Department of Ultrasound, Chinese PLA General Hospital, Beijing 100853, China.
Chin Med J (Engl). 2009 Oct 5;122(19):2325-9.
Left atrial enlargement has been suggested as a more robust marker of diastolic dysfunction. We hypothesize that the ratio of left atrial volume to left ventricular volume (LAV/LVV) may be more reasonable to reflect left atrial enlargement in the patients with hypertension, because hypertensive patients have a characteristic of concentric remodeling of the left ventricle which is often accompanied with diastolic dysfunction. The aim of this study was to determine if the LAV/LVV can be used as a new parameter to assess left atrial size in hypertensive patients and the relationship between the LAV/LVV and diastolic dysfunction.
Ninety-one patients with hypertension and forty-three normal controls were studied. The hypertensive patients were assigned to the normal wall (NW) and hypertrophic wall (HW) groups. The left atrial diameter (LAD), LAV, left atrial volume index (LAVi), LVV and LAV/LVV were measured and calculated by 2-dimensional echocardiography and real time 3-dimensional echocardiography. All of the above parameters were used to evaluate the size of the left atrium. The ratio of peak E velocity of mitral valve inflow to peak E' velocity of lateral mitral annulus (E/E') was measured by pulse Doppler and tissue Doppler. This parameter was used to evaluate diastolic function.
The LAD, LAV, LAVi, LAV/LVV and E/E' in hypertensive groups were significantly higher than those in the normal group (P < 0.05 or 0.01), and those in the HW group were significantly higher than those in the NW group (P < 0.05 or 0.01). The E/E' had a positive correlation with LAV, LAVi and LAV/LVV. The correlation coefficient between E/E' and LAV/LVV was relatively higher than that between E/E' and LAD or LAVi.
LAV/LVV may be used as a new index to evaluate left atrial size in hypertensive patients with diastolic dysfunction.
左心房扩大被认为是舒张功能障碍更有力的标志物。我们假设左心房容积与左心室容积（LAV/LVV）的比值可能更能反映高血压患者的左心房扩大，因为高血压患者的左心室具有同心重构的特征，通常伴有舒张功能障碍。本研究旨在确定 LAV/LVV 是否可作为评估高血压患者左心房大小的新参数，以及 LAV/LVV 与舒张功能障碍的关系。
研究了 91 例高血压患者和 43 例正常对照者。将高血压患者分为正常壁（NW）和肥厚壁（HW）组。通过二维超声心动图和实时三维超声心动图测量并计算左心房直径（LAD）、左心房容积（LAV）、左心房容积指数（LAVi）、左心室容积（LVV）和 LAV/LVV。以上参数均用于评估左心房大小。通过脉冲多普勒和组织多普勒测量二尖瓣口血流速度 E 峰与外侧二尖瓣环运动速度 E' 峰的比值（E/E'），用于评估舒张功能。
高血压组的 LAD、LAV、LAVi、LAV/LVV 和 E/E' 均明显高于正常组（P<0.05 或 0.01），HW 组明显高于 NW 组（P<0.05 或 0.01）。E/E'与 LAV、LAVi 和 LAV/LVV 呈正相关。E/E'与 LAV/LVV 的相关系数高于 E/E'与 LAD 或 LAVi 的相关系数。
LAV/LVV 可作为评估高血压伴舒张功能障碍患者左心房大小的新指标。
