高血压病左心室构型对房室性心律失常的影响

Effect of left ventricular geometry on occurrence of atrial or ventricular arrhythmias in essential hypertensive patients

目的探讨高血压病左室重构不同构型对房、室性心律失常发生及其严重程度的影响。方法入选高血压病患者153例,均经24小时动态心电图检查判定心律失常情况,超声心动图检查分析左心室构型。根据超声心动图检查结果分为4组:正常构型组(31例),向心性重构型组(45例),向心性肥厚型组(42例)和离心性肥厚型组(35例);比较左心室不同构型间心律失常发生率和严重程度的差异。结果①共检出房性心律失常105例(占68.6%),室性心律失常74例(占48.4%),两组有统计学差异(P<0.05)。②不管是房性心律失常、复杂房性心律失常,还是室性心律失常、复杂室性心律失常,他们在高血压病左室重构不同构型组间的发生率均有显著差异(P<0.05),且以向心性肥厚型组和离心性肥厚型组的发生率最高(P<0.05)。结论高血压病左室重构不同构型间心律失常的发生及严重程度存在差异,且向心性肥厚型和离心性肥厚型易发生复杂房、室性心律失常。

AIM To study the effect of different ventricular geometric patterns on the onset and severity of atrial or ventricular arrhythmias in essential hypertensive patients. MRTHODS One hundred and fifty-three essential hypertensive patients were enrolled in this study. Their arrhythmias were monitored by 24-houre ambulatory electrocardiogram and their left ventricular geometric patterns were analyzed by echocardiograph. The patients were classified into four groups according to the echocardiographic findings： normal geometry, concentric remodeling, eccentric hypertrophy and concentric hypertrophy. RESULTS In the 153 essential hypertensive patients, atrial arrhythmia was found in 105 （68.6%） and ventricular arrhythmia in 74 （48.4%） cases（ P 〈0.05 ）. Morbidities of atrial and complex atrial arrhythmia as well as that of ventricular and complex ventricular arrhythmias were significantly different among each left ventricular geometric patterns（P 〈 0.05 ）. The morbidities of these arrhythmias in hypertensive patients with eccentric hypertrophy and concentric hypertrophy were higher than those in other groups （ P 〈 0.05 ）. CONCLUSION The onset and severity of arrhythmias are different in each left ventricular geometric pattern and complex atrial or ventricular arrhythmia is more likely to occur in hypertensive patients with eccentric hypertrophy and concentric hypertrophy.