Yang Haoyi, Deng Youbin, Li Chunlei, Bi Xiaojun, Pan Min, Chang Qing
Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030.
J Huazhong Univ Sci Technolog Med Sci. 2002;22(2):164-7. doi: 10.1007/BF02857684.
The effects of angiotensin II receptor antagonist losartan on elastic properties of aorta in patients with mild to moderate essential hypertension were assessed. The ascending aortic distensibility in 26 patients (48 +/- 3 years) with mild to moderate essential hypertension before and after 12 weeks of treatment with losartan (50 mg/day) was evaluated by using two-dimensional echocardiography. M-mode measurements of aortic systolic (Ds) and diastolic diameter (Dd) were taken at a level approximately 3 cm above the aortic valve. Simultaneously, cuff brachial artery systolic (SBP) and diastolic (DBP) pressures were measured. Aortic pressure-strain elastic modulus (Ep) was calculated as Dd x (SBP-DBP)/(Ds-Dd) x 1333 and stiffness index beta (beta) was defined as Dd x Ln (SBP/DBP)/(Ds-Dd). Blood pressure significantly decreased from 148 +/- 13/95 +/- 9 mmHg to 138 +/- 12/88 +/- 8 mmHg (systolic blood pressure, P = 0.001; diastolic blood pressure, P = 0.003). There was no significant difference in pulse pressure before and after treatment with losartan (53 +/- 10 mmHg vs 50 +/- 7 mmHg). The distensibility of ascending aorta increased significantly as showed by the significant decrease in pressure-strain elastic modulus from 4.42 +/- 5.79 x 10(6) dynes/cm2 to 1.99 +/- 1.49 x 10(6) dynes/cm2 (P = 0.02) and stiffness index beta from 27.4 +/- 32.9 to 13.3 +/- 9.9 (P = 0.02). Although there was a weak correlation between the percent changes in pressure-strain elastic modulus and stiffness index beta and that in diastolic blood pressure after losartan treatment (r = 0.40, P = 0.04 and r = 0.55, P = 0.004, respectively), no correlation was found between the percent changes in pressure-strain elastic modulus and stiffness index beta and that in systolic blood pressure (r = 0.04, P = 0.8 and r = 0.24, P = 0.2, respectively). Our study demonstrated that angiotensin II receptor antagonist losartan has a beneficial effect on aortic distensibility in patients with mild to moderate essential hypertension and this effect is partly independent of blood pressure reduction.
评估了血管紧张素II受体拮抗剂氯沙坦对轻至中度原发性高血压患者主动脉弹性特性的影响。采用二维超声心动图评估26例（48±3岁）轻至中度原发性高血压患者在接受氯沙坦（50mg/天）治疗12周前后升主动脉的扩张性。在主动脉瓣上方约3cm处进行主动脉收缩期（Ds）和舒张期直径（Dd）的M型测量。同时，测量肱动脉袖带收缩压（SBP）和舒张压（DBP）。主动脉压力-应变弹性模量（Ep）计算为Dd×(SBP-DBP)/(Ds-Dd)×1333，硬度指数β（β）定义为Dd×Ln(SBP/DBP)/(Ds-Dd)。血压从148±13/95±9mmHg显著降至138±12/88±8mmHg（收缩压，P=0.001；舒张压，P=0.003）。氯沙坦治疗前后脉压无显著差异（53±10mmHg对50±7mmHg）。升主动脉扩张性显著增加，表现为压力-应变弹性模量从4.42±5.79×10(6)达因/cm2显著降至1.99±1.49×10(6)达因/cm2（P=0.02），硬度指数β从27.4±32.9降至13.3±9.9（P=0.02）。虽然氯沙坦治疗后压力-应变弹性模量和硬度指数β的变化百分比与舒张压变化百分比之间存在弱相关性（r=0.40，P=0.04；r=0.55，P=0.004），但压力-应变弹性模量和硬度指数β的变化百分比与收缩压变化百分比之间未发现相关性（r=0.04，P=0.8；r=0.24，P=0.2）。我们的研究表明，血管紧张素II受体拮抗剂氯沙坦对轻至中度原发性高血压患者的主动脉扩张性有有益作用且该作用部分独立于血压降低。
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