冠脉血流显像技术无创性评价轻度高血压患者冠脉血流储备

Noninvasive assessment of coronary flow reserve in slight hypertension by coronary flow imaging

目的 了解轻度高血压是否存在冠脉循环的功能性损害。方法 应用经胸超声心动图冠脉血流显像技术测量 2 3例无症状轻度高血压患者在静脉输注潘生丁溶液结合等长握力负荷状态下前降支冠脉血流的速度变化 ,并与 2 1例正常健康者对照。结果 轻度高血压组最大冠脉血流与基础冠脉血流速度比值较对照组降低 (峰值速度比为 3 .0 2± 0 .64vs 3 .77± 0 .5 8,P <0 .0 5 ) ,最小冠脉血管阻力指数较对照组增大 ( 0 .3 4± 0 .0 6vs 0 .2 6± 0 .0 8,P <0 .0 5 ) ,舒张功能出现轻度异常。两组左室腔径、左室重量和左室收缩功能无明显改变。结论 无症状的轻度高血压患者可出现冠脉储备降低和舒张功能异常。冠脉血流显像技术为评估冠脉循环功能提供了无创、简便、实用的冠脉血流储备检测手段。

Objective To investigate whether functional abnormalities in coronary vasomotion are present in asymoptomatic patients with slight hypertension.Methods Epicardial coronary blood flow was measured during intravenous dipyridamole combined with sustained isometric handgrip exercise in 23 patients with slight hypertension and 21 matched healthy control subjects.Left ventricle mass,dimensions,and function were evaluated by echocardiography.Results The maximal responses of coronary flow was lower and the minimal coronary vascular resistance index was higher in slight hypertension than in control,the ratios of the peak to baseline coronary flow velocity was 3.02 ± 0.64 vs 3.77 ± 0.58 .LV diastolic function was damaged slightyl and LV mass,dimension and systolic function were normal in slight hypertension.Conclusions The coronary flow imagins provides a noninvasive and efficient method of evaluating coronary flow reserve.Reduced coronary reactivity and augmented coronary vascular resistance exist in patients with slight hypertension.