应变率成像评价血压昼夜节律变异对高血压患者左室局部收缩功能的影响

目的：探讨应变率成像（SRI）评价血压昼夜节律变异对高血压患者左室局部收缩功能的影响。方法i103例经规律治疗及左室射血分数（LVEF）大于55％的原发性高血压患者，根据动态血压分为48例杓型组和55例非杓型组，均行24h动态血压监测，二维超声及SRI检查。结果：两组24h及白天平均收缩压和舒张压无明显差异（P〉0．05），非杓型组夜间平均收缩压和舒张压显著高于杓型组（P〈0．01）。两组LVEF无明显差异（P〉0．05），非杓型组左室心肌收缩应变率（S-Sr）显著低于杓型组（P〈0．01）。结论：非杓型高血压患者左室整体收缩功能尚未改变时就已出现左室局部收缩功能降低，血压昼夜节律异常与左室局部收缩功能下降有重要的关系。

EFFECT OF AMBULATORY BLOOD PRESSURE PROFILE ON REGIONAL LEFT VENTRICULAR SYSTOLIC FUNCTION IN HYPERTENSIVE PATIENTS BY STRAIN RATE IMAGING

Objective： To investigate the effect of ambulatory blood pressure （BP） profile on regional left ventricular （LV） systolic function in essential hypertensive patients by strain rate imaging. Methods：One hundred and three orderly treated essential hypertensive patients with preserved LV ejection fraction （LVEF〉55%） were included in the study. The patients were divided into two groups with respect to ambulatory BP profiles as 48 dippers and 55 nondippers. They were studied by 24 h ambulatory BP monitored, two-dimensional echocardiography and strain rate imaging. Results：There was no significant differ- ence between the two groups with respect to 24 hour and daytime average systolic and diastolic BP（ P〉 0.05）. But nighttime average systolic and diastolic BP were significantly higher in nondipping group than in dipping group（ P 〈0.01）. The two groups had similar LVEF（ P 〉0.05）. However, the nondippers had significantly lower LV myocardial systolic strain rate than the dippers （ P 〈0.01）. Conclusion： Although LV global systolic function was preserved in nondippers, the nondipping profile might be associated with LV myocardial dysfunction which was reflected by LV regional systolic dysfunction.