Verdecchia P, Schillaci G, Guerrieri M, Boldrini F, Gatteschi C, Benemio G, Porcellati C
Civic Hospital Beato G. Villa, Division of Medicine, Città della Pieve PG, Italy.
Eur Heart J. 1990 Aug;11(8):679-91. doi: 10.1093/oxfordjournals.eurheartj.a059783.
The independent contribution of age, sex, duration of hypertension, heart rate, clinic and ambulatory blood pressure and echocardiographic left ventricular mass to left ventricular diastolic filling abnormalities in essential hypertension was investigated in 250 subjects (145 untreated and unselected hypertensives and 105 healthy normotensive controls) undergoing Doppler and standard echocardiography and non-invasive 24-h ambulatory blood pressure monitoring. Late and early diastolic transmitral peak flow velocities and their ratio (all P less than 0.01), the rate of deceleration of early diastolic mitral flow (P less than 0.01) and the time of deceleration of early diastolic mitral flow (P = 0.018) were abnormal in the hypertensive group vs controls. None of these parameters significantly varied in the presence vs absence of LV hypertrophy. In the hypertensive group, the prevalence of abnormal age-corrected Doppler values varied up to 46% (up to 45.4% and 50% in the absence and presence of left ventricular hypertrophy, respectively; P = n.s.). In a stepwise multivariate regression analysis, age and average daytime or night-time ambulatory blood pressure showed a significant independent relationship with each of these Doppler indexes of left ventricular diastolic filling. Late transmitral peak flow velocity and the ratio of late to early peak flow velocity were also independently affected by the heart rate. Sex, duration of hypertension, clinic systolic and diastolic blood pressure and left ventricular mass index did not show any independent relationship to these Doppler parameters of left ventricular filling. In conclusion, Doppler abnormalities of diastolic transmitral blood flow were detected in up to 46% of patients in an unselected hypertensive population with a low prevalence (14.5%) of left ventricular hypertrophy. Age and ambulatory blood pressure, but not sex, duration of hypertension, clinic blood pressure and left ventricular mass itself, were the major independent determinants of these abnormalities.
在250名受试者（145名未经治疗且未挑选的高血压患者和105名健康的血压正常对照者）中，研究了年龄、性别、高血压病程、心率、诊室和动态血压以及超声心动图左心室质量对原发性高血压患者左心室舒张期充盈异常的独立影响，这些受试者均接受了多普勒和标准超声心动图检查以及无创24小时动态血压监测。与对照组相比，高血压组的舒张晚期和早期经二尖瓣血流峰值速度及其比值（均P<0.01）、舒张早期二尖瓣血流减速速率（P<0.01）和舒张早期二尖瓣血流减速时间（P = 0.018）均异常。在有或无左心室肥厚的情况下，这些参数均无显著差异。在高血压组中，年龄校正后的多普勒值异常的患病率高达46%（在无左心室肥厚和有左心室肥厚的情况下分别高达45.4%和50%；P = 无显著性差异）。在逐步多元回归分析中，年龄和日间或夜间平均动态血压与这些左心室舒张期充盈的多普勒指标均显示出显著的独立关系。舒张晚期经二尖瓣血流峰值速度以及舒张晚期与早期峰值血流速度之比也独立受心率影响。性别、高血压病程、诊室收缩压和舒张压以及左心室质量指数与这些左心室充盈的多普勒参数均未显示出任何独立关系。总之，在未经挑选的高血压人群中，高达46%的患者检测到舒张期经二尖瓣血流多普勒异常，其中左心室肥厚的患病率较低（14.5%）。年龄和动态血压是这些异常的主要独立决定因素，而性别、高血压病程、诊室血压和左心室质量本身并非主要决定因素。
