Cuspidi Cesare, Negri Francesca, Giudici Valentina, Sala Carla, Mancia Giuseppe
Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Milano, Italy.
Blood Press. 2010 Aug;19(4):234-9. doi: 10.3109/08037051003606413.
Impaired left ventricular (LV) mechanics in human hypertension are strongly related to LV hypertrophy (LVH). In the present study, we investigated the relationship between LV mid-wall fractional shortening (MWS) and biventricular hypertrophy in uncomplicated essential hypertensives.
A total of 328 hypertensive patients categorized in tertiles of MWS were considered for the analysis. All patients underwent routine and standardized echocardiographic examinations. Biventricular hypertrophy was defined by anterior right ventricular (RV) wall thickness >or=3.1 mm/m(2) in men and >or=3.0 mm/m(2) in women, combined with LV mass index (LVMI) >or=49 g/m(2.7) in men and 45 g/m(2.7) in women.
Biventricular hypertrophy was found in 21% of the study population. In the lowest MWS tertile, the likelihood of biventricular hypertrophy was 1.4- and 1.9-fold greater (p<0.05) than in the intermediate and highest one, respectively; this was not the case for isolated LVH or RV hypertrophy (RVH). In a multivariate analysis, MWS was significantly associated with LV mass index (beta=-0.181, p=0.003) and RV wall thickness (beta=-0.171, p50.01).
In systemic hypertension, a decrease in LV systolic performance may be related not only to LVH, but to the global cardiac involvement occurring in biventricular hypertrophy.
人类高血压患者左心室（LV）力学受损与左心室肥厚（LVH）密切相关。在本研究中，我们调查了单纯原发性高血压患者左心室中层缩短分数（MWS）与双心室肥厚之间的关系。
共纳入328例按MWS三分位数分类的高血压患者进行分析。所有患者均接受常规和标准化超声心动图检查。双心室肥厚的定义为男性右心室（RV）前壁厚度≥3.1 mm/m²，女性≥3.0 mm/m²，同时男性左心室质量指数（LVMI）≥49 g/m².⁷，女性≥45 g/m².⁷。
研究人群中21%发现有双心室肥厚。在MWS最低三分位数组中，双心室肥厚的可能性分别比中间和最高三分位数组高1.4倍和1.9倍（p<0.05）；孤立性LVH或右心室肥厚（RVH）则并非如此。在多变量分析中，MWS与LV质量指数（β=-0.181，p=0.003）和RV壁厚度（β=-0.171，p=0.01）显著相关。
在系统性高血压中，左心室收缩功能降低可能不仅与LVH有关，还与双心室肥厚时发生的全心受累有关。
