高血压病人大动脉硬度与左心室心肌纵向舒张应变率的相关性

CORRELATION BETWEEN LARGE ARTERIAL STIFFNESS AND LONGITUDINAL DIASTOLIC STRAIN RATE OF LEFT VENTRICULAR MYOCARDIUM IN PATIENTS WITH HYPERTENSION

目的探讨高血压病人大动脉硬度与左心室心肌舒张应变间的相关性。方法收集高血压病人60例(高血压组)和健康志愿者30例(对照组),高血压组分为左心室正常构型组(25例)与左心室肥厚组(35例)。以左心室舒张早期峰值应变率(SRE)与左心室舒张晚期峰值应变率(SRA)比值<1.0的左心室节段数目记为左心室异常节段数(Segmental DD);同时测量大动脉硬度指标(脉压/每搏量),比较组间上述参数的差异。结果左心室肥厚组脉压/每搏量与对照组、左心室正常构型组比较差异有显著性(F=14.97,q=3.27、7.73,P<0.05);左心室心肌肥厚组Segmental DD与其他两组比较,差异有显著性(F=71.22,q=11.07、16.31,P<0.05)。多变量线性回归分析结果显示,脉压/每搏量对Segmental DD的影响最大(β=-0.41,P<0.05)。线性相关分析显示,脉压/每搏量与Segmental DD呈正相关(r=0.56,P<0.05)。结论大动脉硬度是高血压病人左心室舒张功能的重要影响因素,对原发性高血压病人的左心室舒张功能具有预测价值。

Objective To investigate the association of large arterial hardness with diastolic strain of left ventricular myocardium in hypertensive patients. Methods This study consisted of 60 hypertensive patients（hypertension group）and 30 healthy volunteers（normal control group）,those in hypertension group were subdivided into left ventricular hypertrophy group（LVH group,n=35）and normal left ventricle group（NLV group,n=25）.Taking the number of the ratio of early peak strain rate（SRE）of left ventricular diastole and late peak strain rate of left ventricular diastole（SRA）of1.0as the number of abnormal segment of left ventricle,and the large-artery hardness index（pulse pressure/stroke volume）were measured.The differences of the above parameters were compared between each group. Results The large-artery hardness index in LVH group was different as compared with that in normal control group and NLV group（F=14.97;q=3.27,7.73;P〈0.05）,in LVH group,the number of abnormal segment in left ventricle was more than that in the other two groups（F=71.22;q=4.28,16.31;P〈0.05）.A multivariate analysis showed that,large-artery hardness had the greatest influence on the abnormal segment in left ventricle（β=-0.41,P〈0.05）,and the hardness was positively correlated with the number of abnormal segment in left ventricle（r=0.56,P〈0.05）.Conclusion Large artery hardness is an important influencing factor on diastolic function of left ventricle in patients with hypertension,and it is of value in predicting the diastolic function of patients with essential hypertension.