家族史对高血压患者血压正常子女左心结构及舒张功能的影响

The influence of family history 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家族史对高血压患者血压正常子女的左心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）检测左心结构及舒张功能，比较两组间的差异。结果试验组舒张末期室间隔厚度（IVST）及舒张末期左心室后壁厚度（LVPWT）、左心室质量指数（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，差异有统计学意义（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）、左心房内径（LA）及二尖瓣口舒张早期血流速度峰值（E）、左心房收缩期血流速度峰值（A）、E／A比较差异无统计学意义。结论高血压患者血压正常子女可以出现左心结构及舒张功能变化。且可在高血压出现之前发生，家族史对其发生有一定影响。

Objective To compare the difference of the left ventricular structure and diastolic function in normotensive offspring with or without a family history of hypertension. Methods One hundred normotensive offspring were assessed. Fifty had a family history of hypertension （experimental group） and 50 had no family history of hypertension （control group）. By echocardiography and Doppler tissue imaging, the following parameters of left ventricular structure and diastolic function were examined： interventricular septal thickness （IVST）, left ventricular posterior wall thickness （LVPWT）, left ventricular internal dimension （LVIDed）, left ventricular mass index（LVMI） and E/A. Results Compared with control group, experimental group had higher IVST, LVPWT and LVMI, lower peak velocity of the early diastolic wave （e） of mitral annulus, and lower e/a （P 〈 0.05）. No differences in LVIDed, left atrial diameter （LA）,aortic dimension （AOD）, E, A and E/A were found between the two groups. Conclusion The results indicate that genetic factor of parental hypertension influence left ventricular structure and diastolic function in normotensive offspring, which may precede the elevation of blood pressure.