高血压并阵发性房颤二尖瓣、肺静脉血流频谱特点的研究

目的对比研究原发性高血压伴有和不伴有阵发性房颤(PAF)患者二尖瓣和肺静脉血流频谱特点.方法年龄、血压和左室心肌重量指数匹配的高血压PAF组24例,非PAF组55例.应用多普勒超声心动图测量二尖瓣舒张早期、舒张晚期血流峰值(E、A)及其流速积分(VTI-E、VTI-A),计算E/A比值;肺静脉血流频谱收缩期、舒张期、血流峰值(PVS、PVD)及其流速积分(VTI-PVS、VTI-PVD)等指标.结果与非PAF组比较,PAF组E和VTI-E显著增加E:(70.94±18.03) cm/s vs (86.66±26.93) cm/s,P<0.01; TVI-E:(12.93±3.50) cm vs (16.74±4.95) cm,P<0.001];A减低(89.20±23.44) cm/s vs (78.62±18.96) cm/s,P<0.05),E/A比值增大(0.82±0.24 vs 1.13±0.36,P<0.01);PVD和VTI-PVD增加PVD:(42.60±12.11) cm/s vs (52.18±14.20) cm/s,P<0.01; TVI-PVD:(10.06±3.19) cm vs (12.16±3.04) cm,P<0.05].结论左房助力泵功能减低、管道功能增强和左房扩大可能是高血压病患者合并PAF的机制之一.

Characteristics of transmitral and pulmonary venous flow indexes in hypertensive patients with paroxysmal atrial fibrillation

Objective To evaluate the changes of transmitral and pulmonary venous flow indexes in hypertensive patients with and without paroxysmal atrial fibrillation (PAF).Methods Twenty four hypertensive patients with PAF and 55 hypertensive patients without PAF were included. The age,gender,history of hypertension,blood pressure and left ventricular mass index were matched in two groups. The following transmitral and pulmonary venous flow Doppler parameters were used: peak early and peak late diastolic flow velocity (E,PAF),the ratio of E and A (E/A),velocity-time integral of E and A (VTI-E,VTI-A),peak pulmonary venous systolic and diastolic flow velocity (PVS,PVD),and velocity-time integral of PVS and PVD (VTI-PVS,VTI-PVD).Results The E,VTI-E,E/A,PVD and VTI-PVD were increased and the A were decreased significantly in patients with PAF compared with patients without PAF (E:70.94±18.03] cm/s vs 86.66±26.93] cm/s,P<0.01; TVI-E: 12.93±3.50] cm vs 16.74±4.95] cm,P< 0.001; E/A: 0.82±0.24 vs 1.13±0.36,P<0.01; PVD: 42.60±12.11] cm/s vs 52.18±14.20] cm/s,P<0.01; TVI-PVD: 10.06±3.19] cm vs 12.16±3.04] cm,P<0.05; A: 89.20±23.44] cm/s vs 78.62±18.96] cm/s,P<0.05).Conclusion Reduced left atrial booster bump function,increased left atrial conduct function and dilated left atrial diameter are the potential mechanisms of PAF in patients with hypertension.