Pelà G, Bruschi G, Cavatorta A, Manca C, Cabassi A, Borghetti A
Dipartimento di Clinica Medica, Nefrologia e Scienze della Prevenzione, University of Parma, Parma, Italy.
Eur J Echocardiogr. 2001 Jun;2(2):108-17. doi: 10.1053/euje.2000.0057.
Doppler tissue echocardiography (DTE) was applied to extract the myocardial wall velocities along different planes and evaluate the left ventricular function in essential hypertension.
Fifty-four hypertensives (HT) were compared to a control group of 31 normotensive (NT) subjects. The short-axis shortening and lengthening was assessed through the parasternal projections, sampling from interventricular septum and posterior wall. Through the apical projections the mitral annulus excursion was observed at four sites (anterior, posteroseptal, lateral, inferior walls) to assess the longitudinal dynamic of the heart. In each myocardial segment, peak velocity and time-velocity integral for systolic (S) and diastolic waves (E and A) were measured and their means for the long- and short-axis directions were calculated. Significant changes in hypertensives involved mainly the longitudinal motion. In diastole, the E-wave relaxation velocity was significantly decreased and the late A-wave velocity was unchanged. The E/A velocity ratio was significantly reduced. Relaxation velocity was negatively correlated to age, left ventricular mass and diastolic blood pressure. In systole, the peak S-wave shortening velocity was reduced and no association with age, left ventricular mass and blood pressure could be demonstrated. The range of segmental data produced by DTE proved useful to manufacture sensitive indices for recognition of hypertensive damage. Single DTE variables also proved slightly more sensitive than those extracted from the mitral flow pattern for the discrimination of HT patients.
The presence of impaired relaxation was confirmed by DTE in a large portion of patients with hypertension and left ventricular hypertrophy. A peculiar systolic disturbance is evidenced by this technique. DTE-derived information can be used to detect early and quantify target-organ damage and its progression or regression during antihypertensive treatment.
应用多普勒组织超声心动图（DTE）提取不同平面的心肌壁速度，并评估原发性高血压患者的左心室功能。
将54例高血压患者（HT）与31例血压正常者（NT）的对照组进行比较。通过胸骨旁切面，从室间隔和后壁取样，评估短轴的缩短和延长情况。通过心尖切面，在四个部位（前壁、后间隔壁、侧壁、下壁）观察二尖瓣环的运动，以评估心脏的纵向动态。在每个心肌节段，测量收缩期（S）和舒张期波（E和A）的峰值速度和时间速度积分，并计算其长轴和短轴方向的平均值。高血压患者的显著变化主要涉及纵向运动。在舒张期，E波舒张速度显著降低，晚期A波速度不变。E/A速度比显著降低。舒张速度与年龄、左心室质量和舒张压呈负相关。在收缩期，S波峰值缩短速度降低，且与年龄、左心室质量和血压无相关性。DTE产生的节段数据范围被证明有助于生成识别高血压损害的敏感指标。对于区分高血压患者，单一的DTE变量也比从二尖瓣血流模式提取的变量略敏感。
DTE证实大部分高血压合并左心室肥厚患者存在舒张功能受损。该技术显示出一种特殊的收缩期紊乱。DTE获得的信息可用于检测早期靶器官损害并对其进行量化，以及在抗高血压治疗期间监测其进展或逆转情况。
