VENTRICULAR ARRHYTHMIAS IN HYPERTENSIVE LEFT-VENTRICULAR HYPERTROPHY - RELATIONSHIP TO CORONARY-ARTERY DISEASE, LEFT-VENTRICULAR DYSFUNCTION, AND MYOCARDIAL FIBROSIS
VENTRICULAR ARRHYTHMIAS IN HYPERTENSIVE LEFT-VENTRICULAR HYPERTROPHY - RELATIONSHIP TO CORONARY-ARTERY DISEASE, LEFT-VENTRICULAR DYSFUNCTION, AND MYOCARDIAL FIBROSIS
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DOI：
10.1093/ajh/3.10.735
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发表时间：
1990-10-01
影响因子：
3.2
通讯作者：
DARGIE, HJ
中科院分区：
文献类型：
--
作者：
MCLENACHAN, JM;DARGIE, HJ
高血压伴左室肥厚(LVH)患者室性心律失常发生率增高。然而，在高血压性左心室肥厚患者中，室性心律失常与共存的冠状动脉疾病、左心功能不全和左心室纤维化之间的关系尚未被研究。我们对15例高血压伴左室肥厚和非持续性室性心动过速患者进行了冠状动脉造影。3个连续的室性复合波)，其中9个(60%)没有明显的(>；50%狭窄)冠状动脉疾病。为了确定其他可能与左室性心律失常相关的因素，对28例LVH患者(17例伴室性心动过速，11例无室性心律失常)进行了左心功能(血管造影射血分数)、左室重量(超声心动图)和左室纤维化(心内膜心肌活检)的定量评估。两组间射血分数无显著差异(53.+-)。8%对62.+-2%，P=NS)。然而，左心室重量明显更大(442.±-.28克v339。+-。34，P<；0.05)和纤维化百分比显著升高(19.+-。4%v 3.+-。室性心动过速患者占1%，P<0.01。因此，高血压并左室肥厚患者的室性心律失常不能完全归因于并存的冠状动脉疾病，也不能完全归因于左心功能不全，而与心肌肥厚和心内膜下纤维化的程度有关。
Ventricular arrhythmias occur with increased frequency in hypertensive patients with left ventricular hypertrophy (LVH). The relationships, however, between ventricular arrhythmias and coexistent coronary artery disease, left ventricular dysfunction and left ventricular fibrosis have not been examined in hypertensive LVH. We carried out coronary arteriography of fifteen hypertensive patients with LVH and nonsustained ventricular tachycardia (.gtoreq. 3 consecutive ventricular complexes) of whom nine (60%) were free of significant (> 50% stenosis) coronary disease. To identify other possible correlates of left ventricular arrhythmias, 28 patients with LVH, comprising 17 with ventricular tachycardia and 11 without ventricular arrhythmias, underwent quantitative assessment of left ventricular function (angiographic ejection fraction), left ventricular mass (echocardiography), and left ventricular fibrosis (endomyocardial biopsy). Ejection fraction was not significantly different between the two groups (53 .+-. 8% v 62 .+-. 2%, P = NS). However, left ventricular mass was significantly greater (442 .+-. 28 g v 339 .+-. 34, P < .05) and percentage fibrosis significantly higher (19 .+-. 4% v 3 .+-. 1%, P < .001) in those patients with ventricular tachycardia. Thus ventricular arrhythmias in hypertensive patients with LVH cannot be entirely attributed to coexistent coronary disease, nor to left ventricular dysfunction, but are related to the degree of cardiac hypertrophy and subendocardial fibrosis.