老年高血压患者左心室构型与长轴功能的QTVI分析

目的应用定量组织速度成像（QTVI）技术测定老年高血压患者在左心室重构过程中左室长轴的功能变化,并探讨其临床意义。方法应用QTVI技术测定82例老年高血压患者和28例健康志愿者的左心室16节段心肌收缩期峰值速度（Vs）。根据Ganau分类法,将老年高血压患者分为左心室正常构型（22例）、向心性重构型（28例）、向心性肥厚型（19例）和离心性肥厚型（13例）。比较老年高血压各组之间及与对照组之间的差异并进行显著性分析。结果老年高血压患者各组左心室各节段Vs均小于对照组相应节段（P〈0.05,0.01）。正常构型、向心性重构型、向心性肥厚型及离心性肥厚型各组间Vs存在显著性差异,且呈逐渐减小趋势（P〈0.05,0.01）。结论老年高血压患者存在左心室长轴收缩功能受损,Vs在左心室重构中的变化可以准确反映高血压左心室重构过程中收缩功能受损程度的变化;QTVI技术对于老年高血压患者左心室长轴收缩功能的正确评价及预后估计等方面具有重要临床应用价值。

Assessment of LV Geometric Remodeling and Long-axis Function in Elderly Patients with Hypertension Using QTVI

Objective To explore the alteration of left ventricular long-axis function during left ventricular geometric remodeling in elderly patients with essential hypertension （EH） using quantitative tissue velocity imaging and to investigate its clinical significance. Methods Totally 82 elderly patients with EH and 28 healthy volunteers were enrolled. Based on Ganau, elderly patients with EH were divided into 4 groups： normal geometry（22 cases）, concentric remodeling（28 cases）, concentric hypertrophy（19 cases） and eccentric hypertrophy（13 cases）. Systolic peak velocity （Vs） was measured at different segments in left ventricular walls using quantitative tissue velocity imaging. Results Vs in each hypertensive groups were significantly lower than in control groups（P 0.05 or 0.01）.The differences between groups were statistically significant and there was a significantly step-down change among normal geometry,concentric remodeling,concentric hypertrophy and eccentric hypertrophy groups in Vs（P0.05 or 0.01）. Conclusion Quantitative tissue velocity imaging can assess left ventricular long-axis function correctly in elderly patients with EH and its alteration during left ventricular geometric remodeling. Quantitative tissue velocity imaging may help to evaluate prognosis of elderly patients with EH.