Cugini P, Chiera A, Petrangeli C M, Capodaglio P F, Voci P, Laurenti A, Papalia U, Marino B, Scibilia G
Semeiotica e Metodologia Medica, Università La Sapienza, Roma.
Recenti Prog Med. 1996 Oct;87(10):460-5.
This study is aimed at investigating the relationship between cardiac hypertrophy and blood pressure (BP) 24-h pattern in 34 heart transplanted patients (HTP), 9 out of them (26%) being considered as normotensives, the other ones (74%) being regarded as hypertensives under adequate treatment, via casual sphygmomanometry. The study is an attempt to explain the occurrence of at least one sign of hypertrophic cardiopathy in 20 cases (59%), hypothesizing the presence of false normotensives among the putative normotensives and presumably-cured hypertensives. The ambulatory BP monitoring was able to identify 7 hypertensives (78%) among the putative normotensives, and 17 not well-cured subjects (68%) among the presumably cured hypertensives. At least one sign of cardiac hypertrophy was found in 5 (50%) of the 10 true normotensives, who were all non-dipper, and in 15 (63%) of the 24 hypertensives. The 9 hypertensives without cardiac hypertrophy (37%) had developed hypertension very recently. These findings stress the role of the ambulatory BP monitoring as a diagnostic tool during the follow-up of HTP, in order to identify the false normotensives as well as the not well-treated hypertensives. This role can contribute to optimize the prophylaxis of hypertensive damage for the transplanted heart.
本研究旨在通过偶测血压，调查34例心脏移植患者（HTP）中心肌肥厚与24小时血压（BP）模式之间的关系。其中9例（26%）被视为血压正常者，其余患者（74%）在接受适当治疗后被视为高血压患者。本研究试图解释20例（59%）出现至少一种肥厚性心肌病体征的情况，推测在假定的血压正常者和推测已治愈的高血压患者中存在假性血压正常者。动态血压监测能够在假定的血压正常者中识别出7例高血压患者（78%），在推测已治愈的高血压患者中识别出17例未得到有效治疗的患者（68%）。在10例真正的血压正常者中，有5例（50%）至少出现一种心肌肥厚体征，这些患者均为非勺型血压，在24例高血压患者中有15例（63%）出现至少一种心肌肥厚体征。9例无心肌肥厚的高血压患者（37%）近期才出现高血压。这些发现强调了动态血压监测在HTP随访期间作为诊断工具的作用，以便识别假性血压正常者以及治疗效果不佳的高血压患者。这一作用有助于优化对移植心脏高血压损伤的预防。
