组织多普勒评价原发性高血压不同左心室构型患者右心室舒张功能

Doppler tissue imaging to assess right ventricular diastolic function of essential hypertension patients with diferent remodeled left ventricle

目的:应用多普勒组织成像(DTI)技术检测原发性高血压(EH)不同左心室构型患者三尖瓣环脉冲组织多普勒(PW-DTI)频谱,评价其右心室舒张功能。方法:EH患者80例,按照Ganau分类方法,以左心室质量指数(LVMI)和相对室壁厚度(RWT)分为:正常左心室构型组(EH1组),向心性重构组(EH2组),向心性肥厚组(EH 3组)及离心性肥厚组(EH 4组);另入选20例健康体检者作为正常对照组。取标准心尖四腔切面,用PW-DTI技术测量各组的三尖瓣瓣环舒张早期峰值速度(E),舒张晚期峰值速度(A)及E/A值。结果:与正常对照组比较:EH1、2、3、4组E峰逐渐减低,A峰逐渐增高,E/A比值逐渐减低(P<0.05);EH各组间比较:平均E峰逐渐减低且随左心室构型改变呈下降趋势(P<0.05);平均A峰逐渐增高且随左心室构型改变呈上升趋势(P<0.05)。结论:①EH患者早期左心室构型正常时已存在右心室舒张功能减低;②EH患者的右心室舒张功能在不同左心室构型中根据恶化程度呈下降趋势;③DTI技术可用于评价EH患者右心室舒张功能。

Objective：To assess diastolic functions of right ventricle in patients with essential hypertension （EH） by Doppler tissue imaging （DTI） technique evaluating tricuspid annular pulsed wave-DTI （PW-DTI） frequency spectrum and discuss its value in this field. Method： Eighty patients with EH were enrolled. According to Ganau categorization, the patients were divided into four groups, and 20 healthy subjects as control group were included. DTI data were acquired from tricuspid annular on apical four-chamber views. PW-DTI technique was used for measuring the peak early diastolic, late diastolic velocities （E, A） of tricuspid annular and the ratio of E/A. Result： ①Compared with control group, E and E/A in EH group 1, 2, 3 and 4 decreased gradually and A increased gradually （P〈0.05）. ②Comparison in the EH groups; E decreased gradually （P〈0.05） and A increased gradually （P〈0.05）, E showed increased tendency and A showed decreased tendency with different patterns of left ventricular geometric models. Conclusion： Right ventricular diastolic function could also decrease in early stage of EH when left ventricle was not remodeled. Right ventricular diastolic functions in patients with EH decreased according to the degree of exacerbation. DTI technique might be used for assessing right ventricular function of EH.