with cardiac function indices,such as FS, EF and E/A. Results LV wall dynamic velocity Sm ,Era in hypertension groups decreased significantly with different degreed compared to normal group （P〈0.05 or P〈0.01 ）. Sm decreased with different degreed in hypertension groups and the lowest Sm was found in eccentric hypertrophy. Em in concentric hypertrophy was the lowest. Conclusion Compared with EF, FS and E/A, QTVI-derived Sm and Em are more sensitive and accurate to defect LV dysfunction early, and functions decrease obviously in essential hypertension with normal left ventricular. QTVI can assess accurately the change characteristic of LV functions with the change of parameters of LV geometric patterns in hypertension.