组织多普勒评价高血压性和运动性心脏重塑的差异

目的探讨TDI技术在评价高血压性心脏重塑与运动性心脏重塑差异上的价值。方法收集高血压性心肌肥厚患者31例(高血压组)、运动员35名(运动员组)和健康志愿者50名(对照组),采用M型及TDI超声心动图观测心脏重塑后左心室结构和功能的变化。结果高血压组与运动员组的室间隔、左心室后壁厚度、左心室舒张末期内径以及左心室心肌质量指数均高于对照组。脉冲多普勒测量结果中,与对照组相比,高血压组A峰升高、E/A值降低(P均<0.05),运动员组A峰降低、E/A值升高(P均<0.05);TDI测量结果中,与对照组和运动员组相比,高血压组舒张早期(Em)、收缩期(Sm)心肌运动速度及E/Em值均出现明显变化(P均<0.05)。结论 TDI超声心动图有助于区分高血压性和运动性心脏重塑。

Tissue Doppler imagine in evaluation on hypertensive and exercise-induced cardiac remodeling

Objective To estimate the value of tissue Doppler imaging (TDI) in distinguishing hypertensive and exercise-induced cardiac remodeling. Methods Thirty-one hypertensive patients with left ventricular hypertrophy, 35 athletes and 50 normal controls were enrolled. M-mode echocardiography and TDI were performed to evaluate the changes of left ventricular structure and diastolic function during cardiac remodeling. Results In both of hypertensive patients and athletes, the thickness of inter-ventricular septum (IVS), left ventricular posterior wall (LVPW) and left ventricular end-diastolic dimension (LVEDD) and left ventricular mass index (LVMI) were statistically higher than those of normal controls (P<0.05). Compared to normal controls, the atrial peak flow velocity (A wave) increased in hypertensive patients and reduced in athletes (both P<0.05); E/A reduced in hypertensive patients and increased in athletes (both P<0.05).The left ventricular lateral myocardial early diastolic velocity (Em), systolic velocity (Sm) and the ratio of E and Em gained from TDI showed significant differences in hypertensive patients compared with normal controls and athletes (all P<0.05). Conclusion TDI is helpful in distinguishing hypertensive and exercise-induced cardiac remodeling.