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[高血压合并左心室肥厚患者的心力衰竭]

[Heart failure in hypertensive patients with left ventricular hypertrophy].

作者信息

Ghanem Wisam M A, Mikes P, Bulas J, Kozlíková K, Sleiman O, Murín J, Reptová A

机构信息

I. interná klinika Lekárskej fakulty UK a Fakultná nemocnica, Bratislava.

出版信息

Vnitr Lek. 2001 Jun;47(6):348-53.

Abstract

Left ventricular hypertrophy (LVH) is supposed to be a useful marker of cardiovascular complications during the course of hypertension. Authors compared the presence of heart failure, left ventricular diastolic dysfunction and chronic atrial fibrillation in hypertensive patients with and without left ventricular hypertrophy defined by echocardiography. Hospital records of 192 hypertensives treated in our medical department during years 1996-1999 were analysed. Left ventricular hypertrophy was defined by echocardiography (Penn convention) as left ventricular mass index > 134 g/m2 in men and > 110 g/m2 in women. Presence of LVH was found in 128 patients (mean age 65.9 years), absence of LVH in 64 patients (mean age 64.8 years). Both groups of hypertensives were matched by demographic parameters, by the presence of hyperlipidemia, by smoking habits. Hypertensive patients with left ventricular hypertrophy were more often treated by ACE inhibitors. There were statistically significant more patients with heart failure, left ventricular diastolic dysfunction and chronic atrial fibrillation in LVH-positive patients than in LVH-negative once. There was also statistically significant lower ejection fraction (50.3 +/- 11.4% vs 56.5 +/- 7.4%) in LVH-positive patients than in LVH-negative once. Left ventricular hypertrophy in patients with hypertension brings usually a complicated course of the disease with a high contribution to the development of chronic heart failure.

摘要

左心室肥厚(LVH)被认为是高血压病程中心血管并发症的一个有用标志物。作者比较了经超声心动图定义为有或无左心室肥厚的高血压患者中心力衰竭、左心室舒张功能障碍和慢性心房颤动的发生率。分析了1996年至1999年期间在我们内科接受治疗的192例高血压患者的医院记录。通过超声心动图(宾夕法尼亚标准)将左心室肥厚定义为男性左心室质量指数>134 g/m²,女性>110 g/m²。128例患者(平均年龄65.9岁)存在LVH,64例患者(平均年龄64.8岁)不存在LVH。两组高血压患者在人口统计学参数、高脂血症的存在情况、吸烟习惯方面相匹配。有左心室肥厚的高血压患者更常接受ACE抑制剂治疗。与LVH阴性患者相比,LVH阳性患者中出现心力衰竭、左心室舒张功能障碍和慢性心房颤动的患者在统计学上显著更多。LVH阳性患者的射血分数(50.3±11.4%对56.5±7.4%)在统计学上也显著低于LVH阴性患者。高血压患者的左心室肥厚通常会带来复杂的病程,对慢性心力衰竭的发生有很大影响。

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