Abnormal left ventricular filling: an early finding in mild to moderate systemic hypertension.
Abnormal left ventricular filling: an early finding in mild to moderate systemic hypertension.
复制标题
左心室充盈异常：轻至中度全身性高血压的早期发现。
DOI：
10.1016/0002-9149(84)90695-7
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发表时间：
1984
期刊：
影响因子：
--
通讯作者：
Tubau,J
中科院分区：
文献类型：
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作者：
Inouye,I;Massie,B;Loge,D;Topic,N;Silverstein,D;Simpson,P;Tubau,J
本研究旨在确定轻中度系统性高血压患者舒张期左心室功能不全的患病率和意义。对39例高血压患者（平均收缩压156 ± 14 mmHg，平均舒张压103 ± 5 mmHg）和11例正常对照者进行静息和运动平衡血池造影。这些研究分析了射血分数（EF）、节段性室壁运动、峰值充盈率（PFR）、达到PFR的时间和按周期长度标准化的前三分之一室壁充盈分数（前三分之一充盈分数）。高血压患者和对照组的静息EF相似（0.63 ± 0.09 vs 0.65 ± 0.07）;只有2例患者EF降低。每例高血压患者的运动EF反应均正常（平均增加至0.74 ± 0.08）;仅1例患者出现能量不齐。相反，即使排除了2例收缩功能异常的患者，舒张期充盈的各项指标与对照组相比也有显著差异。PFR较低（2.29 ± 0.49 vs 2.63 ± 0.39舒张末期容积/秒[EDV/s]，p < 0.05），至PFR的时间较长（199 ± 47 vs 158 ± 17 ms/s，p < 0.01），第一-第三充盈分数较小（0.38 ± 0.11 vs 0.60 ± 0.07，p < 0.001）。84%的高血压患者的后一指数低于正常最低值。舒张期充盈异常程度与患者年龄、心率、血压、高血压病程及收缩功能无关。然而，超声心动图显示左室肥厚的患者舒张期充盈异常较多，后壁厚度与第1/3充盈分数之间存在显著相关性（r =-0.66，p < 0.001）以及质量与PFR时间之间的关系（r = 0.80，p < 0.001）。这些结果表明舒张期异常可能是高血压性心脏病的早期发现，并且它们至少部分地与左室肥厚的程度有关。
This study was undertaken to determine the prevalence and significance of diastolic left ventricular (LV) dysfunction in mild to moderate systemic hypertension. Rest and exercise equilibrium blood pool scintigraphy was performed in 39 hypertensive subjects (mean systolic blood pressure [BP] 156 ± 14 mmHg[± standard deviation];mean diastolic BP 103 ± 5 mmHg) and 11 normal control subjects. These studies were analyzed for ejection fraction (EF), segmental wall motion, peak filling rate (PFR), time to PFR and filling fraction in the first third of diastole normalized for cycle length (first-third filling fraction).EF at rest was similar in the hypertensive patients and control subjects (0.63 ± 0.09 versus 0.65 ± 0.07);only 2 patients had a reduced EF. The EF response to exercise was normal in every hypertensive patient (increasing to a mean of 0.74 ± 0.08);only 1 patient had asynergy. In contrast, even when the 2 patients with abnormal systolic function were excluded, each index of diastolic filling was significantly different from the control group. PFR was lower (2.29 ± 0.49 vs 2.63 ± 0.39 end-diastolic volumes per second [EDV/s], p < 0.05), time to PFR was longer (199 ± 47 versus 158 ± 17 ms/s), p < 0.01) and first-third filling fraction was smaller (0.38 ± 0.11 vs 0.60 ± 0.07, p < 0.001). The latter index fell below the lowest normal value in 84% of the hypertensive patients. The degree of diastolic filling abnormality was not related to the patients' age, heart rate, BP, duration of systemic hypertension or systolic function. However, patients with echocardiographic evidence of LV hypertrophy had more abnormal diastolic filling measurements, and significant correlations were present between posterior wall thickness and first-third filling fraction (r = −0.66, p < 0.001) and between mass and time to PFR (r = 0.80, p < 0.001).These findings indicate that diastolic abnormalities may be an early finding in hypertensive heart disease and that they are, at least in part, related to the degree of LV hypertrophy.