高血压左心室几何构型与心房电-机械时间的关系  

Association of left ventricular geometric model with atrial electromechanical time in patients with essential hypertension

作　　者：黄灿亮[1] 杜鑫[1] 万征[1] 周贵明[1] 孙跃民[1] 袁文利[1] 周旻[1] 

机构地区：[1]天津医科大学总医院心内科,300052

出　　处：《中华超声影像学杂志》2005年第10期740-743,共4页Chinese Journal of Ultrasonography

摘　　要：目的探讨组织多普勒成像(TDI)中高血压左心室几何构型与心房电-机械时间的关系。方法选择原发性高血压患者90例,其中23例有阵发性心房颤动(房颤)病史,67例无房颤病史。20例健康人为对照组。按超声心动图Ganau分类方法再将高血压患者分为四组:左心室几何构型正常组(NG组,30例),左心室向心性重构组(CR组,20例),左心室向心性肥厚组(CH组,16例),左心室离心性肥厚组(EH组,24例)。采用TDI分别测量心电图P波起始至左心室侧壁二尖瓣环处和右心室侧壁三尖瓣环处Aa波起始点的心房电-机械时间(LP-A和RP-A)。结果房颤组的LP-A与RP-A值均较无房颤组延长(P<0.01);无房颤组的LP-A与RP-A值均较对照组延长(P<0.05)。与NG组比较,CR组、CH组和EH组的LP-A与RP-A值均延长;与CR组比较,CH组和EH组的LP-A与RP-A值均延长(P<0.05);LP-A和RP-A值在CH组与EH组之间差异无显著性意义(P>0.05)。结论原发性高血压患者心房电-机械时间随左心室几何构型的进展逐渐延长,在左心室肥厚患者中延长最为明显,其有可能成为房颤的预测指标。Objective To investigate the association of left ventricular geometric model and atrial electromechanical time in patients with essential hypertension by tissue Doppler imaging（TDI）. Methods Ninety patients with essential hypertension were enrolled. Among them, 23 patients had history of paroxysmal atrial fibrillation （AF group）, 67 patients had no history of atrial fibrillation （NAF group）. According to Ganau categories, these patients were divided into four groups： normal left ventricle geometric model （NG group, 30 cases）, concentric remodeling （CR group, 20 cases）, concentric hypertrophy （CH group, 16 cases） and eccentric hypertrophy （EH group,24 cases）, and 20 healthy subjects as control group were included. Left and right atrial electromechanical time（LP-A,RP-A） was acquired by TDI. Results Compared with NAF group, LP-A and RP-A of AF group were longer （ P 〈0.01）. There was also significant difference between NAF group and control group （ P 〈0.05）. Compared with NG groups, LP-A and RP-A of other three groups were all longer. Compared with CR groups, LP-A and RP-A of CH group and EH group were both longer （ P 〈0.05）. There was no significant difference between CH group and EH group （P 〈 0.05）. Conclusions Atrial electromechanical time in patients with essential hypertension is increased following the developing of left ventricular geometric model. It is obviously longer in patients with left ventricle hypertrophy and may be a predictor for the onset of atrial fibrillation.

关 键 词：超声心动描记术 多普勒 高血压 心房颤动 心室功能 左 原发性高血压患者 阵发性心房颤动 左心室几何构型 电-机械时间 左心室向心性重构 组织多普勒成像 LP-A 向心性肥厚 超声心动图 

分 类 号：R541.3[医药卫生—心血管疾病]