高血压对冠脉循环损害的超声研究

Evaluation of coronary flow reserve in patients with hypertension by transesophageal coronary sinus Doppler measurements

目的 应用超声检查探讨高血压对冠脉循环的影响。方法 对照组 10例 ,高血压病组 34例 ,根据是否有心绞痛症状 ,将高血压病组分为有症状组和无症状组。应用经食管超声心动图技术 (TEE)检测受试者静脉注射潘生丁前后冠状窦血流参数 ,以潘生丁负荷后与基础状态下冠状窦前向血流比值为冠脉血流储备(CFR)指标。结果 高血压病组CFR明显低于对照组 (1.93± 0 .5 5vs 3 .0 0± 0 .5 5 ,P <0 .0 0 1) ;高血压病有症状组的CFR明显低于无症状组 (1.6 7± 0 .32vs 2 .39± 0 .5 8,P <0 .0 0 1)。结论 CFR减低是高血压病患者出现静息或劳累性心绞痛的机制之一 ;TEE探测冠状窦血流评估CFR具有较高的应用价值。

Objective To evaluate the effect of hypertension on coronary circulation.Methods Thirty four patients with hypertension ( twenty two patients had clinical symptoms of angina pectoris with angiographically normal epicardial coronary arteries and twelve had asymptoms) were studied. Ten subjects with no cardiovascular disease served as a control group. Transesophageal coronary sinus Doppler measurements were made before and after dipyridamole administration ( 0.56 mg/ kg in 4 minutes ). Coronary flow reserve (CFR) were calculated by dividing coronary sinus flow variables after dipyridamole administration by the respective baseline values.Results CFR was significantly lower in patients with hypertension than that in control subjects ( 1.93 ± 0.55 vs 3.00 ± 0.55 ,P< 0.001 ). CFR was also decreased in hypertensive patients with angina pectoris compared with that in the patients without symptoms ( 1.67 ± 0.32 vs 2.39 ± 0.58 ,P< 0.001 ).Conclusions The reduction of CFR is one of the mechanism of angina pectoris outset in patients with hypertension and normal coronary arteries. Estimation of CFR by transesophageal coronary sinus Doppler measurements is feasible and reliable.