实时三维超声心动图评价不同左室构型高血压病患者左房功能

目的探讨实时三维超声心动图(RT-3DE)评估不同左室构型原发性高血压病(EH)患者左房功能的价值。方法将103例EH患者根据不同左室构型分为4组:正常构型28例(A组)、向心性重构28例(B组)、向心性肥厚25例(C组)、离心性肥厚22例(D组),另选健康志愿者30例为对照组;分析各组左房内径(LAD)、左室内径(LVDd)、室间隔厚度(IVST)、后壁厚度(LPWT)、左房最大容积(LAVmax)和最小容积(LAVmin)、左房收缩前容积(LAVpre)、每搏量(LASV)、左房射血分数(LAEF)等指标的差异。结果与对照组比较,C、D组LAD均增大,LAEF均减小,B、C、D组IVST、LAVmin、LAVpre均增大,EH各组患者LVDd、LPWT、LAVmax、LASV均增大,E/A值减小,差异均有统计学意义(均P<0.05)。与A组比较,B组LPWT增大,C、D组LAD、LVDd、IVST、LPWT、LAVmin均增大,LAEF均减小,B、C、D组LAVmax、LASV均增大,D组LAVpre增大,差异均有统计学意义(均P<0.05)。与B组比较,C、D组LAD、LVDd、IVST、LAVmax、LAVmin、LASV均增大,LAEF均减小,D组LPWT增大,差异均有统计学意义(均P<0.05)。与C组比较,D组LAD、IVST、LPWT均增大,LAEF减小,差异均有统计学意义(均P<0.05)。结论不同左室构型EH患者左房功能改变有一定差异,其中以离心性肥厚EH患者左房功能改变程度最大。RT-3DE评估不同左室构型EH患者左房功能有较好价值。

Evaluation of left atrial function in hypertension patients with different left ventricular configurations by real time three-dimensional echocardiography

Objective To expore the value of real time three-dimensional echocardiography(RT-3DE)in evaluating left atrial function in essential hypertension(EH)patients with different left ventricular configurations.Methods According to the left ventricular configuration,103 EH patients were classified into 4 groups:28 cases of normal configuration(group A),28 cases of concentric remodeling(group B),25 cases of cardiac hypertrophy(group C),22 cases of centrifugal hypertrophy(group D),and 30 healthy volunteers included in the same period were taken as control group.The left atrial diameter(LAD),left ventricular diameter(LVDd),ventricular septal thickness(IVST),posterior wall thickness(LPWT),left atrial maximum volume(LAVmax),minimum volume(LAVmin),left atrial pre-systolic volume(LAVpre),stroke volume(LASV),left atrial ejection fraction(LAEF)in each group were analyzed.Results Compared with the control group,LAD in group C and D was increased,LAEF was decreased,IVST,LAVmin and LAVpre in groups B,C and D were increased,LVDd,LPWT,LAVmax and LASV in EH patients were increased,while E/A was decreased,there were significant differences(all P<0.05).Compared with group A,LPWT in group B was increased,LAD,LVDd,IVST,LPWT and LAVmin in groups C and D were increased,LAEF was decreased,LAVmax and LASV in groups B,C and D were increased,the LAVpre in group D was increased,there were significant differences(all P<0.05).Compared with group B,LAD,LVDd,IVST,LAVmax,LAVmin and LASV in group C and D were increased,LAEF was decreased,LPWT in group D was increased,there were significant differences(all P<0.05).Compared with group C,LAD,IVST and LPWT in group D were increased,while LAEF was decreased,there were significant differences(all P<0.05).Conclusion The changes of left atrial function in EH patients with different left ventricular configurations are different,and the changes in left atrial function in EH patients with eccentric hypertrophy are the largest.RT-3DE has high value in evaluating left atrial function in EH patients with different left ventricular configurations.