组织速度成像评价高血压病右心舒张功能

目的 应用定量组织速度成像(QTVI)定量评价各期高血压病患者右心舒张功能的变化及其指导临床对高血压病进行用药筛选、疗效观察及估测预后.方法 高血压病患者45例,按照WHO标准分为三组:Ⅰ期高血压病组(Ⅰ组)、Ⅱ期高血压病组(Ⅱ组)、Ⅲ期高血压病组(Ⅲ组)各15例.正常对照组20例.用QTVI技术测量三尖瓣环的运动速度,判定不同分期的高血压病患者间右心舒张功能的损害程度.结果 ①频谱多普勒显示高血压病各组舒张功能均减低,但高血压病各组组间比较差异无统计学意义.②QTVI显示高血压病各组三尖瓣环的Ea/Aa<1;各组Ea较对照组均显著减低,且呈逐渐减低趋势;各组Aa均高于对照组,呈递增趋势,但高血压病各组间Aa比较差异均无统计学意义;高血压病各组等容舒张时间均增加,呈递增趋势,且Ⅱ、Ⅲ组与对照组比较差异有统计学意义.结论 QTVI能够定量检测不同分期的高血压病患者右心功能的损害程度,其敏感性和准确性均高于常规超声.

Evaluation of right ventricular diastolic function in patients with essential hypertension by quantitative tissue velocity imaging

Objective To analyze right ventrieular diastolic dysfunction in essential hypertension by quantitative tissue velocity imaging(QTVI). Methods Twenty normotensives and forty-five hypertensives underwent standard Doppler echocardiography and QTVI of right ventricular lateral tricuspid annulus. By QTVI,diastolic measurements were obtained. According to WHO standard, the patients with hypertension were classified into three groups, grade Ⅰ (group Ⅰ) 15 cases, grade Ⅱ(group Ⅱ) 15 cases, grade Ⅲ (group Ⅲ) 15 cases. Results Pulsed Doppler eehocardiography showed impaired Doppler diastolic indexes in hypertensives, without changes among the eases groups. In all hypertension groups, QTVI showed reduction of right ventricular Ea, increase of Aa and Ea/Aa<1 comparison with controls. IVRT of Ⅱ, Ⅲgroups was longer than normal. Conclusions Right ventricular diastolic function with essential hypertension decreased according to the degree of staging. QTVI has a greater predictive value than conventional imaging, and is useful for evaluating right ventricular function in patients with essential hypertension.