Leggio Massimo, Sgorbini Luca, Pugliese Marco, Mazza Andrea, Bendini Maria Grazia, Fera Maria Stella, Giovannini Ezio, Leggio Francesco
Cardiovascular Department, Cardiac Rehabilitation Operative Unit (S.I.), San Filippo Neri Hospital, Via della Lucchina 41, Rome 00135, Italy.
Int J Cardiovasc Imaging. 2007 Apr;23(2):177-84. doi: 10.1007/s10554-006-9139-y. Epub 2006 Sep 14.
Tissue Doppler imaging (TDI) has evolved to become a useful non invasive method that can complement other echocardiographic techniques in the assessment of left ventricular function in different clinical conditions. Spectral pulsed TDI can provide measurements of regional systolic and diastolic myocardial velocities and is particularly useful in detecting abnormalities of left ventricular systolic and diastolic function. We investigated the presence of systo-diastolic dysfunction in patients (pts) with hypertension compared with pts affected by hypertensive cardiomyopathy and normal control subjects.
We evaluated 214 pts with traditional echocardiography and TDI: 69 normal control subjects (Group A); 145 pts with hypertension, divided according to base echocardiographic evaluation in 74 with no evidence of hypertensive cardiomyopathy (diastolic dysfunction and ventricular hypertrophy, Group B), and 71 with evidence of hypertensive cardiomyopathy (Group C). Pts groups were matched for age, sex, heart rate, smoking status and body surface area.
There were no significant differences in ventricular diameters, volumes, shortening and ejection fraction values; TDI showed a progressive systolic wave peak reduction from Group A to B and from Group B to C. Routinely Doppler diastolic function did not show any significant difference between Group A and B; TDI showed progressive E wave peak velocity decrease and A wave peak velocity increase from Group A to B and C and from Group B to C.
TDI evaluation showed a ventricular systolic dysfunction in pts with hypertensive cardiomyopathy; in addition, an early mild systo-diastolic dysfunction was detected in subjects with hypertension but no evidence of hypertensive cardiomyopathy.
组织多普勒成像（TDI）已发展成为一种有用的非侵入性方法，可在不同临床情况下补充其他超声心动图技术用于评估左心室功能。频谱脉冲TDI可提供局部收缩期和舒张期心肌速度的测量，在检测左心室收缩和舒张功能异常方面特别有用。我们比较了高血压患者与高血压性心肌病患者及正常对照受试者中收缩-舒张功能障碍的情况。
我们用传统超声心动图和TDI评估了214例患者：69例正常对照受试者（A组）；145例高血压患者，根据基础超声心动图评估分为74例无高血压性心肌病证据（舒张功能障碍和心室肥厚，B组），以及71例有高血压性心肌病证据（C组）。患者组在年龄、性别、心率、吸烟状况和体表面积方面进行匹配。
心室直径、容积、缩短率和射血分数值无显著差异；TDI显示从A组到B组以及从B组到C组收缩波峰值逐渐降低。常规多普勒舒张功能在A组和B组之间未显示任何显著差异；TDI显示从A组到B组和C组以及从B组到C组E波峰值速度逐渐降低，A波峰值速度逐渐增加。
TDI评估显示高血压性心肌病患者存在心室收缩功能障碍；此外，在无高血压性心肌病证据的高血压患者中检测到早期轻度收缩-舒张功能障碍。
