Liebson P R, Grandits G, Prineas R, Dianzumba S, Flack J M, Cutler J A, Grimm R, Stamler J
Section of Cardiology, Rush-Presbyterian-St. Luke's Medical Center, Chicago.
Circulation. 1993 Feb;87(2):476-86. doi: 10.1161/01.cir.87.2.476.
Echocardiography provides a noninvasive means of assessing left ventricular (LV) structure and evidence of LV wall remodeling in hypertensive persons. The relation of demographic, biological, and other factors with LV structure can be assessed.
LV structure was assessed by M-mode echocardiograms for 511 men and 333 women with mild hypertension (average blood pressure, 140/91 mm Hg). Measurements of LV wall thicknesses and internal dimensions were made, and estimates of LV mass indexes and other derivations of structure were calculated. LV hypertrophy criteria were based on previously reported echocardiographic population studies of normal subjects. These measures were compared by age, sex, race, body mass index, systolic blood pressure, antihypertensive drug use, physical activity, alcohol intake, cigarette smoking, and urinary sodium excretion. Despite virtual absence of ECG-determined LV hypertrophy, 13% of men and 20% of women had echocardiographically determined LV hypertrophy indexed by body surface area (g/m2), and 24% of men and 45% of women had LV hypertrophy indexed by height (g/m). Black participants had slightly higher mean levels of wall thickness than nonblack participants but similar LV mass. Systolic blood pressure and urinary sodium excretion were significantly and independently associated with LV mass index and LV hypertrophy using both g/m2 and g/m. Body mass index was significantly related to LV mass index and LV hypertrophy using g/m. Smoking was significantly associated with LV mass index, i.e., using continuous measurement but not using the dichotomy for LV hypertrophy.
This study of a large population of men and women with mild primary hypertension, largely without ECG evidence of LV hypertrophy, showed a substantial percentage of participants with echocardiographically determined LV hypertrophy. LV mass indexes correlated positively with systolic blood pressure, body mass index, urinary sodium excretion, and smoking.
超声心动图提供了一种评估高血压患者左心室（LV）结构及左心室壁重塑证据的非侵入性方法。可评估人口统计学、生物学及其他因素与左心室结构的关系。
对511名男性和333名女性轻度高血压患者（平均血压140/91 mmHg）进行M型超声心动图检查以评估左心室结构。测量左心室壁厚度和内径，并计算左心室质量指数及其他结构指标。左心室肥厚标准基于先前报道的正常受试者超声心动图人群研究。这些指标按年龄、性别、种族、体重指数、收缩压、降压药物使用情况、体力活动、酒精摄入量、吸烟情况及尿钠排泄量进行比较。尽管几乎没有心电图确定的左心室肥厚，但13%的男性和20%的女性经超声心动图确定存在以体表面积（g/m²）为指标的左心室肥厚，24%的男性和45%的女性存在以身高（g/m）为指标的左心室肥厚。黑人参与者的平均壁厚度水平略高于非黑人参与者，但左心室质量相似。收缩压和尿钠排泄量与左心室质量指数及左心室肥厚显著且独立相关，使用g/m²和g/m两种指标均如此。体重指数与使用g/m²指标的左心室质量指数及左心室肥厚显著相关。吸烟与左心室质量指数显著相关，即使用连续测量时相关，但在左心室肥厚二分法分析中不相关。
这项对大量轻度原发性高血压男性和女性的研究，在很大程度上没有心电图显示左心室肥厚的证据，但显示出相当比例的参与者经超声心动图确定存在左心室肥厚。左心室质量指数与收缩压、体重指数、尿钠排泄量及吸烟呈正相关。
