原发性高血压左室收缩功能无创生物力学分析
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内蒙古自治区教育厅重点领域资助项目(ZL-01049); 内蒙古医学院重大科技项目(NY2003ZD011)


Noninvasive biomechanics assessment of left ventricular systolic function in essential hypertension
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    摘要:

    目的研究用最大心肌劲度(maxEav)评价高血压病左室重构的生物力学特性的临床意义。方法研究对象为96例高血压病患者和30例健康人。应用超声心动图测定左室收缩期及舒张末期内径、左室重量指数(LVMI)和相对室壁厚度(RWT),左室射血分数(EF)、左室短轴缩短率(FS)。联合袖带肱动脉血压值计算左室收缩末期压力。根据LVMI和RWT将高血压患者分为左室正常构型组、向心性重构组、向心性肥厚组、离心性肥厚组。应用上述各测值计算maxEav。结果(1)以EF、FS表示的心脏收缩功能在正常对照组与高血压各组间、高血压组内各组间无明显差异性(P>0.05)。(2)对照组maxEav与高血压各组有明显差异性(P<0.01);高血压各组间maxEav无明显差异性(P>0.05)。结论应用超声心动图无创测定心功能力学参数maxEav对高血压左室重构心肌生物力学特性的评价具有特殊的诊断价值。

    Abstract:

    Objective To evaluate the contractility of left ventricule due to cardiac remodeling in hypertension by meansof maximum myocardial stiffness(maxEav). Method The end-systolic and end-diastolic dimension of left ventricule, leftventricular mass index (LVMI) , relative wall thickness (RWT) , ejection fraction(EF) and short-axis shorting fraction(FS)were measured by echocardiography in 96 patients with essential hypertension and 30 normal subjects.Left ventriculeend-systolic pressure was evaluated by sphygmomanometer. Essential hypertensions were divided into groups with LVnormal geometric patterns,LV concentric remodeling patterns,LV concentric hypertrophy patterns and LV eccentrichypertrophy patterns according to the LVMI and RWT. Maximum myocardial stiffness(maxEav)was calculated by usingof echocardiographic measurements. Result ① There were not significant differcences of LV systolic functionbetween control group and hypertension groups (P>0.05); ② maxEav of hypertension patients was significantly largerthan that of control group(P<0.01 ); but there were not differences between hypertension groups (P>0.05). ConclusionMaximum myocardial stiffness maxEav derived by echocardiography is noninvasive method and worthful for evaluatingthe biomechanical characteristic of LV remodeling due to hypertension.

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司效东,刘志跃,王金锐,杨敬英,徐霞.原发性高血压左室收缩功能无创生物力学分析[J].医用生物力学,2006,21(2):125-128

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