期刊文献+

运动心血池显像评价高血压左心室肥厚患者的心功能

Evaluation of Cardiac Performance by Blood Pool Cardiac Scintigraphyduring Exercise in Hypertensive Patients with Left Ventricular Hypertrophy
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摘要 为探讨高血压左心室肥厚(HLVH)患者LVH及心肌缺血对应激下左心室收缩功能影。方法83例超声确定的HLVH病人行动静态99mTc-MIBI心肌断层显像及心室造影检查,8例行冠脉造影。年龄、性别相配的24例单纯性原发性高血压(HT)病人作对照。HLVH病人又分为单纯LVH组(SLVH)与LVH伴缺血组(LVHI)。结果在静态下,3组间射血分数(EF),最大充盈率(MFR)均无统计学上不同。SLVH组运动高峰时EF(EEF),EMFR以及运动诱发的改变量ΔEF,ΔMFR明显比SHT组低,调整年龄、心率影响,两组间上述指标仍有显著差别。SLVH组ΔEF,EEF明显比LVHI组高,而ΔMFR,EMFR在两组间无差别。SLVH组,ΔEF与SBP,EMFR,ΔMFR相关,而与MFR,LVMI,DBP无相关。LVHI组ΔEF与以上参数均无相关。结论(1)SLVH病人运动时射血功能减弱可能主要由于左心室充盈不足,而不取决于左心室肥厚程度。(2)LVHI病人运动时收缩功能进一步下降可能是心肌缺血引起,受左心室肥厚程度及左心室充盈影响不大。 Aim\ To exporle the effect of left ventricular hypertrophy(LVH) and myocardial ischaemia(MI) on stress left ventricular systolic function in patients with hypertensive LVH(HLVH). Methods\ 83 patients with HLVH,diagnosed by echocardigraphy,were performed.\ 99mTcMIBI myocardial perfusion imaging and ventriculography,8 of them were subjected to coronary angiography.\ Age,sexmatched patients with hypertension(HT,n=24) were served as controls.\ HLVH patients were further divided into simple LVH(SLVH) and LVH complicated with MI(LVHI) groups. Results\ There was no statistical difference in ejection fraction(EF) and maximal filling rate(MFR) at rest among three groups.\ SLVH group showed lower peak exercise EF(EEF),MFR(EMFR) and a smaller increase of exercise in EF(ΔEF) and ΔMFR than that in HT group.\ After adjustment for age and heart rate,the above parameters above remained markedly different between two groups.\ ΔEF,EEF in SLVH group was significantly higher than that in LVHI group,however,no difference in ΔMFR,EMFR and left ventricular mass index(LVMI) between SLVH and LVHI groups was found.\ In SLVH group,ΔEF was markedly related to SBP,EMFR,ΔMFR and irrelevant to MFR,LVMI,DBP.\ However in LVHI group,there was no significant correlation between ΔEF and the above parameters.\ Conclusion\ (1)Exerciseinduced systolic dysfunction in patients with SLVH is associated with impaired diastolic filling in left ventricle;(2)In LVHI patients,further impairment in exerciseinduced systolic function may be ascribed to the degree of MI and is not significantly related to the degree of LVH and the filling augmentation of left ventricle.
出处 《高血压杂志》 CAS CSCD 1997年第4期287-290,共4页 Chinese Journal of Hypertension
关键词 心脏扩大 高血压 心功能 运动 心血池造影 heart enlargement hypertension heart function exercise myocardial perfusion imaging cardial blood pool imaging
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  • 1刘国仗,实用高血压学,1993年
  • 2邬大元,药物分析杂志,1993年,3卷,155页

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