Cunha D M, da Cunha A B, Martins W A, Pinheiro L A, Romêo L J, de Moraes A V, Morcerf F P
Universidade Federal Fluminense, Niterói, RJ, Brazil.
Arq Bras Cardiol. 2001 Jan;76(1):15-28. doi: 10.1590/s0066-782x2001000100003.
To identify left ventricular geometric patterns in hypertensive patients on echocardiography, and to correlate those patterns with casual blood pressure measurements and with the parameters obtained on a 24-hour ambulatory blood pressure monitoring.
We studied sixty hypertensive patients, grouped according to the Joint National Committee stages of hypertension. Using the single- and two-dimensional Doppler Echocardiography, we analyzed the left ventricular mass and the geometric patterns through the correlation of left ventricular mass index and relative wall thickness. On ambulatory blood pressure monitoring we assessed the means and pressure loads in the different geometric patterns detected on echocardiography
We identified three left ventricular geometric patterns: 1) concentric hypertrophy, in 25% of the patients; 2) concentric remodeling, in 25%; and 3) normal geometry, in 50%. Casual systolic blood pressure was higher in the group with concentric hypertrophy than in the other groups (p=0.001). Mean systolic pressure in the 24h, daytime and nighttime periods was also higher in patients with concentric hypertrophy, as compared to the other groups (p=0.003, p=0.004 and p=0.007). Daytime systolic load and nighttime diastolic load were higher in patients with concentric hypertrophy ( p=0.004 and p=0.01, respectively).
Left ventricular geometric patterns show significant correlation with casual systolic blood pressure, and with means and pressure loads on ambulatory blood pressure monitoring.
通过超声心动图识别高血压患者的左心室几何形态，并将这些形态与偶测血压测量值以及24小时动态血压监测所获参数进行关联分析。
我们研究了60例高血压患者，根据美国国家联合委员会高血压分期进行分组。使用一维和二维多普勒超声心动图，通过左心室质量指数与相对室壁厚度的相关性分析左心室质量和几何形态。在动态血压监测中，我们评估了超声心动图检测到的不同几何形态中的平均血压和压力负荷。
我们识别出三种左心室几何形态：1）向心性肥厚，占患者的25%；2）向心性重构，占25%；3）正常几何形态，占50%。向心性肥厚组的偶测收缩压高于其他组（p = 0.001）。与其他组相比，向心性肥厚患者24小时、白天和夜间的平均收缩压也更高（p = 0.003、p = 0.004和p = 0.007）。向心性肥厚患者的白天收缩压负荷和夜间舒张压负荷更高（分别为p = 0.004和p = 0.01）。
左心室几何形态与偶测收缩压以及动态血压监测中的平均血压和压力负荷显著相关。
