Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University, Kagoshima, Japan.
Hypertens Res. 2010 Nov;33(11):1167-73. doi: 10.1038/hr.2010.142. Epub 2010 Aug 19.
Regional left ventricular (LV) systolic dysfunction has been identified in diastolic heart failure (DHF). However, the relationship between regional or global LV systolic function and heart failure symptoms in DHF has not been evaluated in detail. The present study evaluates such relationships in patients with systemic hypertension (HT) and DHF. We assessed LV systolic and diastolic function in 220 consecutive patients with systemic HT and in 30 normal individuals (Control) using Doppler echocardiography. Patients with HT were assigned to groups with DHF, asymptomatic diastolic dysfunction (ADD) and no diastolic dysfunction (Simple HT). Ejection fraction in DHF was significantly decreased (63±8%) compared with the Control, Simple HT and ADD groups (67±5, 66±7 and 68±8%, respectively). Isovolumetric contraction time in DHF (70±30 msec) was significantly increased compared with those in the ADD, Simple HT and Control groups (31±17, 31±15 and 30±19 msec, respectively). Mitral annular systolic velocities were significantly decreased in the DHF and ADD groups (6.4±1.5 and 7.2±1.3 cm sec⁻¹, respectively) compared with those in the Simple HT and Control groups (8.5±1.8 and 8.4±3.0 cm sec⁻¹, respectively), and in the DHF group compared with the ADD group. LV global systolic dysfunction has a significant role in the development of heart failure symptoms associated with DHF in patients with systemic HT.
区域左心室（LV）收缩功能障碍已在舒张性心力衰竭（DHF）中得到证实。然而，DHF 中局部或整体 LV 收缩功能与心力衰竭症状之间的关系尚未得到详细评估。本研究评估了系统性高血压（HT）和 DHF 患者中的这种关系。我们使用多普勒超声心动图评估了 220 例连续系统性 HT 患者和 30 例正常个体（对照组）的 LV 收缩和舒张功能。将 HT 患者分为 DHF 组、无症状舒张功能障碍（ADD）组和无舒张功能障碍（单纯 HT 组）。与对照组、单纯 HT 组和 ADD 组相比，DHF 组的射血分数明显降低（63±8%）（67±5%、66±7%和 68±8%）。DHF 患者的等容收缩时间（70±30msec）明显长于 ADD 组、单纯 HT 组和对照组（31±17、31±15 和 30±19msec）。与单纯 HT 组和对照组相比，DHF 组和 ADD 组的二尖瓣环收缩速度明显降低（分别为 6.4±1.5 和 7.2±1.3cm/s），DHF 组与 ADD 组相比也明显降低。LV 整体收缩功能障碍在伴有 DHF 的 HT 患者心力衰竭症状的发展中起重要作用。
