DTI对原发性高血压所致不同左室构型改变的舒缩运动模式的评价

目的：应用多普勒组织成像技术（DTI）探测室壁各节段的运动速度，以评价原发性高血压所致不同左室构型改变时，左室舒缩运动模式是否相应发生改变。方法：依照Ganau分类法将原发性高血压患者的左室构型分为四型，分别由心尖部位三个切面测量并比较六个室壁基底段、中间段、心尖段三节段的峰值运动速度。结果：正常左室构型组与正常对照组相似，基底段运动速度最快，中间段其次，心尖段最慢。向心性重构组，左室构型趋向椭圆形改变，其三节段运动速度之间比较结果与正常对照组相似，向心性肥厚组，心室形态趋向球形改变，室壁中间段与心尖段运动速度趋近于一致，离心性肥大组，心室形态更接近于球形，室壁三节段运动速度趋势近于一致。结论：上述结果提示，当左室构型趋向球形改变时，左室收缩重心可能已由心底与心尖连线距心底69%的部位逐步移向心室中央。

Evaluation of contractile performance of ventricular geometry remodeling in essential hypertension by DTI

To evaluate the contractile performance of ventricular geometry remodeling in essential hypertension, the velocities of left ventricular wall motion in three segments of six walls were investigated by Doppler tissue imaging (DTI) .Methods: According to Ganau' s categories, the geometry of left ventricle in the hypertensive patients was classified into four groups. And the velocities of three segments in six walls were measured from apical views and compared with each other.Results: In normal left ventricular geometry, as same as the normal controle group, the movement of the base is the fastest, the mid is second and the apex is the slowest. In concertric remodeling the ventricular geometry is more elliptic. But there is no sig-nificent change among three segments. In concentric hypertrophy the ventricular geometry changed to be spheric, the velocities of the middle and apical segments tended to be equal. In eccentric hypertrophy the ventricular geometry changed to be more spheric, the velocities of three segemmts tended to be as same as each other. Conclusion: The results indicated when the ventricular geometry changed to be a sphere one, the centre of gravity probably has gradually moved from 69% of the distance from base to apex to the centre of ventricle.