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既往高血压患者心肌梗死后的左心室重构

Left ventricular remodeling after myocardial infarction in antecedent hypertensive patients.

作者信息

Yoshiyama Minoru, Kamimori Kimio, Shimada Yoshihisa, Omura Takashi, Kino Naoto, Iida Hidetaka, Yoshikawa Junichi

机构信息

Department of Internal Medicine and Cardiology, Graduate School of Medicine, Osaka City University, Osaka, Japan.

出版信息

Hypertens Res. 2005 Apr;28(4):293-9. doi: 10.1291/hypres.28.293.

DOI:10.1291/hypres.28.293
PMID:16138558
Abstract

Antecedent hypertension adversely affects mortality and heart failure after myocardial infarction (MI). In addition, accelerated ventricular remodeling is a contributor to the increased mortality observed after MI. The purpose of this study was to assess the relationship of antecedent hypertension to ventricular remodeling after MI. Ninety-four patients presenting with a first acute MI who were treated with reperfusion therapy within 12 h of their symptom onset were enrolled in this study. All of them underwent left ventriculography immediately after reperfusion therapy and again at 6 months after the occurrence of MI. Patients were divided into two groups: a hypertensive group and a normotensive group. End-diastolic volume index (EDVI), end-systolic volume index (ESVI), and ejection fraction (EF) values in the acute phase were compared to those at 6 months after acute MI in either group. The hypertensive group showed a significant increase in both EDVI and ESVI after 6 months, whereas the normotensive group did not. In addition, there was no change in EF in the hypertensive group, whereas EF increased significantly after 6 months in the normotensive group. As a result, the percent changes in ESVI and EF were significantly different between the hypertensive group and normotensive group. The results demonstrated that antecedent hypertension interacts with ventricular cavity dilatation after MI.

摘要

既往高血压对心肌梗死(MI)后的死亡率和心力衰竭有不利影响。此外,心室重构加速是MI后死亡率增加的一个因素。本研究的目的是评估既往高血压与MI后心室重构的关系。本研究纳入了94例首次发生急性MI且在症状发作后12小时内接受再灌注治疗的患者。所有患者在再灌注治疗后立即进行左心室造影,并在MI发生后6个月再次进行。患者分为两组:高血压组和血压正常组。比较两组急性期的舒张末期容积指数(EDVI)、收缩末期容积指数(ESVI)和射血分数(EF)值与急性MI后6个月时的相应值。高血压组在6个月后EDVI和ESVI均显著增加,而血压正常组则没有。此外,高血压组的EF没有变化,而血压正常组在6个月后EF显著增加。结果,高血压组和血压正常组之间ESVI和EF的百分比变化有显著差异。结果表明,既往高血压与MI后心室腔扩张相互作用。

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