原发性高血压左室质量适宜和过高对左室结构和功能的影响

目的 :利用左室质量比值 (%PLM )将左室重构分为左室质量适宜 (aLVM )、左室质量过高 (iLVM )和左室质量不足 ,观察并比较aLVM和iLVM的心脏结构和功能特点。方法 :对 187例原发性高血压 (EH)患者进行超声心动图检查 ,测量其心脏结构和功能。结果 :aLVM、iLVM和左室质量不足的分布分别占 4 8.1%、4 8.7%和 3.2 %。与aLVM相比 ,iLVM的主动脉根部内径、左房内径、左室质量和相对室壁厚度更高 (P <0 .0 5 ) ;心排血量、心搏量、左室射血分数、左室短轴缩短率和舒张早期充盈峰速度E峰 /舒张晚期充盈峰速度A峰比值更低 (P <0 .0 5 ) ;总外周血管阻力更高 (P <0 .0 5 )。结论 :与aLVM相比 ,iLVM的心脏结构和功能特点提示它是左室重构发展的进一步阶段。

The effects of adequate left ventricular mass and inappropriately high left ventricular mass on left ventricular structure and function in essential hypertension

Objective:The ratio of observed/predicted left ventricular mass (%PLM) divides left ventricular remodeling into adequate left ventricular mass (aLVM), inappropriately high left ventricular mass (iLVM), and inadequate left ventricular mass. Then, investigation and comparation of left ventricular structure and function between aLVM and iLVM. Methods:Left ventricular geometry and cardiac function are assessed by echocardiography in 187 cases of essential hypertension. Results:In this study, 48.1 % had aLVM, 48.7 % had iLVM, 3.2 % had inadequate LVM. In comparison with aLVM, aortic root dimension? left atrial dimension? left ventricular mass (LVM) and relative wall thickness (RWT) were higher (P< 0.05 ), while cardiac output?stroke volume? ejection fraction (EF)? fractional shortening (FS), and E/A ratio were lower (P< 0.05 ), and total peripheral resistance (TPR) was higher (P< 0.05 ) in subjects with iLVM. Conclusion:Compared with aLVM, iLVM was a more developing stage of left ventricular remodeling.