三维全容积成像技术评价原发性高血压患者左心室容积及收缩功能

Three-dimensional Full-volume Imaging Technology in Evaluating the Left Ventricular Volume and Systolic Function in Patients with Primary Hypertention

目的利用超声三维全容积技术对原发性高血压患者是否合并超体重的左心室容积和收缩功能进行评价。方法选取2018年6-12月西南医科大学附属医院就诊的79例原发性高血压患者,根据体重指数(BMI)是否≥25 kg/m^2分为高血压组(n=40)和高血压合并超重组(n=39)。选择同期本院体检中心年龄、性别相匹配且BMI正常(18.5 kg/m^2≤BMI<25 kg/m^2)的健康成人38例作为对照组。三维超声采集动态四腔心全容积图像,进行在线分析,得到左心室收缩功能参数。结果与对照组相比,高血压组及合并超重组舒张末容积(EDV)、每搏输出量(SV)减低,超重组减低尤为明显(P<0.05),高血压组和超重组EF值减低,差异有统计学意义(P<0.05)。对照组、高血压组和超重组,3组间左心室容积收缩同步性参数即收缩期失同步指数(SDI)、收缩后时间容积(PostContr)、收缩前时间容积(PreContr)、收缩末离散度/差(DISPES)及平均收缩末时间(MES)参数两两比较,差异有统计学意义(P<0.05)。结论高血压疾病可以导致患者左心室收缩功能减低,收缩期失同步性风险增高,而较高体重将加重这种损害。

Objective To evaluate the left ventricular volume and systolic function by the three-dimensional full-volume imaging technology in essential hypertension patients with or without overweight.Methods A total of 79 patients with essential hypertension treated in The Affiliated Hospital of Southwest Medical University from June to December of 2018 were selected and divided into the hypertension group(n=40)and the hypertension combined with overweight group(n=39)according to whether the body mass index(BMI)was no less than 25kg/m^2 or not.The 38 healthy age-and gender-matched adults with the normal BMI(18.5kg/m^2≤BMI<25kg/m^2)in Physical Examination Center of the hospital over the corresponding period were enrolled into the control group.The dynamic four-chamber full-volume images were collected by the three-dimensional full-volume imaging technology and analyzed online to figure out the left ventricular systolic function parameters.Results The end-diastolic volume(EDV)and stroke volume(SV)were decreased in the hypertension group and the hypertension combined with overweight group when compared with the control group,and the decrease was significantly greater in the hypertension combined with overweight group than in the hypertension group(P<0.05).The ejection fraction(EF)values were decreased in the hypertension group and hypertension combined with overweight group,and the differences were statistically significant(P<0.05).The left ventricular volume systolic synchronization parameters including the systolic dyssynchrony index(SDI),post-contraction time volume(PostContr),pre-contraction time volume(PreContr),dispersion in end systole(DISPES)and mean end-systolic time(MES)were significantly different between the three groups(P<0.05).Conclusion Hypertension can decrease the left ventricular systolic function and increase the risk of systolic dyssynchrony,which can be aggravated by higher body weight.