Marcó E J, Dopico A M, Otero F, Ramírez A J, Sánchez R A
División Hipertensión Arterial, Hospital Instituto de Cardiología, Academia Nacional de Medicina, Buenos Aires, Argentina.
Medicina (B Aires). 1992;52(4):311-9.
In order to assess their ventricular function at rest and during exercise, 42 essential hypertensives (164 +/- 2/98.7 +/- 2 mmHg) and 12 normotensives (131.7 +/- 4/81.2 +/- 1 mmHg) were studied. Ejection fraction (EF), peak filling rate (PFR) and peak ejection rate (PER) were measured by means of gated radionuclide ventriculography. At rest, no differences in EF, PFR and PER between hypertensives and normotensives were found. During exercise, hypertensives showed lower PFR (5.3 +/- 0.2 EDV/s) and EF (67.7 +/- 1%) than normotensives (PFR 7 +/- 0.5 EDV/s, p < 0.005 and EF 79.4 +/- 2%, p < 0.001). Likewise, hypertensive showed a lower increase from rest to exercise in PFR and in EF than normotensives p < 0.001. In addition, hypertensives showed a great individual variability in EF response to exercise, where 23 patients increased EF more than 5% and 19 patients failed to increase it during stress. Moreover, the last group of patients had higher systolic blood pressure (SBP) both at rest and during exercise than patients who increased EF, p < 0.01. In addition, there was a significantly negative correlation between resting SBP and the variation of Ef (r = 0.47 y: 163.1-0.79X, p < 0.01). Left ventricular mass (LVM) was similar in the two groups of hypertensives. On the other hand, there were no differences in any of the variables analyzed between the hypertensives with LV hypertrophy and those with normal LVM. These findings suggest that abnormalities in both systolic and diastolic LV during exercise may be found in hypertensive patients even before myocardial hypertrophy can be detected.
为了评估42例原发性高血压患者（收缩压164±2/舒张压98.7±2mmHg）和12例血压正常者（收缩压131.7±4/舒张压81.2±1mmHg）静息及运动时的心室功能，对其进行了研究。通过门控放射性核素心室造影测量射血分数（EF）、峰值充盈率（PFR）和峰值射血率（PER）。静息时，高血压患者与血压正常者在EF、PFR和PER方面未发现差异。运动时，高血压患者的PFR（5.3±0.2EDV/s）和EF（67.7±1%）低于血压正常者（PFR 7±0.5EDV/s，p<0.005；EF 79.4±2%，p<0.001）。同样，高血压患者从静息到运动时PFR和EF的增加幅度低于血压正常者，p<0.001。此外，高血压患者在运动时EF反应存在很大的个体差异，其中23例患者EF增加超过5%，19例患者在应激时未能增加EF。而且，后一组患者静息及运动时的收缩压（SBP）均高于EF增加的患者，p<0.01。此外，静息SBP与Ef变化之间存在显著负相关（r = 0.47，y：163.1 - 0.79X，p<0.01）。两组高血压患者的左心室质量（LVM）相似。另一方面，左心室肥厚的高血压患者与LVM正常的高血压患者在分析的任何变量上均无差异。这些发现表明，即使在检测到心肌肥厚之前，高血压患者在运动时左心室收缩和舒张功能可能就已出现异常。
