超声心动图对高血压病人左室舒张功能再评价

Reevaluation of Left Ventricular Diastolic Function in Essential Hypertension Patients by Echocardiography

目的 探讨超声心动图对高血压 (EH)病人左室舒张功能评价价值。方法 140例EH病人分为左室肥厚组 47例 ,非左室肥厚组 93例 ,予二维超声心动图及Doppler频谱检测 ,并与 2 5例正常人对照。 结果 在正常组和NLVH组 ,E/A比值、PA值和PAi有显著差异 ;IVRT、LAD在 3组之间有显著差异 ;EF %值在NLVH组与正常组相似 ,与LVH组差异有统计学意义。结论 PA、PAi增高、E/A比值减低、IVRT延长和LAD增大是EH左室舒张功能减低的敏感指标。EF值变化提示EH早期左室收缩功能并未受到影响 ,随着疾病进展而逐步受损。

Purpose: To assess left ventricular diastolic function in the patients with essential hypertension. Methods: 25 normotensives,93 hypertensiives without hypertrophy (NLVH) and 47 with hypertrophy (LVH) (LVMI, left ventricular mass index > 124 g/m2 in males and 110 g/m 2 in females) underwent 2DE and Doppler echocardiography. Results: The ratio of early to late peak velocity (E/A) was 1. 21 ± 0. 24 in normotensives and 1. 03 ± 0. 23 in NLVH patients (P < 0. 01); reversed pulmonary venous flow at atrial systole PA wave was (32. 7 ± 7. 5) vs (38. 9 ± 8. 7) cm/s (P < 0. 01) in normotensives and in NLVH patients respectively. The isovolumic relaxation time (IVRT) and left atrial dimension (LAD) have significant differences in three groups (P < 0. 05 - 0. 001 EF value was similar between normotensives and NLVH patients, but it was lower in LVH patients (P < 0. 01). Conclusions: E/A ratio, PA wawe, Pai, IVRT and LAD are sensitive parameters indicating mild diastolic left ventricular dysfunction. Systolic left ventricular function has no change in NLVH patients.