原发性高血压左心室心肌重量指数与心肌收缩功能的关系

目的 探讨原发性高血压左心室心肌重量指数与心肌收缩功能的关系。方法 以M型超声心动图对75例不同左心室心肌重量指数(LVMI)的原发性高血压患者和47例正常人的左心室心肌收缩功能与收缩末期室壁应力(ESS)的关系进行观察。结果 正常人左心室短轴缩短率(FS)与收缩末期室壁应力(ESS)呈负相关(r=-0.74,P<0.001)。LVMI轻度增加时,收缩功能正常,FS与ESS亦呈负相关(r=-0.71,P<0.001),其回归直线斜率(S)较正常人无明显变化。LVMI明显增加时,收缩功能受损,FS与ESS相关不良(r=-0.25,P<0.05),S明显变小。结论LVMI轻度增加时,心肌收缩功能是后负荷依赖性的;LVMI明显增加时,存在与后负荷无关的左心室心肌收缩功能不全。

The relationship between left ventricular mass index and systolic function in patients with essential hypertension

Objective To evaluate the relationship between left ventricular mass index and systolic function in patients with essential hypertension. Methods Observe the relationship between left ventricular (LV) systolic function and end systolic wall stress (ESS) in 75 hypertension patients with different left ventricular mass index (LV-MI) and 47 age-matched normal controls by M-mode echocardiography. Results LV shortening fraction (FS) was reversely correlated with ESS (r=-0. 74>P<0. 001)in normal controls. In patients with mild LVMI increase,LV systolic function was preserved and FS was also reversely correlated with ESS (r= - 0. 71 ,P<0. 001). The regression line slope was comparable to that of normal controls. In patients with severe LVMI increase, LV systolic function was impaired and the correlation between FS and ESS was weakened (r=- 0. 25,P<0. 05). The regression line slope was significantly reduced (P<0. 05). Conclusion LV systolic function was afterload dependent in patients with mild LVMI increase. However, in patients with severe LVMI increase, LV systolic function was impaired independently of afterload .