高血压患者左心室舒张功能与左心房几何重构的相关性研究

摘要

Objective:To evaluate the left atrial geometry remodeling in hypertension patients with left ventricular diastolic dysfunction by echocardiography. Methods:130 patients as hypertension group and 60 cases as control group were studied,and 130 hypertension patients were divided into four groups by left ventricular diastolic dysfunction grade,normal group (30 cases),imp-aired relaxation group (35 cases),pseudo-normal group (35 cases),restrictive group (30 cases). Left atrial eccentricity index (LAEI) was measured by two-dimensional echocardiography to describe left atrial geometry remodeling with normal EF. The ratio of early diastolic transmitral flow velocity E to early diastolic mitral annular velocity Em (E/Em)and the ratio of E to transmitral flow propagation velocity Vp (E/Vp) were measured. Results:LAEI decreased,E/Em and E/Vp increased with severity of left ventricular diastolic dysfunction grade (P＜0.05). LAEI were significantly negatively related with E/Em and E/Vp (r=-0.72;r=-0.67). Conclusion:In patients with normal LVEF,left atrial geometry remodeling has intently relation with left ventricular diastolic dysfunction. LAEI may be a sensitive reference index for patients with left ventricular diastolic dysfunction in clinic use.%目的:应用超声心动图探讨高血压病左心室不同舒张功能状态与左心房几何重构的相关性. 方法:收集高血压患者130例,高血压病患者根据左心室舒张充盈状态分级分为4组(舒张功能正常组30例,舒张功能降低组35例,假性正常化组35例,限制性充盈障碍组30例).同时收集健康受检者60例作为对照组.应用超声心动图检测左心室射血分数(LVEF)在正常范围时,测量左心房离心指数(LAEI)评价左房几何重构;并测量二尖瓣口舒张早期流速峰值(E峰)与二尖瓣环舒张期早期运动速度Em峰比值(E/Em),E峰与M型峰值血流速度Vp比值等左心室舒张功能相关参数. 结果:随着左室舒张充盈状态分级的增加, LAEI逐渐降低,而E/Em、E/Vp增大(P＜0.05);LAEI与E/Em、E/Vp均呈负相关(r=-0.72;r=-0.67). 结论:在LVEF值正常情况下,左心房几何重构与左心室舒张充盈状态密切相关,LAEI可作为临床评价左心室舒张充盈状态的敏感参考指标.