老年高血压患者胰岛素抵抗与左室结构改变的关系

目的探讨老年原发性高血压患者胰岛素抵抗（IR）在高血压发生、发展过程中对左室结构的影响。方法72例高血压患肯依照左室质量指数（LVMI）和相对室壁厚度（RWT）分为左室正常构型组（34例）、向心性重构组（18例）、向心性肥厚组（11例）、离心性肥厚组（9例），并行口服葡萄糖耐量试验（OGTT）加同步胰岛素释放试验，计算胰岛素敏感性指数（ISI）、血糖曲线下面积（AG）、胰岛素曲线下面积（AI）、空腹血胰岛素/空腹血糖（FSI／FSG）比值、AI／AG比值。设健康对照组35例。应用单元和多元回归分析观察RWT和LVMI与各胰岛素敏感性指标的关系。结果高血压组的RWT与FSI、FSG无关（P〉0．05），与AI、AG呈正相关（r值分别为0．160、0．227，P〈0．05），与ISI呈负相关（r值为=0．266，P〈0．01）；LVMI与各胰岛素敏感性指标无相关性（P〉0．05）。逐步回归分析显示RWT与ISI呈独立相关（r^2=0．071、P〈0．05）。结论高胰岛素血症（HIS）及IR存在于老年高血压患者各种左室几何构型中，其中与向心性重构关系最密切，与IR相关的HIS是参与和促进左心室向心性重构的重要影响因素。     

高血压病患者左室几何构型与胰岛素抵抗关系的研究

目的　探讨高血压病 (EH)患者胰岛素抵抗 (IR)对左室几何构型的影响。方法　依照左室质量指数 (LVMI)和相对室壁厚度 (RWT)将 118例EH患者分为左室正常构型组 (5 8例 )、向心性重构组 (2 2例 )、向心性肥厚组 (14例 )、离心性肥厚组 (2 4例 )。并行口服葡萄糖耐量试验和同步胰岛素释放试验 ,计算胰岛素敏感性指数 (ISI)、血糖曲线下面积 (AG)、胰岛素曲线下面积 (AI)、空腹血浆胰岛素 /空腹血糖 (FSI/FSG)比值、AI/AG比值。设对照组 86例。应用单元和多元回归分析观察RWT、LVMI与各胰岛素敏感性指标的关系。结果　与对照组比较 ,EH各左室构型组除FSG外 ,FSI、ISI、AG、AI、FSI/FSG、AI/AG差异均有显著性 (P <0 0 5～P <0 0 1) ,但各构型组间差异无显著性 (P >0 0 5 )。单因素相关分析显示EH组RWT与FSI、AG、AI、收缩压呈正相关 (r值分别为 0 193,0 196 ,0 2 36 ,0 183,P均 <0 0 5 ) ,与ISI呈负相关 (r值为 - 0 2 5 1,P <0 0 1) ,LVMI与体重指数、收缩压、舒张压呈正相关 (r值分别为 0 2 4 2 ,0 2 14 ,0 184 ,P <0 0 5～P <0 0 1) ,而与各胰岛素敏感性指标不相关 (P >0 0 5 )。逐步回归分析显示RWT与ISI呈独立相关 (R2 =0 0 6 3,P =0 0 0 6 )。结论　HIS及IR存在于EH患者各种左室几何     

Structural abnormalities of small resistance arteries in essential hypertension

Regardless of the mechanisms that initiate the increase in blood pressure, the development of structural changes in the systemic vasculature is the end result of established hypertension. In essential hypertension, the small arteries smooth muscle cells are restructured around a smaller lumen, and there is no net growth of the vascular wall, while in some secondary forms of hypertension, a hypertrophic remodeling may be detected. Also, in non-insulin-dependent diabetes mellitus, a hypertrophic remodeling of subcutaneous small arteries is present. The results from our own group have suggested that indices of small resistance artery structure, such as the tunica media to internal lumen ratio, may have a strong prognostic significance in hypertensive patients, over and above all other known cardiovascular risk factors. Therefore, the regression of vascular alterations is an appealing goal of antihypertensive treatment. Different antihypertensive drugs seem to have different effect on vascular structure, both in human and in animal models of genetic and experimental hypertension. A complete normalization of small resistance artery structure is demonstrated in hypertensive patients, after long-term and effective therapy with ACE inhibitors, angiotensin II receptor blockers and calcium antagonists. Few data are available in diabetic hypertensive patients; however, blockade of the renin–angiotensin system seems to be effective in this regard. In conclusion, there are several pieces of evidence that suggest that small resistance artery structure may be considered an intermediate endpoint in the evaluation of the effects of antihypertensive therapy; however, there are presently no data available about the prognostic impact of the regression of vascular structural alterations in hypertension and diabetes.     

高血压病患者左室肥厚及构型改变与胰岛素抵抗的关系

目的:探讨高血压病(EH)患者胰岛素抵抗(IR)对左心室肥厚(LVH)和几何构型的影响。方法:检测124 例EH病人的左室重量指数(LVMI),相对室壁厚度(RWT),空腹血清葡萄糖(FSG)、空腹血胰岛素(FSI)浓度, 并计算胰岛素敏感性指数(ISI)。依照LVMI及RWT的数值124例EH病人被分为左室正常构型(51例),向心性构型(30例),向心性肥厚型(22例),离心性肥厚型(21例)。结果:RWT与年龄、体重指数(BMI)、收缩压(SBP)、舒张压(DBP)、平均心率呈正相关(r=0.16-0.22,P<0.05),与ISI呈负相关(r=-0.24),LVMI与SBP、DBP呈正相关(r=0.16-0.20,P<0.05),与ISI不相关。向心性重构组和向心性肥厚组年龄、RWT、HR、BMI大于正常构型组(P<0.05-<0.01),而ISI小于正常构型组(P<0.01)。结论:胰岛素敏感性降低与EH患者左心室肥厚无关,与RWT增加密切相关;ISI可能是EH患者发生左室向心性构型的重要影响因素之一。     

原发性高血压患者血清胱抑素C与左室构型的关系

目的 研究心功能正常范围原发性高血压患者血清胱抑素C（CysC）水平与左室构型变化的关系,探讨左室重构与CysC的相关性,并探讨其机制.方法 纳入收缩功能正常（LVEF＞50％）原发性高血压患者180例为试验组,正常体检者50名为对照组.检测血清CysC浓度并行超声心动图检查,测量左室舒张末期内径（LVDD）、室间隔厚度（ⅣS）、左室后壁厚度（LVPW）,并计算左室重量指数（LVMI）、室壁相对厚度（RWT）.按Ganau’s分类法,将试验组分为正常型、向心性重构型、向心性肥厚型、离心性肥厚型4种构型,对各组间血浆CysC水平进行两两比较.结果 试验组较对照组血清CyaC浓度明显升高（P＜0.05）.按Ganau’s分类后,以向心性肥厚组CysC水平升高最显著（P＜0.05）,向心性构型组和离心性肥厚组依次次之（P＜0.05,P＜0.05）,正常构型组CysC水平升高最低.正常构型组较对照组CysC水平升高,但差异无统计学意义（P＞0.05）.结论 原发性高血压患者血清CysC浓度与左室构型相关,CysC在原发性高血压左室构型的变化发展中起着一定作用.     

Relationship between left ventricular geometry and left atrial size and function in patients with systemic hypertension

BACKGROUND: Arterial hypertension determines distinct adaptive left ventricular geometric responses, which may differently affect left ventricular function and left atrial performance. OBJECTIVES: In this study, the effect of left ventricular geometry on left atrial size and function, and the relationship between left atrial size and left ventricular mass were assessed in 336 patients with systemic arterial hypertension who had undergone Doppler echocardiography. METHODS AND RESULTS: Patients were classified into concentric (110 patients with concentric left ventricular geometry defined as relative wall thickness > or = 0.44) and eccentric groups (226 patients with relative wall thickness < 0.44). Comparison to the latter, the former had greater left atrial size, left atrial ejection force, left ventricular mass and lower left ventricular midwall fractional shortening. Left ventricular concentric, rather than eccentric, geometry emerged by multivariate analysis as a factor independently associated with the highest degree of left atrial ejection force. Left atrial size was positively related to left ventricular mass in the whole population (r = 0.65, SEE = 6 ml, P < 0.00001). This relationship was maintained in the subgroups with concentric (r = 0.65, SEE = 6 ml, P < 0.00001) or eccentric geometry (r = 0.59, SEE = 6 ml, P < 0.00001). CONCLUSIONS: Our results indicate that the relationship of left ventricular geometry to both left atrial size and ejection force in hypertensive patients is relevant. Concentric left ventricular geometry is associated with greater left atrial size and ejection force than eccentric geometry, suggesting that increased left ventricular stiffness has a greater effect in stimulating left atrial performance than left ventricular end-systolic stress. The degree of left atrial enlargement similarly depends on left ventricular mass in patients with concentric and eccentric geometry.     

The influence of left ventricular geometry on coronary vasomotion in patients with essential hypertension

The objective of this study was to assess the influence of left ventricular (LV) geometric pattern on coronary vasomotion in patients with essential hypertension. We studied 34 hypertensive patients, who had never been treated, with angiographically normal coronary arteries. Patients were classified into four LV geometric patterns by echocardiography: normal, concentric remodeling, eccentric hypertrophy, and concentric hypertrophy. The responses of coronary vasomotion in left anterior descending artery to vasoactive agents (acetylcholine, isosorbide dinitrate, adenosine triphosphate) were examined using a Doppler guidewire and quantitative coronary angiography. The percent increase in coronary blood flow evoked with acetylcholine (endothelium-dependent vasomotion) showed lowest in concentric hypertrophy, followed by eccentric hypertrophy, concentric remodeling, and normal geometry. The significant linear relationship between acetylcholine-induced coronary blood flow and LV mass was noted. There was no difference in the percent increase in coronary blood flow evoked with isosorbide dinitrate (endothelium-independent vasomotion of conduit vessel) among the four groups. The percent increase in coronary blood flow evoked with adenosine triphosphate (endothelium-independent vasomotion of resistant vessel) was significantly lower in patients with concentric hypertrophy than in the other three groups. The results in this study suggest that coronary vasomotion may be associated with LV geometry in patients with hypertension. The endothelium-dependent vasodilation is impaired progressively as LV hypertrophy advances. The endothelium-independent vasodilation of microvessels is impaired only in concentric hypertrophy. This advanced abnormality of coronary vasomotion may contribute to the high cardiovascular morbidity and mortality in patients with concentric hypertrophy.     

Association between exercise capacity and left ventricular geometry in overweight patients with mild systemic hypertension

The purpose of this study was to determine the relation between left ventricular (LV) geometry and exercise capacity in unmedicated, hypertensive patients. Analysis of the data revealed peak oxygen consumption (ml kg(-1) min(-1)) for concentric hypertrophy (corrected mean +/- SE 23.5 +/- 1.2) was significantly less (F = 3.68, p <0.02) than the concentric remodeling (28.1 +/- 1.2) and normal (27.3 +/- 0.6) geometries. The LV geometric pattern was found to be associated with exercise capacity in unmedicated, hypertensive patients, such that patients with concentric hypertrophy showed reduced capacity.     

原发性高血压患者动脉僵硬度与心脏重构的相关性研究

目的 探讨原发性高血压患者动脉僵硬度与左心功能的相关性.方法 纳入原发性高血压患者79例,根据颈桡脉搏波传导速度（PWV）将患者分为对照组（PWV＜0.9m/s,n=42）和观察组（PWV≥0.9m/s,n=37）,两组患者均行心脏彩超检查比较心功能参数差异.结果 两组患者间左室舒张末期内径（LVEDd）、左室射血分数（LVEF）、左室质量指数（LVMI）、二尖瓣舒张早期血流峰速（E）、舒张晚期血流峰速（A）及二者比值（E/A）差异具有统计学意义（P＜0.05）;Pearson相关分析显示PWV与LVMI存在显著的相关性（r=0.347,P＜0.05）.结论 原发性高血压患者动脉僵硬度与左心重构存在显著的相关性,在临床上检测动脉弹性对于评价高血压患者心脏重构具有显著的临床意义.     

原发性高血压患者心肌能量消耗水平变化与左心室舒张功能的关系

目的探讨左心室舒张功能障碍与舒张功能正常的原发性高血压患者心肌能量消耗(MEE)水平的不同及其临床意义。方法选取原发性高血压患者128例,分别用组织多普勒和脉冲多普勒成像技术测量左心室舒张功能指标二尖瓣环舒张早期及舒张晚期运动速度之比(E'/A')、二尖瓣口舒张早期及舒张晚期血流速度之比(E/A)以及F/F';同时测量心脏结构指标、收缩功能指标,计算左心室收缩末周向室壁应力(cESS)、MEE。根据E'/A'将患者分为Gl组(E'/A'≥1)和G2组(E'/A'<1),根据E/A分为G3组(E/A≥1)和G4组(E/A<1),根据E/E'分为G5组(E/E'≥8)和G6组(E/E'<8)。结果 G2组左心房内径、左心室内径、室间隔厚度、左心室后壁(PWTd)、左心室质量指数、cESS及MEE明显高于G1组,LVEF明显低于G1组(P<0.01);G4组年龄、PWTd明显高于G3组;G6组体重指数、短轴缩短率、LVEF明显高于G5组,左心房内径、每搏输出量及左心室射血时间、心率、cESS及MEE明显低于G5组。双变量相关分析显示,E'/A'、E/E'与cESS、MEE等各指标间均有相关关系。结论左心室舒张功能障碍的原发性高血压患者MEE水平明显高于舒张功能正常的原发性高血压患者。     

Effects of gestational hypertension on left ventricular geometry

BACKGROUND: During pregnancy heart rate, stroke volume, cardiac output and left ventricular (LV) mass increase while peripheral vascular resistance decreases. Gestational hypertension (GHT) which is noted in some pregnancies during the third trimester, is considered a temporary condition. Its effects on LV geometry are not known. AIM: To assess the effects of acute pressure overload in GHT on the LV geometry. METHODS: Forty three pregnant women (mean age 28.7+/-8.9 years) with GHT were included in the study (Group A). Blood pressure levels >140/90 mmHg were considered diagnostic for GHT. Fifty six pregnant women (mean age 25.7+/-5.7 years) with normal blood pressure formed the control group (Group B). Transthoracic echocardiography was performed in all subjects before delivery. LV end-systolic (ESD) and end-diastolic (EDD) diameters, LV septal and posterior wall thickness were measured, and LV mass index (MI) as well as relative wall thickness (RWT) were calculated using Devereux and Ganau formulas. LV geometry was defined as normal (N), concentric hypertrophic (CH), eccentric hypertrophic (EH) or concentric remodelling (CR). RESULTS: LVMI and RWT were 138+/-13.8 g/m2 and 0.46+/-0.09 in Group A, and 117+/-15 g/m2 and 0.4+/-0.03 in Group B (p=0.01 and p=0.03). LV geometry patterns were: 38.9% - N, 19.4% - EH, 14% - CH and 27.7% - CR in group A and 78.6% - N, 7% - EH, 5.4% - CH and 9% - CR in normotensive pregnancies (p<0.001). CONCLUSIONS: These findings suggest that LVMI and RWT are greater in GHT compared to normotensive pregnant women. Most frequently observed abnormal geometric patterns are EH and CR.     

Maternal diastolic dysfunction and left ventricular geometry in gestational hypertension

The objective of this study was to evaluate diastolic parameters and left ventricular geometry in gestational hypertension. Twenty-one consecutive pregnant women with gestational hypertension and 21 normotensive women matched for age and gestational age were enrolled in the third trimester of gestation. Echocardiographic and uterine color Doppler evaluations were performed. Systolic, diastolic, and mean blood pressure, total vascular resistance (TVR), and uterine resistance index were higher in hypertensive women than in control subjects (P<0.01). Left atrial function and cardiac output were significantly lower in gestational hypertension (P<0.01). Patients with gestational hypertension had longer left ventricular isovolumetric relaxation time (IVRT) (P<0.0001); lower velocity-time integral of the A wave (P<0.05) and of the diastolic pulmonary vein flow (P<0.05); and higher velocity-time integral of the reverse pulmonary vein flow (P<0.05). Systolic fraction of the pulmonary vein flow was higher in women with gestational hypertension than in control subjects (P<0.01); the difference in duration of pulmonary vein flow and A wave was closer to 0 in gestational hypertension (P<0.0001). Altered left ventricular geometry was found in 100% of hypertensive patients and in 19.05% of normotensive patients (P<0.001). IVRT, left ventricular end-systolic volume, atrial function, and uterine resistance index were directly related to TVR (P<0.01); deceleration time of the E wave showed a quadratic correlation with TVR (P<0.01). Gestational hypertension is characterized by an altered cardiac geometric pattern of concentric hypertrophy. The altered geometric pattern assessed during gestational hypertension is associated, in our study, with depressed systolic function, high TVR, altered diastolic function, and left atrial dysfunction. Deceleration time of the E wave, IVRT, and left atrial fractional area change, found in concomitance with the highest TVR, may be useful in the evaluation of cardiac function and hemodynamics present in pregnancy-induced hypertension.     

Relation of coronary artery calcium to left ventricular mass and geometry in patients with essential hypertension

BACKGROUND: There is a close relationship between left ventricular hypertrophy and cardiovascular diseases that are observed in hypertension. In this study, the amount of coronary artery calcium, which is an indicator of atherosclerosis, has been measured and its relationship with left ventricular hypertrophy and geometry and other traditional risk factors has been investigated. DESIGN: A total of 249 (104 females, 145 males) hypertensive asymptomatic patients, without diabetes with an average age of 55.09 +/- 11.32 years were included in the study. Left ventricular mass of the patients was measured with M-mode echocardiography and coronary artery calcium with electron beam tomography. The average age of the patients who had calcium in their coronary arteries (CAC+) was 59.99 +/- 9.85 years, and the average age of the ones without calcium (CAC-) was 49.29 +/- 10.19 years. RESULTS: Mean left ventricular mass index (LVMI) was measured as 130.18 +/- 43.24 g/m2 in CAC+ patients and as 108.47 +/- 29.09 g/m2 in CAC- patients. These two groups did not differ in terms of the parameters such as total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride and uric acid levels, the presence of early coronary disease in the family and smoking. Patients who had calcium in their coronary arteries (CAC+) were more obese (P < 0.004). In the logistic regression analysis, we demonstrated that body mass index and age were the factors affecting the presence and amount of calcification seen in coronary arteries in left ventricular hypertrophy. In the analysis performed by taking left ventricular hypertrophy into consideration, mean calcium scores of the patients with normal remodeling, concentric remodeling, eccentric hypertrophy and concentric hypertrophy were 50.9 +/- 187.4, 68.6 +/- 159.3, 92.2 +/- 160.2 and 315.4 +/- 760.6, respectively. In the patients with concentric left ventricular hypertrophy (LVH), the mean calcium scores of the coronary arteries and the rate of being CAC+ were significantly high, although these patients were also older. After linear regression, the relationship between concentric LVH and coronary artery calcium (CAC) was still significant. CONCLUSION: In conclusion, left ventricular hypertrophy that is observed in hypertension is an important risk factor for sub-clinical atherosclerosis. Concentric left ventricular hypertrophy is a more important risk factor than other geometric patterns.     

高血压病左室肥厚与心律失常的相关性临床研究

目的 探讨高血压病左心室肥厚与心律失常的关系。方法 选择2001-2003年上海交通大学附属第一人民医院心内科246例原发性高血压患者,进行静息同步12导联心电图,动态心电图及超声心动图测定,监测左室重量指数等指标。结果 左心室肥厚组平均左室重量指数水平为(151.6±15.8)g/m~2,和左心室正常者相比差异有显著性(P<0.01)。左心室肥厚组定性心律失常及复杂性定性心律失常的检出率为93.27％和51.92％,明显高于左心室正常组(35.21％,10.56％),差异有显著性(P<0.001)。结论 原发性高血压左心室肥厚相关性心律失常,尤其是复杂性心律失常,与左室肥厚的程度及是否合并左房肥大有明确的规律关系。     

Left ventricular geometry and survival in patients with normal left ventricular ejection fraction

In hypertensive populations, left ventricular (LV) geometry, which is characterized by hypertrophy, predicts cardiovascular outcome. The left ventricle can also alter its shape by concentric remodeling (CR) in the absence of LV hypertrophy, a feature that is detected by echocardiography. This study assessed the prevalence and prognostic significance of various forms of LV geometry and changes in LV geometry over time in patients with normal LV systolic function. Retrospective analysis of a large clinical population (n = 35,602) that was referred for echocardiography was done, with all-cause mortality as the primary outcome. Abnormal LV geometry was identified in 46% of patients, with CR present in 35% (n = 12,362) and LV hypertrophy in 11% (n = 3,958). Patients with abnormal LV geometry were older and more obese compared with subjects with normal LV geometry. There was a strong relation between abnormal LV geometry and mortality, and patients with CR and LV hypertrophy exhibited considerably higher relative risk for all-cause mortality compared with subjects with normal LV geometry (relative risk [RR] 1.99, 95% confidence interval [CI] 1.88 to 2.18, p <0.0001; RR 2.13, 95% CI 1.89 to 2.40, p <0.0001, respectively). Subjects with CR who reverted to a normal geometric pattern had improved survival (RR 0.64, 95% CI 0.42 to 0.97, p = 0.03) compared with those who progressed to LV hypertrophy (RR 1.54, 95% CI 1.01 to 2.47, p = 0.05). In conclusion, CR, a form of cardiac adaptation, is frequently noted in patients with normal LV ejection fractions and confers a risk of death similar to that of LV hypertrophy. Normalization of CR is associated with better survival, whereas transition to LV hypertrophy increases mortality.     

Postinfarction left ventricular remodeling in patients with hypertension

1-3 years after myocardial infarction 140 patients (66 with - group 1, and 74 without - group 2 - hypertension before infarction) were examined by echocardiography. In group 1 concentric remodeling was found in 71.4% of patients with postinfarction scar occupying 相似文献   

Changes in extracellular matrix in subcutaneous small resistance arteries of patients with primary aldosteronism

CONTEXT AND OBJECTIVE: It has been previously demonstrated that aldosterone may possess a strong profibrotic action in vitro and in animal models of genetic or experimental hypertension. Our aim was to evaluate whether such a profibrotic action is present also in the human microcirculation. DESIGN AND PATIENTS: We investigated 13 patients with primary aldosteronism, seven patients with essential hypertension, and 10 normotensive controls. All subjects were submitted to a biopsy of gluteal sc fat tissue. Small resistance arteries were dissected and mounted on an isometric myograph, and the tunica media to internal lumen ratio was measured. MAIN OUTCOME MEASURES: The total collagen content within the tunica media was detected (Sirius red staining and image analysis), and collagen subtypes were evaluated using polarized light microscopy; under this condition thicker type I collagen fibers appear orange or red, whereas thinner type III collagen fibers are yellow or green. RESULTS: Tunica media to internal lumen ratio was significantly increased in primary aldosteronism and in essential hypertension compared with normotensive controls. Clinic blood pressure values were similar in primary aldosteronism and in essential hypertension, and greater than in normotensive controls. Normotensive controls had less total and type III collagen (3.23 +/- 0.58 and 1.60 +/- 0.22%, respectively) in respect to the two hypertensive groups (P < 0.001). Total collagen and type III vascular collagen were significantly greater in primary aldosteronism (total collagen, 8.17 +/- 1.38%; type III collagen, 6.06 +/- 0.74%; P < 0.05) than in essential hypertension (total collagen, 6.84 +/- 1.15%; type III collagen, 5.25 +/- 0.80%). CONCLUSIONS: Our results indicate that, in small resistance arteries of patients with primary aldosteronism, a pronounced fibrosis may be detected, even more evident than in blood-pressure-matched patients with essential hypertension.     

Relation of ambulatory blood pressure load with left ventricular geometry in untreated patients with mild-to-moderate hypertension.

Whether ambulatory blood pressure (ABP) load is associated with left ventricular (LV) geometry was assessed in 335 patients (range 32-72 years) with stage I-II essential hypertension by performing 24-h ABP monitoring and echocardiographic examination. Of these 335 hypertensive subjects, 116 (34.5%) had normal LV geometry, 136 (40.5%) had concentric LV remodelling, 37 (11%) had eccentric LV hypertrophy and 46 (14%) had concentric LV hypertrophy according to the relative wall thickness and left ventricular mass index. Subjects with concentric LV hypertrophy had significantly increased 24-h systolic BP (SBP), diastolic BP (DBP) and mean arterial pressure as well as increased 24-h SBP and DBP load compared to those with normal LV geometry or concentric LV remodelling while there was no difference in the above parameters in comparison with the subjects with eccentric LV hypertrophy. The incidence of patients with normal LV geometry was significantly decreasing and the incidence of patients with LV-CH was significantly increasing as the degree of ABP loads were increasing. Using multiple regression analysis models with each type of LV geometry as a dependent variable and various degree of ABP loads as independent variables, it was revealed that normal LV geometry was significantly related with normal values of 24-h SBP and DBP load (P < 0.05) while there was not any significant relation between concentric LV remodelling and 24-h SBP or DBP load values. Concentric LV hypertrophy was significantly related with increased values of both 24-h SBP and DBP load (P < 0.05) while eccentric LV hypertrophy was significantly related with increased values of 24-h DBP load only (P < 0.05). In conclusion normal LV geometry is associated with normal values of SBP and DBP load while concentric LV hypertrophy is associated with increased values of both SBP and DBP load.     

高血压病患者淋巴细胞肾上腺素能β2受体密度与心脏不同几何构型的关系

目的 :研究高血压病患者外周血淋巴细胞 β2 受体密度与心脏不同几何构型之间的关系。方法 :采用放射性配基结合分析法 ,测定不同心脏构型高血压病患者 91例外周血淋巴细胞的 β2 受体密度 ,并与正常人 31例对照。结果 :与对照组比较 ,向心性重构 （CCR）及向心性肥厚 （CCH）组 β2 受体密度显著增加 ,离心性肥厚 （ECH）组 β2 受体密度显著减少 ,而正常几何构型 （NG）组无明显变化。结论 :高血压病患者外周血淋巴细胞 β2 受体密度与其心脏的几何构型有关。