超声心动图在检测高血压病患者左心室构型的应用

目的 :研究高血压患者左心室不同构型的超声心动图表现。方法 :Ⅰ组 130例 ,为高血压病患者 ,Ⅱ组119例 ,为对照的正常健康体检者。采用超声心动图测定舒张末期室间隔厚度 (IVST)、左室后壁厚度 (PWT)、左心室内径 (LVD) ,计算左心室重量 (LVM )、左心室重量指数 (LVMI)及左心室壁相对厚度 (RWT)。根据LVMI和RWT分析高血压病患者的左心室不同构型。结果 :左心室离心性肥厚的LVD最大 (6 .12± 0 .5 4 )cm ,其次为向心性肥厚 (5 .18± 0 .4 8)cm ,二者显著高于其它二种构型及Ⅱ组 (P <0 .0 1) ;左心室离心性肥厚的LVMI最高 (16 1.12±36 .2 4 ) g/m2 ,其次为向心性肥厚 (14 2 .0 9± 35 .12 ) g/m2 ,二者显著高于其它二种构型及Ⅱ组 (P <0 .0 1) ;左心室向心性肥厚的RWT最高 0 .4 8± 0 .0 8,其次为向心性重构组 0 .4 7± 0 .0 8,二者显著高于其它二种构型及Ⅱ组 (P <0 .0 1) ;在Ⅰ组中左心室正常型占 4 8.6 % ,离心性肥厚型 30 .4 % ,向心性肥厚型 12 .1% ,向心性重构型 8.9%。结论 :在高血压病患者中 ,左心室离心性肥厚的LVMI最高 ,向心性肥厚的RWT最高 ,正常构型最常见 ,离心性肥厚较向心性肥厚常见 ,向心性重构型少见

Patterns of Left Ventricular Geometry Using Transthoracic Echocardiography in Primary Hypertensive Patients

Objective To study the patterns of left ventricular geometry using transthoracic echocardiography in hypertensive patients.Methods The intraventricular septal thickness(IVST), left ventricular posterior wall thickness(PWT) and left ventricular dimension in the end of diastolic period(LVD) were determined by transthoracic echocardiography in 130 primary hypertensive patients(group Ⅰ) and 119 normal control subjects(group Ⅱ). The left ventricular mass index(LVMI) and relative wall thickness(RWT) were determined in group Ⅰ and group Ⅱ.Different left ventricular geometric patterns were analyzed according to LVMI, RWT. Results There were four left ventricular geometric patterns in group Ⅰ. LVD was (6.12±0.54)cm in eccentric left ventricular hypertrophy and (5.18±0.48)cm in concentric left ventricular hypertrophy, they were significantly higher than other left ventricular geometric patterns and group Ⅱ (P <0.01). LVMI was(161.12±36.24)g/m 2 in eccentric left ventricular hypertrophy and(142.09±35.12)g/m 2 in concentric left ventricular hypertrophy, they were significantly higher than other left ventricular geometric patterns and group Ⅱ (P <0.01). RWT was 0.48± 0.08 in concentric left ventricular hypertrophy and 0.47±0.08 in concentric remodeling of left ventricle,they were significantly higher than other left ventricular geometric patterns and group Ⅱ (P<0.01). Among the four patterns 48.6% had normal left ventricular geometric patterns, 30.4% had eccentric left ventricular hypertrophy, 12.1% had concentric left ventricular hypertrophy and 8.9% concentric remodeling of left ventricle. Conclusions In hypertensive patients,LVMI is large in eccentric left ventricular hypertrophy,RWT is large in concentric left ventricular hypertrophy, normal left ventricular geometric patterns is the most common,eccentric left ventricular hypertrophy is more common than concentric left ventricular hypertrophy.