等长运动对原发性高血压患者左室功能的影响

Effect of isometric exercise on left ventricular function in patients with essential hypertension

目的:探讨等长运动负荷对原发性高血压患者左心功能的影响,寻找可靠的早期检出和评估手段。 方法:45例原发性高血压患者(按高血压危险分层条件为A组和B组患者)(高血压组)按相同年龄、性别、身高和体质量与正常人(对照组)进行1:1配对。治疗前1周高血压组进行等长运动负荷试验,对照组测试在体检期间进行。 结果:左室舒张功能指标比较中,运动前高血压组的左室舒张晚期峰值(A波)(55.85±16.31)mm/s和E/A(0.91±0.04)明显高于对照组[(49.33±14.72)mm/s和0.83±0.07],左室舒张早期峰值(E波)(68.27±10.73)mm/s明显低于对照组(70.29±18.63)mm/s(t=2.047～2.131,P均<0.05)。等长运动后两组对象的全部左室舒张功能指标均较运动前有显著改善(t=1.939～2.531,P均<0.05),同时高血压组的E波、左房射血前期均明显低于对照组,而A,E/A、左房射血时间和左室等容舒张时间均明显高于对照组(t=2.084～2.283,P均<0.05)。左室收缩功能指标比较中,运动后两组对象的全部收缩功能指标均较运动前有显著变化,高血压组的左室舒张末内径明显高于对照组,而左室短轴缩短率、周径纤维缩短速度和左室射血分数明显低于对照组(t=2.027～2.379,P均<0.05)。 结论:等长运动负荷实验是早期检出原发性高血压患者心功能异常的可靠方法。

AIM:To study the effect of isometric exercise load on left ventricular function in patients with essential hypertension,and to find out reliable method of early examination and evaluation.METHODS:Forty-five patients with essential hypertension were matched with normal subjects (control group) by the same age,sex,height and weight,and the hypertensive group was subdivided into group A and B according to risk stratification condition.One week before treatment,isometric movement(IM) in the hypertensive group was tested,while it was tested at while health examination.RESULTS:In the comparison of the left ventricular diastole function index,before movement the values of A[ (55.85±16.31) mm/s] and E/A (0.91±0.04) in the hypertensive group were obviously higher than those in the control group[(49.33±14.72) mm/s and(0.83±0.07)],but the value of E[ (68.27±10.73) mm/s] was significantly lower than that in the control group [ (70.29±18.63) mm/a] (t = 2.047-2.131,P<0.05).After the exercise,all results of left ventricular diastole function in both groups obviously improved than those before exercise (t= 1.939-2.531,P < 0.05),the values of E,left atrial ejection prophase in the hypertensive group was obviously lower than that in the control group,while the values of A,A/E,left atrail ejection time(LAET) and left ventricular isovolumic relaxation time were obviously higher than those in the control group (t = 2.084-2.283,all P < 0.05).In comparison of the indexes of left ventricular systolic function (LVSF),all results after movement in both group had obvious changes,the value of left ventricular end-diastolic diameter (LVEDd) in the hypertensive group was obviously higher but the values of fractional shortening(FS),mean fiber shortening rate(VCF),ejection fraction (EF) were obviously lower than those in the control gorup( t =2.027-2.379,all P <0.05).CONCLUSION:Isometric exercise load test is a reliable mean of the early diagnosis of heart dysfunction in patients with essential hypertension.