超声心动图评价高血压患者右室重构与右室功能的研究

目的 探讨超声心动图评价高血压右室重构及右室功能的临床价值.方法 高血压患者62例,按左室重量指数分为无左室肥厚组(A组,33例)和左室肥厚组(B组,29例).对照组为28例健康者.二维超声测量右室前壁厚度(RVAWTd)、右室舒张期内径(RVEDd);三尖瓣反流法估测肺动脉收缩压(PASP);脉冲组织多普勒成像技术(PW-TDI)测量三尖瓣环心肌运动收缩期峰值速度(Sm)、舒张早期峰值速度(Em)、舒张晚期峰值速度(Am)和S峰速度时间积分(Sm-VTI),分别采用PW-TDI与脉冲多普勒测量右室Tei指数.结果 与对照组比较,A、B组Em和Em/Am下降,Am和Tei指数升高(均P＜0.01);与A组比较, B组Em、Em/Am、Sm下降,Am、Tei指数、RVAWTd及PASP升高(P＜0.05,P＜0.0 1).两种方法所测Tei指数存在相关性:对照组(r＝0.78,P＜0.01),高血压组(r＝0.72,P＜0.01).结论 高血压患者右室功能减低,在左室肥厚同时可发生右室重构并进一步影响右室功能,TDI测定右室Tei指数能简便有效评价高血压右室功能.

Study on right ventricular remodeling and right ventricular function in hypertensive patients by echocardiography

Objective To investigate the clinical value of echocariogrphy in assessment of right ventricular remodeling and fight ventricular function in hypertensive patients.Methods Sixty-two patients with hypertension and 28 normal subjects underwent transthoracic echocardiography.All patients were divided into group A(non-left ventricular hypertrophy patients,33 cases)and group B(left ventricular hypertrophy patients,29 cases)according to left ventricular mass index.Right ventricular anterior wall diastolic thickness(RVAWTd),right ventricular end-diastolic dimension(RVEDd)and pulmonary artery systolic pressures(PASP)were mea- sured by 2D echocardiography and pulsed wave Doppler of tricuspid flow regurgitation,respectively.Systolic peak velocities(Sm),S peak velocity time integral(Sm-VTI),early-and late-diastolic peak velocities(Em and Am),the Em/Am ratio of tricuspid annular motion were detected by pulsed wave tissue Doppler imaging(PW-TDI).Tei index of right ventricule was measured by PW-TDI and pulsed wave Doppler of tricuspid flow(PWD),respectively.Results Compared with the control group,group A,group B showed in- creased Am,Tei index and decreased Em,Em/Am ratio(all P<0.01).Compared with group A,group B showed decreased Em, Em/Am ratio,Sm and increased Am,Tei index,RVAWTd and PASP(P<0.05 or P<0.01).Tei index measured by PW-TDI and PWD correlated with each other both in hypertensive patiens(r=0.72,P<0.01 )and control group(r=0.78,P<0.01).Conclu- sion Right ventricular function decreases in hypertensive patients,right ventricular remodeling maybe exist with left ventricular hyper- trophy and further effect the right ventricular function.Tei index measured by TDI is a reliable and simple method in assessment of right ventricular function in hypertensive patients.