Shemirani Hasan, Khosravi Alireza, Hemmati Rohola, Gharipour Mojgan
Department of Cardiology, Faculty of Medicine, Isfahan University of Medical Sciences (IUMS), Isfahan, Iran.
Int J Prev Med. 2012 Mar;3(3):211-20.
Numerous studies have now demonstrated that heart failure with a normal ejection fraction (HFnlEF) is common. Hypertension is also the most commonly associated cardiac condition in patients with HFnlEF. Despite the observed link between microalbuminuria, obesity, and cardiovascular disorders, this question has remained - 'Which is more important for the prediction and prevention of diastolic dysfunction in non-diabetic hypertensive patients?'
The current study was a cross-section study conducted on a total of 126 non-diabetic hypertensive patients screened to identify those with hypertension. Urine creatinine was measured by the picric acid method and urine albumin content was measured by a sensitive, nephelometric technique. The urinary albumin/creatinine ratio (UACR) was determined as an indicator of microalbuminuria. Complete two-dimensional, doppler, and tissue-doppler echocardiography was performed and the recording of the diastolic function parameters was carried out.
High body mass index and high systolic blood pressure were positively correlated with the appearance of left ventricular hypertrophy, whereas, the UACR index had no significant relationship with hypertrophy. Multivariable analysis also showed that advanced age and systolic blood pressure were significantly associated with the E/E annulus parameter.
According to our investigation obesity is more important than microalbuminuria for the prediction and prevention of diastolic dysfunction in non-diabetic hypertensive patients.
目前大量研究表明,射血分数正常的心力衰竭(HFnlEF)很常见。高血压也是HFnlEF患者中最常见的相关心脏疾病。尽管观察到微量白蛋白尿、肥胖与心血管疾病之间存在联系,但这个问题仍然存在——“对于非糖尿病高血压患者舒张功能障碍的预测和预防,哪一个更重要?”
本研究是一项横断面研究,共纳入126例经筛查确诊为高血压的非糖尿病患者。采用苦味酸法测定尿肌酐,采用灵敏的散射比浊技术测定尿白蛋白含量。测定尿白蛋白/肌酐比值(UACR)作为微量白蛋白尿的指标。进行完整的二维、多普勒和组织多普勒超声心动图检查,并记录舒张功能参数。
高体重指数和高收缩压与左心室肥厚的出现呈正相关,而UACR指数与肥厚无显著关系。多变量分析还显示,高龄和收缩压与E/E环参数显著相关。
根据我们的调查,对于非糖尿病高血压患者舒张功能障碍的预测和预防,肥胖比微量白蛋白尿更重要。