慢性心力衰竭患者AngⅡ、Ald水平与左室平均室壁应力的关系

目的探讨慢性心力衰竭（CHF）患者血浆血管紧张素Ⅱ（AngⅡ）、醛固酮水平（Ald）含量变化与左室平均室壁应力（mean wall stress，MWS）的相关性分析及临床意义。方法应用放射免疫法测定20例正常人和61例慢性充血性心力衰竭患者血浆血管紧张素Ⅱ、醛固酮含量，心脏超声测定左室收缩／舒张内径及室壁厚度并计算平均室壁应力。结果CHF患者血浆血管紧张素Ⅱ、醛固酮含量较正常对照组明显升高，并随着心功能等级的增加而有升高趋势。血浆血管紧张素Ⅱ、醛固酮含量与左室平均室壁应力呈正相关。结论慢性心力衰竭患者血清血浆血管紧张索Ⅱ、醛固酮含量的变化及室壁应力增加参与慢性心力衰竭致病机制，它们之间可能还有相互作用及影响，共同参与慢性心力衰竭的致病机制。

Relationships between Left Ventricular Mean Wall Stress and Plasma level of Angiotensin II and Aldosterone and in Patients with Chronic Heart Failure

Objective To investigate relationships between the left ventricular mean wall stress（MWS） and levels of plasma angiotensin II , aldosterone in the patients with chronic heart failure （CHF）. Methods CHF group include 61 patients, healthy control group include 20 healthy volunteers, plasma concentration of angiotensin II and aldosterone were measured by specific ra- dioimmunoassays. LVDd, LVDs, IVSd, IVSs, LVPWd and LVPWs were determined by two-dimensional echocardiography, and MWS was calculated. Results The plasma angiotensin II , aldosterone and MWS in the patients with CHF were significantly higher than these in healthy control group;the plasma angiotensin II and aldosterone were positively with MWS（ r = 0. 4658 ,r = 0.4367,P 〈 0.001 ）. Conclusion Changes of plasma concentration of angiotensin ]I, aldosterone and MWS in the patients with CHF may play a role in the pathogenic mechanism of chronic heart failure, they may interact and influence each other in the pathogcnic mechanism of chronic heart failure.