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[高血压患者室性心律失常与临床及超声心动图参数的关系]

[Relationship between ventricular arrhythmia and clinical and echocardiographic parameters in hypertensive patients].

作者信息

Pedro E, Falcão M, Bonhorst D, Gomes R S

机构信息

Serviço de Cardiologia do Hospital de Santa Cruz.

出版信息

Rev Port Cardiol. 1992 Jan;11(1):29-34.

PMID:1599697
Abstract

OBJECTIVE

Evaluation in arterial hypertension (HTA) patients, of the relationship between supraventricular and ventricular arrhythmias, stage of hypertension and echocardiographic parameters.

DESIGN

Retrospective study based on the files of ambulatory electrocardiography (Holter).

SETTING

Arrhythmology Outpatients Clinic from a Cardiac Department.

PATIENTS

Adult patients with arterial hypertension, males and females, who underwent ambulatory electrocardiography (Holter) and echocardiography examinations.

MATERIAL AND METHODS

Thirty patients, 15 males and females, 54 +/- 12 years old, were studied. Arterial hypertension was stratified in three stages according with the diastolic value. Symptoms, serum potassium, left ventricular hypertrophy (LVH) on the ECG, and echocardiographic parameters such as left ventricular dimensions, shortening fraction, septal wall and posterior wall thickness and left atrium dimensions were analysed. These parameters were correlated with the arrhythmic pattern concerning the number of premature supraventricular contractions and the number and complexity of premature ventricular contractions (PVC), evaluated by ambulatory electrocardiography (Holter).

RESULTS

No relation was found between the arrhythmic pattern, stage of hypertension, symptoms and LVH on the ECG. Septal wall thickness was 14 +/- 3 mm in the group of patients with PVC greater than or equal to 10/hour and 12 +/- 3 mm in the population with PVC less than 10/hour (p less than 0.04). The shortening fraction was 27 +/- 8% in the group of repetitive PVC and 34 +/- 7% in the population without (p less than 0.003). A borderline relation was found between repetitive PVC and left atrium and left ventricular diastolic dimensions.

CONCLUSIONS

In a population of arterial hypertension (HTA) who performed ambulatory electrocardiography (Holter), the prevalence of frequent or repetitive PVC was low. A positive correlation between frequent PVC and septal wall thickness and an inverse relation between repetitive PVC and LV shortening fraction, was found. These conclusions are according with the literature, relating the ectopic activity with LVH or deterioration of LV function. No relation was found between arrhythmias and stage of hypertension.

摘要

目的

评估动脉高血压(HTA)患者室上性和室性心律失常、高血压分期与超声心动图参数之间的关系。

设计

基于动态心电图(Holter)记录的回顾性研究。

地点

心脏科心律失常门诊。

患者

接受动态心电图(Holter)和超声心动图检查的成年动脉高血压患者,男女不限。

材料与方法

研究了30例患者,男女各15例,年龄54±12岁。根据舒张压值将动脉高血压分为三个阶段。分析症状、血清钾、心电图上的左心室肥厚(LVH)以及超声心动图参数,如左心室尺寸、缩短分数、室间隔壁和后壁厚度以及左心房尺寸。通过动态心电图(Holter)评估这些参数与心律失常模式(关于室上性早搏数量以及室性早搏(PVC)的数量和复杂性)之间的相关性。

结果

未发现心律失常模式、高血压分期、症状与心电图上的LVH之间存在关联。PVC≥10次/小时的患者组室间隔壁厚度为14±3mm,PVC<10次/小时的人群中为12±3mm(p<0.04)。重复性PVC组的缩短分数为27±8%,无重复性PVC的人群中为34±7%(p<0.003)。在重复性PVC与左心房和左心室舒张期尺寸之间发现了一种临界关系。

结论

在进行动态心电图(Holter)检查的动脉高血压(HTA)人群中,频繁或重复性PVC的患病率较低。发现频繁PVC与室间隔壁厚度呈正相关,重复性PVC与左心室缩短分数呈负相关。这些结论与文献一致,即异位活动与LVH或左心室功能恶化有关。未发现心律失常与高血压分期之间存在关联。

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