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肥胖所致离心性左心室肥厚时左心室舒张期充盈异常。

Abnormal left ventricular diastolic filling in eccentric left ventricular hypertrophy of obesity.

作者信息

Chakko S, Mayor M, Allison M D, Kessler K M, Materson B J, Myerburg R J

机构信息

Medical Service, Veterans Administration Medical Center, Miami, Florida 33125.

出版信息

Am J Cardiol. 1991 Jul 1;68(1):95-8. doi: 10.1016/0002-9149(91)90718-z.

Abstract

Left ventricular (LV) diastolic filling pattern of obese subjects with eccentric LV hypertrophy was studied. Findings were compared with those of normal control subjects and hypertensive patients with concentric LV hypertrophy. M-mode, 2-dimensional and Doppler echocardiograms were recorded in 11 obese (body mass index greater than 30 kg/m2) normotensive patients with eccentric LV hypertrophy, 10 normal control subjects, and 18 nonobese, hypertensive patients with concentric LV hypertrophy whose antihypertensive medications were discontinued 2 weeks before study. LV hypertrophy was defined as LV mass/height greater than 143 g/m. Hypertrophy in the obese patients was eccentric: Their LV internal dimension (61 +/- 3 mm) was greater than that of hypertensive patients (55 +/- 5 mm, p less than 0.001) and normal control subjects (55 +/- 2 mm, p less than 0.01); their septal (10.7 +/- 0.7 mm) and posterior (10.9 +/- 0.6 mm) wall thicknesses were smaller than those of the hypertensive patients (12.2 +/- 1.7 mm, p less than 0.05 and 11.7 +/- 1.2 mm, respectively, difference not significant). Pulsed-wave Doppler echocardiographic filling indexes were used to evaluate LV diastolic filling. Obese patients had a higher peak velocity of atrial filling (69 +/- 14 vs 54 +/- 15 cm/s, p less than 0.05), lower early/atrial filling velocity ratio (1.0 +/- 0.26 vs 1.32 +/- 0.21, p less than 0.05), prolonged deceleration half-time (108 +/- 9 vs 86 +/- 15 ms, p less than 0.01) and lower peak filling rate corrected to stroke volume (4.08 +/- 0.68 vs 4.96 +/- 0.88 stroke volume/s, p less than 0.05) than normal control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对患有离心性左心室肥厚的肥胖受试者的左心室舒张期充盈模式进行了研究。将研究结果与正常对照受试者以及患有向心性左心室肥厚的高血压患者的结果进行了比较。对11名患有离心性左心室肥厚的肥胖(体重指数大于30kg/m²)血压正常患者、10名正常对照受试者以及18名非肥胖、患有向心性左心室肥厚的高血压患者进行了M型、二维和多普勒超声心动图检查,这些高血压患者在研究前2周停用了抗高血压药物。左心室肥厚定义为左心室质量/身高大于143g/m。肥胖患者的肥厚为离心性:他们的左心室内径(61±3mm)大于高血压患者(55±5mm,p<0.001)和正常对照受试者(55±2mm,p<0.01);他们的室间隔(10.7±0.7mm)和后壁厚度(10.9±0.6mm)小于高血压患者(分别为12.2±1.7mm,p<0.05和11.7±1.2mm,差异不显著)。使用脉冲波多普勒超声心动图充盈指数来评估左心室舒张期充盈。肥胖患者的心房充盈峰值速度较高(69±14 vs 54±15cm/s,p<0.05),早期/心房充盈速度比值较低(1.0±0.26 vs 1.32±0.21,p<0.05),减速半衰期延长(108±9 vs 86±15ms,p<0.01),校正每搏量后的峰值充盈率较低(4.08±0.68 vs 4.96±0.88每搏量/s,p<0.05),均低于正常对照受试者。(摘要截短至250字)

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