遗传因素对高血压患者血压正常子女左心结构及舒张功能的影响

Genetic influence on left ventricular structure and diastolic function in normotensive offspring of parents with essential hypertension

目的:利用超声心动图技术探讨遗传因素对有高血压家族史的血压正常者左室结构及舒张功能的影响。方法:血压正常者100例,其中无高血压家族史者50例(对照组),有高血压家族史者50例(试验组)。分别行M型、二维超声及多普勒组织成像(DTI)检测左心形态及舒张功能,比较两组间的差异。结果:试验组舒张末期室间隔厚度(IVST)及舒张末期左室后壁厚度(LVPWT)、左室质量指数(LVMI)均高于对照组。二尖瓣环舒张早期运动速度e及e与二尖瓣环舒张晚期运动速度a比值(e/a)较对照组减低,差异有显著性(P<0.05)；两组之间主动脉根部内径(AOD)、左心室舒张末期内径(LVIDed)、左房内径(LA)及二尖瓣口舒张早期血流速度峰值E、左房收缩期血流速度峰值A、E／A无显著差异。结论:易患高血压的高危人群其心脏形态及功能的变化可先于血压升高而发生,遗传因素对其发生有一定的影响。

Objectives： To compare the difference of the left ventricular mass and diastolic function in normotensive offspring with or without a familial history of hypertension. Methods： 100 normotensive offspring with ages ranging from 15 to 40 years old were assessed, 50 had hypertensive parents （NOH） and 50 had normotensive parents （NON）. By echocardiography and doppler tissue imaging, the following parameters of left ventricular structure and diastolic function were examined： IVST, LVPWT, LVIDed, LVMI, e/a and E/A ratio. Results： Compared with NON, the normotensive offspring of hypertensive parents had greater IVST,LVPWT and LVMI, lower peak velocity of the early diastolic wave（e） of mitral annulus, and lower c/a ratio （P〈0. 05）. No differences in LVIDed,LA,AOD and E/A ratio were found between the two groups. Conculsion： The results indicate that genetic factor of parental hypertension influences left ventricular structure and diastolic function in normotensive offspring, suggesting that cardiac involvement may precede the elevation of blood pressure.