Denolle T, Julien J, Chatellier G, Battaglia C, Luo P, Plouin P F, Corvol P
Département d'hypertension artérielle, hôpital Broussais, Paris.
Arch Mal Coeur Vaiss. 1992 Aug;85(8):1131-5.
Assessment of left ventricular (LV) structural modifications following etiologic treatment of secondary hypertension, in a group of 43 patients.
M-Mode echocardiograms were independently analysed by 2 trained investigators before and 7.4 months (RV), 11 patients with COnn's adenoma (C) and 9 patients with phaeochromocytoma (PH).
Age, sex ratio, antihypertensive treatment, and duration of hypertension before treatment were comparable among the 3 groups. Blood pressure was higher in C and RV than in PH for casual (C: 190/116; RV: 193/109; PH: 146/91; p < 0.01/0.05) as well as ambulatory blood pressure (C: 140/93; RV 153/89; PH: 126/80; p < 0.01/0.05). Before etiologic treatment, systolic function was normal in the 3 groups whereas LV mass index differed between the 3 groups (C: 147; RV: 118; PH: 85 g/m2). LV end diastolic diameter index was smaller in PH (26.4 mm/m2) than in C (29.1) and RV (28.8). After treatment, there was a significant reduction on office (C: -43/-20; RV: -39/-19; PH: -20/-12 mmHg) and ambulatory (C: -6.6/-5.6; R: -20/-9.9; PH: -4.7/- 4.5) blood pressure. Systolic function was not altered. LV mass index was significantly reduced in C and RV but not in PH (C: -18%; RV: -7%; PH: -5%). Changes in LV end diastolic diameter index were not significant (C: -2%; RV: 0%; PH: + 6%). There was no correlation between LV mass index changes and blood pressure differences.
Etiologic treatment leads to significant regression of LV hypertrophy in patient with renovascular hypertension or Conn's adenoma, at least partly independently of blood pressure change. Humoral and volume factors may play a role in LV regression.
评估43例患者继发性高血压病因治疗后左心室（LV）结构改变情况。
由2名经过培训的研究人员对M型超声心动图进行独立分析，分别于治疗前以及治疗后7.4个月（肾血管性高血压组，RV）、11例原发性醛固酮增多症患者（C组）和9例嗜铬细胞瘤患者（PH组）进行检查。
3组患者的年龄、性别比、降压治疗情况以及治疗前高血压病程具有可比性。C组和RV组的偶测血压（C组：190/116；RV组：193/109；PH组：146/91；p<0.01/0.05）以及动态血压（C组：140/93；RV组153/89；PH组：126/80；p<0.01/0.05）均高于PH组。病因治疗前，3组患者的收缩功能均正常，但3组之间左心室质量指数存在差异（C组：147；RV组：118；PH组：85g/m²）。PH组的左心室舒张末期内径指数（26.4mm/m²）小于C组（29.1）和RV组（28.8）。治疗后，诊室血压（C组：-43/-20；RV组：-39/-19；PH组：-20/-12mmHg）和动态血压（C组：-6.6/-5.6；R组：-20/-9.9；PH组：-4.7/-4.5）均显著降低。收缩功能未改变。C组和RV组的左心室质量指数显著降低，而PH组未降低（C组：-18%；RV组：-7%；PH组：-5%）。左心室舒张末期内径指数的变化不显著（C组：-2%；RV组：0%；PH组：+6%）。左心室质量指数变化与血压差异之间无相关性。
病因治疗可使肾血管性高血压或原发性醛固酮增多症患者的左心室肥厚显著消退，至少部分独立于血压变化。体液和容量因素可能在左心室消退中起作用。
