实时三维超声心动图评价左心室构型正常的原发性高血压患者左心房功能  

Assessment of left atrial mechanical function with real-time three-dimensional echocardiography in essential hypertension patients with normal left ventricular geometric

作　　者：张荔[1] 吕清[1] 谢明星[1] 李玲[1] 李玉曼[1] 武晓燕[1] 王巧[1] 李玥霖 

机构地区：[1]华中科技大学同济医学院附属协和医院超声影像科,湖北武汉430022

出　　处：《中国医学影像技术》2011年第1期78-82,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的应用实时三维超声心动图技术评价左心室构型正常的原发性高血压患者左心房功能。方法 高血压组为50例左心室构型正常[即左心室重量指数(LVMI)男性<125g/m2,女性<120g/m2,相对室壁厚度(RWT)<0.45]原发性高血压患者(高血压组),正常对照组为50名年龄、体表面积与研究组相匹配的正常人。采集全部受检者心尖四腔心全容积图像,采用QLab软件脱机分析,获取左心房容积曲线,得到左心房最大容积(LAVmax)、最小容积(LAVmin)及左心房收缩前容积(LAVpre)。计算出左心房总排空容积(LAVt)、左心房总排空分数(LAVtEF)、左心房被动排空容积(LAVp)、左心房被动排空分数(LAVpEF)、左心房主动排空容积(LAVa)、左心房主动排空分数(LAVaEF)及管道容积(CV)。同法测量左心室最大容积(LVmax)及最小容积(LVmin),并计算左心室搏出量(SV)和左心室射血分数(LVEF)。以上数据均用体表面积(BSA)标化。结果 与正常对照组比较,高血压组左心房LAVmax、LAVmin、LAVpre、LAVt、LAVa均明显增高,差异有统计学意义(P<0.001);LAVtEF、LAVpEF、LAVaEF、LAVp、CV差异无统计学意义(P>0.05);高血压组左心室LVmax、SV增高,差异有统计学意义(P<0.05),LVmin、LVEF差异无统计学意义(P>0.05)。结论 左心室构型正常的原发性高血压患者左心房储存器功能明显增加,助力泵功能有所增加,管道功能无变化。高血压左心室构型正常患者左心房容积及功能的变化早于左心室构型变化,评价左心房功能可更早地反映高血压对心脏的影响。Objective To estimate left atrial mechanical function with three-dimensional echocardiography in essential hypertension patients with normal left ventricular geometric.Methods Fifty essential hypertension patients with normal left ventricular geometric（left ventricular mass index LVMI,man125 g/m2,woman120 g/m2,relative wall thickness RWT0.45） and 50 age-BSA matched healthy controls were enrolled.All subjects were collected full volume imaging at apical four-chamber view with real-time three-dimensional echocardiography.Left atrial volume curve,left atrium maximal volume（LAV_max）,left atrium minimal volume（LAV_min） and left atrium presystolic volume（LAVpre） were analyzed with QLAB workstation.Following parameters including left atrium passive emptying volume（LAVp）,left atrium passive emptying fraction（LAVpEF）,conduit volume（CV）,left atrium active emptying volume（LAVa）,left atrium active emptying fraction（LAVaEF）,left atrium total emptying volume（LAVt） and left atrium total emptying fraction（LAVtEF） were calculated.Left ventricle maximal volume（LVmax） and left ventricle minimal volume（LVmin） were measured by same way,then stroke volume（SV） and left ventricular ejection fraction（LVEF） were calculated.All volumes were standardized for body surface area.Result LAV_max,LAV_min,LAVpre,LAVt,LAVa,LV_max,SV increased obviously in hypertensives than in the controls（P0.001）,while LAVtEF,LAVpEF,LAVaEF,LAVp,CV,LV_min and LVEF were similar in both groups（P0.05）.Conclusion Atrial reservoir and booster pump functions increase in hypertensive patients,but conduit function does not changed.Left atrial volume changes before left ventricle geometric does.

关 键 词：高血压 心房功能 左 超声心动描记术 三维 

分 类 号：R544.1[医药卫生—心血管疾病] R540.45[医药卫生—内科学]