Schmieder R E, Grube E, Impelmann V, Rüddel H, Schulte W
Medizinische Universitätsklinik, Vegetatives Nervensystem und Psychosomatik, Bonn-Venusberg.
Z Kardiol. 1990 Aug;79(8):557-64.
The impact of clinical parameters on the pathogenesis of myocardial hypertrophy was examined in 75 male patients with mild essential hypertension. Clinical parameters were age, body weight, sodium excretion (as an estimate for dietary salt intake), systolic and diastolic blood pressure at work, casual blood pressure, resting and stress blood pressure during mental stress test and physical exercise. Left ventricular mass as a parameter for the degree of left ventricular hypertrophy was assessed by 2-D guided M-mode echocardiography. Left ventricular mass correlated with body weight (r = 0.47, p less than 0.002), with body mass index (r = 0.48, p less than 0.001), with systolic blood pressure at the worksite (r = 0.28, p less than or equal to 0.05), and systolic blood pressure at rest (r = 0.35, p less than or equal to 0.01), whereas no correlation was found between casual or stress blood pressure readings during physical exercise and mental stress with the degree of left ventricular hypertrophy. Sodium excretion was related to the end-diastolic diameter of the left ventricle (r = 0.33, p less than or equal to 0.01) and to left ventricular mass (r = 0.35, p less than or equal to 0.01). Multiple regression analysis revealed that sodium excretion over 24 hours, systolic blood pressure at the worksite and body mass index were independent determinants of left ventricular mass. Thus, dietary salt intake was found to modulate the degree of left ventricular hypertrophy independently of the pressure load imposed on the myocardium.(ABSTRACT TRUNCATED AT 250 WORDS)
在75例轻度原发性高血压男性患者中,研究了临床参数对心肌肥厚发病机制的影响。临床参数包括年龄、体重、钠排泄量(作为饮食中盐摄入量的估计值)、工作时的收缩压和舒张压、随机血压、精神应激试验和体育锻炼期间的静息血压和应激血压。通过二维引导M型超声心动图评估左心室质量,作为左心室肥厚程度的参数。左心室质量与体重(r = 0.47,p < 0.002)、体重指数(r = 0.48,p < 0.001)、工作场所的收缩压(r = 0.28,p ≤ 0.05)和静息收缩压(r = 0.35,p ≤ 0.01)相关,而体育锻炼和精神应激期间的随机或应激血压读数与左心室肥厚程度之间未发现相关性。钠排泄与左心室舒张末期直径(r = 0.33,p ≤ 0.01)和左心室质量(r = 0.35,p ≤ 0.01)相关。多元回归分析显示,24小时钠排泄量、工作场所的收缩压和体重指数是左心室质量的独立决定因素。因此,发现饮食中盐的摄入量可独立于施加在心肌上的压力负荷来调节左心室肥厚的程度。(摘要截断于250字)