Hashimoto Y, Oniki T, Kaneko E, Hata A, Matsumura A, Kobayashi T, Numano F
Third Department of Internal Medicine, Tokyo Medical and Dental University, School of Medicine, Japan.
Angiology. 1993 Nov;44(11):883-8. doi: 10.1177/000331979304401106.
Although aortic regurgitation (AR) in patients with Takayasu arteritis (TA) is believed to be caused by dilatation of the aortic ring or thickening of the aortic cusps, the pattern of left ventricular hypertrophy (LVH) in these patients has not been described. To clarify the geometry of the LV in patients with TA that had been documented both echocardiographically and hemodynamically, the authors evaluated 22 patients with TA and severe AR (group 1), 10 with TA and systemic hypertension (group 2), and 17 with isolated severe AR of other etiologies (group 3). M-mode echocardiography showed that LV dimensions were smaller in groups 1 and 2 than in group 3 and that wall thickness was greater in group 1 than in group 3. The concentric hypertrophic ratio (CHR = wall thickness/LV end-diastolic dimension+wall thickness) was larger than group 1 (p < 0.001) and group 2 (p < 0.01) than in group 3. CHR was similar in groups 1 and 2. Systolic blood pressure was significantly increased in group 2 and showed a tendency to increase in group 1 as compared with group 3. The results confirmed the presence of concentric LVH related to a pressure overload in patients with TA, even when TA was complicated by severe AR.
虽然人们认为，大动脉炎（TA）患者的主动脉瓣反流（AR）是由主动脉环扩张或主动脉瓣叶增厚引起的，但这些患者左心室肥厚（LVH）的模式尚未得到描述。为了明确经超声心动图和血流动力学记录的TA患者左心室的几何形态，作者评估了22例患有TA和重度AR的患者（第1组）、10例患有TA和系统性高血压的患者（第2组）以及17例患有其他病因的孤立性重度AR的患者（第3组）。M型超声心动图显示，第1组和第2组的左心室尺寸小于第3组，且第1组的室壁厚度大于第3组。同心肥厚率（CHR = 室壁厚度/左心室舒张末期内径 + 室壁厚度）第1组和第2组大于第3组（第1组p < 0.001，第2组p < 0.01）。第1组和第2组的CHR相似。与第3组相比，第2组的收缩压显著升高，第1组有升高趋势。结果证实，即使TA合并重度AR，TA患者仍存在与压力负荷过重相关的同心性LVH。
