高血压患者左室重构和舒张功能变化与血管内皮功能关系的超声检测

目的 研究原发性高血压患者左室重构和左室舒张功能的变化,并探讨其与肱动脉内皮依赖性舒张功能之间的关系.方法 检测22例高血压病左室肥厚患者(LVH组),18例非左室肥厚患者(非LVH组)及20例正常对照者的心脏结构和功能,并观察肱动脉加压反应性充血后内径变化的百分率(FMD%).结果 高血压病LVH组与非LVH组肱动脉反应性充血后内径变化百分率(FMD%)、E/A均较正常对照组明显降低(P<0.05) ;左室质量指数(LVMI)高血压病LVH组较非LVH组及正常对照组明显增大(P<0.001) ;FMD%与LVMI明显相关(r=-0.721,P<0.01),并与E/A有相关性(r=0.392, P<0.05).结论 超声无创检测肱动脉内皮依赖性舒张功能为临床评估高血压病提供了一项重要信息.

Relationship between left ventricular remodeling, left ventricular diastolic function and endothelial function in essential hypertension

Objective To investigate the relationship between the left ventricular remodeling,left ventricular diastolic function and endothelium-dependent vasodilation of brachial artery. Methods Forty patients with essential hypertension(22 cases with LVH , 18 cases with non-LVH ) and twenty normal subjects were examined with echocardiography, and the percentage of changes of the brachial artery diameter induced by hyperemia(FMD%) was detected with high frequency ultrasound.Results The decrease of FMD% and E/A in patients with hypertension was significant than that in normal subjects (P<0.05),and the decrease in group of LVH was significantly than that in the group of Non-LVH;The left ventricular mass index (LVMI) was higher in patients with LVH than that in patients with non-LVH and normal subjects (P<0.001).Monovariant analysis showed that FMD% correlated well with LVMI and E/A (r=-0.721,P<0.001,r=0.392,P<0.05).Conclusions Endothelium-dependent vascular relaxation of brachial artery could be detected with ultrasound ,which provides an important index for evaluation of essential hypertension in clinic.