经胸彩色多普勒超声心动图评估高血压房颤患者心脏结构和功能的研究

Transthoracic color Doppler echocardiography in evaluation on cardiac structure and function in patients with hypertension complicated by atrial fibrillation

目的探讨应用经胸多普勒超声心动图评估高血压房颤患者心脏结构和功能的价值。方法病例对照研究。抽取2020年1月至2022年7月延安大学附属医院收治的105例高血压合并房颤患者纳入高血压房颤组,抽取同期90例高血压未合并房颤患者纳入高血压组,另抽取医院进行健康体检者90例纳入对照组。所有纳入对象均进行超声心动图检查,比较三组超声心动图指标水平。结果经超声心动图检测,高血压房颤组、高血压组左室收缩末期内径、左室舒张末期内径、左室收缩末期后壁厚度、左室舒张末期后壁厚度、收缩期室间隔壁厚度、舒张期室间隔厚度水平高于对照组,高血压房颤组上述指标水平高于高血压组(P<0.05);高血压房颤组、高血压组右房容积、左房容积大于对照组,高血压房颤组上述指标水平大于高血压组(P<0.05);三组左室容积、右室容积水平比较,差异未见统计学意义(P>0.05);高血压房颤组、高血压组二尖瓣舒张早期峰值流速(E)、舒张晚期峰值流速(A)高于对照组,高血压房颤组上述指标水平高于高血压组(P<0.05),高血压房颤组、高血压组E/A水平低于对照组,高血压房颤组E/A水平低于高血压组(P<0.05);高血压房颤组、高血压组心排血指数、每搏输出量水平高于对照组,高血压房颤组上述指标水平高于高血压组,高血压房颤组、高血压组左室射血分数(LVEF)水平低于对照组,高血压房颤组LVEF水平低于高血压组(P<0.05)。结论高血压房颤患者超声心动图检测显示患者左右心房容积增加,左室肥厚,心室收缩与舒张功能减退。

ObjectiveTo investigate the role of transthoracic color Doppler echocardiography in evaluation on cardiac structure and function in patients with hypertension complicated by atrial fibrillation.MethodsThis study was a case-control study.A total of 105 patients with hypertension complicated by atrial fibrillation admitted to Yan’an University Affiliated Hospital from January 2020 to July 2022 were included in the hypertension-atrial fibrillation group,while 90 hypertensive patients without atrial fibrillation were included in the hypertension group.In addition,90 patients who underwent health check-ups in the hospital were included in the control group.All subjects were subjected to echocardiography;and the levels of echocardiographic parameters were compared among the three groups.ResultsEchocardiography revealed that the left ventricular end systolic diameter,left ventricular end diastolic diameter,left ventricular end systolic posterior wall thickness,left ventricular end diastolic posterior wall thickness,systolic interventricular septal thickness,diastolic interventricular septal thickness in the hypertension-atrial fibrillation group and hypertension group were higher than those in the control group,and the levels of these indicators in the hypertension-atrial fibrillation group were higher than those in the hypertension group(P<0.05).The right atrial volume and left atrial volume in the hypertension-atrial fibrillation group and hypertension group were greater than those in the control group,and the levels of above indicators in the hypertension-atrial fibrillation group were greater than those in the hypertension group(P<0.05).There was no significant difference in the levels of left ventricular volume and right ventricular volume among the three groups(P>0.05).The peak early diastolic velocity(E)and peak late diastolic velocity(A)of the mitral valve in the hypertension-atrial fibrillation group and hypertension group were higher than those in the control group(P<0.05);the levels of the above indicators in the hypertension-atrial fibrillation group were higher than those in the hypertension group(P<0.05).The hypertension-atrial fibrillation group and hypertension group had lower E/A ratio compared with the control group,and the hypertension-atrial fibrillation group had lower E/A ratio than the hypertension group(P<0.05).The hypertension-atrial fibrillation group and hypertension group had higher levels of cardiac output index and stroke volume compared with the control group,and hypertension-atrial fibrillation group had higher cardiac output index and stroke volume compared with the hypertension group(P<0.05).The levels of left ventricular ejection fraction(LVEF)in the hypertension-atrial fibrillation group and hypertension group were lower than that in the control group,and the level of LVEF in the hypertension atrial fibrillation group was lower than that in the hypertension group(P<0.05).ConclusionsIn patients with hypertension complicated by atrial fibrillation,an increase in left and right atrial volume,left ventricular hypertrophy and decline of ventricular systolic and diastolic function can be found by echocardiography.