Dart A, Silagy C, Dewar E, Jennings G, McNeil J
Alfred & Baker Medical Unit, Baker Medical Research Institute, Melbourne, Australia.
Eur Heart J. 1993 Nov;14(11):1465-70. doi: 10.1093/eurheartj/14.11.1465.
Aortic mechanical properties were assessed in a group of elderly subjects with untreated isolated systolic hypertension using two-dimensional echocardiography. Echocardiographic (two-dimensional and Doppler) assessment of left ventricular structure and function was also made. Ten subjects (mean age 71.7 +/- 1.9 years, 20% male, mean clinic blood pressure 163.6/79.2 +/- 1.2/2.0 mmHg) were compared with 16 normotensive subjects of similar age (69.4 +/- 1.6 years, 38% male, mean clinic blood pressure 129.8/78.2 +/- 3.2/2.9 mmHg). Aortic distensibility at the level of the transverse aortic arch was significantly reduced among subjects with isolated systolic hypertension. The thickness of the interventricular septum was approximately 20% greater in the hypertensive subjects (P < 0.01) and the average wall thickness to radius ratio was increased by 30%. Patterns of transmitral diastolic flow were also different in subjects with isolated systolic hypertension. Deceleration time was significantly greater (P < 0.01) and the ratio of early to late transmitral diastolic peak flow velocities was significantly less in the hypertensive (P < 0.05) than in the normotensive group. Left ventricular systolic function was well preserved. These findings are consistent with the suggestion that isolated systolic hypertension represents a state of increased aortic stiffness which may contribute to the development of left ventricular hypertrophy. Whether this increase in aortic stiffness is the cause or effect of the elevated systolic blood pressure remains unresolved.
采用二维超声心动图对一组未经治疗的单纯收缩期高血压老年受试者的主动脉力学特性进行了评估。同时还对左心室结构和功能进行了超声心动图（二维和多普勒）评估。将10名受试者（平均年龄71.7±1.9岁，男性占20%，平均诊室血压163.6/79.2±1.2/2.0 mmHg）与16名年龄相仿的血压正常受试者（69.4±1.6岁，男性占38%，平均诊室血压129.8/78.2±3.2/2.9 mmHg）进行了比较。单纯收缩期高血压受试者的主动脉弓水平的扩张性显著降低。高血压受试者的室间隔厚度大约厚20%（P<0.01），平均壁厚与半径之比增加了30%。单纯收缩期高血压受试者的二尖瓣舒张期血流模式也有所不同。减速时间显著更长（P<0.01），高血压患者二尖瓣舒张期早期与晚期峰值流速之比显著低于血压正常组（P<0.05）。左心室收缩功能保持良好。这些发现与以下观点一致，即单纯收缩期高血压代表主动脉僵硬度增加的一种状态，这可能有助于左心室肥厚的发展。主动脉僵硬度的增加是收缩压升高的原因还是结果仍未解决。
