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[尼卡地平降压治疗期间左心室解剖结构和功能变化的超声心动图分析]

[Echocardiographic analysis of anatomical and functional changes in the left heart ventricle during antihypertensive treatment with nicardipine].

作者信息

Costantino G, Di Lorenzo L, Buonissimo S, Moccia D, Soro S, Ferrara L A, De Simone G

机构信息

Istituto di Medicina Interna e Malattie Dismetaboliche, II Facoltà di Medicina e Chirurgia dell'Università degli Studi di Napoli.

出版信息

G Ital Cardiol. 1988 Aug;18(8):644-8.

PMID:2977346
Abstract

Changes in hemodynamic variables regulating systolic function were assessed by M-mode echocardiography, under 2D control, in 11 patients with primary uncomplicated hypertension treated with nicardipine (60 mg/daily). At the end of treatment (8 weeks) blood pressure and end-systolic stress were greatly reduced (p less than 0.001), and systolic fractional shortening was increase (p less than 0.02). The percentage increase in fractional shortening was correlated with a decreased in end-systolic stress (r = 0.67). The index of left ventricular performance (systolic pressure/end-systolic dimension ratio) was reduced: no variation was found in the hypertrophy-independent index of the inotropic state (systolic pressure/end-systolic dimension ratio normalized for posterior wall thickness). No change in the inotropic state was caused by a negligible sympathetic reflex outflow: heart rate also remained unchanged. The only index of left ventricular hypertrophy which was slightly reduced after two months of treatment was left ventricular mass (p less than 0.001). In conclusion, the short-term treatment with nicardipine, in hypertensive patients, showed powerful effects in the improvement of systolic function; the possible regression of left ventricular hypertrophy must be confirmed in long-term therapy.

摘要

在二维超声心动图控制下,采用M型超声心动图对11例单纯原发性高血压患者(服用尼卡地平,60毫克/日)调节收缩功能的血流动力学变量变化进行了评估。治疗结束时(8周),血压和收缩末期应力大幅降低(p<0.001),收缩期缩短分数增加(p<0.02)。缩短分数的增加百分比与收缩末期应力的降低相关(r = 0.67)。左心室功能指数(收缩压/收缩末期内径比)降低:在不依赖肥厚的变力状态指数(收缩压/收缩末期内径比经后壁厚度校正)方面未发现变化。交感神经反射流出可忽略不计,未引起变力状态改变:心率也保持不变。治疗两个月后,唯一略有降低的左心室肥厚指标是左心室质量(p<0.001)。总之,尼卡地平对高血压患者的短期治疗在改善收缩功能方面显示出强大作用;左心室肥厚可能的消退必须在长期治疗中得到证实。

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