Shemirani Hasan, Hemmati Rohola, Khosravi Alireza, Gharipour Mojgan, Jozan Mahnaz
Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2012 Feb;17(2):133-7.
Early diagnosis of left ventricular mass (LVM) inappropriateness and left ventricular hypertrophy (LVH) can result in preventing diastolic left ventricular dysfunction and its related morbidity and mortality. This study was performed to determine if diastolic dysfunction is associated with LVH and inappropriate LVM.
One hundred and twenty five uncomplicated hypertension from Isfahan Healthy Heart Program underwent two-dimensional echocardiography. Inappropriate LVM was defined as an LVM index greater than 88 g/m(2) of body-surface area in women and greater than 102 g/m(2) in men. LVH-defined septal and posterior wall thickness greater than 0/9 cm in women and greater than 1 cm in men, respectively. Echocardiographic parameters, including early diastolic peak velocity (E)/late diastolic peak velocity (A), deceleration time (DT), and E/early mitral annulus velocity (E') were measured.
The mean systolic and diastolic blood pressure at the patients' admission day were 142.87 ± 18.12 and 88.45 ± 9.18 mmHg, respectively. Totally, 21.7% of subjects had inappropriate LV mass that moderate and severe abnormal LV mass was revealed in 5.6% and 5.6%, respectively. The mean of age and BMI was significantly higher in patients with moderate left ventricular hypertrophy (P < 0.05). Adjusted by age, gender, BMI, and systolic and diastolic blood pressures, both E/A ratio and deceleration time were higher in those with the severer ventricular hypertrophy. Subjects with severe showed significantly higher BMI 33. 7 ± 3.7 (P < 0.001). There was a slight difference between the grade of diastolic dysfunction and the severity of inappropriate LV mass (P = 0.065). But no significant difference was found between E/A, E/E', and deceleration time and the level of inappropriate LV mass (P > 0.05). Spearman's Rank test was used to test the correlation between diastolic dysfunction and LV mass (P = 0.025).
LVH is correlated with the severity of diastolic dysfunction manifested by the E/A value and deceleration time, but inappropriate LVM can slightly predict diastolic dysfunction severity in uncomplicated hypertension.
早期诊断左心室质量（LVM）异常和左心室肥厚（LVH）有助于预防舒张性左心室功能障碍及其相关的发病率和死亡率。本研究旨在确定舒张功能障碍是否与LVH和不适当的LVM相关。
对来自伊斯法罕健康心脏项目的125例无并发症高血压患者进行二维超声心动图检查。不适当的LVM定义为女性体表面积的LVM指数大于88g/m²，男性大于102g/m²。LVH定义为女性室间隔和后壁厚度分别大于0.9cm，男性大于1cm。测量超声心动图参数，包括舒张早期峰值速度（E）/舒张晚期峰值速度（A）、减速时间（DT）和E/二尖瓣环早期速度（E'）。
患者入院当天的平均收缩压和舒张压分别为142.87±18.12和88.45±9.18mmHg。总体而言，21.7%的受试者左心室质量不适当，其中中度和重度左心室质量异常分别占5.6%和5.6%。中度左心室肥厚患者的平均年龄和体重指数显著更高（P<0.05）。经年龄、性别、体重指数以及收缩压和舒张压校正后，心室肥厚较严重者的E/A比值和减速时间均更高。重度患者的体重指数显著更高，为33.7±3.7（P<0.001）。舒张功能障碍程度与不适当左心室质量的严重程度之间存在轻微差异（P=0.065）。但E/A、E/E'和减速时间与不适当左心室质量水平之间未发现显著差异（P>0.05）。采用Spearman秩检验来检验舒张功能障碍与左心室质量之间的相关性（P=0.025）。
LVH与由E/A值和减速时间所表现出的舒张功能障碍严重程度相关，但在无并发症的高血压患者中，不适当的LVM对舒张功能障碍严重程度的预测作用较弱。
