扩张性心肌病伴高血压患者心功能及预后的变化

目的观察扩张性心肌病患者伴有高血压与不伴高血压者临床特征的差异。方法对我院1989年至2006年155例诊断扩张性心肌病的住院病例的临床资料进行回顾性分析。结果(1)扩张性心肌病伴高血压的患者出现心力衰竭后血压高于140/90 mm Hg者占30%。(2)伴高血压的扩张性心肌病组左心室后壁厚度(LVPW)、室间隔厚度(IVS)、左心室射血分数(LVEF)、左心室心肌重量(LVMW)等各指标高于无高血压组。(3)治疗后伴有高血压组心功能改善更明显。结论(1)利用血压水平作为排除高血压所引起的心脏损害的标准有一定的局限性。(2)少部分伴高血压的扩张性心肌病可能由于高血压病史不详而属于高血压引起的心脏损害的范畴。

Heart function and prognosis of dilated cardiomyopathy patients complicating with hypertension

Objective To investigate clinical characteristics of dilated cardiomyopathy(DCM) patients complicating with or without hypertension(HTN). Methods Clinical characteristics as heart function,blood pressure,heart events and echocardiography indexes were analyzed retrospectively in 155 DCM patients(88 cases with HTN and 67 cases without HTN).Results(1)30% DCM patients with HTN had blood pressure ≥ 140/90 mm Hg when they suffered heart failure.(2)Left ventricular posterior wall(LVPW),interventricular septum(IVS),Left ventricular ejection fraction(LVEF) and left ventricular mass weight(LVMW) values were higher in patients with HTN than without HTN.(3)After treatment,heart function improved more significantly in patients with HTN than patients without HTN. Conclusions(1) There is limitation in using blood pressure level as a standard to exclude or diagnose dilated cardiomyopathy.(2)Some diagnosed "dilated cardiomyopathy" complicating hypertension may belong to the category of cardiomyopathy resulting from hypertension.