奥美沙坦酯胶囊对高血压右房功能影响的超声研究

目的应用二维及脉冲组织多普勒（PW-TDI）超声心动图、声学定量（AQ）技术评价奥美沙坦酯胶囊（口服8周）对高血压患者右房功能的影响。方法对照组20例，高血压组50例。服用奥美沙坦酯前及服药8周后，测量舒张期三尖瓣口血流频谱E波、A波峰值流速，计算E／A比值。应用PW-TDI技术测量三尖瓣环附于右室侧壁处的舒张早、晚期运动速度（分别为Em、Am），计算Em／Am比值。应用AQ技术，测量RV、PFR代表右房储存器功能，REF、PRER及PRER／PAER代表右房管道功能，AEF、PAER代表右房助力泵功能。结果与对照组比较，高血压组Em／Am＜1，E／A＜1；右房RV和PFR增高（P值均＜0．01）；PRER／PAER减低（P＜0.01）；PAER增高（P＜0.01）。药物治疗后Em／Am、E／A比值均升高（P值均＜0．001）；右房PFR显著减低（P＜0．01）。结论高血压患者左室肥厚及右室舒张功能异常的进展导致右房功能异常，降压治疗可改善右房功能。

Effects of Olmesartan on Right Atrial Function in Hypertension Patients

Objective The effects of Olmesartan Medoxomil on right atrial (RA) function were evaluated using two-dimensional,acoustic quantification(AQ) technique and pulsed-wave tissue Doppler imaging(PW-TDI) in 50 patients with hypertension.Methods Twenty age-and sex-matched normal subjects served as the control.Two-dimensional and Doppler echocardiograms were recorded before and after 8 weeks of oral antihypertensive therapy.The sample lines were placed at the tricuspid valvular annuli(TVA) in the lateral wall of the right ventricle (RV).The peak velocity of TVA in early and late diastolic phases (Em and Am,respectively),and Em/Am ratio were calculated.The peak flow velocity of RV early and late diastolic filling (E and A waves) were measured by placing the sample volume at the tricuspid valve,and E/A ratio were calculated.Acoustic quantification(AQ) was performed for the derivation of the following variables:RA reservoir volume (RV) and peak filling rate(PFR) were measured as RA reservoir function;rapid emptying fraction(REF),peak rapid emptying rate(PRER) and ratio of peak rapid emptying rate and peak atrial emptying rate(PRER/PAER) were measured as RA booster conduit function;atrial emptying fraction(AEF) and peak atrial emptying rate(PAER) were measured as RA booster pump function.Results Compared with the control subjects,RA-E/A ratio and Em/Am ratio were decreased in hypertension patients.RA-PRER/PAER was decreased significantly.RV,PFR and PAER were increased significantly.After therapy,the ratio of E/A and Em/Am were increased and RA-PFR was decreased.Conclusions RA function is deteriorated along with the development of left ventricular hypertrophic severity and RV diastolic dysfunction in hypertensive patients is improved after antihypertensive therapy.