Hüting J, Kramer W, Reitinger J, Kühn K, Schütterle G, Wizemann V
Center of Internal Medicine, Justus-Liebig University, Giessen, Germany.
Clin Nephrol. 1991 Jul;36(1):21-8.
To determine characteristics of diastolic left ventricular (LV) function in patients on continuous ambulatory peritoneal dialysis (CAPD), two groups of CAPD patients without (n = 23; group 1) vs with (n = 25; group 2) LV hypertrophy (greater than 13 mm) were compared with a group of untreated non-renal hypertensive patients with LV hypertrophy (n = 11; group 3) using Doppler-echocardiography. Age and body surface area were comparable in all three groups, mean CAPD-duration (32 +/- 28 vs 26 +/- 23 months; p = NS) was comparable in renal patients. LV systolic function in echocardiography (LVEF: 62 vs 64 vs 63%) and systolic time intervals were normal and comparable in all three groups. Atrial maximum filling velocities (96 +/- 25 vs 91 +/- 25 vs 67 +/- 8 cm/s) were comparably increased, the ratio of maximal early/atrial filling velocities was comparably decreased (0.73 +/- 0.25 vs 0.77 +/- 0.21 vs 0.99 +/- 0.05) in both groups of renal patients as compared to group 3 (p less than 0.05-0.01). Atrial filling fractions were increased in all three groups, more pronounced in group 1 than in group 3 (50 +/- 11 vs 40 +/- 7%; p less than 0.05). The normal correlation of Doppler parameters with age and with LV radius/thickness ratio was altered in renal patients such that high patient age tended to have an additional negative influence on LV diastolic function of hypertrophied, but not of normal myocardium. Isovolumic relaxation time was prolonged in all three groups (134 +/- 38 vs 131 +/- 34 vs 116 +/- 17 ms; p = NS). We conclude that in patients on CAPD, diastolic LV filling is impaired both in normal and hypertrophied myocardium. High age is a factor that further attributes to diastolic dysfunction of hypertrophied myocardium in CAPD.
为了确定持续性非卧床腹膜透析（CAPD）患者左心室舒张功能的特征，使用多普勒超声心动图，将两组CAPD患者（无左心室肥厚组，n = 23；第1组）与有左心室肥厚组（n = 25；第2组）与一组未经治疗的非肾性高血压左心室肥厚患者（n = 11；第3组）进行比较。三组患者的年龄和体表面积相当，肾病患者的平均CAPD持续时间（32±28 vs 26±23个月；p =无显著性差异）相当。超声心动图中的左心室收缩功能（左心室射血分数：62% vs 64% vs 63%）和收缩时间间期在三组中均正常且相当。两组肾病患者的心房最大充盈速度（96±25 vs 91±25 vs 67±8 cm/s）均有相当程度的增加，与第3组相比，两组肾病患者的最大早期/心房充盈速度比值均有相当程度的降低（0.73±0.25 vs 0.77±0.21 vs 0.99±0.05）（p＜0.05 - 0.01）。三组患者的心房充盈分数均增加，第1组比第3组更明显（50±11 vs 40±7%；p＜0.05）。肾病患者中，多普勒参数与年龄以及左心室半径/厚度比值的正常相关性发生改变，以至于高龄患者往往对肥厚心肌而非正常心肌的左心室舒张功能有额外的负面影响。三组患者的等容舒张时间均延长（134±38 vs 131±34 vs 116±17 ms；p =无显著性差异）。我们得出结论，在CAPD患者中，正常心肌和肥厚心肌的左心室舒张充盈均受损。高龄是导致CAPD患者肥厚心肌舒张功能障碍的一个进一步因素。
