实时三维牛眼征参数评价卡维地洛对高血压病心脏正常构型患者心功能的影响研究

Effect of carvedilol on left ventricular function in hypertension patients with normal configuration using Bull's eye chart parameters of real-time three-dimensional echocardiography

目的应用实时三维牛眼图指标评价卡维地洛对高血压病心脏正常构型患者心功能的影响。方法选择心脏正常构型高血压病患者62例,口服卡维地洛,监测其血压的变化,分别于用药前和用药6个月后行超声检查,将图像储存于QLAB工作站,计算实时三维牛眼图参数:测量左室轴向运动最大距离(E max)、最小距离(E min)、平均距离的标准差(ESD)、轴向运动的平均距离所需时间占R-R间期平均百分比(E%);以及比较治疗前后的局部射血分数(REF)、左室射血分数(LVEF)。结果卡维地洛可以有效降低血压,治疗后E max、E min和ESD分别与治疗前比较,均明显增加,差异均有统计学意义(均P﹤0.05);E%与治疗前比较明显缩短,差异亦有统计学意义(P﹤0.05)。治疗后REF和LVEF分别与治疗前比较均增加,但差异无统计学意义(P﹥0.05)。结论实时三维牛眼图指标能够准确评价卡维地洛对正常构型高血压病患者心脏功能的影响,此药物能对其靶器官早期干预,改善心功能,防治或延缓心室重构及高血压型心脏病的发生。

Objective To analyze the effect of Carvedilol on cardiac function in hypertension patients with normal configuration using bull＇s eye chart parameters of real-time three-dimensional echocardiography.Methods Sixty-two hypertension patients with normal configuration were treated with Carvedilol. The changes of blood pressure were monitored. Real- time three-dimensional echocardiography was performed before and 6 months after treatment. All above images were stored for off- line analysis with the dedicated QLAB workstation and all bull＇s eye chart parameters, including the maximum distance （Emax）, minimum distance （Emin）, the standard difference （ESD） of the excursion, the average percentage of R-R the time required of excursion （E%） were calculated, the regional ejection fraction（REF） and left ventricular ejection fraction （LVEF） were compared before and after treatment. Results Carvedilol could decrease the blood pressure effectively. After treatment, the Emax, Emin and ESD were significantly increased than those before treatment （all P 〈 0.05 ）, E% was decreased （P 〈 0.05 ）.REF and LVEF were increased, but there was no significant difference （P 〉 0.05）.Conclusion Bull＇s eye chart parameters could accurately evaluate the effect of Carvedilol on cardiac function in hypertension patients with normal configuration. Carvedilol therapy could reduce the damage of target organ early, improve the cardiac function, prevent or delay the ventricular remodeling and hypertensive heart disease.