Zizek Bogomir, Poredos Pavel, Trojar Andrej, Zeljko Tadej
Department of Angiology, University Medical Centre, Ljubljana, Slovenia.
Cardiology. 2008;111(1):8-15. doi: 10.1159/000113420. Epub 2008 Feb 1.
We investigated left ventricular (LV) morphology and function in association with insulin level/insulin resistance (IR) and aldosterone level in normotensive offspring of subjects with essential hypertension (familial trait, FT).
The study encompassed 76 volunteers of whom 44 were normotensive with FT (aged 28-39 years) and 32 age-matched controls without FT. LV mass and function were measured using conventional echocardiography and tissue Doppler imaging. LV diastolic function was reported as peak septal annular velocities (E(m) and E(m)/A(m) ratio) in tissue Doppler imaging. Fasting insulin and aldosterone were determined.
In subjects with FT, the LV mass was higher than in controls (92.14 +/- 24.02 vs. 70.08 +/- 20.58 g; p < 0.001). The study group had a worse LV diastolic function than control subjects (lower E(m) and E(m)/A(m) ratio; p < 0.001). In subjects with FT, the E(m)/A(m) ratio was independently associated with IR (partial p = 0.029 in multivariate model, R(2) = 0.51), but not with LV mass. The aldosterone level was comparable in both groups.
In normotensive individuals with FT, LV morphological and functional abnormalities were found. LV dysfunction but not an increase in LV mass is associated with IR. The aldosterone level is probably not responsible for the development of early hypertensive heart disease.
我们研究了原发性高血压患者（家族性特征，FT）的血压正常的后代的左心室（LV）形态和功能与胰岛素水平/胰岛素抵抗（IR）及醛固酮水平之间的关系。
该研究纳入了76名志愿者，其中44名是有FT的血压正常者（年龄28 - 39岁），32名是与之年龄匹配的无FT的对照者。使用传统超声心动图和组织多普勒成像测量左心室质量和功能。左心室舒张功能以组织多普勒成像中的室间隔环峰值速度（E(m)和E(m)/A(m)比值）来表示。测定空腹胰岛素和醛固酮水平。
有FT的受试者的左心室质量高于对照组（92.14±24.02 vs. 70.08±20.58 g；p<0.001）。研究组的左心室舒张功能比对照组差（E(m)和E(m)/A(m)比值更低；p<0.001）。在有FT的受试者中，E(m)/A(m)比值与IR独立相关（多变量模型中偏p = 0.029，R(2)=0.51），但与左心室质量无关。两组的醛固酮水平相当。
在有FT的血压正常个体中，发现了左心室形态和功能异常。左心室功能障碍而非左心室质量增加与IR相关。醛固酮水平可能与早期高血压性心脏病的发生无关。
