组织多普勒显像技术评价西尼地平对高血压左室舒张功能的影响

目的借组织多普勒显像(TDI)技术评价西尼地平对高血压患者左室舒张功能的影响。方法37例高血压患者分为非左室肥厚(NLVH)组及左室肥厚(LVH)组,给予西尼地平治疗8周,治疗前、后用TDI技术测量收缩期运动速度(Sa)、舒张早期运动速度(Ea)、舒张晚期运动速度(Aa)及Ea/Aa,并与血流多普勒指标E波速度(E)、A波速度(A)、E/A进行比较,观察降压效果及对左室舒张功能的影响。结果(1)高血压LVH组较NLVH组Ea降低(P<0.01),Ea/Aa降低(P<0.05);而E、E/A等指标两组间差异无统计学意义;(2)西尼地平治疗8周后收缩压(SBP)、舒张压(DBP)均较治疗前下降(P<0.001),HR与治疗前比较无统计学意义;(3)治疗后E波减速时间(EDT)较治疗前降低(P<0.05),治疗后E、E/A、Ea均较治疗前升高(P<0.01),Ea/Aa较治疗前升高(P<0.001),等容舒张期(IVRT)较治疗前降低(P<0.001)。治疗后A、Sa、Aa与治疗前比较差异无统计学意义。结论TDI技术在评价左室舒张功能方面较二尖瓣血流频谱更准确;西尼地平对轻中度高血压患者具有良好的降压作用,不引起反射性心率加快,且能改善患者左室舒张功能。

TDI Assessment Effect of Cinidipine on Left Ventricular Diastolic Function in Hypertensive Patients

Objective To assess the effect of cilnidipine on the left ventricular diastolic function in hypertensive patients with TDI.Methods A total of 37 hypertensive patients were clasified into non-left ventricular hypertrophy(NLVH) group and left ventricular hypertrophy (LVH) group according to left ventricular mass index(LVMI),and were treated with cilnidipine for 8 weeks.Before and after the treatment,the patients were examined by tissue Doppler imaging and pulsed Doppler echocardiography,and Sa,Ea,Aa,Ea/Aa,E,A and E/A were recorded.Results 1.Ea and Ea/Aa were significantly lower in the LVH group than those in the NLVH group.2.After 8 weeks cilnidipine treatment,SBP and DBP were significantly decreased without changes in HR.3.After 8 weeks treatment with cilnidipine,EDT and IVRT were significantly decreased and E,E/A,Ea and Ea/Aa were significantly increased without changes in A,Sa and Aa.Conclusions Tissue Doppler imaging is more reliable than pulsed Doppler echocardiography in the assessment of the left ventricular diastolic function.Cilnidipine is an effective antihypertensive drug and does not cause reflex tachycardia in improving the left ventricular diastolic function of hypertension patients.