实时三维超声心动图评价射血分数正常高血压左心室肥厚患者左心室协调性

摘要

Objective To assess the asynchrony in patients with hypertension and left ventricular hypertrophy ( LVH ) but with normal left ventricular ejection fraction ( LVEF ) and fractional shortening ( FS ) by real-time three-dimensional echocardiography ( RT-3DE ). Methods RT-3DE and two-dimensional echocardiography were performed on 50 patients with hypertension and left ventricular hypertrophy ( LVH group ) and 30 healthy subjects ( control group ). The stand deviation ( SD ) of the rntime to the point with minimal systolic volume ( Tmsv ) in 16, 12, and 6 segments determined and adjusted by R-R interval ( Tmsv SD％ , Tmsv Dif％ ) were obtained by RT-3DE. LVEF, FS and the wall thickness were assessed by two-dimensional echocar-diography. Results Tmsv 16-SD％ 、Tmsv 16-Dif％ 、Tmsv 12-SD％ 、Tmsv 12-Dif％、 Tmsv 6-SD％ , and Tmsv 6-Dif％ were increased ( P ＜ 0. 05 ). Conclusion Even with normal LVEF and FS, the asynchrony of patients with hypertension and LVH could decrease compared with those of normal controls. The 3DE method could objectively assess the asynchrony of patients with hypertension and LVH.%目的 应用实时三维超声心动图评价左心室射血分数正常的高血压左心室肥厚患者左心室协调性.方法 选取30 例正常人(正常对照组)和50 例高血压左心肥厚患者(左心室肥厚组),应用实时三维超声心动图测量左心室室壁17个节段容积-时间曲线,计算左心室特定节段达到最小收缩容积时间 (Tmsv)的标准偏差和最大差值被标准化为心动周期的百分比Tmsv 16-SD%、Tmsv 12-SD%、Tmsv 6-SD%、Tmsv 16-Dif%、Tmsv 12-Dif%、Tmsv6-Dif%.结果 与正常对照组比较,高血压左心室肥厚患者的 Tmsv 16-SD%、Tmsv 12-SD%、Tmsv 6-SD%、Tmsv 16-Dif%、Tmsv 12-Dif%、Tmsv6-Dif% 均显著增加(P<0.05).结论 高血压患者即使左心室射血分值正常,左心室协调性也较正常人显著减低,尤其是在高血压左心室肥厚患者.室壁运动的协调性是反映心功能的一项重要指标,利用实时三维超声心动图能发现高血压左心室肥厚非心力衰竭患者左心室协调性变化,对于明确高血压左心室肥厚患者心脏功能变化有帮助.