左心房容积指数与高血压患者左心室舒张功能相关性探讨

Evaluation relationship between left atrial volume index and left ventricular diastolic function in patients with hypertension

目的探讨左心房容积指数(LAVI)与原发性高血压患者左心室舒张功能之间的关系,为评估原发性高血压患者左心室舒张功能提供一项较准确的指标。方法原发性高血压患者110例,分为舒张功能正常组(组2)、舒张早期功能不全组(组3)、假性正常化组(组4)和限制性充盈障碍组(组5),健康对照组30例(组1),行常规超声心动图及脉冲组织多普勒(PW-TDI)检测获取各超声指标。将高血压各组的LAVI与健康对照组进行比较,并将LAVI与E/Em对左心室舒张功能的评估进行对照分析。结果①从健康对照组(组1)到高血压各组(2～5组),LAVI值依次增高(P<0.05)。②LAVI、E/Em比值用于诊断高血压患者左心室舒张功能不全的ROC曲线下面积分别是0.841和0.877;两者ROC曲线下面积差异无统计学意义(P>0.05)。结论①LAVI为评估高血压患者左心室舒张功能较准确的指标之一。②LAVI越大,高血压患者左心室舒张功能受损越严重。

[Objective] By researching the relationship between left atrial volume index （LAVI） and left ventricular diastolic function of essential hypertensive patients, we may provide a index to evaluate the left ventricular diastolic function in patients with hypertension. [Methods] 110 patients with essential hypertension and healthy control group of 30 patients （group 1） were enrolled in this research. All of them were detected by conventional eehoeardiography and Pulsed-Wave Tissue Doppler Imaging （PW-TDI） parameters were de- tected. Patients with essential hypertension were divided into four groups： Group 2： normal diastolic function group; Group 3： early diastolic dysfunction group; Group 4： pseudo-normalization group; Group 5： restrictive filling group. The LAVI between each group of patients with hypertension and the healthy control group （group 1） were compared. Besides, the circulation of LAVI and E/Em which to judge left ventrieular diastolic dysfunction was analyzed. [Results] From the healthy control group to group 2, group 3, group 4 and group 5, LAVI increased gradually （P〈0.05）. The area under the ROC curve （AUC） for LAVI, E/Em to detect left ventricular diastolic dysfunction in hypertensive patients were 0.841, 0.877. The AUC of LAVI and E/Ein had no significant difference （P〉0.05）. [Conclusion] Left atrial volume index is suggested to be a good index to assess left ventricular diastolic function in hypertensive patients. The larger left atrial volume index has got,the more severe of left ventricular diastolic dysfunction would be.