多普勒组织成像对原发性高血压右心室舒张功能的评价

Assessment of right ventricular diastolic function in patients with essential hypertension by Doppler tissue imaging

目的 应用多普勒组织成像 (DTI)技术评价原发性高血压右心室舒张功能的变化。方法 原发性高血压患者 60例 ,按Ganau分类方法将原发性高血压分为 4型 :正常左心室构型 (Ⅰ组 ,14例 )、向心性重构 (Ⅱ组 ,13例 )、向心性肥厚 (Ⅲ组 ,18例 )及离心性肥厚 (Ⅳ组 ,15例 ) ;正常对照组 2 0例。于心尖四腔观和右心室两腔观以DTI技术测量三尖瓣前叶、后叶及隔叶瓣环处的运动速率 ,检测指标包括舒张早期峰值速率 (Ea)、舒张晚期峰值速率 (Aa)和等容舒张时间 (IVRT)。结果 ①原发性高血压各组三尖瓣环的平均Ea/Aa <1,平均Ea较对照组均显著减低 (P <0 .0 1) ;②原发性高血压各组三尖瓣前、后叶瓣环的Ea/Aa <1,Ⅰ、Ⅱ及Ⅲ组隔叶瓣环的Ea/Aa <1;③原发性高血压各组的平均IVRT较对照组增加 (分别为 0 .10 2s ,0 .119s ,0 .13 2s ,0 .13 7s) ,呈递增趋势 ,且Ⅱ、Ⅲ、Ⅳ组差异有显著意义 (P <0 .0 1) ;④原发性高血压各组的平均Aa均高于对照组 ,并表现为逐渐增高 (分别为 12 .44cm /s ,12 .74cm /s ,14 .18cm /s ,14 .2cm/s) ,但只有Ⅲ、Ⅳ组差异有显著性意义 (P <0 .0 5 )。结论 原发性高血压引起右心室舒张功能减低 ,随着左心室构型的不同 。

Objective To assess diastolic functions of right ventricle in patients with essential hypertension by Doppler tissue imaging (DTI) technique.Methods Sixty patients with essential hypertension were enrolled.According to Ganau categories,these patients were divided into four groups as following: normal left ventricle(Ⅰgroup,14 cases), concentric remodeling(Ⅱgroup,13 cases), concentric hypertrophy(Ⅲgroup,18 cases) and eccentric hypertrophy(Ⅳ group,15 cases),and 20 age matched healthy subjects as control group were included.DTI data were acquired from tricuspid annular on apical four chamber and right ventricular two chamber views.Results Compared with control group,Ea/Aa<1 and Ea in hypertension groups were all decreased with different degree.There were Ea/Aa<1 of anterior and posterior tricuspid annular in all patients and Ea/Aa<1 of septal tricuspid annular inⅠ,Ⅱ,Ⅲ groups.IVRT of Ⅱ,Ⅲ,Ⅳ groups was longer than normal.Aa of all patients was increased than normal,but there was only significant difference between normal and Ⅲ or Ⅳ groups (P< 0.05 ).Conclusions Right ventricular diastolic functions in patients with essential hypertension are decreased according to the degree of exacerbation.