高血压患者左心室舒张功能与心房电机械时间的关系

目的 采用组织多普勒成像(TDI)研究原发性高血压患者不同心室舒张功能与心房电机械时间(P-A)的关系.方法 选择原发性高血压患者90例共分3组,每组30例:左心室舒张功能弛缓性降低组(I组),左心室舒张功能假性正常化组(Ⅱ组),左心室舒张功能限制性充盈障碍组(Ⅲ组);另选择健康人30例作对照组(Ⅳ组).用TDl分别测量P波起始点至左心室侧壁二尖瓣环和右心室侧壁三尖瓣环处P-A,分别记为LP-A、RP.A,计算电机械时间离散度(Pd).结果 左心室舒张功能与心房电机械时间(LP-A)在Ⅳ、I、Ⅱ及Ⅲ组间呈逐渐延长趋势,(61.67±6.78)ms、(68.01±4.53)ms、(74.15±5.50)ms、(85.52±2.79)ms,4组间两两比较差异有统计学意义(P<0.01);右心室舒张功能与心房电机械时间(RP-A)在Ⅳ、I、Ⅱ及Ⅲ组间呈逐渐延长趋势(32.80±4.20)ms、(35.66±3.33)ms、(37.86±2.97)ms、(44.49±2.52)ms,各组间两两比较差异有统计学意义(P<0.01或<0.05);Pd在Ⅳ、I、Ⅱ及Ⅲ组间亦呈逐渐延长趋势,(28.87±4.89)ms、(32.39±4.12) ms、(36.29i±2.96)ms、(41.03±1.56)ms,各组闻两两比较差异有统计学意义(P<0.01或<0.05).结论 原发性高血压患者P-A、Pd随左心室舒张功能受损加重逐渐延长,以限制性充盈障碍时延长的最明显,为临床早期控制高血压改善心室舒张功能避免,心房颤动发生提供理论依据.

Relationship between left ventricular diastolic function and atrial electrical-mechanical time in hypertensive patients

Objective To evaluate the effect of different left ventricular diastolic functions on atrial electrical-mechanical time（P-A） in patients with essential hypertension by tissue Doppler imaging（TDI）. Methods Ninety cases of essential hypertension patients were selected and divided into three groups, each group 30 cases： lowered left ventricular diastolic function group（group Ⅰ ）, pseudo normalization group（group Ⅱ ）, restrictive filling group（group Ⅲ ）. Another 30 cases of healthy people were selected as control group（group Ⅳ ）. P-A was acquired by determination of TDI. LP-A was defined as the onset of P wave to the onset of mitral annulus, while RP-A was defined as the onset of P wave to the onset of tricuspid annulus. Intra-atrial conduction interval（Pd） was calculated. Results Among group Ⅳ, Ⅰ , Ⅱ , Ⅲ ,LP-A showed a gradual extension,the values were （61.67±6.78） ms, （68.01±4.53） ms, （74.15±5.50） ms,（85.52±2.79） ms,and the difference between the two groups was statistically significant （ P〈0.01）. Among group Ⅳ, Ⅰ , Ⅱ , Ⅲ ,RP A showed a gradual extension,the values were （32.80±4.20） ms,（35.66±3.33） ms,（37.86±2.97） ms,（44.49±2.52） ms,and the difference between the two groups was statistically significant （ P 〈0.01 or〈0.05）. Among group Ⅳ, Ⅰ , Ⅱ , Ⅲ ,Pd showed a gradual extension,the values were （28.87±4.89） ms,（32.39±4.12） ms,（36.29±2.96） ms, （41.03± 1.56） ms,and the difference between the two groups was statistically significant （ P 0.01 or〈0.05）. Conclusion In evaluating P A and Pd, the indicator of left ventricular diastolic P-A in patients with essential hypertension is increased in association with the development of left ventrieular diastolic dysfuntion, which is significantly longer in patients with restrictive filling. It provides a theoretical basis for clinic to control hypertension, ameliorate diastolic function and prevent atrial fibrillation early.