【摘要】 目的应用声学定量(acoustic quantification,AQ)技术评价高血压患者不同左心室构型左心房功能变化。方法选择正常对照组29例,原发性高血压患者116例,按照Ganau分型法分为4组,即左心室正常构型组(LN,25例),向心重构组(CR,38例),向心肥厚组(CH,33例),离心肥厚组(EH,20例)。利用AQ技术测量并计算(1)贮存功能指标左房贮存容积(LARV)、左房总排空分数(LATEF)、左心房峰值充盈率(PFR);(2)管道功能指标左房快速排空容量(LREV)、左房快速排空分数(LREF)、峰值快速排空率(PRER);(3)助力泵功能指标左房主动收缩排空容积(LAEV)、左心房射血分数(LAEF)、峰值心房排空率(PAER)等指标。结果 (1)贮存功能指标与正常对照组相比,CH组与EH组的PFR明显增大,差异有统计学意义(P<0.01～0.05);与CH组相比,EH组的LATEF减低,差异有统计学意义(P<0.05);LARV有增加趋势,但差异无统计学意义。(2)管道功能指标比较与正常对照组相比,EH组的LREF明显降低(P<0.001),与LN组、CR组及CH组相比,EH组的LREF仍降低(P<0.01);LREV有降低趋势,但差异无统计学意义。(3)助力泵指标与正常对照组相比,高血压各组LAEV、PAER明显增大(P<0.01～0.001),CR组、CH组LAEF增大(P<0.05);与CR、CH组比较,EH组LAEF减低,差异无统计学意义。结论原发性高血压患者左心房贮存功能及助力泵功能增加,以CR组及CH组明显,但EH组减低;管道功能减低,以EH组明显。AQ技术为左心房功能的评价提供了无创性新方法。更多还原

【Abstract】 Objective To evaluate left atrial(LA) function between various left ventricular(LV) geometry in patients with hypertension by acoustic quantification(AQ) technique and to explore new methods and quantitive index for assessing LA function.Methods The study included 29 healthy participants as the control group and 116 patients with primary hypertension.The patients were divided into groups of normal geometric LV(LN,n= 25),concentric remodeling (CR,n=38),concentric hypertrophy(CH,n=33)and eccentric hypertrophy(EH,n=20).Left atrial reservoir volume (LARV),left atrial total emptying fraction(LATEF),peak filling rate(PFR),left rapid emptying volume(LREV), left rapid emptying fraction(LREF),peak rapid emptying rate(PRER),left atrial emptying volume(LAEV),Left atrial ejection fraction(LAEF),and peak atrial emptying rate(PAER) were measured with AQ technique.Results Compared with the control subjects,PFR increased significantly in CH and EH group(P<0.01～0.05).Compared with the CH group,LATEF decreased significantly in EH group(P<0.05).The rise in LARV was a trend,but the results among different hypertensive groups had no statistical significance.Compared with the control subjects,LREF decreased significantly in EH group(P<0.001),there was significant difference between EH group and any other group(P< 0.01).Compared with the control subjects,LAEV and PAER increased significantly(P<0.01～0.001);LAEF increased significantly in CR and CH group(P<0.05),Compared with the CR and CH group,LAEF decreased,but the difference had no statistical significance.Conclusions In hypertensive patients,left atrial booster pump function and reservoir function increase to compensate for impaired left ventricular diastolic function while conduit function decreases, especially in CH and EH group,but decrease in EH group.AQ technique may be used as a method to quantify left atrial function in patients with hypertension.更多还原