Maternal Diastolic Dysfunction and Left Ventricular Geometry in Gestational Hypertension
Maternal Diastolic Dysfunction and Left Ventricular Geometry in Gestational Hypertension
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妊娠期高血压的母亲舒张功能障碍和左心室几何形状
DOI：
10.1161/01.hyp.37.5.1209
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发表时间：
2001
期刊：
影响因子：
--
通讯作者：
A. Galante
中科院分区：
文献类型：
--
作者：
H. Valensise;G. Novelli;B. Vasapollo;G. Di Ruzza;M. Romanini;M. Marchei;G. Larciprete;D. Manfellotto;C. Romanini;A. Galante
摘要：本研究的目的是评估妊娠期高血压患者的舒张参数和左心室几何构型。21例妊娠期高血压孕妇和21例年龄和胎龄相匹配的血压正常妇女在妊娠晚期入组。进行超声心动图和子宫彩色多普勒评估。女性高血压患者的收缩压、舒张压、平均血压、总血管阻力（TVR）和子宫阻力指数均高于对照组（P <0.01）。妊娠期高血压组左房功能和心输出量均明显降低（P <0.01）。妊娠期高血压患者左室等容舒张时间（IVRT）较长（P <0.0001），A波和舒张期肺静脉血流速度-时间积分较低（P <0.05），反向肺静脉血流速度-时间积分较高（P <0.05）。妊娠期高血压组肺静脉血流频谱中的收缩期分数高于对照组（P <0.01），肺静脉血流时间与A波时间之差接近于0（P <0.0001）。高血压组左室构型改变发生率为100%，正常对照组为19.05%（P <0.001）。IVRT、左室收缩末期容积、心房功能、子宫阻力指数与TVR呈正相关（P <0.01），E波减速时间与TVR呈二次相关（P <0.01）。妊娠性高血压的特征是心脏向心性肥大的几何构型改变。在我们的研究中，妊娠高血压期间评估的几何模式改变与收缩功能降低、TVR高、舒张功能改变和左心房功能障碍相关。与最高TVR同时出现的E波减速时间、IVRT和左心房面积分数变化可能有助于评价妊娠高血压综合征患者的心功能和血流动力学。
Abstract—The objective of this study was to evaluate diastolic parameters and left ventricular geometry in gestational hypertension. Twenty-one consecutive pregnant women with gestational hypertension and 21 normotensive women matched for age and gestational age were enrolled in the third trimester of gestation. Echocardiographic and uterine color Doppler evaluations were performed. Systolic, diastolic, and mean blood pressure, total vascular resistance (TVR), and uterine resistance index were higher in hypertensive women than in control subjects (P <0.01). Left atrial function and cardiac output were significantly lower in gestational hypertension (P <0.01). Patients with gestational hypertension had longer left ventricular isovolumetric relaxation time (IVRT) (P <0.0001); lower velocity-time integral of the A wave (P <0.05) and of the diastolic pulmonary vein flow (P <0.05); and higher velocity-time integral of the reverse pulmonary vein flow (P <0.05). Systolic fraction of the pulmonary vein flow was higher in women with gestational hypertension than in control subjects (P <0.01); the difference in duration of pulmonary vein flow and A wave was closer to 0 in gestational hypertension (P <0.0001). Altered left ventricular geometry was found in 100% of hypertensive patients and in 19.05% of normotensive patients (P <0.001). IVRT, left ventricular end-systolic volume, atrial function, and uterine resistance index were directly related to TVR (P <0.01); deceleration time of the E wave showed a quadratic correlation with TVR (P <0.01). Gestational hypertension is characterized by an altered cardiac geometric pattern of concentric hypertrophy. The altered geometric pattern assessed during gestational hypertension is associated, in our study, with depressed systolic function, high TVR, altered diastolic function, and left atrial dysfunction. Deceleration time of the E wave, IVRT, and left atrial fractional area change, found in concomitance with the highest TVR, may be useful in the evaluation of cardiac function and hemodynamics present in pregnancy-induced hypertension.
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DOI：
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发表时间：
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期刊：
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影响因子：
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10.1016/0735-1097(92)90385-z
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影响因子：
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