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实时三维超声心动图评价原发性高血压患者左室重构的研究 总被引:1,自引:0,他引:1
目的 应用实时三维超声心动图(RT-3DE)以评价原发性高血压左室霞构患者左室功能及质量的情况.方法 对30例正常人、30例无左室肥厚(NLVH)及33例高血压伴左室肥厚(LVH)患者进行常规二维超声检查及RT3DE检查,测量左室质量指数(LVMI)、左室舒张末容积(LVEDV)、左室收缩末容积(LVESV)及左室射血分数(LVEF).同时,用组织多普勒(TDI)技术测量左室舒张功能参数Ea,Aa及Ea/Aa.结果 LVH组LVMI、LVEDV、LVESV明显高于NLVH组及正常对照组(P<0.05),而LVEF、Ea/Aa降低(P<0.05).高血压病患者IVMI与LVEF呈负相关(r=-0.654,P<0.05).LVH组LVEF低于大样本正常范围低值,但两者间差异无统计学意义.结论 RT-3DE可以评估原发性高血压病患者心脏的功能及结构.对于伴有心力衰竭的原发性高血压病患者,联合LVMI和LVEF进行评估左室收缩功能可能有更重要的临床意义. 相似文献
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用二维超声心动图对50例急性心肌梗塞患者的左室重构分析可见;前壁梗塞时;室间隔变薄、动度减弱,下后壁梗塞时,左室后壁变薄,动度减弱.心梗后左室扩大,室壁膨出,EDV、ESV显著增大(P相似文献
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应用二维超声心动图测量56例左室急性透壁性心肌梗塞(LVMI)患者的右室舒张末期(RVDV)容积和右室收缩末期容积(RVSV)。左室心梗后,RVDV、RVSV都扩大,但其程度和发生时间有明显不同。无论左室前壁还是下壁梗塞,双室都发生重构,但右室重构的程度较左室轻微,而且其于下壁梗塞时又比前壁梗塞时更轻且仅出现在早期。 相似文献
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目的 探讨实时三维超声心动图(RT-3DE)对冠心病心肌梗死(心梗)后左室重构的评价.方法 对30例冠心病心梗后左室重构患者及30例正常对照组,分别应用M型(MME)、二维超声心动图(2DE)及RT-3DE测量左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室射血分数(LVEF)、左室心肌质量(LVM)、左室重构指数(LVRI).分析组间及组内的差异,并用左室重构患者测值与Gensini评分进行相关性分析.结果 (1)左室重构组左室容积、LVM较正常对照组增加,而LVEF、LVRI减小;(2)RT-3DE在正常对照组中与MME及2DE测值差异无统计学意义(P>0.05),而在重构组中与MME、2DE测值差异存在统计学意义(P<0.05);(3)RT-3DE测量的LVEDV、LVESV、LVEF及LVRI与Gensini积分有较好的相关性(r=0.844,0.880,-0.839,-0.854),而LVM与Gensini积分无显著相关性(r=0.431);(4)RT-3DE能直观地显示冠心病心梗后左室形态的不规则改变.结论 应用RT-3DE可较好地评价冠心病心梗后左室大小形态的重构及功能重构,其测量的LVRI可定量评价其不规则重构的程度. 相似文献
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原发性高血压患者的超声心动图左室构型 总被引:15,自引:1,他引:15
本文应用二维及M型超声心动图方法对272例原发性高血压患者的左室构型进行了研究。左室正常构型占51%;向心性重构占18%,其相对壁厚度增加,而左室质量指数仍在正常范围内,似与平时舒张压增高有关;离心性肥厚占21%,呈室壁增厚和心腔扩大,与长期血压增高致心肌收缩功能降低有关;而典型的向心性肥厚病程显著长于离心性肥厚,故离心性肥厚不一定是由向心性肥厚发展而来,二者可能为各自独立的高心病表现。 相似文献
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目的采用实时三维超声心动图(real time three-dimensional echocardiography,RT-3DE)评价缺血性二尖瓣反流(ischemic mitral regurgitation,IMR)的左室(left ventricle,LV)重构。方法选取30例IMR患者(IMR组),30例单纯冠心病(coronary arteray disease,CAD)患者(CAD组)及36例正常人(对照组),采集RT-3DE全容积图像,下线分析LV整体和17节段的容积及射血分数(ejection fraction,EF);测量LV舒张末期球形指数(sphericity index,SI),三组间比较并分析IMR的独立预测因子。结果对照组、CAD组和IMR组的LV整体容积,基底段、中间段和下后壁容积均依次增大;IMR组SI增大;IMR组的下后壁EF低于CAD组。LV舒张末期容积、下后壁容积和SI是IMR的独立预测因子。结论 RT-3DE可有效评价LV重构。IMR的LV整体重构和局部重构更加严重,形态趋于球形,并伴下后壁的功能异常。 相似文献
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目的 探讨原发性高血压不同左室构型对左室功能的影响。方法 根据Ganau’s分类法将 72例原发性高血压患者分为正常左室构型组 ,向心性重构组 ,向心性肥厚组、离心性肥大组。运用超声心动图和彩色多普勒技术检测各组LVEF、CO、CI、SV ;二尖瓣口E、A峰 ,E、A峰流速积分 (EVI、AVI)及E/A、EVI/AVI和IVRT ,并与正常组对照。结果 ①向心性重构组CI、SV值降低、离心性肥大组LVEF值降低 ,高血压各组E/A、EVI/AVI、A峰、AVI、IVRT有改变 ,与对照组比较有显著性差异 ;②高血压各组间多无显著性差异。③向心性肥厚和离心性肥大组可有E/A <1、12 .0三种模式 ,其中 1相似文献
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高血压患者左室重构和舒张功能变化与血管内皮功能关系的超声检测 总被引:4,自引:0,他引:4
目的 研究原发性高血压患者左室重构和左室舒张功能的变化,并探讨其与肱动脉内皮依赖性舒张功能之间的关系.方法 检测22例高血压病左室肥厚患者(LVH组),18例非左室肥厚患者(非LVH组)及20例正常对照者的心脏结构和功能,并观察肱动脉加压反应性充血后内径变化的百分率(FMD%).结果 高血压病LVH组与非LVH组肱动脉反应性充血后内径变化百分率(FMD%)、E/A均较正常对照组明显降低(P<0.05) ;左室质量指数(LVMI)高血压病LVH组较非LVH组及正常对照组明显增大(P<0.001) ;FMD%与LVMI明显相关(r=-0.721,P<0.01),并与E/A有相关性(r=0.392, P<0.05).结论 超声无创检测肱动脉内皮依赖性舒张功能为临床评估高血压病提供了一项重要信息. 相似文献
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左室血栓的超声诊断价值 总被引:1,自引:0,他引:1
目的 旨在初步探讨左室血栓(LVT)的超声心科表现及其诊断价值。方法 回顾性地分析了14例检出LVT患者的超声心动图特征,并就其血栓类型与基础心脏 联系进行了初步分析。结果 14例LVT的超声影像学特征大致可分为片状、蓬草状、球状和瘀积状,其中状5例见于急性心肌梗塞和多发性大动脉炎,蓬草状2例见于风湿性心瓣膜病二尖瓣置换术后,球状3例和瘀积状4例见于心肌病。结论 LVT的超声心动图特征与基础心脏病 相似文献
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Left Ventricular Function Assessed by One‐Point Carotid Wave Intensity in Newly Diagnosed Untreated Hypertensive Patients
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Olga Vriz MD Serena Favretto MD Joanna Jaroch MD Rychard Wojciech MD Eduardo Bossone MD Caterina Driussi MD Francesco Antonini‐Canterin MD Paolo Palatini MD Krystyna Loboz‐Grudzien MD 《Journal of ultrasound in medicine》2017,36(1):25-35
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原发性高血压病患者超声心动图左室构型与动态血压关系的探讨 总被引:3,自引:0,他引:3
目的探讨高血压病患者超声心动图左室构型与动态血压的关系。方法用彩色多普勒超声心动图对212例原发性高血压患者的左室构型进行了研究,并对全部患者进行了24小时动态血压监测(ABPM)。结果左室正常构型66例,向心性重构49例,向心性肥厚55例,离心性肥厚42例。向心型肥厚及离心性肥厚其ABPM24小时平均血压、血压负荷及血压昼夜节律消失者明显高于左室正常构型(P<0.05)。结论高血压病患者24小时血压水平、血压负荷与血压昼夜节律状况可反映左室构型发生和发展,而左室肥厚的有无又与左室舒张、收缩功能的改变具有密切关系。 相似文献
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【目的】比较高血压病有无左室肥厚患者核素心室造影左室功能的特点。【方法】对经超声心动图确诊的24例高血压病伴左室肥厚(LVH)患者及20例无左室肥厚患者进行放射性核素心室造影检测,并与正常人对照。【结果】无左室肥厚患者左室舒张功能只有轻度减退,仅表现为1/3充盈分数(1/3FF)减低,而左室肥厚患者左室舒张功能明显减退,表现为高峰充盈率(PFR)与1/3FF减低。高峰充盈时间(TPF)延长;且随着左室肥厚的加重,舒张功能进一步减退。【结论】左室重量指数与PFR,1/3FF呈负相关,而与TPF呈正相关。 相似文献
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Shima Ibrahim Ali Yuman Li Mohamed Adam Mingxing Xie 《Journal of ultrasound in medicine》2019,38(1):39-49
Hypertension is an independent risk factor for cardiovascular diseases. The accurate evaluation of cardiovascular risk is of paramount importance in the management of hypertensive patients. Conventional echocardiographic methods have provided the assessment of left ventricular systolic function and mass for many years. Tissue Doppler imaging, 3‐dimensional echocardiography, and speckle tracking echocardiography are newer echocardiographic modalities for the left ventricular systolic function and mass quantification. The major emphasis of this review is to evaluate the left ventricular systolic function and mass by conventional and newly developed echocardiographic in hypertensive patients. 相似文献
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氯沙坦对高血压左室肥厚和左室舒张功能的作用 总被引:2,自引:0,他引:2
目的:观察氯沙坦对高血压左室肥厚及左室舒张功能的作用。方法:对符合WHO关于高血压诊断标准的68例原发性高血压合并左室肥厚患,服用氯沙坦治疗,用多普勒彩超超声心动图测定治疗前后左室肥厚指标,左室舒张及收缩功能指标。结果:治疗后室间隔厚度,左室后壁厚度,左室心肌重量.左室心肌重量/左室容量均明显减少.舒张早期流速峰值明显增大,舒张晚期流速下降.两比值下降.左室射血分数无变化。结论:氯沙坦可有效逆转高血压患左室肥厚,改善左室舒张功能。 相似文献
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目的探讨原发性高血压左心室不同构型QT离散度(QTd)的特点。方法对120例原发性高血压患者均进行心脏彩色超声心动图和常规12导联心电图(纸速50 mm/s)检查,算出左心室重量指数(LVMI)和相对壁厚度(RWT),按2个指标来划分左心室构型,同时计算出每位患者的QTd值,比较不同构型组QTd的差异(用F和q检验)。结果得出Ⅰ型正常左室构型30例,Ⅱ型向心性重构40例,Ⅲ型向心性肥厚35例,Ⅳ型离心型肥厚15例;离心性肥厚组的QTd值长于其它各组,向心性肥厚组的QTd值长于向心性重构和正常构型组,而向心性重构组的QTd数值虽稍大于正常构型但无统计学上的差异。结论原发性高血压左心室舒张功能异常发生多先于收缩功能,左心室构型变化越大,QTd也越大。 相似文献
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目的探讨实时三维超声心动图(RT-3DE)定量评价心力衰竭患者左室功能的可行性和准确性。方法36例心力衰竭患者(心衰组)和33例健康志愿者(正常组)均行M型超声(ME)、二维超声(2DE)和RT-3DE检查,并评价左室收缩功能。结果ME和2DE、RT-3D检测心衰组患者的LVEF值比较差异有统计学意义(P〈0.01);心衰组LVEDV、LVESV值明显高于正常组,LVEF值明显低于正常组,差异有统计学意义(P〈0.01)。结论RT-3DE为临床上定量分析心力衰竭患者重构左室容积和收缩功能提供了一种无创、准确可信的新途径。 相似文献
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SJOERD A. MOLLEMA M.D. PATRICK KLEIN M.D. † JOGIEN HEERSCHE M.D. MARTIN J. SCHALIJ M.D. Ph .D. ERNST E. VAN DER WALL M.D. Ph .D. MICHEL I.M. VERSTEEGH M.D. † ROBERT J.M. KLAUTZ M.D. Ph .D.† LIESELOT VAN ERVEN M.D. Ph .D. JEROEN J. BAX M.D. Ph .D. 《Pacing and clinical electrophysiology : PACE》2009,32(7):913-917
Background: Besides implantation of an implantable cardioverter-defibrillator (ICD), a proportion of patients with left ventricular (LV) dysfunction due to ischemic cardiomyopathy are potential candidates for surgical LV reconstruction (Dor procedure), which changes LV ejection fraction (LVEF) considerably. In these patients, LVEF as selection criterium for ICD implantation may be difficult. This study aimed to determine the value of LVEF as criterium for ICD implantation in heart failure patients undergoing surgical LV reconstruction.
Methods: Consecutive patients with end-stage heart failure who underwent ICD implantation and LV reconstruction were evaluated. During admission, two-dimensional (2D) echocardiography (LV volumes and LVEF) was performed before surgery and was repeated at 3 months after surgery. Over a median follow-up of 18 months, the incidence of ICD therapy was evaluated.
Results: The study population consisted of 37 patients (59 ± 11 years). At baseline, mean LVEF was 23 ± 5%. Mean left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) were 175 ± 73 mL and 225 ± 88 mL, respectively. At 3-month follow-up, mean LVEF was 41 ± 9% (P < 0.0001 vs. baseline), and mean LVESV and LVEDV were 108 ± 65 mL and 176 ± 73 mL, respectively (P < 0.0001 vs. baseline). During 18-month follow-up, 12 (32%) patients had ventricular arrhythmias, resulting in appropriate ICD therapy. No significant relations existed between baseline LVEF (P = 0.77), LVEF at 3-month follow-up (P = 0.34), change in LVEF from baseline to 3-month follow-up (P = 0.28), and the occurrence of ICD therapy during 18-month follow-up.
Conclusion: LVEF before and after surgical LV reconstruction is of limited use as criterium for ICD implantation in patients with end-stage heart failure. 相似文献
Methods: Consecutive patients with end-stage heart failure who underwent ICD implantation and LV reconstruction were evaluated. During admission, two-dimensional (2D) echocardiography (LV volumes and LVEF) was performed before surgery and was repeated at 3 months after surgery. Over a median follow-up of 18 months, the incidence of ICD therapy was evaluated.
Results: The study population consisted of 37 patients (59 ± 11 years). At baseline, mean LVEF was 23 ± 5%. Mean left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) were 175 ± 73 mL and 225 ± 88 mL, respectively. At 3-month follow-up, mean LVEF was 41 ± 9% (P < 0.0001 vs. baseline), and mean LVESV and LVEDV were 108 ± 65 mL and 176 ± 73 mL, respectively (P < 0.0001 vs. baseline). During 18-month follow-up, 12 (32%) patients had ventricular arrhythmias, resulting in appropriate ICD therapy. No significant relations existed between baseline LVEF (P = 0.77), LVEF at 3-month follow-up (P = 0.34), change in LVEF from baseline to 3-month follow-up (P = 0.28), and the occurrence of ICD therapy during 18-month follow-up.
Conclusion: LVEF before and after surgical LV reconstruction is of limited use as criterium for ICD implantation in patients with end-stage heart failure. 相似文献