Nogueira J B, Mourão L, Morais C, Freitas A, Silva D, Soares-Costa J T, da Costa J N
Medicina 1, Hospital de Santa Maria, Lisboa.
Rev Port Cardiol. 1991 Nov;10(11):837-43.
To evaluate the effects of arterial hypertension on the pulmonary circulation and the right heart.
Coronary Care Unit (UTIC Arsénio Cordeiro) Hemodynamics Laboratory and Medicine I Echocardiography Laboratory-Santa Maria Hospital.
38 hypertensive patients separated in two groups: 24 with thickened septum and left ventricular posterior wall (10 with hemodynamic evaluation)--Group A--and 14 without thickening--Group B; a control group of 12 healthy volunteers--Group C.
The hypertensive patients with hemodynamic evaluation had normal pulmonary capillary wedge pressure the average pulmonary resistance (135.29 +/- 63.47 dyn.cm.5), pulmonary systolic (31.30 +/- 10.01 mmHg) and mean pressures (18.23 +/- 8.21 mmHg) were raised, but the diastolic pulmonary pressure was normal. The right ventricle systolic pressure was raised (32.10 +/- 9.12 mmHg) and there was no modification of the right atrial or ventricular telediastolic pressures. On echocardiography there was a diastolic thickening of the right ventricular free wall in both group A (7.08 +/- 1.41 mm) and B (4.07 +/- 1.00 mm) as compared to group C (3.08 +/- 0.51 mm); there were similar findings regarding systolic thickness with statistical significance in group A (p less than 0.001). The right ventricular ejection fraction was normal in both groups. There was a positive correlation between the diastolic thickness of left ventricular posterior wall and right ventricular free wall in hypertensive patients and normotensive volunteers (r = 0.7754; p less than 0.001).
The findings suggest an anatomic an functional relationship between both ventricles regarding the cardiac repercussions of arterial hypertension.
评估动脉高血压对肺循环和右心的影响。
冠心病监护病房(阿尔塞尼奥·科代罗大学医院)血流动力学实验室及圣玛丽亚医院医学I超声心动图实验室。
38例高血压患者分为两组:24例室间隔及左心室后壁增厚患者(10例进行了血流动力学评估)——A组;14例无增厚患者——B组;12名健康志愿者作为对照组——C组。
进行血流动力学评估的高血压患者肺毛细血管楔压正常,平均肺阻力(135.29±63.47达因·厘米⁻⁵)、肺收缩压(31.30±10.01毫米汞柱)及平均压(18.23±8.21毫米汞柱)升高,但肺舒张压正常。右心室收缩压升高(32.10±9.12毫米汞柱),右心房或心室舒张末期压力无改变。超声心动图显示,与C组(3.08±0.51毫米)相比,A组(7.08±1.41毫米)和B组(4.07±1.00毫米)右心室游离壁均有舒张期增厚;A组收缩期厚度也有类似发现,具有统计学意义(p<0.001)。两组右心室射血分数均正常。高血压患者和血压正常志愿者的左心室后壁舒张期厚度与右心室游离壁舒张期厚度呈正相关(r=0.7754;p<0.001)。
这些发现提示,在动脉高血压的心脏影响方面,两个心室之间存在解剖和功能关系。