Bongiovì S, Palatini P, Macor F, Visentin P, Pessina A C
Clinica Medica I, University of Padua, Italy.
J Hypertens Suppl. 1992 Apr;10(2):S25-30.
To evaluate the influence of different clinical and echocardiographic parameters on left ventricular diastolic filling in 66 mild to moderate hypertensives and 49 normotensives.
All subjects underwent an echocardiographic study with a pulsed Doppler evaluation of left ventricular filling. The hypertensive subjects also underwent non-invasive 24-h blood pressure monitoring.
The ratio of early to atrial peak diastolic filling velocity and the ratio of the corresponding areas under the curve (AUC) were significantly lower in the hypertensives compared with the normotensives (P less than 0.001). In the hypertensives, office blood pressure, average 24-h mean blood pressure, the left atrial dimension and the left ventricular mass index were each related both to age and to diastolic filling. The variable most closely related to diastolic filling independently of age and the R-R interval was 24-h blood pressure (ratio of early: atrial peak filling velocity versus 24-h blood pressure: r = -0.307, P less than 0.05; ratio of early: atrial AUC versus 24-h blood pressure: r = -0.261, P less than 0.05). When the normotensives and hypertensives were each grouped according to age less than or equal to or greater than 40 years, the normotensive-hypertensive mean difference was greater in the subjects aged greater than 40 years for both the early:atrial maximal velocity ratio and the early:atrial AUC ratio.
Age is the strongest clinical correlate for left ventricular diastolic function indices, in both hypertensives and normotensives. In the present study, average 24-h blood pressure and, to a lesser extent, the heart rate were also associated with an impaired diastolic performance.
评估不同临床和超声心动图参数对66例轻度至中度高血压患者和49例血压正常者左心室舒张期充盈的影响。
所有受试者均接受超声心动图检查，并采用脉冲多普勒评估左心室充盈情况。高血压患者还进行了无创24小时血压监测。
与血压正常者相比，高血压患者舒张早期与心房峰值充盈速度之比以及相应曲线下面积（AUC）之比显著降低（P<0.001）。在高血压患者中，诊室血压、24小时平均血压、左心房内径和左心室质量指数均与年龄和舒张期充盈有关。与舒张期充盈独立于年龄和R-R间期最密切相关的变量是24小时血压（舒张早期：心房峰值充盈速度之比与24小时血压之比：r = -0.307，P<0.05；舒张早期：心房AUC之比与24小时血压之比：r = -0.261，P<0.05）。当血压正常者和高血压患者分别按年龄小于或等于40岁或大于40岁分组时，对于舒张早期：心房最大速度之比和舒张早期：心房AUC之比，40岁以上受试者的血压正常者-高血压患者平均差异更大。
年龄是高血压患者和血压正常者左心室舒张功能指标最强的临床相关因素。在本研究中，24小时平均血压以及在较小程度上心率也与舒张功能受损有关。
