Tavil Yusuf, Kaya Mehmet Gungor, Sen Nihat, Tacoy Gulten, Okyay Kaan, Yazici Huseyin Ugur, Yalcin Mehmet Ridvan, Cengel Atiye
Department of Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey.
Blood Press Monit. 2008 Apr;13(2):79-84. doi: 10.1097/MBP.0b013e3282faa732.
Hyperuricemia (HU) is a well-recognized risk factor for cardiovascular diseases. The independence of this association from other confounding factors has remained controversial. The possible contributory effect of HU to myocardial impairment produced by hypertension (HT), however, has not been clarified yet. The study was designed to assess the left ventricular (LV) systolic and diastolic function in patients with HT with or without HU. Tissue Doppler imaging (TDI) was used for detailed analysis as this method was superior to other conventional echocardiographic techniques.
The study participants consisted of 27 patients (men 56%, mean age+/-SD; 55+/-10 years) with HT without HU, and 27 patients with HT with HU (men 62%, mean age+/-SD; 56+/-9 years), and 27 age-matched healthy control participants (men 57%, mean age+/-SD; 53+/-11 years). Cardiac functions were determined using echocardiography, comprising standard two-dimensional and conventional Doppler and TDI. Peak systolic myocardial velocity at mitral annulus (Sm), mitral inflow velocities and early diastolic mitral annular velocity (Em), late diastolic mitral annular velocity (Am), peak systolic mitral annular velocity, Em/Am, and myocardial performance index were calculated by TDI.
Mitral inflow velocities and tissue Doppler-derived mitral annular diastolic velocities were significantly different in the patient groups (HT without HU and HT with HU) compared with the control cases. Tissue Doppler-derived myocardial performance index (LV-MPI) was significantly impaired in the patient groups compared with those of the control's (0.48+/-0.09, 0.53+/-0.07, and 0.39+/-0.07, respectively, P<0.001). Significant differences were also observed between the patients who had HT without HU and the patients who had HT with HU regarding LV-MPI. Significant correlations were observed between the serum uric acid levels and LV function parameters.
高尿酸血症（HU）是公认的心血管疾病风险因素。这种关联独立于其他混杂因素这一点仍存在争议。然而，HU对高血压（HT）所致心肌损伤的可能促成作用尚未阐明。本研究旨在评估有或无HU的HT患者的左心室（LV）收缩和舒张功能。采用组织多普勒成像（TDI）进行详细分析，因为该方法优于其他传统超声心动图技术。
研究参与者包括27例无HU的HT患者（男性占56%，平均年龄±标准差；55±10岁）、27例有HU的HT患者（男性占62%，平均年龄±标准差；56±9岁）以及27例年龄匹配的健康对照者（男性占57%，平均年龄±标准差；53±11岁）。使用超声心动图测定心功能，包括标准二维、传统多普勒和TDI。通过TDI计算二尖瓣环处的收缩期心肌峰值速度（Sm）、二尖瓣流入速度以及舒张早期二尖瓣环速度（Em）、舒张晚期二尖瓣环速度（Am）、二尖瓣环收缩期峰值速度、Em/Am以及心肌做功指数。
与对照组相比，患者组（无HU的HT组和有HU的HT组）的二尖瓣流入速度和组织多普勒得出的二尖瓣环舒张期速度有显著差异。与对照组相比，患者组的组织多普勒得出的心肌做功指数（LV-MPI）显著受损（分别为0.48±0.09、0.53±0.07和0.39±0.07，P<0.001）。在无HU的HT患者和有HU的HT患者之间，LV-MPI也存在显著差异。血清尿酸水平与LV功能参数之间存在显著相关性。
