高血压左室构型与左室中层力学的关系

目的：用室壁应力－左室中层缩短率关系做为评价心肌收缩性的指标，研究高血压不同左室构患者心肌收缩性的改变与心功能变化的关系。方法：应用超声心动图计算左室重量指数（ＬＶＭＩ）和相对室壁厚度（ＲＷＴ），按ＬＶＭＩ和ＲＷＴ将左心室分为四种构型。对１１７例原发性高血压病人和４５例健康人左心室结构按左室室壁应力（ＭＥＳＳ）和室壁中层缩短率（ｍＦＳ）来估计心功能情况。结果：以射血分数、左室短轴缩短率和左室中层缩短率表示的收缩功能离心性肥厚受损严重，以室壁应力－左室中层缩短率关系表示的心肌收缩性，向心性肥厚最重。以ＥＦ斜率等表示的心脏舒张功能高血压不同左室构型患者损害不同，舒张功能的改变与心肌收缩必的损害成正相关。结论：高血压不同左室构型患者心肌收缩性损害不同，左室构型向向心性发展在一定阶段上代偿了心肌收缩性的下降，以保持心脏

The Relation Between Left Ventricular Midwall Fractional Shortening and Left Ventricular Geometric Patterns in Hypertensive Patients

Objective:To study the relationship between the alteration of myocardial contractility and cardiac function in hypertensive patients with different left ventricular geometry using the end systolic stress midwall fractional shortening. Methods:Left ventricular geometry and cardiac function was assessed by echocardiography in 117 cases of essential hypertension, with 45 normal cases as control. Patients were divided into four groups based on LVMI and RWT. Midwall fractional shortening(mFs) and meridional end systolic stress(MESS) were calculated. Results:The most serious impairment of left ventricular systolic function was shown in eccentric hypertrophy decreases in ejection fraction, fractional shortening and midwall fractional shortening. However myocardial contractility shown by end systolic stress midwall fractional shortening relation was worst in concentric hypertrophy group. The damage of diastolic function showed as EF slope was strongly correlated with the decreased myocardial contractility. Conclusion: The degree of myocardial contractility impairment was different in patients with different left ventricular geometry. Concentric hypertrophy of left ventricle compensated the reduction of myocardial contractility in some phases in order to maintain the normal systolic function.