患儿女,1岁1个月。因“发现心脏杂音1个月余”入院。既往无特殊。体格检查:胸骨右缘第二肋间可闻及Ⅳ级收缩期喷射样杂音。经胸超声心动图检查:二维超声显示主动脉瓣下可见一条带状回声,收缩期脱入左室流出道;三维超声清晰显示膜状纤维...患儿女,1岁1个月。因“发现心脏杂音1个月余”入院。既往无特殊。体格检查:胸骨右缘第二肋间可闻及Ⅳ级收缩期喷射样杂音。经胸超声心动图检查:二维超声显示主动脉瓣下可见一条带状回声,收缩期脱入左室流出道;三维超声清晰显示膜状纤维束连接于二尖瓣前叶与室间隔近心尖段室壁上;CDFI示收缩期左室流出道呈五彩镶嵌血流信号;频谱多普勒示左室流出道收缩期峰值血流速度4.4m/s,压差78 mm Hg(1 mm Hg=0.133 kPa);左室射血分数60%。展开更多
The effects of angiotensinⅡreceptor antagonist losartan on elastic properties of aorta in patients with mild to moderate essential hypertension were assessed.The ascending aortic distensibility in 26 patients(48±...The effects of angiotensinⅡreceptor antagonist losartan on elastic properties of aorta in patients with mild to moderate essential hypertension were assessed.The ascending aortic distensibility in 26 patients(48±3 years)with mild to moderate essential hypertension before and after 12 weeks of treatment with losartan(50 mg/day)was evaluated by using two-dimensional echocardiography.M-mode measurements of aortic systolic(D_(s))anD_(d)iastolic diameter(D_(d))were taken at a level approximately 3 cm above the aortic valve.Simultaneously,cuff brachial artery systolic(SBP)anD_(d)iastolic(DBP)pressures were measured.Aortic pressure-strain elastic modulus(E p)was calculated as D_(d)×(SBP-DBP)/(D_(s)-D_(d))×1333 and stiffness index beta(β)was defined as D_(d)×Ln(SBP/DBP)/(D_(s)-D_(d)).Blood pressure significantly decreased from 148±13/95±9 mmHg to 138±12/88±8 mmHg(systolic blood pressure,P=0.001;diastolic blood pressure,P=0.003).There was no significant difference in pulse pressure before and after treatment with losartan(53±10 mmHg vs 50±7 mmHg).The distensibility of ascending aorta increaseD_(s)ignificantly as showed by the significant decrease in pressure-strain elastic modulus from 4.42±5.79×10^(6)dynes/cm^(2)to 1.99±1.49×10^(6)dynes/cm^(2)(P=0.02)anD_(s)tiffness index beta from^(2)7.4±32.9 to 13.3±9.9(P=0.02).Although there was a weak correlation between the percent changes in pressure-strain elastic modulus anD_(s)tiffness index beta and that in diastolic blood pressure after losartan treatment(r=0.40,P=0.04 and r=0.55,P=0.004,respectively),no correlation was found between the percent changes in pressure-strain elastic modulus anD_(s)tiffness index beta and that in systolic blood pressure(r=0.04,P=0.8 and r=0.24,P=0.2,respectively).Our study demonstrated that angiotensinⅡreceptor antagonist losartan has a beneficial effect on aortic distensibility in patients with mild to moderate essential hypertension and this effect is partly independent of blood pressure reduction.展开更多
文摘患儿女,1岁1个月。因“发现心脏杂音1个月余”入院。既往无特殊。体格检查:胸骨右缘第二肋间可闻及Ⅳ级收缩期喷射样杂音。经胸超声心动图检查:二维超声显示主动脉瓣下可见一条带状回声,收缩期脱入左室流出道;三维超声清晰显示膜状纤维束连接于二尖瓣前叶与室间隔近心尖段室壁上;CDFI示收缩期左室流出道呈五彩镶嵌血流信号;频谱多普勒示左室流出道收缩期峰值血流速度4.4m/s,压差78 mm Hg(1 mm Hg=0.133 kPa);左室射血分数60%。
文摘The effects of angiotensinⅡreceptor antagonist losartan on elastic properties of aorta in patients with mild to moderate essential hypertension were assessed.The ascending aortic distensibility in 26 patients(48±3 years)with mild to moderate essential hypertension before and after 12 weeks of treatment with losartan(50 mg/day)was evaluated by using two-dimensional echocardiography.M-mode measurements of aortic systolic(D_(s))anD_(d)iastolic diameter(D_(d))were taken at a level approximately 3 cm above the aortic valve.Simultaneously,cuff brachial artery systolic(SBP)anD_(d)iastolic(DBP)pressures were measured.Aortic pressure-strain elastic modulus(E p)was calculated as D_(d)×(SBP-DBP)/(D_(s)-D_(d))×1333 and stiffness index beta(β)was defined as D_(d)×Ln(SBP/DBP)/(D_(s)-D_(d)).Blood pressure significantly decreased from 148±13/95±9 mmHg to 138±12/88±8 mmHg(systolic blood pressure,P=0.001;diastolic blood pressure,P=0.003).There was no significant difference in pulse pressure before and after treatment with losartan(53±10 mmHg vs 50±7 mmHg).The distensibility of ascending aorta increaseD_(s)ignificantly as showed by the significant decrease in pressure-strain elastic modulus from 4.42±5.79×10^(6)dynes/cm^(2)to 1.99±1.49×10^(6)dynes/cm^(2)(P=0.02)anD_(s)tiffness index beta from^(2)7.4±32.9 to 13.3±9.9(P=0.02).Although there was a weak correlation between the percent changes in pressure-strain elastic modulus anD_(s)tiffness index beta and that in diastolic blood pressure after losartan treatment(r=0.40,P=0.04 and r=0.55,P=0.004,respectively),no correlation was found between the percent changes in pressure-strain elastic modulus anD_(s)tiffness index beta and that in systolic blood pressure(r=0.04,P=0.8 and r=0.24,P=0.2,respectively).Our study demonstrated that angiotensinⅡreceptor antagonist losartan has a beneficial effect on aortic distensibility in patients with mild to moderate essential hypertension and this effect is partly independent of blood pressure reduction.
