脉压对高血压患者心脏功能的影响

为探讨原发性高血压 (以下简称高血压 )患者 2 4h动态脉压 (APP)与心脏功能的关系 ,对 5 5 5名初诊或停药 2周以上的轻中度高血压患者〔男 2 75例 ,女 2 80例 ;年龄 ( 4 7.1± 1 2 .7)岁〕进行 2 4h动态血压监测和超声心动图检查。根据脉压 (PP) ,将 5 5 5名患者分为 4组 ,A组 :PP≤ 5 .3 2kPa( 4 0mmHg) ;B组 :5 .45kPa( 4 1mmHg)≤PP≤ 6.65kPa( 5 0mmHg) ;C组 :6.78kPa( 5 1mmHg)≤PP≤ 7.98kPa( 60mmHg) ;D组 :PP≥ 8.1 1kPa( 61mmHg)。研究结果显示 :随 2 4hAPP增大 ,左室舒张功能减退 ,主要表现为心房收缩期与舒张早期充盈峰值流速之比值 (A/E)增加 ,舒张早期充盈时间 (EDFP)延长 ;左室收缩功能无明显变化。提示 :脉压增高导致高血压患者左室舒张功能减退 ,而对左室收缩功能无明显影响。

Influence of Pulse Pressure on Left Ventricular Diastolic Function in Patients with Essential Hypertension

The objective was to investigate the relationship between pulse pressure (PP) and left ventricular function in patients with essential hypertension. 24 h ambulatory blood pressure were monitored, and two-dimensional echocardiography were examined in 555 initially untreated patients (275 men and 280 women), aged (47.1± 12.7) years. The patients were divided into four groups according to ambulatory pulse pressure (PP) respectively: Group A: PP≤5.32 kPa(40 mmHg); Group B: 5.45 kPa(41 mmHg)≤PP≤6.65 kPa(50 mmHg); Group C: 6.78 kPa(51 mmHg)≤PP≤7.98 kPa(60 mmHg); Group D: PP≥8.11 kPa(61 mmHg). Results: With increased ambulatory pulse pressure, left ventricular diastolic function decreased. It was manifested as increased ratio of peak flow velocity of atrial contraction to early diastole (A/E) and prolonged early diastolic filling period (EDFP). There were no changes in systolic function with increased pulse pressure. The results show that increased pulse pressure induces decreased left diastolic ventricular function in patients with essential hypertension.