Jehle J, Hoffmann V, Lauber A, Spiller P
Z Kardiol. 1984 Apr;73(4):248-56.
Using digital subtraction angiography, left ventricular function and pulmonary artery pressure at rest and during submaximal exercise (98 +/- 33 watts) were examined in 25 patients with systemic hypertension. All patients had normal coronary arteries and a normal left ventricular function at rest. Heart rate increased in all patients (from 82 +/- 14 to 134 +/- 20 min-1, p less than 0.001). Systolic blood pressure also increased significantly in all patients (from 153 +/- 12 to 190 +/- 14 mmHg, p less than 0.001). End-diastolic and end-systolic volumes did not change on average (89 +/- 22 and 87 +/- 19 ml/m2, 28 +/- 8 and 28 +/- 10 ml/m2, respectively), neither did stroke volume nor ejection fraction (61 +/- 18 and 59 +/- 16 ml/m2, 68 +/- 7 and 67 +/- 9%, respectively). The increase in end-systolic volumes and concomitantly the decrease in ejection fraction during exercise in 8 patients points to an impairment of left ventricular function. This effect is frequently found in ventricles with less distinct hypertrophy. Cardiac index increased in each patient (from 5.1 +/- 2.1 to 8.2 +/- 2.9 I/min/m2, p less than 0.001). This is caused by the increase in heart rate while stroke volume remains unchanged. Mean pulmonary artery pressure increased in all patients from 19 +/- 6 to 35 +/- 10 mmHg on average (p less than 0.001). A pathologic increase could be observed in 18 patients. There was no correlation to angiographic parameters of left ventricular function. The exercise test was stopped in 12 patients mainly because of dyspnea. In 11 of these patients a pathologic increase of mean pulmonary artery pressure was found. As in these patients the angiographic parameters of left ventricular function were normal, the increase in pulmonary pressure is related to an impairment of diastolic function caused by hypertrophy.
采用数字减影血管造影术，对25例系统性高血压患者静息及次极量运动（98±33瓦）时的左心室功能和肺动脉压力进行了检查。所有患者冠状动脉正常，静息时左心室功能正常。所有患者心率均增加（从82±14次/分钟增至134±20次/分钟，p<0.001）。所有患者收缩压也显著升高（从153±12 mmHg增至190±14 mmHg，p<0.001）。舒张末期和收缩末期容积平均无变化（分别为89±22和87±19 ml/m²，28±8和28±10 ml/m²），每搏输出量和射血分数也无变化（分别为61±18和59±16 ml/m²，68±7和67±9%）。8例患者运动时收缩末期容积增加，同时射血分数降低，提示左心室功能受损。这种效应在肥厚不太明显的心室中常见。每位患者的心指数均增加（从5.1±2.1增至8.2±2.9 I/分钟/m²，p<0.001）。这是由于心率增加而每搏输出量保持不变所致。所有患者平均肺动脉压力平均从19±6 mmHg增至35±10 mmHg（p<0.001）。18例患者可观察到病理性升高。与左心室功能的血管造影参数无相关性。12例患者主要因呼吸困难而停止运动试验。其中11例患者平均肺动脉压力有病理升高。由于这些患者左心室功能的血管造影参数正常，肺动脉压力升高与肥厚引起的舒张功能受损有关。
