Second Department of Internal Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
J Am Soc Echocardiogr. 2011 Feb;24(2):192-9. doi: 10.1016/j.echo.2010.10.020. Epub 2010 Dec 10.
Systolic reserve is an important compensatory mechanism against increasing afterload. Although longitudinal systolic dysfunction with preserved ejection fraction has been reported in hypertensive hearts, radial and circumferential function has not been fully examined. The aim of this study was to investigate three-directional systolic function and its relationships with left ventricular geometry in asymptomatic hypertensive patients using two-dimensional speckle-tracking imaging.
Echocardiographic evaluations were performed in 74 hypertensive patients and 55 age-matched control subjects.
Longitudinal strain was significantly reduced in the hypertrophy groups compared with that in control subjects (concentric, -15.1 ± 4.0%; eccentric, -15.9 ± 4.4%; control, -18.9 ± 3.3%; P < .05). Conversely, radial strain was significantly higher in the normal geometry group than in control subjects (53.8 ± 19.4% vs 40.3 ± 15.1%, P < .05). However, this augmentation was attenuated in the other geometries.
Hypertrophic remodeling attenuates compensatory augmentation of radial systolic function and is associated with latent longitudinal systolic dysfunction.
收缩储备是应对后负荷增加的重要代偿机制。虽然高血压心脏中已报道存在射血分数保留的纵向收缩功能障碍，但径向和环向功能尚未得到充分检查。本研究旨在使用二维斑点追踪成像技术研究无症状高血压患者的三向收缩功能及其与左心室几何形状的关系。
对 74 例高血压患者和 55 例年龄匹配的对照组进行超声心动图评估。
与对照组相比，肥厚组的纵向应变明显降低（向心性，-15.1±4.0%；离心性，-15.9±4.4%；对照组，-18.9±3.3%；P<0.05）。相反，正常几何组的径向应变明显高于对照组（53.8±19.4%比 40.3±15.1%，P<0.05）。然而，在其他几何形状中，这种增加被减弱了。
肥厚性重构减弱了径向收缩功能的代偿性增强，并且与潜在的纵向收缩功能障碍有关。
