【摘要】 目的探讨多普勒超声指标心肌能量消耗(MEE)评估原发性高血压不同左室构型特点以及左室收缩功能的潜在临床价值。方法选取门诊或住院治疗的106例原发性高血压患者,24例健康人为对照组。用多普勒超声心动图测量心脏结构指标、左室收缩功能常规指标(射血分数、短轴缩短率),应用相关公式计算MEE、左室收缩末周向室壁应力(cESS)、左室质量指数(LVMI)、相对室壁厚度(RWT)。根据LVMI和RWT将高血压患者分为左室正常构型组(22例)、向心性重构组(34例)、向心性肥厚组(26例)和离心性肥厚组(24例);分析各组间左室结构、功能的差异,探讨MEE、cESS与左室结构、功能指标的相关性。结果高血压4组cESS均明显高于对照组,其中离心性肥厚组最高;除向心性重构组外,其余高血压3组MEE均明显高于对照组(均P<0.05),离心性肥厚组MEE最高。相关分析显示:MEE、cESS与左室收缩功能指标以及左心室重构指标均明显相关。结论多普勒超声心动图无创检测原发性高血压患者的MEE水平可反映高血压左室不同构型的心肌生物能量消耗特点;MEE、cESS是评价高血压不同构型左室收缩功能的有效指标。更多还原

【Abstract】 Objective To investigate the value of myocardial energy expenditure(MEE) for assess left ventricular systolic function and remodeling in essential hypertension patients.Methods A total of 106 hypertensives and 24 normal subjects were recruited. The left ventricular structural and functional parameters were measured by Doppler echocardiography.Hypertensives were divided into four groups according to left ventricular mass index(LVMI) and relative wall thickness(RWT): normal group(LVN,n=22),concentric remodeling group(LVCR,n=34),concentric hypertrophy group(LVCH,n=26) and eccentric hypertrophy group(LVEH,n=24).The correlation of MEE,circumferential end-systolic wall stress(cESS) and left ventricular structural and functional parameters were analysed.Results The hypertensive patients had significantly higher cESS than controls,and significantly higher MEE than controls except patients in LVCR(all P<0.05).Patients in LVCH had the highest cESS and MEE.MEE and cESS showed significant correlations with indicators of left ventricular systolic function and remodeling in bivariate correlation analysis.Conclusion MEE obtained noninvasively from echocardiographic measurements could reflect different energy expenditure characteristics of different left ventricular hypertrophic patterns,both MEE and cESS may be effective indicators for assessing left ventricular systolic function in essential hypertension.更多还原