超声心动图评价血管紧张素受体拮抗剂对高血压病患者 左室舒张功能的影响

目的应用多普勒超声心动图评价血管紧张素II1型受体(AT1)拮抗剂对高血压病患者左室舒张功能的影响.方法分别于AT1拮抗剂(Losartan)服用前和服用12周后,对26例轻至中度原发性高血压病患者进行超声心动图检查.在心尖左心长轴切面上,用多普勒超声心动图测量二尖瓣口舒张早期峰值速度E、舒张晚期峰值速度A和E峰减速时间,并计算E/A比值;在左室长轴切面上,在二维超声心动图引导下用M型超声心动图测量舒张末期左室内径、室间隔和左室后壁厚度,并计算左室重量.结果服用Losartan 12周后,E/A比值(1.20±0.32)明显高于服用前(1.07±0.31,P＜0.0001),E峰减速时间从185±32 ms下降到164±29 ms(P=0.002);左室重量从220±53g减低为194±53g(P=0.003).结论AT1拮抗剂losartan具有改善高血压病患者左室舒张功能的作用.

Evaluation of the Effect of Angiotensin Receptor Antagonist on Left Ventricular Diastolic Function in Patients with Mild to Moderate Essential Hypertension by Echocardiography

Objective To evaluate the effect of angiotensin II type 1 receptor antagonist on left ventricular diastolic function in patients with mild to moderate essential hypertension. Methods Pulsed Doppler echocardiographic recordings of transmitral flow velocity were obtained and left ventricular end-diastolic dimension, end-diastolic septal thickness and end-diastolic posterior wall thickness were measured before and after 12 weeks of losartan treatment in 26 hypertensive patients by echocardiography. Results After 12 weeks of losartan administration, the ratio of peak velocity in early diastole to that at atrial contraction increased significantly from 1.07±0.31 to 1.20±0.32 (P<0.0001), and mitral valve E-peak deceleration time decreased significantly from 185±32 ms to 164±29 ms (P=0.002); Left ventricular mass reduced significantly from 220±53 g to 194±53 g after losartan treatment (P=0.003). Conclusion Treatment with angiotensin II type 1 receptor antagonist losartan improved the left ventricular diastolic function in patients with mild to moderate essential hypertension.